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Journal of Bodywork & Movement Therapies (2011) 15, 517e524

available at www.sciencedirect.com

journal homepage: www.elsevier.com/jbmt

EXERCISE PHYSIOLOGY RESEARCH

Influence of dynamic versus static core exercises


on performance in field based fitness tests
Kelly L. Parkhouse, BSc, ASCC a, Nick Ball, PhD, ASCC, CSCS b,*

a
Department of Sport and Exercise Science, University of Portsmouth, UK
b
National Institute of Sports Studies, Faculty of Health, University of Canberra, ACT 2601, Australia

Received 5 July 2010; received in revised form 16 November 2010; accepted 30 November 2010

KEYWORDS Summary Minimal evidence supports the claim that core stability training transfers into
Lumbopelvic; improved performance and the most effective training method to perform core exercises is
Stability ball; still unknown. The purpose of the study was to compare the effects of a 6 week unstable static
Performance versus unstable dynamic core training program, on field based fitness tests. A static (n Z 6)
and dynamic (n Z 6) training group performed two 45 min sessions per week for six weeks.
Seven performance tests, consisting of three core (plank; double leg lowering; back exten-
sions), one static (standing stork) and three dynamic (overhead medicine ball throw; vertical
jump; 20 m sprint), were administered pre- and post training. Between group differences were
assessed using a repeated measures MANOVA (P < 0.05). Both training groups improved in each
of the core tests (P < 0.05). Neither training group demonstrated improvement in the dynamic
field based tests (medicine ball throw, vertical jump height and 20 m sprint) (P > 0.05). Find-
ings indicate that both types of training improved specific measures of core stability but did
not transfer into any sport-related skill.
Crown Copyright ª 2010 Published by Elsevier Ltd. All rights reserved.

Introduction Rutherford and Jones, 1986; Vera-Garcia et al., 2000), power


(Jeffreys, 2002) and balance (Anderson and Behm, 2005;
Core stability training on unstable surfaces is commonplace Goodman, 2003; Lehman et al., 2005). Generally, findings
in both healthcare and conditioning settings. Proponents of have indicated that as the degree of instability increases, the
unstable training argue that such training enhances neuro- degree of core muscle activity increases proportionally
muscular pathways (Beache and Earle, 2000; Hedrick, 2000), (Anderson and Behm, 2005; Behm et al., 2005; Marshall and
leading to greater strength (Behm et al., 2005; Gamble, 2007; Murphy, 2005; Murphy and Wilson, 1996; Vera-Garcia et al.,
2000). For this reason, resistance exercises performed on
unstable surfaces have been emphasized as most effective for
* Corresponding author. Tel.: þ61 (0) 2 6201 2419; fax: þ61 (0) 2 the development of core stability (Boyle, 2004; Chek, 1999).
6201 5615. Kibler et al. (2006) defined core stability as ‘the ability to
E-mail address: Nick.ball@canberra.edu.au (N. Ball). control the position and motion of the trunk over the pelvis,

1360-8592/$ - see front matter Crown Copyright ª 2010 Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.jbmt.2010.12.001
518 K.L. Parkhouse, N. Ball

