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Abstract

Clinical Scenario: The core is a functional unit connecting the upper and lower extremities consisting of abdominal, back, and hip musculature. Core stability is a determining factor in patient motor performance and provides optimal force production and precision of movement. A highly functional core is essential in injury prevention and rehabilitation. Traditional means of core stability training are performed on a stable surface. Emerging research suggests patients may benefit from core stability training on unstable mediums such as is used with suspension training. Clinical Question: Does suspension training improve core activity in an active population? Search Strategy: Key words used to guide the search were core strength OR core stability AND suspension training, unstable surface AND strength. Inclusion criteria included articles published in or after 2017, manuscripts that explored suspension training AND core stability, strength, endurance, and were completed using an active adult population. Manuscripts were excluded if they were published prior to 2017, did not assess pre and post measurements, and were completed on a sedentary or injured population. Data bases searched included EBSCO Host, SportDiscus, and PubMed. Search Results: Overall 11 articles were collected and appraised to determine relevance to answering the clinical question. Evidence was appraised by three researchers using the Oxford Centre for Evidence-Based Medicine Level of evidence criteria and the PEDro scale to determine validity of evidence. Evidence at a level 1B or higher and a PEDro score of 5 or higher were included. Best Evidence: In total, two relevant studies emerged to meet inclusion criteria. These studies utilized suspension training or TRX to facilitate activation of the core musculature. All three studies met level 1B criteria of the CEBM. Clinical Bottom Line: Evidence suggests improvement to core strength, endurance, and stability can be achieved with the inclusion of suspension training. Suspension exercises of push-up, inverted row, bridge, and planks show greatest activation of core musculature. A 6 month program of incorporating suspension training in addition to a routine program shows most beneficial. This evidence combined suggests suspension training is an effective tool in improving core activity. Further, evidence to identify the lasting benefits of suspension training to train core activity is inconclusive and should be continued. Strength of Recommendation: Grade B evidence exists that suspension training is an effective intervention to improve core activity in an active population.

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