Effects of core stability exercise on rehabilitation in stroke patients with hemiplegia： a meta-analysis

Objective： To evaluate the effects of core stability exercise （CST） on rehabilitation in stroke patients with hemiplegia. Methods： Randomly controlled trials about the effects of CST on rehabilitation in stroke patients with hemiplegia were searched in the database, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, CBM and VIP. Search terms include “core stability training / core stability exercise / core stabilization training / core stabilization exercise/ core strength training / core strength exercise” and “stroke / brain ischemia / cerebral infarction / cerebral hemorrhage / intracranial thrombosis / brain hemorrhage / cerebrovascular disorder /cerebrovascular accident, cerebrovascular disease / hemiplegia / hemiparesis/ stroke rehabilitation”. Study screening, data extraction and quality assessment were conducted by two researchers independently. Data was analyzed using RevMan 5.3 software. Results： Totally 11 studies and 704 patients were included with 352 patients in experiment group and 352 in control group. Results of meta-analysis showed that combination of CST and conventional rehabilitation had better effects on trunk control [MD = 10.44, 95% CI （8.83-12.04）, P 〈 0.001], banlace [MD = 5.6, 95% CI （4.81-6.39）, P 〈 0.001], activities of daily living [MD = 12.06, 95% CI （7.65-16.46）, P 〈 0.001], ambulation functional [MD = 0.72, 95% CI （0.32-1.12）, P 〈 0.001] and walking speed [MD = 3.39, 95% CI （2.03-4.76）, P 〈 0.001] than conventional rehabilitation, but there is no clear difference on walking stride [MD = 2.52, 95% CI （-0.25-5.29）, P = 0.07] between two groups. Conclusion： CST together with conventional rehabilitation can better improve trunk control, banlace, activities of daily living, ambulation functional and walking speed in stroke patients compared with conventional rehabilitation, but can not make the walking stride better significantly. However, since the conclusion of this meta-analysis was drawn based on middle quality RCTs, future high quality researchs should be conducted to confirm its positive intervention effects.

Effect of core stability training on balance in elderly women

Objective:The study investigated the effect of core stability training on balance in elderly women.Method:Sixty female volunteers 61-70 years of age were divided into training(n=30)and control groups(n=30).Core stability training was given to patients in the training group,and walk-ing exercise was given to patients in the control group.The function of static and dynamic balance was detected before training and 30 weeks after training.Results:The time of standing on one foot with eyes closed after training in the training group was significantly longer than the control group,and the stellate balance test with stretching the lower limbs straight ahead,behind,and laterally in the training group was significantly better than the control group.The performance of two lower limbs during the training in the straight ahead di-rection,behind,and to the outer side in the training group was significantly better than the control group.Significant differences also occurred when the left leg was supported on the outer rear,and the right leg was supported on the medial front and rear.Conclusion:Core stability training is more beneficial than walking exercises in improving balance in elderly women.

Physical exercises for preventing injuries among adult male football players:A systematic review

Background:Football is the most practised sport in the world and is associated with the risk of injuries in the players.Some studies have been published that identify injury prevention programs,but there is no review of the full body of evidence on injury prevention programs for use by football coaches.The aim of this article was to carry out a systematic review of published studies on injury prevention programs for adult male footballers,identify points of common understanding and establish recommendations that should be considered in the design of injury prevention strategies.Methods:PubMed and EMBASE databases were used to identify relevant published articles using the following keywords:"soccer"AND"injury"AND"prevention".Results:A total of 2512 studies were identified initially,but only 11 studies met the inclusion criteria,and their outcomes are presented.Results revealed that injury prevention programs in football have focused on strength training,proprioceptive training,multicomponent programs(balance,core stability,and functional strength and mobility),and warm-up programs.Conclusion:Based on results from the studies analyzed,football players can lower the incidence of match and training injuries by participating in dynamic warm-up programs that include preventive exercises before games or during training sessions,and by adding strength,balance,and mobility training to the training sessions.

Postural control quantification in minimally and moderately impaired persons with multiple sclerosis:The reliability of a posturographic test and its relationships with functional ability

Background:Postural control has been associated with the functional impairment in persons with multiple sclerosis(pwMS).However,there is a need for reliable methods to assess postural control in early stages of the disease,when subtle changes can be difficult to detect.The aims of this study were to assess the absolute and relative reliability of a standing and a sitting posturographic protocol in minimally(Expanded Disability Status Scale≤2)and moderately(2.5≤Expanded Disability Status Scale≤4)impaired pwMS,and to analyze relationships among postural control and functional mobility and gait performance.Methods:To assess postural control in an upright stance,14 minimally and 16 moderately impaired pwMS performed six 70 s trials in tandem stance,3 with their weaker leg behind(TSWL)and 3 with their stronger leg behind(TSSL).Additionally,participants completed five 70 s trials using an unstable sitting protocol(US)to assess trunk stability.The mean radial errors of TSWL,TSSL,and US trials were calculated as postural control indexes.Furthermore,participants performed the Timed Up and Go test(TUG)and the Timed 25-foot Walk test(T25FW)to measure their functional mobility and gait speed,respectively.Reliability was evaluated using the intraclass correlation coefficient(ICC3,1)and the standard error of measurement(SEM).Analyses of variances were carried out to assess between-group differences.Hedges’g index(dg)was used to estimate the effect size of differences.Pearson correlation analyses(r)were performed to examine the relationships among the postural control and the functional tests.Results:Posturographic tests showed a high reliability in both minimally(0.87≤ICC≤0.92;9.32%≤SEM≤11.76%)and moderately(0.80≤ICC≤0.92;10.33%≤SEM≤15.33%)impaired pwMS.Similarly,T25FW and TUG displayed a high consistency in minimally(0.89≤ICC≤0.94;3.43%≤SEM≤5.17%)and moderately(0.85≤ICC≤0.93;5.57%≤SEM≤6.56%)impaired individuals.Minimally impaired pwMS showed a better performance on the TUG,T25FW,and TSWL than moderately impaired individuals(p<0.05;dg≥0.8).The TSWL,TSSL,and US variables correlated with TUG scores(0.419≤r≤0.604;p<0.05),but TSWL also correlated with T25FW scores(r=0.53;p<0.01).Furthermore,US scores correlated with both tandem stance parameters(TSWL:r=0.54,p<0.01;TSSL:r=0.43,p<0.05).Conclusion:Tandem and sitting posturographic tests provide reliable measures of postural control in pwMS,even in individuals with a homogeneous disease profile.Gait speed,functional mobility,and weaker leg status seem decisive in assessing the degree of physical activity limitation in pwMS.Finally,although trunk stability does not seem to be so affected by the course of the disease,it remains relevant for postural control and functional capacity.