thereby allowing optimum production, transfer and control et al., 2007). The assessment of further neuromuscular and
of force and motion to the terminal segment in integrated kinetic adaptations or transfer would require the use of
athletic kinetic chain activities’. The role of core muscles in specific technology such as electromyography (Winter et al.,
movement is varied according to the dynamics and postural 2007), linear encoders (Harris et al., 2010) and force plat-
demands of a given activity (Brown, 2006; Rogers, 2006). The forms (Winter et al., 2007) which are not freely available.
core region can be divided into local and global groups (based The purpose of the study was to compare the effects of a 6-
on location and attachment site) (Johnson, 2002). Local week unstable static versus unstable dynamic core stability
muscles consist of small, deep muscles that control inter- training program on core strength and other performance
segmental motion between adjacent vertebrae (Johnson, variables. Based on the principle of specificity, we predict
2002) and act as ‘stabilizers’ (Carter et al., 2006). Global a positive transfer of training effect of dynamic core exercise
muscles are large, superficial muscles that transfer force to the dynamic based tasks and a positive transfer of training
between the thoracic cage and pelvis and play a role in effect of static core exercise to the static based tasks.
creating movement (Carter et al., 2006). As the core is
central to most kinetic chains in sports movements, control of Methods
core strength, balance and motion will maximize the kinetic
chains of upper and lower extremity function (Kibler et al.,
Experimental approach to the problem
2006), resulting in more efficient, stronger and powerful
movements (Hedrick, 2000; McCurdy et al., 2005). Hence,
there is an assumption that an improved core will increase This study involved a two group, two factor design to address
one’s ability to run, jump, throw, strike and swing. whether a static or dynamic core stability ball intervention
There are two primary types of core training; static and improved core and field based performance tests. Factor one
dynamic training. Static training involves the joint and was test, which had two levels: pre- and post testing. Factor
muscle either working against an immovable force (maximal two was training, which also had two levels: static or
dynamic group. Dependent variables included 3 measure-
muscle action) or being held in a static position while opposed
by resistance (sub-maximal muscle action) (Siff, 2004). ments of core performance (a static plank and double leg
Actions within a wide variety of sports require isometric lowering test and a dynamic back extension test), 3 dynamic
strength; for example, climbing, mountain biking, Judo, performance tests for speed (20 m sprint), lower body power
wrestling, gymnastics and horseback riding (Stone et al., (vertical jump), upper body power (overhead medicine ball
2003). Dynamic strength is the ability to exert a muscle throw) and a static balance test (standing stork).
force concentrically or eccentrically repeatedly or continu-
ously over time. Due to the body’s functional design, during Participants
dynamic movement there is more dependence on core
musculature than just skeletal rigidity as in a static situation; A group of 12 participants (6 male: 21.2  3.3 years;
as the purpose of movement is to resist a force that changes 174.5  6.3 cm; 78.7  3.7 kg, 6 female: 20.6  1.7 years;
its plane of motion (Siff, 2004). The surface the core exercise 172.6  4.7 cm; 67.7  2.3 kg) volunteered for the study.
is performed on can also be varied to attempt to stimulate Informed consent was obtained and health history question-
increased core activation through increased proprioceptive naires were completed. All participants competed in Univer-
demands compared to floor based exercises (Cosio-Lima sity level sport >8 h per week and reported no history of acute
et al., 2003). Dynamic exercises performed on unstable or chronic low back injury prior to this experiment. All
surfaces are unable to reproduce the force and power participants had prior experience of core stability exercises
outputs found when performing the same exercise on a stable but had never undertaken a prescribed core stability program.
surface (Anderson and Behm, 2005; Carter et al., 2006; Participants were asked to refrain from any other form of core
McGill, 2001; Scibek et al., 2001) thus questioning the use specific exercises during the training period. Before
of performing conventional exercises on unstable surfaces to commencement, the University Ethics review board approved
enhance the transfer of training effect for the prescribed the study. Participants were randomly assigned to either the
movement. However the transfer of training effect of static or dynamic core stability training group ensuring an
dynamic core exercises into dynamic movements has not equal gender split in each group.
been investigated.
There is disagreement amongst coaches about which type Testing procedures
of strength is preferably developed for optimal performance
(Plamondon et al., 1999; Stone et al., 2003). Past research Participants were instructed on how to perform each test
has shown a positive transfer of training effect of dynamic and were allowed a familiarization period. Participants
exercises to dynamic tasks and static exercise to static tasks recorded their assessed test no less than 3 min following
for non-core musculature (O’Shea and O’Shea, 1989). Several the familiarization period. Sufficient rest of at least 10 min
investigators also suggest that isometric forceetime char- was given between each test. Participants were told to put
acteristics are poorly correlated with dynamic performance in maximal effort throughout each test whilst maintaining
(Haff et al., 2005; Murphy and Wilson, 1996). This indicates the correct position of the lumbar spine, with correct
a limited transfer of training of static core exercises to technique overseen by a qualified strength and conditioning
dynamic performance. coach. The battery of seven tests were completed 1 week
The use of field based fitness tests is an easy and conve- prior to the training interventions and repeated one week
nient assessment method to allow coaches and users to track after the training interventions. All tests were randomised
and monitor progress following an intervention (Winter for each participant to minimize learning effects.
Influence of dynamic versus static core exercises on performance in field based fitness tests 519

Static core tests Vertical jump (lower body power)


