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De Blaiser C.1, De Ridder R.1, Willems T.1,2, Danneels L.1, Vanden Bossche L.3, Roosen P.1
1Ghent University, Department of Rehabilitation Sciences and Physiotherapy, Gent, Belgium, 2Ghent University, Department of Physical Therapy and Orthopedics, Gent, Belgium, 3Ghent University, Physical and Rehabilitation Medicine, Sportsmedicine, Gent, Belgium
Background: Many intrinsic risk factors for lower extremity muscle strains have already been identified. More recently, attention has turned to the role of core stability components in the development of lower extremity injuries since it is hypothesized that impaired stability of the core leads to uncontrolled joint displacements and accessory movements throughout the kinetic chain. However, no prospective study has yet identified physical and modifiable, core stability related intrinsic risk factors for these injuries. Identifying the relationship between impaired core stability components and lower extremity muscle strains could have important implications in the fields of injury prevention and rehabilitation.
Purpose: The purpose of this study was to investigate whether core stability components can be considered as a risk factor for lower extremity muscle strains. It was hypothesized that inadequate core stability components would predispose a physically active population to an increased risk of lower extremity muscle strains.
Methods: This study included 139 physically active adults for analysis. Anthropometric characteristics were collected and various core stability components were investigated. Isometric hip and trunk muscle strength was measured with a hand-held dynamometer. Core muscle endurance was measured using the left and right side bridging tests, the prone bridging test and the Biering-Sörenson test. The subjects were prospectively followed during a one-year period. The injury follow-up of the subjects was assessed with a weekly online questionnaire and injuries were confirmed by a medical examiner. Binary logistic regression analysis was performed to identify potential risk factors for sustaining a lower extremity muscle strain.
Results: During injury follow-up, a total of 21 participants (15%) were diagnosed with a lower extremity muscle strain. Quadriceps, hamstring, adductor and calf muscle strains were identified. Binary logistic regression analysis revealed that subjects with a decreased holding time for the left (95%CI for OR: [0.958 0.998]) or right (95%CI for OR: [0.953 0.996]) side bridging test are at greater risk for lower extremity muscle strains. No other study variables could be identified as a risk factor.
Conclusion(s): Decreased core muscle endurance, measured with the side bridging test is associated with an increased risk for the development of lower extremity muscle strains. Other core stability components such as hip and trunk muscle strength were not identified as risk factors. Replication in larger samples with more injured cases is warranted to further ascertain the importance of this risk factor.
Implications: The side bridging test is an easy to administer, cost-effective screening tool to identify physically active subjects at risk for sustaining a lower extremity muscle strain and can be used in the fields of injury prevention, rehabilitation and athletic training.
Funding acknowledgements: No funding was used in this study.
Topic: Musculoskeletal: peripheral
Ethics approval: This study was approved by the ethics committee of the University Hospital of Ghent.
All authors, affiliations and abstracts have been published as submitted.
