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ABSTRACT BACKGROUND AND OBJECTIVES: Chronic nonspecific low back pain (CNLBP) is a public health issue. Dysfunctions in muscle activation and spinal stability are estimated to directly impact pain intensity. Additionally, senior women experience greater decline in muscle function due to aging, rendering this demographic more susceptible to developing low back pain. The aim of this study was to analyze the correlation between core muscle instability, strength, and endurance with pressure pain threshold in senior individuals with CNLBP. METHODS: This is a quantitative observational study, with a descriptive cross-sectional design, conducted on women aged 60 to 79 years. The pressure pain threshold (PPT). The pressure pain threshold (PPT) was assessed using a pressure algometer applied to the paravertebral and anterior tibial musculature. Trunk instability was assessed on both a stable and an unstable seat, positioned atop a force platform that provided real-time displacement of the pressure center. Maximum isometric strength and endurance of trunk flexors and extensors were assessed using the McGill protocol. Person's correlations coefficient (r) was calculated, and the data were presented as mean and standard deviation. The significance level was set at p<0.05. RESULTS: This study included 49 senior women (67,3±5,6 years; body mass index of 28,5±5,2 kg/m2; pain intensity of 4,6±2,3 on a 0-10scale). No correlation was observed between PPT at L3, L5 and TA with lumbar instability, maximum isometric strength and trunk muscle endurance. CONCLUSION: In this study, no correlation was found between lumbar instability, maximum isometric strength and trunk muscle endurance with the PPT in senior women with CNLBP.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor lombar crônica inespecífica (DLCI) é um problema de saúde pública. Estima-se que disfunções na ativação muscular e na estabilidade da coluna possam repercutir diretamente na intensidade da dor. Além disso, em decorrência da idade, as mulheres idosas apresentam maior declínio na função muscular, tornando esse público mais suscetível a desenvolver a dor lombar. O objetivo deste estudo foi analisar a correlação entre instabilidade, força e resistência dos músculos do core com o limiar de dor por pressão em idosas com DLCI. MÉTODOS: Trata-se de um estudo observacional quantitativo, com delineamento transversal descritivo, realizado em mulheres com idade entre 60 e 79 anos. O limiar de dor por pressão (LDP) foi avaliado com um algômetro de pressão na musculatura paravertebral (bilateralmente ao processo espinhoso nível de L3 a L5) e cinco cm abaixo da tuberosidade da tibial direita no tibial anterior. A instabilidade de tronco foi avaliada em um assento estável e outro instável, posicionados sobre uma plataforma de força para análise do deslocamento do centro de pressão em tempo real. A força isométrica máxima e a resistência de flexores e extensores do tronco foi avaliada por meio do protocolo de McGill. Foi calculado o coeficiente de correlação de Pearson (r), os dados foram expressos em média e desvio padrão e o valor considerado significativo quando p<0,05. RESULTADOS: Participaram deste estudo 49 mulheres (67,3±5,6 anos; índice de massa corporal de 28,5±5,2 kg/m2; intensidade da dor 4,6±2,3 em uma escala de 0- a 10). Não foi encontrada correlação entre o LDP em L3, L5 e TA com instabilidade lombar, força isométrica máxima e resistência dos músculos do tronco. CONCLUSÃO: Não foi encontrada, neste estudo, uma correlação entre a instabilidade lombar, a força isométrica máxima e a resistência dos músculos do tronco com o LDP em mulheres idosas com DLCI.

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ABSTRACT Introduction Strong core stability and strength enable the trunk to transfer the maximum amount of torque to the terminal segments, which is conducive to improving athletic performance. Because sling training is a new core exercise method, its effect on trunk endurance relative to basketball performance has rarely been studied. Objective To investigate whether a core exercise program in a specific sports group can improve core and sports-specific performance. Methods A total of 40 college students majoring in basketball were randomly assigned to training and control groups. A standardized set of core endurance and basketball-specific performance tests were used to determine and assess the effects of sling training on trunk strength, endurance, and control. Results Flexor, extensor, and right and left lateral trunk flexor muscles endurance were significantly greater in the training group than in the control group, and the time to complete the layup obstacle course was shorter than in the control group at the end of the training program, p<0.01. No differences between the two groups were found in the penalty shot, the fixed position shot, or the vertical jump and reach at the end of the training program. Conclusions Sling exercises can improve the core endurance and strength of basketball players and increase the speed of lay-ups over obstructions. Level of evidence I; Randomized clinical trial.