Vertical jump height was taken from a static position with
Plank both feet together. Participants were instructed to place
Participants were required to lie face down on a mat with both hands on their hips and upon a verbal signal self-
their forearms and toes on the floor. On command, partic- selected their depth for the countermovement jump.
ipants were asked to raise their hips off the floor to form Participants were required to jump vertically as high as they
a straight line from the shoulders to the heels, with could. The jump height was recorded (cm) using a vertical
a neutral back. Tests commenced once the correct position jump meter (Takei, Japan).
was assumed and discontinued when the position changed.
A demonstration was shown and teaching points empha- 20 m sprint (speed)
sized. The test was timed (s) using a stopwatch. A straight 20 m line was measured and marked with cones.
Light gates (Brower, UK) were positioned at both 0 m and
20 m. Participants were asked to start with their feet behind
Double leg lowering
the start cone and to perform the task maximally. On the
Participants laid with their back on a mat and knees to
commands ‘take your marks’ and then ‘go’ participants
chest. After contracting the core region, they slowly slid
both legs out into a straight position, with feet remaining were asked to sprint towards and the time gates at the 20 m
mark. Time (s) was recorded from the timing gates.
5 cm off the floor at all times. Participants were instructed
to keep a neutral back for the duration of the test. Tests
were discontinued when the body position changed or when
Training procedure
legs became less than 180 to the body. The test was timed
(s) using a stopwatch. Each training group was required to attend two 45 min
training sessions per week with a three day gap between
each session. Three days prior to the commencement of the
Dynamic core test
first training session, participants completed a familiariza-
tion session to ensure they were comfortable with the
Back extensions procedures and to minimize any learning effects. During this
Participants were required to lay face down with hands at they practiced the concepts of ‘drawing in’ (neutralizing the
the temples. The number of repetitions performed was spine and working the transverse abdominis and multifidus),
recorded in 2 min. They were encouraged to avoid lifting the correct postural control, the importance of breathing
feet off the floor to avoid the gluteus maximus aiding the (Carter et al., 2006; Gamble, 2007) and stability ball balance
lower back. A back extensor endurance test was used rather (Goodman, 2003). Each participant was given a ball that was
than a common curl-up test because there is only very low in accordance to their height. The size of the ball was
correlation of curl-up tests with core strength and endur- conducive to achieving >90 angle at both the hip and knee
ance (Knudson, 2001), whereas back extensor tests give (Goodman, 2003). The stability balls were 55, 65 or 75 cm in
a better indication of lumbo-pelvic stability and strength. diameter. At the start of each training session, participants
completed a thorough 10 min warm-up which included
Static field based test exercises such as jogging, skipping, but kicks and side step-
ping, followed by static stretching and specific lumbo-pelvic
Standing stork (balance) mobility exercises to reduce injury risk and lower back pain.
Participants stood with hands on hips and were instructed Stretching was also completed upon completion of each
to lift 1 leg and place the sole of the foot on the inner thigh session. All participants in both training groups completed 6
of the other leg. On command, participants raised the heel exercises per session. Overload was provided in the forms of
of the straight leg to stand on the toes. Participants were increased duration and frequency (sets, reps, time under
required to balance for as long as possible without the heel tension), increasing the complexity of exercises (adding
of the foot touching the ground, or the other foot moving opposite limb movements), increasing the lever arm of the
away from the knee. The test was repeated on the other exercises, altering the base of support and increased loading
leg. The test was timed (s) using a stopwatch. (external weights) (Gamble, 2007) (see Tables 1 and 2). The
static group used a duration of 20 s or more when using sub-
Dynamic field based tests maximal loads (such as body weight) and 8e10 s with
external resistance. The dynamic group performed 16 or
Overhead medicine ball throw (upper body power) more repetitions when using sub-maximal loads and 8e12
Participants were required to kneel with the back erect, repetitions with external resistance. Exercises are based on
facing the throwing direction with their knees just behind previous references for core exercise prescription and were
the start line. With a 4 kg medicine ball grasped in both considered safe and effective (Cissik, 2002; Goodman, 2003;
hands, participants were instructed to bring the ball back Hedrick, 2000; Lehman et al., 2005; Plamondon et al., 1999;
over the head and in 1 motion, throw the ball forwards and Stanton et al., 2004; Vera-Garcia et al., 2000).
upwards with maximal power. It was emphasized that the
spine must not be rotated and the favored arm must not Statistical analyses
be used to throw the arm. Stockbrugger and colleagues
(Stockbrugger and Haennel, 2001) have shown this test to be On the completion of data collection, statistical analyses
a valid and reliable test for assessing explosive core and comprised of descriptive statistics to identify means and
upper body power. standard deviations for each variable of interest. The initial
520 K.L. Parkhouse, N. Ball

