@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2019;11(4):189-196
ISSN: 2008-2630 Iranian Journal of War & Public Health 2019;11(4):189-196
Effect of Core Stability Training on Static and Dynamic Balance and Strength in Disabled Veterans with Unilateral Below Knee Amputation
ARTICLE INFO
Article Type
Original ResearchAuthors
Ghassemi S.A. (*1)Rahnama N. (2)
Daneshmandi H. (3)
(*1) Sport Injuries & Corrective ExercisesDepartment, Physical Education & Sport Sciences Faculty, Kish International Campus, University of Tehran, Kish, Iran
(2) Sport Injuries & Corrective Exercises Department, Physical Education & Sport Sciences Faculty, University of Isfahan, Isfahan, Iran
(3) Sport Injuries & Corrective Exercises Department, Physical Education & Sport Sciences Faculty, , University of Guilan, Guilan, Iran
Correspondence
Address: Kish International Campus, University of Tehran, Niyayesh Street, Mirmohana Boulevard Kish, Iran. Postal Code: 7941639982Phone: +98 (51) 38810231
Fax: +98 (51) 35010430
sayyedalighassemi@yahoo.com
Article History
Received: December 31, 2018Accepted: September 3, 2019
ePublished: December 21, 2019
ABSTRACT
Aims
Individuals with lower extremity amputation have more difficulties than healthy people in static and dynamic balance. The significant effect of core stability training in different subjects has proven in previous studies. Therefore, the aim of this study was to investigate the effect of core stability training on static and dynamic balance and strength on disabled veterans with unilateral below knee amputation.
Materials & Methods This semi-experimental study with pretest-posttest design and control group was carried out on 36 disabled veterans with unilateral below knee amputation in Mashhad city in 2018. The subjects were selected by the purposive sampling method and the subjects were randomly divided into two experimental and control groups (N=18). After measuring the static and dynamic balance and strength variables, core stability training was performed for the subjects of the experimental group for 8 weeks and 3 sessions per week under the supervision of the researcher. Then, the research variables were again evaluated in two groups. Data were analyzed through SPSS 19 software using independent and paired sample t-tests.
Findings There was a significant difference between the mean scores of post-test and pre-test in the experimental group (p<0.0001), but there was no significant difference between the mean scores of the posttest and pretest in the control group (p>0.05). Also, there was a significant difference between the experimental and control groups in the post-test step (p<0.0001).
Conclusion The offered training can be effective in the balance, strength and core stability in people with unilateral lower limb amputation and can improve their balance.
Materials & Methods This semi-experimental study with pretest-posttest design and control group was carried out on 36 disabled veterans with unilateral below knee amputation in Mashhad city in 2018. The subjects were selected by the purposive sampling method and the subjects were randomly divided into two experimental and control groups (N=18). After measuring the static and dynamic balance and strength variables, core stability training was performed for the subjects of the experimental group for 8 weeks and 3 sessions per week under the supervision of the researcher. Then, the research variables were again evaluated in two groups. Data were analyzed through SPSS 19 software using independent and paired sample t-tests.
Findings There was a significant difference between the mean scores of post-test and pre-test in the experimental group (p<0.0001), but there was no significant difference between the mean scores of the posttest and pretest in the control group (p>0.05). Also, there was a significant difference between the experimental and control groups in the post-test step (p<0.0001).
Conclusion The offered training can be effective in the balance, strength and core stability in people with unilateral lower limb amputation and can improve their balance.
CITATION LINKS
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[14]Hof AL, van Bockel RM, Schoppen T, Postema K. Control of lateral balance in walking: experimental findings in normal subjects and above-knee amputees. Gait Posture. 2007;25(2):250-8.
[15]Buckley JG, O’Driscoll D, Bennett SJ. Postural sway and active balance performance in highly active lower-limb amputees. Am J Phys Med Rehabil. 2002;81(1):13-20.
[16]Vrieling AH, Van Keeken HG, Schoppen T, Otten E, Hof AL, Halbertsma JP, et al. Balance control on a moving platform in unilateral lower limb amputees. Gait Posture. 2008;28(2):222-8.
[17]Leijendekkers RA, van Hinte G, Nijhuis-van der Sanden MW, Staal JB. Gait rehabilitation for a patient with an osseointegrated prosthesis following transfemoral amputation. Physiother Theory Pract. 2017;33(2):147-61.
[18]Angela MD. The relationship between core stability and athletic performance [Dissertation]. Arcata, California: Humboldt State University; 2010.
[19]Willardson JM. Core stability training: applications to sports conditioning programs. J Strength Cond Res. 2007;21(3):979-85.
[20]Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil. 2004;85(3 Suppl 1):S86-92.
[21]Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sport Med. 2006;36(3):189-98.
