Effects of Core Stabilization Exercises on Pulmonary Functions, Respiratory Muscle Strength and Functional Capacity

NCT03461614 | Completed

• 1 other identifier: 122
• Study Type: interventional
• Target: 49
• Locations: 1 country
• Sites: 1

Brief Summary

In recent years adolescent substance abuse is a serious and growing problem. Substance use among adolescents means the use of alcohol, opiates, amphetamines, inhalants, cocaine, marijuana, benzodiazepines, hallucinogens, and anabolic steroids. The United Nations Office on Drugs and Crime reports that approximately 5% of the world's population used an illicit drug in 2010 and it is estimated that heroin, cocaine and other drugs are responsible for 0.1 to 0.2 million deaths per year. There is a limited number of studies in the literature that investigate the relationship between substance use disorder and respiratory functions. In Taylor et al., study reported that the proportion of cannabis-dependent study members with an FEV1/FVC ratio of, 80% was 36% compared to 20% for non-smokers. Another research of Taylor et al., in longitudinal observations over 8 years in young adults (cannabis smoking on lung function in young adults between the ages of 18 and 26) revealed a dose-dependent relationship between cumulative cannabis consumption and decline in FEV1/VC. In a monograph, stated that follow-up studies of regular cannabis-only smokers also found impaired respiratory function and pathological changes in lung tissue like those preceding the development of chronic obstructive pulmonary disease . The core anatomically described as a box, with the abdominals at the front, spinal and gluteal muscles at the back, the diaphragm on the top, and the pelvic floor and hip muscles on the bottom. Correct breathing is vital to abdominal training because respiratory muscles are directly involved during common core stability exercises. Moreover, the diaphragm, a component of core stability, plays a role in respiration and trunk stability by controlling intra-abdominal pressure . Oh et al.reported that, 30-min, 3 days a week for 8 weeks lumbar stabilization exercise had a more positive effect on pulmonary function than general physical therapy on stroke patients. Our hypothesis was that core exercises may positive effect on respiratory functions and functional capacity of substance use disorder individuals. The aim of our study is to investigate the effects of core exercises on respiratory functions and functional capacity in adolescents with substance use disorder.

Conditions

Substance Use Disorders; Substance Abuse; Substance Use

Keywords

pulmonary function; respiratory muscle strength; functional capacity; core exercises; rehabilitation

Outcome Measures

Primary Outcomes (3)

• Pulmonary Function Test

  Pulmonary functions were measured using portable spirometry (Spirobank II; Medical International Research Rome, Italy). Measurements were performed according to the criteria of the American Thoracic Society (ATS) and the European Respiratory Society (ERS) guidelines.

  6 weeks

• Maximal Inspiratory and Expiratory Pressures

  Participants' maximal inspiratory and expiratory pressures was measured and recorded according to ATS/ERS criteria using a portable, electronic intraoral pressure gauge (Carefusion, USA) . During the test, subjects were encouraged verbally. Technically acceptable, the highest of at least three measurements that did not differ by more than 5 cm H2O was recorded for maximal inspiratory and expiratory pressures. A percentages of the predicted values of maximal inspiratory and expiratory pressures were expressed as described by Black and Hyatt.

  6 weeks

• Functional Capacity

  Functional capacity was measured with the 6-Minute Walk Test (6MWT) according to the guideline of ERS. The 6MWT to be a reliable, reproducible, and valid functional test for assessing exercise tolerance and endurance. Subjects were instructed to walk from one end to the other of a 30 m hallway at their own pace, while attempting to cover as much ground as possible in the allotted 6 min. The test was self-paced and the subject could rest if he or she so wished.

  6 weeks

Secondary Outcomes (3)

• Respiratory Related Symptoms

  6 weeks

• The Modified Medical Research Council (mMRC) Dyspnoea Scale

  6 weeks

• The Fagerstrom Test of Nicotine Dependence (FTND)

  6 weeks

Study Arms (2)

Exercise Group

EXPERIMENTAL

In addition to the service routine rehabilitation program, in this group all participant receive as group training with instructor supervising 5-6 participants. The specific days of the week and time of day in which the participants trained remained constant throughout each training protocol. Training programs lasted 6 weeks and comprised 2 training sessions per week with a total of 12 training sessions. A 45-60 min training sessions per week with a 2 day gap between each session.