Table 1 Static core stability program. Exercise, frequency, duration and applied progression and overload for each week.
Exercise Side planka Shoulder bridge Full plank Birddoga Diagonal Reverse
cruncha hyper-
extension
Week 1 Time e secs 25 (2) 30 (2) 25 (2) 30 (2) 20 (2) 15 (2)
(sets)
Instruction On elbow, Arms to side, Knees dropped, 1 leg only Hands on Hands by
Top arm by feet wide, knees on elbows knees side
side bent
Week 2 Time e secs 35 (2) 45 (2) 35 (2) 40 (2) 30 (2) 25 (2)
(sets)
Progression Increase Forearms up, Increase time Increase time Increase Increase
time increase time time time
Week 3 Time e secs 25 (2) 35 (2) 35 (2) 30 (2) 25 (2) 35 (2)
(sets)
Progression Top arm 1 leg straight On elbows, Opposite Hands on Arms on
in air legs straight arm & leg chest chest
Week 4 Time e secs 25 (2) 35 (2) 45 (2) 40 (2) 35 (2) 45 (2)
(sets)
Progression Bottom arm on Both legs straight, Increase time Increase time Increase Increase
hand, top arm heels on ball time time
by side
Week 5 Time e secs 35 (2) 40 (2) 40 (2) 30 (2) 30 (2) 30 (2)
(sets)
Progression Increase time Arms off floor, On hands with Both arms Hands by Hands by
increase time legs straight and 1 leg temples temples
Week 6 Time e secs 35 (2) 40 (2) 45 (2) 40 (2) 40 (2) 40 (2)
(sets)
Progression Top arm in air Lift 1 leg off Increase time Increase time Increase Increase
the ball time time
a
Z each side.

data was analyzed and it determined that data was para- on each parameter measured. Independent variables were
metric. Therefore, A 2  2 (static, dynamic  test time) gender, age and training type. Mauchly’s test of sphericity
multivariate analysis of variance (MANOVA) with repeated revealed that my data remained normally distributed across
measures was performed to determine the effect of training all time points (P > 0.05). Where a main effect was observed,

Table 2 Dynamic core stability program. Exercise, frequency, duration and applied progression and overload for each week.
Exercise Jack knife Russian twista Reverse Lateral rolla Hip crossovera Reverse crunch
hyper-
extension
Week 1 Reps (sets) 8 (2) 8 (2) 25 (2) 8 (2) 8 (2) 20 (2)
Instruction Hands wide, Hands together, Arms by side Wide feet Arms by side Arms on knees
knees on ball wide feet
Week 2 Reps (sets) 12 (2) 10 (2) 35 (2) 12 (2) 10 (2) 30 (2)
Progression Increase reps Increase reps Increase reps Increase reps Increase reps Increase reps
Week 3 Reps (sets) 12 (2) 10 (2) 35 (2) 12 (2) 12 (2) 25 (2)
Progression Hands narrow Narrow feet Hands on chest Narrow feet Increase reps Arms on chest
Week 4 Reps (sets) 8 (2) 12 (2) 45 (2) 8 (2) 8 (2) 35 (2)
Progression Toes on ball Increase reps Increase reps Increase reps Elbows up, hands Increase reps
on chest
Week 5 Reps (sets) 12 (2) 10 (2) 40 (2) 10 (2) 10 (2) 30 (2)
Progression Increase reps Add weight Arms in front Lift 1 leg Increase reps Hands by
plate temples
Week 6 Reps (sets) 16 (2) 12 (2) 45 (2) 12 (2) 12 (2) 40 (2)
Progression Increase reps Increase reps Increase reps Increase reps Increase reps Increase reps
a
Z each side.
Influence of dynamic versus static core exercises on performance in field based fitness tests 521