RESUMEN Introducción La sólida estabilidad y fuerza del core permiten que el tronco transfiera el torque máximo a los segmentos terminales, lo que conduce a mejorar el rendimiento deportivo. Como método novedoso de ejercicio para el core, se ha estudiado poco el efecto del entrenamiento con ejercicios con sling sobre la resistencia del tronco en relación con el rendimiento en el baloncesto. Objetivo Investigar si un programa de ejercicios para el core en un grupo deportivo específico puede mejorar el rendimiento del core y específico del deporte. Métodos Un total de 40 estudiantes universitarios con especialización en baloncesto fueron asignados aleatoriamente a grupos de entrenamiento y de control. Se utilizó una serie estandarizada de pruebas de resistencia del core y rendimiento específico del baloncesto para determinar y evaluar los efectos de los ejercicios con sling en la fuerza, la resistencia y el control del tronco. Resultados La resistencia de los músculos flexores, extensores y flexores laterales derecho e izquierdo del tronco fue significativamente mayor en el grupo de entrenamiento en comparación con el grupo de control, y el tiempo para completar la prueba de tiro con obstáculos fue menor que el del grupo de control al final del programa de entrenamiento, p<0,01. No hubo diferencias entre los dos grupos en lo que respecta a: tiro libre, lanzamiento en posición fija y salto vertical y alcance al final del programa de entrenamiento. Conclusiones Los ejercicios con sling pueden mejorar la resistencia y la fuerza del core en jugadores de baloncesto y aumentar la velocidad de los tiros con dribling. Nivel de evidencia I; Ensayo clínico aleatorizado.

RESUMO Introdução A sólida estabilidade e a força do core permitem que o tronco transfira o torque máximo para os segmentos terminais, o que é propício para melhorar o desempenho atlético. Como um novo método de exercício para o core, o efeito do treinamento com sling na resistência do tronco com relação ao desempenho no basquete tem sido pouco estudado. Objetivo Investigar se um programa de exercícios para o core em um grupo esportivo específico pode melhorar o desempenho do core e específico do esporte. Métodos Um total de 40 estudantes universitários formados em basquete foram aleatoriamente designados para grupos de treinamento e controle. Uma série padronizada de testes de resistência do core e desempenho específico do basquete foi usada para determinar e avaliar os efeitos dos exercícios com sling na força, resistência e controle do tronco. Resultados A resistência dos músculos flexores, extensores e flexores laterais direito e esquerdo do tronco foi significativamente maior no grupo treinamento em comparação ao grupo controle e o tempo para concluir o teste de bandeja com obstáculos foi menor que o do grupo controle no final do programa de treinamento, p < 0,01. Não houve diferenças entre os dois grupos quanto ao lance livre, arremesso em posição fixa e salto vertical e alcance no final do programa de treinamento. Conclusões Os exercícios com sling podem melhorar a resistência e a força do core em jogadores de basquete e aumentar a velocidade das bandejas com drible. Nível de evidência I; Estudo clínico randomizado.

