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 injury have already been investigated. More recently, attention has turned to the role of core stability related factors in the altered biomechanical function of the lower extremity and the development of injuries. It is hypothesized that impaired core stability increases vulnerability in the development of general lower extremity injuries through uncontrolled joint kinematics and accessory movements throughout the kinetic chain. However, as it is unclear to this day how impaired core stability could lead to injuries, researching and identifying the relationship between impaired core stability and lower extremity injuries could have important implications in the fields of injury prevention and rehabilitation.
Purpose: The main objective of this study was to summarize and research the current literature regarding the role of core stability as a risk factor in the development of lower extremity injuries.
Methods: A systematic literature search in the databases MEDLINE/Pubmed, Embase and Web of Science was conducted in august 2016 using the following search terms and key words: core stability, lumbopelvic hip complex, lumbopelvic control, lumbopelvic stability, spinal stability, trunk stability, lumbar stability, core muscles, core musculature, core strength, core endurance, core proprioception and injury. Papers were included subsequently on title, abstract and full text when they investigated core stability as a risk factor in the development of lower extremity injuries in an athletic population. Additionally, reference lists were hand searched afterwards.
Results: In total, 9 prospective cohort studies were included for review. Conflicting results were found for the role of core muscle endurance as a risk factor for lower extremity injuries. Evidence was found for low relative core muscle strength as a risk factor for ACL injuries. Furthermore, impaired proprioception of the core was established a risk factor for knee injuries in general and finally, moderate evidence was found for neuromuscular control of the core as being a risk factor for lower extremity injuries in general.
Conclusion(s): Although no clear standardized definition of core stability is at hand, some evidence exists for the role of specific core stability components in the development of lower extremity injuries. Impaired core endurance, core strength, core proprioception and neuromuscular control of the core were identified as a risk factor for the development of lower extremity injuries in an athletic population. However, more methodologically sound studies on this topic are needed to gain more insight in the relation between core stability and lower extremity injuries.
Implications: Preliminary evidence exists for different components of core stability as being a risk factor in the development of lower extremity injuries. Core stability measures need to be considered when screening an athlete and could have an important impact in the field of injury prevention and rehabilitation.
Funding acknowledgements: No funding was used in this study.
Topic: Musculoskeletal: lower limb
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.