a least significant difference (LSD) post hoc analysis was dynamic training group to show greater improvements than
conducted to identify the source of the difference (P < 0.05). the static group in all 3 core tests (P < 0.05).
Further analysis of the data was carried out using Pearson’s No improvements were found in any of the dynamic tests
correlation coefficient which identified inter-relationships for both static and dynamic groups (P > 0.05). However,
between all test variables. All statistical analysis was carried standing stork scores increased in the static group post
out using SPSS for windows version 14. Intra-subject reli- training (F1 10 Z 1.16, P Z 0.000) (Fig. 1).
ability was based on the vertical jump scores with an intra- For the static training group, Pearson’s Correlation
class correlation coefficient of 0.95 obtained. coefficient found strong positive relationships between the
plank/double leg lowering test (0.817), plank/vertical jump
Results height (0.821), and standing stork/double leg lowering test
(0.820). Very strong negative relationships were found for
the plank/20 m sprint test (0.927), and double leg
Static/dynamic core and field based tests lowering/20m sprint test (0.822). The dynamic training
group was found to have strong positive relationships
Table 3 presents the results of each core and field based test between the plank/20 m sprint test (0.942), and moder-
for both training groups before and after 6 weeks of training. ately strong positive relationships between medicine ball
The mean scores of the dynamic core training group were throw/back extensions (0.805) and between 20 m sprint/
improved at the post-test in six out of the seven functional vertical jump height (0.794).
tests; however the mean scores of the static core training
group only showed improvement in five out of seven tests.
Both groups improved in all core based tests (Static Group e Discussion
Plank: F (1 10) Z 11.755, P Z 0.000; Double leg lowering:
F (1 10) Z 1.04, P Z 0.000; Back Extension: F (1 10) Z 97.5, The purpose of the study was to compare the effects of a 6
P Z 0.006; Dynamic Group e Plank: F (1 10) Z 81.8, P Z 0.000; week core stability training program with exercises per-
Double leg lowering: F (1 10) Z 40.1, P Z 0.000; Back Exten- formed on an unstable surface on field based performance
sion: F (1 10) Z 16.64, P Z 0.002). Post Hoc LSD found the tests. This study suggests that 6 weeks of both static and

Table 3 Static and dynamic core and field based test results after 6 weeks of training for both static and dynamic training
groups (means  SD). Static indicates the group that performed a static core training program; Dynamic indicates that the group
performed a dynamic core training program.
n Pre Post % Difference p
Static core tests
Plank (sec)
Static 6 59.0  4.69 64.0  4.6 8.5% **
Dynamic 6 51.76  4.43 63.8  5.04 23.3% **
Double leg lowering (sec)
Static 6 25.65  2.62 28.18  3.78 9.9% **
Dynamic 6 24.68  2.45 35.43  2.58 43.6% **
Dynamic core tests
Back extension (reps)
Static 6 67.00  4.34 77.80  2.64 14.9% *
Dynamic 6 65.60  2.16 70.10  1.94 45.8% *
Static field based tests
Standing stork (sec)
Static 6 3.98  0.17 6.55  0.44 64.5% **
Dynamic 6 4.42  0.43 4.80  0.48 8.6% NS
Dynamic field based tests
Vertical jump (cm)
Dynamic 6 33.4  1.92 32.7  2.16 0.9% NS
Static 6 32.9  1.36 34.7  1.75 6.1% NS
20 m Sprint (sec)
Static 6 5.56  0.48 5.50  0.30 1.1% NS
Dynamic 6 5.51  0.31 5.59  0.41 1.4% NS
Medicine ball throw (m)
Static 6 3.48  0.36 3.58  0.26 2.9% NS
Dynamic 6 3.53  0.22 3.5  0.22 0.8% NS
NS Z P > 0.05.
* Z P < 0.01.
* Z P < 0.001.
522 K.L. Parkhouse, N. Ball