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Introducción: El deporte paralímpico se originó como parte de procesos de re-habilitación para personas que tuvieran discapacidad. Durante la ejecución de las disciplinas paralímpicas el control motor en la región del tronco y en especial del abdomen es de gran importancia para prevenir lesiones y mejorar el registro de la marca deportiva. Son muchas las herramientas utilizadas por los entrenadores de-portivos para mejorar la fuerza muscular y por consiguiente la estabilidad de tronco, buscando disminuir el riesgo en el ámbito deportivo. Sin embargo, las investigaciones sobre el uso de realidad virtual, junto con plataformas de estabilometría para el en-trenamiento de deportistas paralímpicos con lesiones físicas, son escasas.Objetivo: Establecer el efecto de un programa de entrenamiento del tronco apoya-do en realidad virtual en deportistas de alto rendimiento paralímpicos, lanzadores de bala y jabalina con lesiones físicas y que compiten en sillas de lanzamiento. Materiales y método: La investigación fue diseñada como un estudio cuasiex-perimental intrasujeto. Se evaluaron cinco sujetos deportistas paralímpicos de alto rendimiento con discapacidad física. Se empleó un software de realidad virtual que incluye patrones y juegos lúdicos ajustables en tiempo e intensidad y una platafor-ma de bipedestación dinámico como parte del equipo de intervención, ajustable al paciente, que permite reeducar el equilibrio, la propiocepción, fortalecer y lograr el control del tronco. Las variables de análisis fueron el nivel del desplazamiento ante-roposterior y lateral del tronco y los cambios en el volumen de acción. Se realizó una evaluación inicial, una intervención que duró de seis semanas y la evaluación final. Resultados: En las evaluaciones iniciales de todos los atletas se observó una ten-dencia al desplazamiento en sentido posterior. En la evaluación final, los rangos de desplazamiento aumentan en casi todos los sujetos con excepción del sujeto 5, cuyos valores permanecen casi estables tanto en las evaluaciones iniciales como las finales. La diferencia en el desplazamiento entre la prueba inicial y final en promedio de los participantes fue de 6.26 grados. Conclusiones: los resultados positivos del entrenamiento del tronco apoyado en realidad virtual para los participantes constituyen un aporte al conocimiento sobre el tema y abren la posibilidad de incluir esta tecnología en protocolos de entrenamiento en deporte paralímpico.

Introduction: Paralympic sport originated as part of rehabilitation processes for people with disabilities. During the execution of Paralympic disciplines, motor con-trol in the trunk region and especially in the abdomen is of great importance to prevent injuries and improve the registration of the sports record. There are many tools used by sports coaches to improve muscle strength and therefore trunk stability to reduce the risk in the sports field. However, research on the use of virtual reality along with stabilometry platforms for the training of Paralympic athletes with phys-ical injuries are scarce.Objective: To establish the effect of a trunk training program supported by virtual reality in high performance Paralympic athletes, shot put and javelin throwers with physical injuries who compete in throwing frames. Materials and method: The research was designed as an intrasubject quasi-ex-perimental study. Five high-performance Paralympic athletes with physical disabili-ties were evaluated. A virtual reality software that includes patterns and playful games adjustable in time and intensity and a dynamic standing platform were used as part of the intervention equipment, adjustable to the patient, which allows reeducating balance, proprioception, strengthening, and achieving trunk control. The variables of analysis were the level of anteroposterior and lateral displacement of the trunk and changes in the volume of action. An initial evaluation, an intervention that lasted six weeks, and a final evaluation were carried out. Results: In the initial evaluations of all athletes, a tendency towards posterior dis-placement was observed. In the final evaluation, the displacement ranges increase in almost all subjects except for subject 5, which showed values that remain almost sta-ble in both the initial and final evaluations. The difference in displacement between the initial and final test on average of the participants was 6.26 degrees. Conclusions: the positive results of trunk training supported by virtual reality for the participants constitute a contribution to the knowledge on the subject and open the possibility of including this technology in training protocols in Paralympic sports.

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Core muscle function is considered a risk factor for low back pain appearance in dancers. The purpose of this study was to examine the transversus abdominis and lumbar multifidus thickness among Argentine Tango dancers in different functional dance positions. A secondary purpose was to compare muscle thickness at rest and contraction between dancers and untrained participants. Ten trained dancers and ten untrained women aged 33.8 ± 6.09 years participated in this study. Using ultrasonography, the transversus abdominis and lumbar multifidus muscle thickness were measured at rest and during contraction in three different dance positions: Basic in Open embrace, Basic in Close embrace, and Volcada. The results showed a significant increase in muscle thickness during contraction compared to thickness at rest for both muscles (p < 0.05). The group of dancers showed a greater transversus abdominis thickness than the untrained group (p < 0.05). Further, transversus abdominal thickness progressively increased from Basic in Open embrace to Basic in Close embrace position, as well as from Basic in Close embrace to Volcada position in dancers (p < 0.05), while fewer changes between positions were found for the untrained group. Multifidus muscle thickness also differed between positions, but no group differences were observed (p > 0.05). Training exercises in these Argentine Tango positions may be beneficial for the performance and prevention of low back pain, especially in Argentine Tango dancers.