Other: Exercise group

Control Group

OTHER

In addition to the service routine rehabilitation program, participants in the Control group participated in leisure activities such as table tennis/basketball under service staff supervision for 45-60 minutes, 2 times a week, 6 weeks similar time period of Exercise group.

Other: Control group

Interventions

Exercise group OTHER

Exercise group mainly conducted the 5 core stabilization exercises as described by McGill. These include the curl-up, side bridge, trunk extension, double leg lifts and bird-dog exercises that support respiratory functions. In other words, every single training session consisted of frontal, dorsal, and lateral core exercise. In general, participants always exercised in group so that for integration and motivation. During training weeks 1-2, participants exercises with 3 sets per exercise and 10 s contraction time and 10 repetitions. During training weeks 3-4, contraction times and repetitions were increased to 15 s and 15 repetitions. Additionally, increasing the complexity of exercises, adding opposite limb movements and increasing the lever arm of the exercises were done.

Also known as: Core stabilization exercise

Exercise Group

Control group OTHER

In addition to the service routine rehabilitation program mentioned above, participants in the Control group participated in leisure activities such as table tennis/basketball under service staff supervision for 45-60 minutes, 2 times a week, 6 weeks similar time period of Exercise group.

Also known as: Aerobic exercise

Control Group

Eligibility Criteria

• Age: 15 Years - 18 Years
• Sex: male
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• were between 15 and 18 years of age,
• met current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for substance use disorder,
• be using substances over a year,
• have not participated regularly in any exercise training program for the past six months,
• were currently engaged in inpatient substance abuse treatment.

You may not qualify if:

• a history of psychotic disorder or current psychotic symptoms,
• physical disabilities or medical problems,
• inability to adapt to the evaluation and treatment program,
• have a respiratory system problems such as bronchiectasis, asthma and tuberculosis, infectious health problem (HIV, hepatitis B etc.).

Sponsors & Collaborators

• Istanbul University: lead

Study Sites (1)

Rustem Mustafaoğlu

Istanbul, Turkey (Türkiye)

Location

Related Publications (20)

• Carney T, Myers BJ, Louw J, Okwundu CI. Brief school-based interventions and behavioural outcomes for substance-using adolescents. Cochrane Database Syst Rev. 2014 Feb 4;(2):CD008969. doi: 10.1002/14651858.CD008969.pub2.

  PMID: 24563456 RESULT

• Chakravarthy B, Shah S, Lotfipour S. Adolescent drug abuse - awareness & prevention. Indian J Med Res. 2013 Jun;137(6):1021-3. No abstract available.

  PMID: 23852281 RESULT

• Taylor DR, Poulton R, Moffitt TE, Ramankutty P, Sears MR. The respiratory effects of cannabis dependence in young adults. Addiction. 2000 Nov;95(11):1669-77. doi: 10.1046/j.1360-0443.2000.951116697.x.

  PMID: 11219370 RESULT

• Taylor DR, Fergusson DM, Milne BJ, Horwood LJ, Moffitt TE, Sears MR, Poulton R. A longitudinal study of the effects of tobacco and cannabis exposure on lung function in young adults. Addiction. 2002 Aug;97(8):1055-61. doi: 10.1046/j.1360-0443.2002.00169.x.

  PMID: 12144608 RESULT

• Key J. 'The core': understanding it, and retraining its dysfunction. J Bodyw Mov Ther. 2013 Oct;17(4):541-59. doi: 10.1016/j.jbmt.2013.03.012. Epub 2013 Jun 28.

  PMID: 24139017 RESULT

• Park SJ, Lee JH, Min KO. Comparison of the effects of core stabilization and chest mobilization exercises on lung function and chest wall expansion in stroke patients. J Phys Ther Sci. 2017 Jul;29(7):1144-1147. doi: 10.1589/jpts.29.1144. Epub 2017 Jul 15.

  PMID: 28744034 RESULT

• Oh DS, Park SE. The effect of lumbar stabilization exercise on the pulmonary function of stroke patients. J Phys Ther Sci. 2016 Jun;28(6):1896-900. doi: 10.1589/jpts.28.1896. Epub 2016 Jun 28.

