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RCT of the effects of a trunk stabilization program on trunk control and knee loading
Jamison ST, McNeilan RJ, Young GS, Givens DL, Best TM, Chaudhari AMW
Medicine and Science in Sports and Exercise 2012 Oct;44(10):1924-1934
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Many athletic maneuvers involve coordination of movement between the lower and upper extremities, suggesting better core muscle utilization may lead to improved athletic performance and reduced injury risk. PURPOSE: To determine to what extent a training program with quasi-static trunk stabilization exercises would improve measures of core performance, leg strength, agility, and dynamic knee loading, compared to a program incorporating only resistance training. METHODS: 37 male subjects were randomly assigned to either a resistance training only (RT) or a resistance and trunk stabilization (TS) training program, each lasting 6 weeks. Core strength and endurance, trunk control, knee loading during unanticipated cutting, leg strength, and agility were collected pre- and post-training. RESULTS: Between-group analyses showed the TS group significantly improved only core endurance when compared to the RT group (side bridge; p = 0.050). Within-group analyses showed the TS group improved lateral core strength (MVIC cable on non-dominant side 44.5 +/- 61.3N, p = 0.037). Both groups increased leg strength (deadlift 1RM; TS 55.1 +/- 46.5lbs, p = 0.003; RT 33.4 +/- 17.5lbs, p < 0.001) and decreased sagittal plane trunk control (sudden force release (SFR) test; cable in front; TS 2.54 +/- 3.68 degrees, p = 0.045; RT 3.47 +/- 2.83 degrees, p = 0.004), but only the RT group decreased lateral trunk control (SFR cable on dominant side 1.36 +/- 1.65 degrees, p = 0.029). The RT group improved standing broad jump (73.2 +/- 108.4mm, p = 0.049), but also showed increased knee abduction moment during unanticipated cutting (1.503 fold increase (%bw x ht), p = 0.012). CONCLUSIONS: Quasi-static trunk stabilization exercises did not improve core strength, trunk control or knee loading relative to resistance training, potentially because of a lack of exercises including unexpected perturbations and dynamic movement. Together these results suggest the potential importance of targeted trunk control training to address these known ACL injury risk factors.

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