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BACKGROUND: There are a limited number of tests for the assessment of shoulder and pelvic girdle stability. Reliable instruments are important to evaluate movement dysfunction at these joints in order to provide more objective parameters. OBJECTIVE: To evaluate the inter-day reliability of the Upper Body Test in young adults. METHODS: A reliability study was carried out with three assessments of the shoulder and pelvic girdle stability within 48-h intervals (Monday, Wednesday, and Friday). The OctoBalance® platform was used to perform the Upper Body Test in 31 active young adults (24.5±8 years). Intraclass Correlation Coefficient (ICC2,2) two-way mixed model, Coefficient of Variation, and Bland-Altman plots were used to verify the reliability of the test. The standard error of measurement (SEM) and the minimum detectable difference (MDD95%) were calculated for clinical applicability. RESULTS: The Intraclass Correlation Coefficient ranged from 0.87 to 0.94 - Featuring a mean difference of 0.89 (95%CI=-0.19-1.97) to left and 0.95 (95%CI=-0.38-2.27) for the right side, with a low variation coefficient (3.31-5.91%) between the second and third days of assessment. There was a statistically significant difference between the first assessment day and the other test sessions. The Bland-Altman analyses revealed low bias with scores within the limits of agreement. Minimum detectable difference scores were between 4.02 and 5.10, and standard error of measurement between 1.75 and 2.72, depending on the movement side. CONCLUSION: The Upper Body Test presented good inter-day reliability for assessing the stability of the shoulder and pelvic girdle in young active healthy adults.

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OBJECTIVES: The need to accurately assess trunk and lumbopelvic proprioception and neuromuscular control is widely accepted. However, based on current literature, there is a lack of reliable clinical tests to evaluate these aspects in clinical practice. The objective of this study is to investigate intra- and inter-tester reliability of the lateral step down test and the lumbopelvic position-reposition test in a healthy population. METHODS: Protocol and scoring methods were developed for the lateral step down test and lumbopelvic position-reposition test, used to assess trunk and lumbopelvic neuromuscular control and proprioception respectively. Each test was performed once by thirty participants and video analysis for test scoring was performed. Three items on the lateral step down test were scored to evaluate neuromuscular control and, four items on the lumbopelvic position-reposition test were scored to evaluate proprioception. Aggregate scores for each test were calculated based on the separate item scores. Intraclass correlation coefficients and linear weighted kappa coefficients were determined for intra- and inter-tester reliability. RESULTS: Based on the aggregate score, excellent intra- and inter-tester reliability (ICC (2,1)=0.73-0.88) was found for both tests. Moderate/almost perfect intra-and inter-tester agreement (K=0.62-0.91) was found for the separate items of the lateral step down test and fair/substantial agreement (K=0.25-0.76) for the items of the lumbopelvic position-reposition test. CONCLUSION: Current testing protocol and scoring method for the lateral step down test is reliable. Adjustments for the scoring method of the lumbopelvic position-reposition test are warranted to improve reliability.

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BACKGROUND: Programs designed to prevent or rehabilitate athletic injuries or improve athletic performance frequently focus on core stability. This approach is based upon the theory that poor core stability increases the risk of poor performance and/or injury. Despite the widespread use of core stability training amongst athletes, the question of whether or not sufficient evidence exists to support this practice remains to be answered.OBJECTIVES: 1) Open a dialogue on the definition and components of core stability. 2) Provide an overview of current science linking core stability to musculoskeletal injuries of the upper extremity. 3) Provide an overview of evidence for the association between core stability and athletic performance.DISCUSSION: Core stability is the ability to control the position and movement of the trunk for optimal production, transfer, and control of forces to and from the upper and lower extremities during functional activities. Muscle capacity and neuromuscular control are critical components of core stability. A limited body of evidence provides some support for a link between core stability and upper extremity injuries amongst athletes who participate in baseball, football, or swimming. Likewise, few studies exist to support a relationship between core stability and athletic performance.CONCLUSIONS: A limited body of evidence exists to support the use of core stability training in injury prevention or performance enhancement programs for athletes. Clearly more research is needed to inform decision making when it comes to inclusion or emphasis of core training when designing injury prevention and rehabilitation programs for athletes.