[22]Schultz DG. Validity of the Schultz Slam Test (SST) as a core power measure in football [Dissertation]. Arcata, California: Humboldt State University; 2012.
[23]Fox EE, Hough AD, Creanor S, Gear M, Freeman JA. Effects of pilates-based core stability training in ambulant people with multiple sclerosis: multicenter, assessor-blinded, randomized controlled trial. Phys Ther. 2016;96(8):1170-8.
[24]Willson JD, Dougherty CP, Ireland ML, Davis IM. Core stability and its relationship to lower extremity function and injury. J Am Acad Orthop Surg. 2005;13(5):316-25.
[25]Carpes FP, Reinehr FB, Mota CB. Effects of a program for trunk strength and stability on pain, low back and pelvis kinematics, and body balance: a pilot study. J Bodyw Mov Ther. 2008;12(1):22-30.
[26]Sekendiz B, Cug M, Korkusuz F. Effects of Swiss-ball core strength training on strength, endurance, flexibility, and balance in sedentary women. J Strength Cond Res. 2010;24(11):3032-40.
[27]Li S, Yin Y, Zhang R, Chen W, Zhang Y. Minimally invasive treatment for fractures of lower extremity amputees using a rapid reductor. Int Orthop. 2019;43(6):1473-8.
[28]McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Arch Phys Med Rehabil. 1999;80(8):941-4.
[29]Sohbatiha M, Aslankhani MA, Farsi A. The Effect of aquatic and land-based exercises on static and dynamic balance of healthy male older people. Iran J Ageing. 2011;6(20):54-63. [Persian]
[30]Faries MD, Greenwood M. Core training: stabilizing the confusion. Strength Cond J. 2007;29(2):10-25.
[31]Haruyama K, Kawakami M, Otsuka T. Effect of core stability training on trunk function, standing balance, and mobility in stroke patients: a randomized controlled trial. Neurorehabil Neural Repair. 2017;31(3):240-9.
[32]Kahle NL, Gribble PA. Core stability training in dynamic balance testing among young, healthy adults. Athl Train Sport Health Care. 2009;1(2):65-73.
[33]Hassan IHI. The effect of core stability training on dynamic balance and smash stroke performance in badminton players. Int J Sport Sci Phys Educ. 2017;2(3):44-52.
[34]Iacono AD, Martone D, Alfieri A, Ayalon M, Buono P. Core Stability Training Program (CSTP) effects on static and dynamic balance abilities. Gazz Med Ital Arch per le Sci Med. 2014;173(4):197-206.
[35]Chan EWM, Adnan R, Azmi R. Effectiveness of core stability training and dynamic stretching in rehabilitation of chronic low back pain patient. Malaysian J Move Heal Exerc. 2019;8(1):1-13.
[36]Naderi Z, Jalali K. The effect of eight weeks of core stability and Pilates trainings on ankle proprioception, postural control, walking performance, self-efficacy and fear of falling in elderly women. Rep Health Care. 2018;4(3):1-13.
[37]Kidgell DJ, Horvath DM, Jackson BM, Seymour PJ. Effect of six weeks of dura disc and mini-trampoline balance training on postural sway in athletes with functional ankle instability. J strength Cond Res. 2007;21(2):466-9.
[38]Freeman JA, Gear M, Pauli A, Cowan P, Finnigan C, Hunter H, et al. The effect of core stability training on balance and mobility in ambulant individuals with multiple sclerosis: a multi-centre series of single case studies. Mult Scler. 2010;16(11):1377-84.
[39]Oshima Y, Miyamoto T, Tanaka S, Wadazumi T, Kurihara N, Fujimoto S. Relationship between isocapnic buffering and maximal aerobic capacity in athletes. Eur J Appl Physiol Occup Physiol. 1997;76(5):409-14.
[40]Lederman E. The myth of core stability. J Bodyw Mov Ther. 2010;14(1):84-98.
[41]Carter JM, Beam WC, Mcmahan SG, Barr ML, Brown LE. The effects of stability ball training on spinal stability in sedentary individuals. J Strength Cond Res. 2006;20(2):429-35.
[42]Aytar A, Pekyavas NO, Ergun N, Karatas M. Is there a relationship between core stability, balance and strength in amputee soccer players? a pilot study. Prosthet Orthot Int. 2012;36(3):332-8.
[43]Miller WC, Speechley M, Deathe AB. Balance confidence among people with lower-limb amputations. Phys Ther. 2002;82(9):856-65.
[44]Sartipzadeh M, Moazami M, Mohammadi MR. The effect of core stabilization training on elderly balance and knee pain with knee osteoarthritis. J Paramed Sci Rehabil. 2016;5(3):7-17.
[45]Petrofsky JS, Cuneo M, Dial R, Pawley AK, Hill J. Core strengthening and balance in the geriatric population. J Appl Res. 2005;5(3):423-33.