however no improvements in swim performance. Further-


more Nesser and colleagues (Nesser et al., 2008) showed no
correlation of core strength to strength and power measures
in collegiate athletes. This indicates that power performance
may not be affected by core strength refuting previous
claims. However core training has been shown to improve
5,000 m run times (Sato and Mokha, 2009) indicating that core
training modalities may have a better transfer to more
endurance based events in the resistance of fatigue and
maintenance of posture (Brumitt, 2004). Stanton and
colleagues (Stanton et al., 2004) showed no improvement in
running economy, however did not include a timed measure
for the run trials performed. These studies and the current
study’s findings support the notion that core training
emphasizes local muscle adaptation and core strength
without concomitant improvements in power based physical
performance.
Although the outcomes appear clear, it must be high-
lighted that only 12 participants were used in the study. We
Figure 1 Mean pre- and post training standing stork scores
suggest that any future studies in this area should include
for both groups (N Z 12).
a much larger sample size to ensure sound reliability of
results. Furthermore, the transfer of training effect of the
dynamic type core training improves core performance dynamic core exercises to the dynamic movements may
(P < 0.05). However, no transfer of training effect to the have required a longer duration training program or an
dynamic tests was shown (P > 0.05). This is the first empirical increased frequency of sessions. Early phase adaptations
study to examine the effect of static versus dynamic core including increased stability, neuromuscular activity and
stability ball training on physical performance. While core proprioceptor activity have been shown after 5 weeks of
stability ball training remains a popular adjunct to training training doing abdominal and one lower back exercise per
for many athletes and anecdotal evidence supports its day (Cosio-Lima et al., 2003), however these improvements
widespread use, results of this study appear to be consistent were shown mainly in neuromuscular changes opposed to
with previous research which has found no transfer of training strength changes as measured by isokinetic testing. Thus
effect (Nesser et al., 2008; Scibek et al., 2001; Tse et al., the neuromuscular control and co-ordination trained by
2005). core dynamic exercises may only improve muscular
The static training group had a significant transfer into recruitment in the initial phases opposed to the trans-
the balance test, which accepts part of our hypothesis and ferring into an external measure. Thus the benefits of the
is similar to previous research. Rutherford and Jones core training program here for the dynamic exercise may
(Rutherford and Jones, 1986) found that early adaptations in not be transfer into performance measures but may
short term static core training resulted in greater gains in potentially improve kinematic and kinetic measures.
torso balance. Supporters of instability training propose the Alongside program duration the nature of the exercise used
neuromuscular system is challenged to a greater extent and may be changed for athletes with free weight exercises
increases proprioceptive demands (Rutherford and Jones, using moderate levels of instability may be more suitable to
1986). The unstable nature of the ball forces one to make maintain specificity (Behm et al., 2010).
postural adjustments to increase co-ordination, which The concept of specificity suggests that quick, explosive
require activation of the appropriate core musculature to dynamic performance variables are likely to be improved
stabilize the lumbar spine. The deep postural muscles of the by similar type training actions. To train improved speed
trunk have a primary purpose to ensure this lumbar stabili- of force application more importance is placed on per-
zation and to maintain the body’s centre of gravity within its forming the exercise powerfully compared to the selection
base of support to minimize loss of balance (Anderson and of the exercise movement (Behm and Sale, 1993). Although
Behm, 2005). However, although static core training has dynamic exercises were performed by the dynamic training
proved effective in a measure of static balance, more sports group, explosive power and high rates of force development
specific research may be needed to clarify this transfer. were not emphasized and subsequently not transferred over.
No improvements were found in the overhead medicine A lower repetition range with emphasis on increased speed
ball throw, 20 m sprint and vertical jump height scores post of movement whilst maintaining lumbo-pelvic stability may
both static and dynamic training. These results provide no have seen a better transfer into the sprint, jump and throw
support for the proposal of a more enhanced and efficient tests as the core would be trained in a similar manner to its
transfer of energy due to an enhanced core. Therefore we use within these tests. The loading measures used in this
reject part of our hypothesis in that dynamic exercise will study may not have been sufficient to improve core muscle
demonstrate a positive transfer of training effect to dynamic function during dynamic exercises. Hibbs and colleagues
tasks. This is in agreement with Scibek and colleagues (Scibek (Hibbs et al., 2008) suggested that the cores are trained
et al., 2001) who looked at the effect of Swiss ball core more for everyday requirements (low loads, slow move-
stability training on subsequent swim performance. Their ments) opposed to an athlete requirement of high load and
results showed enhanced core strength in static exercises resistive movements. The population group in this study
Influence of dynamic versus static core exercises on performance in field based fitness tests 523

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Sincere thanks to all the participants who devoted their
exercises. Dynamic Medicine 4. doi:10.1186/1476-5918-4-6.
time and effort to this study.
Marshall, P.W., Murphy, B.A., 2005. Core stability exercises on and
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