Archives of Medicine and Health Sciences

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 8  |  Issue : 2  |  Page : 236--239

Relationship between core stability and static balance in non-elite collegiate athletes


Lovely Sharma1, Shahin Naz Jamali1, Jyoti Sharma2, Shaheen Khanum1,  
1 Department of Physiotherapy, School of Health Sciences, Noida International University, Greater Noida, Uttar Pradesh, India
2 Department of Physiotherapy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India

Correspondence Address:
Dr. Shahin Naz Jamali
School of Health Sciences, Noida International University, Plot 1, Sector-17A, Yamuna Expressway, Gautum Budh Nagar, Noida - 203 201, Uttar Pradesh
India

Abstract

Background and Aim: Core stability has become very popular in fitness training and injury prevention programs that incorporate spinal musculature training including core strengthening and stability. Core dysfunction could be related to lower extremity functional performance including balance. The aim of present study was to evaluate the relationship between core stability and static balance. It will provide a rationale to focus on core stability training to enhance lower-limb performance, improvement of balance, and reduction of injuries. Materials and Methods: Based on inclusion and exclusion criteria, thirty nonelite collegiate athletes (male and female) were recruited for the study. Their core stability was analyzed using extensor endurance test (EET), flexor endurance test, and side-bridge test (SBT), whereas the static stability was evaluated using stork stand balance test. Results: Static balance was significantly correlated with EET and right and left SBT of core stability. Conclusion: The study concludes that there is a significant relationship between core stability and static balance in nonelite collegiate athletes in sagittal plane.



How to cite this article:
Sharma L, Jamali SN, Sharma J, Khanum S. Relationship between core stability and static balance in non-elite collegiate athletes.Arch Med Health Sci 2020;8:236-239


How to cite this URL:
Sharma L, Jamali SN, Sharma J, Khanum S. Relationship between core stability and static balance in non-elite collegiate athletes. Arch Med Health Sci [serial online] 2020 [cited 2021 Feb 28 ];8:236-239
Available from: https://www.amhsjournal.org/text.asp?2020/8/2/236/304733


Full Text



 Introduction



A significant relationship between core stability and static balance help to enhance athletic performance by keeping body into correct biomechanical alignment and eventually reduce sports injuries. Core strengthening and stability exercises are considered to be the anatomic and functional centerpieces for any fitness training and injury prevention programs.[1] Core stability can be achieved through the stabilization of one's torso (by production, transfer, and control of forces) and moving the terminal segment during the dynamic whole-body activity.[2] Core musculature consists of abdominals in the front, paraspinals at the sides, gluteal in the back, the diaphragm as the roof, and the pelvic floor along with hip girdle musculature at the bottom. Hence, it is a muscular box comprising 29 pairs of muscles.[3] Without these muscles, the spine would become mechanically unstable with compressive forces as little as 90 N.[4] The core is particularly important because it provides “proximal stability for distal mobility.”[5] A weak core is believed to cause alterations in the transfer of energy results in reduced static balance. There is also a risk of injury to a weak or underdeveloped muscle group.[6],[7] The integrated approach of core stability can be achieved through the combined action of active spinal stabilizers (muscles), passive stabilizers (spinal column), and neural control mechanism. To maximize balance and promote efficient biomechanics, it requires a dynamically controlled transfer of large forces from the upper and lower extremities through the core.[8]

Balance is considered to be an important aspect of performance for all individuals which is achieved by a complex process involving the function of the musculoskeletal and neurological systems.[9] Balance is described as the ability to control the body position in space for the purpose of equilibrium and orientation.[10] Postural control is the ability to maintain a base of support (BOS) with minimal movement. Dynamically, it is the ability to perform a task while maintaining a stable position.[11] Balance is a complex motor skill that describes the dynamics of body posture to prevent falls. Biomechanically, balance is the ability to maintain or return the body's center of gravity (COG) within the limits of stability, as determined by BOS. It is a well-known fact that the position of body's COG is significantly influenced by the positions of intervertebral segments. Furthermore, the higher core stabilization is responsible for more optimum control of the vertebral segments.[12]

As core stability is suggested to play an important role for any individual to maintain their postural equilibrium, therefore the aim of this present study was to determine the correlation among different tests of core stability and the static balance performance in nonelite collegiate athletes. This correlation will provide a direct evidence of association between core stability and static balance performance.

