Initiating core muscles - how to put into lay terms?

[gcoe]

Hi Jen

I know this isn't answering your question, and I am not having a go at you personally. However this issue seems to arise quite a bit and it concerns me:

of applying some preliminary evidence about core stability muscles from one area of physiotherapy and making some giant blindfolded leap into applying core stability training to the neurological patient.

The "core stability" literature centres around muscles such as Transverse abdominus and multifidus in low back pain and lumbar instability. There has also been some work into an analogue for neck pain and neck-related headache (deep neck flexors), and some consider the VMO a similar issue in the patello femoral joint problem. However to my knowledge there is not one study that looks at the core stability of muscles in relation to neurological disease or disability.

However I have seen this core stability approach being blindly applied to patients with balance disorders and cerebellar ataxia - without a shred of evidence that this is the underlying motor control problem these patients have or that they are helped by core stability training. This is really bad science. And it trivialises what we do understand about the balance and mobility.

If you or another reader knows of even one clinical trial that provides evidence for this approach with a neurological patient group I would love to be informed.

[mckenzie]

You're right Gcoe, it didn't answer my question. But thanks for your input.

There are a LOT of approaches used in physio that are not well evidence based but this does not mean they have no role in our treatment. For example acupuncture which is now part of the NICE guidelines for low back pain. There is far too much useless research out there. If any physio claims they only use treatment that has masses of evidence to support it they are lying, it's about using our tool box of skills and treatment techniques and applying them appropriately to each individual patient using our clinical reasoning skills and the patient's own goals.

If anyone can actually answer the question I would be grateful to hear from you. Not interested in a debate about the use of core stability.
Many thanks, J