[46]Sandrey MA, Mitzel JG. Improvement in dynamic balance and core endurance after a 6-week core-stability-training program in high school track and field athletes. J Sport Rehabil. 2013;22(4):264-71.
[2]Fuenzalida Squella SA, Kannenberg A, Brandão Benetti Â. Enhancement of a prosthetic knee with a microprocessor-controlled gait phase switch reduces falls and improves balance confidence and gait speed in community ambulators with unilateral transfemoral amputation. Prosthet Orthot Int. 2018;42(2):228-35.
[3]Seppala LJ, Wermelink AMAT, de Vries M, Ploegmakers KJ, van de Glind EMM, Daams JG, et al. Fall-risk-increasing drugs: a systematic review and meta-analysis: II. Psychotropics. J Am Med Dir Assoc. 2018;19(4):371.e11-7.
[4]Gadelha AB, Neri SGR, Oliveira RJ, Bottaro M, David AC, Vainshelboim B, et al. Severity of sarcopenia is associated with postural balance and risk of falls in community-dwelling older women. Exp Aging Res. 2018;44(3):258-69.
[5]Steinberg N, Gottlieb A, Siev-Ner I, Plotnik M. Fall incidence and associated risk factors among people with a lower limb amputation during various stages of recovery–a systematic review. Disabil Rehabil. 2019;41(15):1778-87.
[6]Geurts AC, Mulder TW, Nienhuis B, Rijken RA. Dual-task assessment of reorganization of postural control in persons with lower limb amputation. Arch Phys Med Rehabil. 1991;72(13):1059-64.
[7]Melzer I, Elbar O, Tsedek I, Oddsson LIE. A water-based training program that include perturbation exercises to improve stepping responses in older adults: study protocol for a randomized controlled cross-over trial. BMC Geriatr. 2008;8(1):19.
[8]Geurts ACH, Mulder TW. Reorganisation of postural control following lower limb amputation: theoretical considerations and implications for rehabilitation. Physiother Theory Pract. 1992;8(3):145-57.
[9]Johansson J, Nordström A, Nordström P. Greater fall risk in elderly women than in men is associated with increased gait variability during multitasking. J Am Med Dir Assoc. 2016;17(6):535-40.
[10]Miller WC, Deathe AB, Speechley M, Koval J. The influence of falling, fear of falling, and balance confidence on prosthetic mobility and social activity among individuals with a lower extremity amputation. Arch Phys Med Rehabil. 2001;82(9):1238-44.
[11]Miller WC, Deathe AB. A prospective study examining balance confidence among individuals with lower limb amputation. Disabil Rehabil. 2004;26(14-15):875-81.
[12]Feick E, Hamilton PR, Luis M, Corbin M, Salback NM, Torres-Moreno R, et al. A pilot study examining measures of balance and mobility in children with unilateral lower-limb amputation. Prosthet Orthot Int. 2016;40(1):65-74.
[13]Silver-Thorn MB, Kempfer J, Schnorenberg AJ, Slavens BA. Use of a dynamic balance system to quantify postural steadiness and stability of individuals with lower-limb amputation: a pilot study. J Prosthet Orthot. 2017.
[14]Hof AL, van Bockel RM, Schoppen T, Postema K. Control of lateral balance in walking: experimental findings in normal subjects and above-knee amputees. Gait Posture. 2007;25(2):250-8.
[15]Buckley JG, O’Driscoll D, Bennett SJ. Postural sway and active balance performance in highly active lower-limb amputees. Am J Phys Med Rehabil. 2002;81(1):13-20.
[16]Vrieling AH, Van Keeken HG, Schoppen T, Otten E, Hof AL, Halbertsma JP, et al. Balance control on a moving platform in unilateral lower limb amputees. Gait Posture. 2008;28(2):222-8.
[17]Leijendekkers RA, van Hinte G, Nijhuis-van der Sanden MW, Staal JB. Gait rehabilitation for a patient with an osseointegrated prosthesis following transfemoral amputation. Physiother Theory Pract. 2017;33(2):147-61.
[18]Angela MD. The relationship between core stability and athletic performance [Dissertation]. Arcata, California: Humboldt State University; 2010.
[19]Willardson JM. Core stability training: applications to sports conditioning programs. J Strength Cond Res. 2007;21(3):979-85.
[20]Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil. 2004;85(3 Suppl 1):S86-92.
[21]Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sport Med. 2006;36(3):189-98.
[22]Schultz DG. Validity of the Schultz Slam Test (SST) as a core power measure in football [Dissertation]. Arcata, California: Humboldt State University; 2012.
[23]Fox EE, Hough AD, Creanor S, Gear M, Freeman JA. Effects of pilates-based core stability training in ambulant people with multiple sclerosis: multicenter, assessor-blinded, randomized controlled trial. Phys Ther. 2016;96(8):1170-8.
