A comparison study between core stability and trunk extensor endurance training in the management of acute low back pain in field hockey players
Objectives: When we consider the body position of a field hockey player, the lumbar spine is always in a flexed position, which combined with rotational movements during various hitting and pushing techniques, increases the strain upon the spine and surrounding muscles, thus leading to low back pain. To determine the relationship between core strength and trunk extensor endurance relating to the incidence of acute low back pain in field hockey players. Project Design: The research project was in the form of a quantitative cross-sectional study, using human subjects. Setting: The research project occurred during the field hockey season (2008) with players who had acute low back pain. The players were clinically assessed and subdivided into necessary groups at the Chiropractic Day Clinic at the Durban Institute of Technology. Subjects: Adult, male patients, aged between 18 and 30 years of age, playing premier field hockey. Out of the thirty players, 12 players have played in the National u/21 squad, 7 players have played in a Junior National team and 11 players have played senior provincial field hockey. Outcome measure: This included three tests. Firstly, the absolute difference of pressure from the reference value of 70mmHg (prone) and 40mmHg (supine) was used as the outcome measure on a Pressure Biofeedback Unit and length of time (in seconds), a correct contraction of the core stability muscles was maintained. Secondly, the length of time (in seconds) for Trunk Extensor Endurance. Thirdly, repeated measures for NRS-101 and Quebec Back Pain Disability Scale for the duration of the research period. v Results: It was found that there was no statistical evidence or convincing trend to show that the training programmes (core stability and trunk extensor endurance) increased the subjects’ core strength or trunk extensor endurance in the time allocated, although there seemed to be a placebo effect in the Trunk Extensor Group, which showed improvement in some of the core stability outcomes. There was statistical evidence that the intervention (training programmes) reduced pain, according to the Quebec Back Pain Disability Scale (Quebec) score over time, and a non-significant trend suggested this according to the Numerical Rating Scale-101 (NRS). Since both groups’ NRS and Quebec scores were not significantly different at baseline, the difference can be attributed to the effect of the intervention. Conclusions: The results of this study found that the Trunk Extensor Endurance Group, that performed the trunk extensor endurance training programme, yielded better results in core stability and trunk extensor endurance. However, the Core Stability Group, that performed the core stability training programme, showed a quicker reduction in pain levels during the three week intervention period. Therefore, by combining both training programmes, future rehabilitation of athletes suffering from acute low back pain will be more successful. Sport performance of the athletes (field hockey players), through the proponents of swiss ball training, will also improve.