Introduction: Adequate trunk muscle endurance and extensibility as also adequate spine mobility are considered to be an important components of the spine and pelvis stabilizing system; therefore, a dysfunction in any of the above components increases the risk of low back pain or injury occurrence. To prevent or reduce the risk of low back pain occurrence, lumbopelvic stabilization exercises are shown to be effective, and also hatha yoga practice is increasingly appearing in the prevention research. In hatha yoga, exercises are gradually escalated, aims at improving and balancing the muscular endurance and body flexibility. Little prevention research on trunk muscle endurance and flexibility training exists. Purpose: The purpose of the doctoral thesis was to create a professional and scientifically based exercise program to improve and balance the trunk muscle endurance and extensibility as also the spine mobility. Furthermore, the objective of this study was also to verify if two groups of trunk muscle endurance tests show comparable results. Methods: A non-randomized control study was conducted. Participants were healthy adults without low back pain and injuries, who did not perform exercises to improve the trunk muscles endurance and/or flexibility before entering the study. The study was conducted in two phases: 1) comparison of two groups of trunk muscle endurance tests (standard tests as proposed by McGill (MG tests) vs alternative tests, performed at 45 degrees Roman chair (RC tests); 2) the proposed exercise program effectiveness analysis. In phase 2, participants were divided into two groups: exercise group (EG), performed hatha yoga exercise program graded by the segmental stabilization of the spine and pelvis model (12 weeks, twice a week for 60 minutes); or control group (CG), in which participants were asked to maintain their current lifestyle during the study period. Upon inclusion in the study (PRE) and after the exercise period (POST), the trunk muscle endurance and extensibility as also the thoracolumbar spine mobility were measured. A statistical analysis of MG and RC tests comparison was performed in phase 1. The analysis of the measured variables changes (PRE-POST analysis, EG-CG comparison) and the association of those changes with the selected characteristics of the participants' lifestyle (multiple regression analysis) were analysed in phase 2. Results: Sixty-eight subjects (aged 31.9 (7.2) years) participated in the study phase 1. As compared to MG tests, holding time was significantly (p < 0.001) longer in three of four RC tests, the calculations of endurance ratios were comparable in MG and RC (with the exception of the FL:EX ratio; p < 0.001), and two of three test positions in RC tests were evaluated as slightly easier to perform than tests MG (p ⡤ 0.001). Seventy-two subjects (nEG = 36, aged 32.2 (6.8) years; nCG = 36, aged 29.9 (7.8) years) participated in the study phase 2. After the exercise program, EG participants had a significantly better results in trunk muscles endurance (p < 0.01) and better FL:EX ratio (p = 0.005). The iliopsoas muscle extensibility (p ⡤ 0.001), V-Sit and Reach Test (p = 0.001) and the thoracolumbar spine mobility (p < 0.05) improved significantly in EG. The result of the V-Sit and Reach Test worsened significantly (p = 0.031) in CG, other changes in CG were not significant. Between both groups, significant differences were found only in the V-Sit and Reach Test (p = 0.032) and spine rotations (p = 0.036). Most of the changes in the measured variables were associated with participation in the exercise program (p < 0.05), while only a few individual associations were associated with other lifestyle characteristics. Discussion and conclusion: RC tests revealed some comparable characteristics and some potentially more feasible characteristics as tests MG. Hatha yoga practice, graded by segmental stabilization exercise model, results in significant improvement of trunk muscle endurance and some of their endurance ratios, improvement of the some muscle extensibility and the thoracolumbar spine mobility. In the future, the long-term effects of the proposed exercise program should be studied on a larger sample of subjects.
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