[24]Willson JD, Dougherty CP, Ireland ML, Davis IM. Core stability and its relationship to lower extremity function and injury. J Am Acad Orthop Surg. 2005;13(5):316-25.
[25]Carpes FP, Reinehr FB, Mota CB. Effects of a program for trunk strength and stability on pain, low back and pelvis kinematics, and body balance: a pilot study. J Bodyw Mov Ther. 2008;12(1):22-30.
[26]Sekendiz B, Cug M, Korkusuz F. Effects of Swiss-ball core strength training on strength, endurance, flexibility, and balance in sedentary women. J Strength Cond Res. 2010;24(11):3032-40.
[27]Li S, Yin Y, Zhang R, Chen W, Zhang Y. Minimally invasive treatment for fractures of lower extremity amputees using a rapid reductor. Int Orthop. 2019;43(6):1473-8.
[28]McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Arch Phys Med Rehabil. 1999;80(8):941-4.
[29]Sohbatiha M, Aslankhani MA, Farsi A. The Effect of aquatic and land-based exercises on static and dynamic balance of healthy male older people. Iran J Ageing. 2011;6(20):54-63. [Persian]
[30]Faries MD, Greenwood M. Core training: stabilizing the confusion. Strength Cond J. 2007;29(2):10-25.
[31]Haruyama K, Kawakami M, Otsuka T. Effect of core stability training on trunk function, standing balance, and mobility in stroke patients: a randomized controlled trial. Neurorehabil Neural Repair. 2017;31(3):240-9.
[32]Kahle NL, Gribble PA. Core stability training in dynamic balance testing among young, healthy adults. Athl Train Sport Health Care. 2009;1(2):65-73.
[33]Hassan IHI. The effect of core stability training on dynamic balance and smash stroke performance in badminton players. Int J Sport Sci Phys Educ. 2017;2(3):44-52.
[34]Iacono AD, Martone D, Alfieri A, Ayalon M, Buono P. Core Stability Training Program (CSTP) effects on static and dynamic balance abilities. Gazz Med Ital Arch per le Sci Med. 2014;173(4):197-206.
[35]Chan EWM, Adnan R, Azmi R. Effectiveness of core stability training and dynamic stretching in rehabilitation of chronic low back pain patient. Malaysian J Move Heal Exerc. 2019;8(1):1-13.
[36]Naderi Z, Jalali K. The effect of eight weeks of core stability and Pilates trainings on ankle proprioception, postural control, walking performance, self-efficacy and fear of falling in elderly women. Rep Health Care. 2018;4(3):1-13.
[37]Kidgell DJ, Horvath DM, Jackson BM, Seymour PJ. Effect of six weeks of dura disc and mini-trampoline balance training on postural sway in athletes with functional ankle instability. J strength Cond Res. 2007;21(2):466-9.
[38]Freeman JA, Gear M, Pauli A, Cowan P, Finnigan C, Hunter H, et al. The effect of core stability training on balance and mobility in ambulant individuals with multiple sclerosis: a multi-centre series of single case studies. Mult Scler. 2010;16(11):1377-84.
[39]Oshima Y, Miyamoto T, Tanaka S, Wadazumi T, Kurihara N, Fujimoto S. Relationship between isocapnic buffering and maximal aerobic capacity in athletes. Eur J Appl Physiol Occup Physiol. 1997;76(5):409-14.
[40]Lederman E. The myth of core stability. J Bodyw Mov Ther. 2010;14(1):84-98.
[41]Carter JM, Beam WC, Mcmahan SG, Barr ML, Brown LE. The effects of stability ball training on spinal stability in sedentary individuals. J Strength Cond Res. 2006;20(2):429-35.
[42]Aytar A, Pekyavas NO, Ergun N, Karatas M. Is there a relationship between core stability, balance and strength in amputee soccer players? a pilot study. Prosthet Orthot Int. 2012;36(3):332-8.
[43]Miller WC, Speechley M, Deathe AB. Balance confidence among people with lower-limb amputations. Phys Ther. 2002;82(9):856-65.
[44]Sartipzadeh M, Moazami M, Mohammadi MR. The effect of core stabilization training on elderly balance and knee pain with knee osteoarthritis. J Paramed Sci Rehabil. 2016;5(3):7-17.
[45]Petrofsky JS, Cuneo M, Dial R, Pawley AK, Hill J. Core strengthening and balance in the geriatric population. J Appl Res. 2005;5(3):423-33.
[46]Sandrey MA, Mitzel JG. Improvement in dynamic balance and core endurance after a 6-week core-stability-training program in high school track and field athletes. J Sport Rehabil. 2013;22(4):264-71.