 Materials and Methods



Sample size

Before the conduction of the study, the sample size was calculated using Power Analysis and Sample Size (PASS) 2008 Software by NCSS, Kaysville, Utah. A sample size of 30 individuals was achieved based on the effect size of 0.14, alpha level of 0.05, and power (1-beta) of 0.80.[13]

Subjects

On the basis of inclusion and exclusion criterion, thirty nonelite (those individuals that competed at recreational, amateur, or university standard without any formal commitment, contract, or payment)[14] male and female athletes of age between 18 and 30 years were recruited from Noida International University. Participants with any form of neuromuscular, cardiovascular, or orthopedic problems were excluded from the study, and to eliminate biased data results, those, who were involved in any sort of training program for core stability or balance, were also not taken in the study and a part of exclusion.

The purpose of the study was explained to all the potential participants, and informed consent was obtained from each of them. Participation in the study was completely voluntary and noncommercial. All participants were permitted to terminate the study whenever they wanted. The study was anonymous, and confidentiality of data was guaranteed. Expedited ethical approval was taken from the institutional ethical committee of the university.

Study design

This was a cross-sectional observational study.

Procedure

After acquiring consent, demographic variables of all participants such as gender, age, height, and body mass index were assessed. Explanation and familiarization trial of the testing procedure was given to all participants, and they were asked to report after 2 h of pretest data recording to avoid the fatigue of familiarization trails. Participants were instructed not to consume heavy meals during the gap period of 2 h.

Variables

A series of tests, consisting of flexor endurance test (FET), extensor endurance test (EET), and side-bridge test (SBT) (right and left), were used to measure core stability. Whereas, stork stand balance test (SSBT) on both lower extremities (right and left) was done to measure static balance. Complete data were recorded in a single session.

Flexor endurance test

This test assesses the muscular endurance of the deep core muscles (transverse abdominis, quadratus lumborum, and erector spinae).[15] For the test, participants were positioned supine, with both hips and knees flexed to 90° and trunk inclined at 60° resting on a prefabricated wedge. A belt was used for stabilization around the table and over the dorsum of the feet (with shoes on). Participants crossed their arms across the chest and placed their hands-on opposite shoulders in a comfortable manner. Participants maintained their body position for as long as they can after the wedge was moved back 10 cm. Observation was measured from the instant the prefabricated wedge was moved back until the participant visually reestablished contact with the wedge.[16] Time for which participants could withhold the position in a single trail was recorded.

Extensor endurance test

This test determines the muscular endurance of the torso extensor muscles (erector spinae, longissimus, iliocostalis, and multifidi).[15] The participants were instructed to lie prone and their lower bodies were fixed to the table surface through straps at the ankles, knees, and hips. The upper bodies of participants (from just above the level of the anterior superior iliac crest) were off the surface of the plinth. Participants held the upper body off the end of the table by pushing with extended arms on a chair directly below them. Participants were instructed to maintain the horizontal position for as long as possible once testing commenced. When the participants claimed that the position could no longer be held due to fatigue or discomfort, the test was terminated and the holding time, for a single trail, was recorded.[16]

Side-bridge (right and left) test

The trunk lateral endurance test, also called the side-bridge test, assesses the muscular endurance of the lateral core muscles (transverse abdominis, obliques, quadratus lumborum, and erector spinae).[15] The test consisted of the participant in side-lying position, with legs extended. Participants were instructed to support themselves lifting their hips off the mat to maintain a straight line over their full body length and supported themselves on the elbow and their feet. The duration for which they could maintain the full straight position, in a single trail, was the measurement of the performance of the test.[13]

Stork stand balance test

This was used to measure static balance performance. Participants were instructed to assume a single-leg standing position on the testing limb followed by the command to raise his/her heel and maintain the balance on the ball of toes of the foot for the maximum possible duration. The time duration between the assumption of the position and the loosing of the stable position was taken as the score of the test.[17] In this measurement, three trials are given for each leg and the time of the longest balance for each leg was recorded.

Statistical analysis

The data entry was done on Microsoft Excel 2013, and statistical analysis was done using IBM Statistical package for social sciences (SPSS) software, Statistics for Windows, Version 24.0 by Armonk, NY: IBM Corporation. The demographic characteristics of participants were analyzed using the frequency distribution of the descriptive analysis tool. The relationship between core stability tests and stork balance tests was done using Karl Pearson correlation (r-test). The level of significance was set at P < 0.05.