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CONTEXTUALIZAÇÃO: O teste da ponte com extensão unilateral do joelho avalia a estabilidade de tronco e pelve. A avaliação dessa estabilidade pode contribuir para o entendimento da ocorrência de lesões musculoesqueléticas. OBJETIVOS: Investigar a confiabilidade intra e interexaminador de uma análise qualitativa e a confiabilidade intrateste de uma análise quantitativa do alinhamento pélvico no plano transverso durante o teste da ponte com extensão unilateral do joelho. MÉTODO: Foram avaliados 30 participantes (24,73±4,24 anos). A análise qualitativa foi realizada pelo julgamento do alinhamento pélvico no plano transverso por dois examinadores, e sua confiabilidade determinada pelo Coeficiente Kappa Ponderado (k w). A análise quantitativa foi realizada pela medida do maior ângulo de desalinhamento pélvico no plano transverso e a confiabilidade determinada pelo Coeficiente de Correlação Intraclasse (CCI); pela análise da mudança na média dos dados, utilizando-se o intervalo de confiança de 95% da média da diferença (95%IC ) e método de Bland-Altman; pelo dimensionamento da variabilidade entre medidas, considerando-se o erro-padrão da medida combinado (EPM) e coeficiente de variação do erro típico (CV ET). Além disso, verificou-se a mudança mínima detectável (MMD95). RESULTADOS: A confiabilidade intraexaminador variou de razoável a moderada (k w=0,32-0,58) e a confiabilidade interexaminador foi substancial (k w=0,80). A confiabilidade intrateste foi excelente (CCI=0,82) e apresentou o IC95% de -0,51º a 1,99º, EPM de 2,38º e o CV ET de 28,75%. O MMD95 foi de 6,59º. CONCLUSÕES: O índice de confiabilidade interexaminador foi superior ao intraexaminador, a confiabilidade intrateste foi excelente e não apresentou erro sistemático e aleatório.

BACKGROUND: The bridge test with unilateral knee extension evaluates the stability of the trunk and pelvis. The evaluation of this stability can contribute to the understanding of the occurrence of musculoskeletal injuries. OBJECTIVES: To investigate the intra- and inter-rater reliability of a qualitative analysis and intra-test reliability of a quantitative analysis of transverse plane pelvic alignment during the bridge test with unilateral knee extension. METHOD: Thirty participants (24.73±4.24 years old) were tested. The qualitative analysis was conducted by asking two raters to judge the transverse plane pelvic alignment and its reliability was assessed with the weighted kappa coefficient (k w). The quantitative analysis was conducted by measuring the greatest pelvic tilt angle in transverse plane and its reliability was assessed by use of the intraclass correlation coefficient (ICC); the mean change, which was evaluated using 95% confidence interval of the mean difference (95%CI ) and Bland-Altman plot; and the quantification of measurement variability, which was assessed using standard error of measurement (SEM) and the coefficient of variation of the typical error (CV TE). In addition, the minimal detectable change (MDC95) was determined. RESULTS: The intra-rater reliability ranged from fair to moderate (k w=0.32 to 0.58) and the inter-rater reliability was substantial (k w=0.80). The intra-test reliability was excellent (ICC=0.82), the 95% CI ranged from -0.51º to 1.99º, the SEM was 2.38º and the CV TE was 28.75%. The MDC95 was 6.59º. CONCLUSIONS: The inter-rater reliability was greater than the intra-rater reliability; the intra-test reliability was excellent and showed no systematic or random error.

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