The effects of isolated and integrated 'core stability' training on athletic performance measures: A systematic review

Background: Core stability training, operationally defined as training focused to improve trunk and hip control, is an integral part of athletic development, yet little is known about its direct relation to athletic performance. Objective: This systematic review focuses on identification of the association between core stability and sports-related performance measures. A secondary objective was to identify difficulties encountered when trying to train core stability with the goal of improving athletic performance. Data sources: A systematic search was employed to capture all articles related to athletic performance and core stability training that were identified using the electronic databases MEDLINE, CINAHL and SPORTDiscu(1982-June 2011).Study selection: A systematic approach was used to evaluate 179 articles identified for initial review. Studies that performed an intervention targeted toward the core and measured an outcome related to athletic or sport performances were included, while studies with a participant population aged 65 years or older were excluded. Twenty-four in total met the inclusionary criteria for review. Study appraisal and synthesis methods: Studies were evaluated using the Physical Therapy Evidence Database (PEDro) scale. The 24 articles were separated into three groups, general performance (n = 8), lower extremity (n = 10) and upper extremity (n = 6), for ease of discussion. Results: In the majority of studies, core stability training was utilized in conjunction with more comprehensive exercise programmes. As such, many studies saw improvements in skills of general strengths such as maximum squat load and vertical leap. Surprisingly, not all studies reported measurable increases in specific core strength and stability measures following training. Additionally, investigations that targeted the core as the primary goal for improved outcome of training had mixed results. Limitations: Core stability is rarely the sole component of an athletic development programme, making it difficult to directly isolate its affect on athletic performance. The population biases of some studies of athletic performance also confound the results. Conclusions: Targeted core stability training provides marginal benefits to athletic performance. Conflicting findings and the lack of a standardization for measurement of outcomes and training focused to improve core strength and stability pose difficulties. Because of this, further research targeted to determine this relationship is necessary to better understand how core strength and stability affect athletic performance.