 Results



The demographic data of participants including gender, age, weight, and height are descriptively summarized in [Table 1]. The mean and SD of tests for core stability (FET, EET, and right and left SBT) and test for static stability (right and left SSBT) are depicted in [Table 2].{Table 1}{Table 2}

Left SSBT was significantly correlated with EET (r = 0.576, P = 0.001), right SBT (r = 0.497, P = 0.005), and left SBT (r = 0.556, P = 0.001). A similar type of relation was found between right SSBT and left SBT (r = 0.449, P = 0.001) [Table 3].{Table 3}

It is also illustrates from Table 3 that right SSBT was not significantly related to EET (r = 0.250, P = 0.183) and right SBT (r = 0.250, P = 0.184). It also shows that FET is neither associated with right SSBT (r = 0.233, P = 0.216) nor with left SSBT (r = 0.320, P = 0.085).

Henceforth, the result suggests that static balance is significantly correlated with EET and right and left SBT but does not correlate with FET.

 Discussion



The primary purpose of this study was to determine the relationship between core stability and lower-limb static balance in nonelite collegiate athletes. The outcome of the study indicates that the left SSBT was significantly correlated with EET, right SBT, and left SBT. Similarly, right SSBT was significantly associated with left SBT. Different muscle components were evaluated by the different tests of core stability. The result of the present study supports the finding of Aggarwal et al.,[13] as they also suggested that the static balance performance of the left single-leg stand test was significantly correlated by the EET.

During the SSBT, the weight of the body gets stabilized over the ball of the toes. It is known that when Centre of gravity (COG) is maintained at correct position then only the correct position of spine can be maintained. This leads to the coordinated action of muscle synergy pattern to counteract perturbations and maintain the body's balance and optimal postural control. A stronger core allows optimal sustained contraction of deep spinal stabilizer muscles which are responsible to control movements in the sagittal plane. The SSBT evaluates combined coordination between superficial and deep spinal muscles. Henceforth, a stronger core provide effective control to spine that maintains the centre of gravity (COG) at optimal position and eventually maintain overall equilibrium.[13] This possibly justifies a higher correlation of stork stand balance test and extension endurance test as more coordination of these spinal muscles will lead to more trunk control to stabilizing body weight while performing stork stand balance test.

In SBT, lateral stabilizer muscles (quadrates lumborum) of the trunk get activated.[18] In this study, a significant correlation among the static balance test and SBT was found. Contraction of lateral muscles supports deep spinal muscles and generates higher force to control the movement of the truck and maintains spinal stability and balance.[19] This study did not find a correlation between static balance and flexion endurance tests, and it could be due to the activation of global abdominal muscles (rectus abdominis and external oblique muscles); the deep sited core muscles could have to get masked.

A stable core leads enhancement of balance that eventually reduces the incidence of lower-limb injuries. Willson et al. showed that there is a clear association between core muscle stability and lower-limb injury.[20] Stronger core muscles create more stability in the trunk, which facilitates the mobility in the lower limb. The abdominal muscle complex, including transverse abdominal muscle, the internal and external oblique muscles, and rectus abdominal muscle, provides stability to the spinal cord with their contraction and provides a stronger support for the movements of the lower limbs.[21] According to Kibler's findings, activation of core muscles in the movement pattern of lower limbs improves postural control, and the body uses core stabilizing muscles to produce rotational force torque around the body and create limb movement and hence maintains equilibrium.[6]

Limitations and future prospective of study

The present study was conducted on athletes of all sports. Athletes from specific sports can be studied further as per the sports-specific requirement of core endurance and stability. The current study is conducted on nonelite collegiate athletes. It can be conducted on professional athletes in future. Moreover, only static stability was focused and assessed in the given study. Future research can expand the evidence for dynamic stability too.

 CONCLUSION



This study concludes that there is a significant relationship between core stability and static balance in nonelite collegiate athletes. The challenge in addressing trunk endurance is to apply the knowledge and skills to design exercise programs that still incorporate principles of kinesiology, biomechanics, neuroscience, physiology, motor learning, and psychology but within the context of the environment, personal goals, and societal demands to improve endurance and subsequently balance that will reduce lower-limb musculoskeletal injuries that could be encountered in sports and will enhance the performance of athletes.

Acknowledgement

We express our deep gratitude to the participants for their enthusiasm and willingness to participate in the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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