  PMID: 27390442 RESULT

• Macleod J, Robertson R, Copeland L, McKenzie J, Elton R, Reid P. Cannabis, tobacco smoking, and lung function: a cross-sectional observational study in a general practice population. Br J Gen Pract. 2015 Feb;65(631):e89-95. doi: 10.3399/bjgp15X683521.

  PMID: 25624312 RESULT

• Fletcher C. Standardised questionnaire on respiratory symptoms: a statement prepared and approved by the MRC Committee on the Aetiology of Chronic Bronchitis (MRC breathlessness score). Bmj. 1960;2(2):1665.

  RESULT

• Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999 Jul;54(7):581-6. doi: 10.1136/thx.54.7.581.

  PMID: 10377201 RESULT

• Stavem K, Rogeberg OJ, Olsen JA, Boe J. Properties of the Cigarette Dependence Scale and the Fagerstrom Test of Nicotine Dependence in a representative sample of smokers in Norway. Addiction. 2008 Sep;103(9):1441-9. doi: 10.1111/j.1360-0443.2008.02278.x.

  PMID: 18783499 RESULT

• Fagerstrom KO. Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. Addict Behav. 1978;3(3-4):235-41. doi: 10.1016/0306-4603(78)90024-2. No abstract available.

  PMID: 735910 RESULT

• Uysal MA, Kadakal F, Karsidag C, Bayram NG, Uysal O, Yilmaz V. Fagerstrom test for nicotine dependence: reliability in a Turkish sample and factor analysis. Tuberk Toraks. 2004;52(2):115-21.

  PMID: 15241694 RESULT

• Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, Coates A, van der Grinten CP, Gustafsson P, Hankinson J, Jensen R, Johnson DC, MacIntyre N, McKay R, Miller MR, Navajas D, Pedersen OF, Wanger J. Interpretative strategies for lung function tests. Eur Respir J. 2005 Nov;26(5):948-68. doi: 10.1183/09031936.05.00035205. No abstract available.

  PMID: 16264058 RESULT

• Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J; ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J. 2005 Aug;26(2):319-38. doi: 10.1183/09031936.05.00034805. No abstract available.

  PMID: 16055882 RESULT

• American Thoracic Society/European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002 Aug 15;166(4):518-624. doi: 10.1164/rccm.166.4.518. No abstract available.

  PMID: 12186831 RESULT

• Domenech-Clar R, Lopez-Andreu JA, Compte-Torrero L, De Diego-Damia A, Macian-Gisbert V, Perpina-Tordera M, Roques-Serradilla JM. Maximal static respiratory pressures in children and adolescents. Pediatr Pulmonol. 2003 Feb;35(2):126-32. doi: 10.1002/ppul.10217.

  PMID: 12526074 RESULT

• Puente-Maestu L, Palange P, Casaburi R, Laveneziana P, Maltais F, Neder JA, O'Donnell DE, Onorati P, Porszasz J, Rabinovich R, Rossiter HB, Singh S, Troosters T, Ward S. Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement. Eur Respir J. 2016 Feb;47(2):429-60. doi: 10.1183/13993003.00745-2015. Epub 2016 Jan 21.

  PMID: 26797036 RESULT

• Flemmen G, Unhjem R, Wang E. High-intensity interval training in patients with substance use disorder. Biomed Res Int. 2014;2014:616935. doi: 10.1155/2014/616935. Epub 2014 Mar 2.

  PMID: 24724089 RESULT

• Buchowski MS, Meade NN, Charboneau E, Park S, Dietrich MS, Cowan RL, Martin PR. Aerobic exercise training reduces cannabis craving and use in non-treatment seeking cannabis-dependent adults. PLoS One. 2011 Mar 8;6(3):e17465. doi: 10.1371/journal.pone.0017465.

  PMID: 21408154 RESULT

MeSH Terms

Conditions

Substance-Related Disorders

Interventions

Control Groups; Exercise

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Research Design; Methods; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Rustem Mustafaoğlu, PT

  İstanbul Üniversitesi, Sağlık Bilimleri Fakültesi

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: February 28, 2018
• First Posted: March 12, 2018
• Study Start: February 1, 2017
• Primary Completion: April 5, 2018
• Study Completion: April 5, 2018
• Last Updated: April 6, 2018

Record last verified: 2018-04

Locations

TU (1)