Core Stability Training for Young Gymnasts With Adductor Strain

NCT07466134 | Completed

• 1 other identifier: P.T.REC/012/005528
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Adductor muscle strain is a common cause of groin pain in young athletes, particularly in gymnasts who frequently perform movements that require extreme hip flexibility and strength. Muscle imbalance around the hip joint and reduced core stability may increase the risk of adductor injuries. This randomized clinical trial aims to investigate the effect of adding core stability training to a traditional physiotherapy rehabilitation program on the hip adduction-abduction strength ratio in young gymnasts with adductor muscle strain. Thirty-six young gymnasts aged 7-10 years with Grade I or II adductor strain will be randomly assigned to two groups. Both groups will receive a traditional physiotherapy rehabilitation program for eight weeks, while the study group will also perform additional core stability exercises. Outcomes will include hip adductor and abductor strength measured using a hand-held dynamometer, pain intensity assessed using the Visual Analog Scale (VAS), and hip and groin function evaluated using the Copenhagen Hip and Groin Outcome Score (HAGOS). The findings of this study may help determine whether adding core stability training improves rehabilitation outcomes in young gymnasts with adductor muscle strain.

Conditions

Groin Pain; Adductor Muscle Strain

Keywords

Core Stability Training; Adductor Muscle Strain; Hip Adduction Abduction Ratio; Gymnastics Injuries

Outcome Measures

Primary Outcomes (1)

• Hip Adduction-Abduction Strength Ratio (ADD:ABD ratio)

  Hip adduction and abduction muscle strength were measured using a hand-held dynamometer, and the ratio between adduction and abduction strength was calculated to evaluate hip muscle balance.

  Baseline and after 8 weeks of intervention.

Secondary Outcomes (2)

• pain intensity

  Baseline and after 8 weeks of intervention.

• hip and groin function

  Baseline and after 8 weeks of intervention.

Study Arms (1)

Arm1(study group) , Arm2 (control group)

ACTIVE COMPARATOR

Arm 1 - Study Group (Intervention Arm) Arm Description: Participants in this arm received a core stability training (CST) program in addition to the traditional physiotherapy program for the rehabilitation of adductor muscle strain. The intervention was performed three times per week for eight weeks. Each session consisted of 30 minutes of core stability exercises combined with 40 minutes of traditional physiotherapy. The CST program included exercises targeting trunk and lumbopelvic stability such as abdominal hollowing, abdominal bracing, dissociation of the shoulder and pelvic girdles, cat-camel exercise, quadruped stance, front bridge, side bridge, and supine bridge, applied in progressive phases. \- Arm 2 - Control Group Arm Description: Participants in this arm received a traditional physiotherapy program alone for the rehabilitation of adductor muscle strain. The treatment was conducted three times per week for eight weeks, with each session lasting approximately 70 minutes.

Other: core stability training + traditional physio therapy for study group; Other: traditional physiotherapy for control group

Interventions

core stability training + traditional physio therapy for study group OTHER

Core stability training (CST) was implemented to improve trunk control and lumbopelvic stability in young gymnasts with adductor muscle strain. The program was performed three times per week for eight consecutive weeks and was provided in addition to the traditional physiotherapy program. Each session included approximately 30 minutes of CST exercises focusing on neuromuscular control of the trunk and pelvis. The training protocol consisted of progressive exercises including abdominal hollowing, abdominal bracing, dissociation of the shoulder and pelvic girdles, cat-camel exercise, quadruped stance, front bridge, side bridge (both sides), and supine bridge. The program was delivered in three progressive phases with gradual increases in training difficulty to enhance trunk muscle activation, improve lumbopelvic stability, and optimize force transmission through the kinetic chain during lower limb movements.

Also known as: core stability exercises

Arm1(study group) , Arm2 (control group)

traditional physiotherapy for control group OTHER

The traditional physiotherapy program was designed for the rehabilitation of adductor muscle strain and was conducted three times per week for eight weeks, with each session lasting approximately 70 minutes. The program included a 10-minute warm-up using a cycle ergometer followed by pain-free strengthening exercises targeting hip flexion, extension, abduction, and adduction performed in side-lying and standing positions. Isometric adductor strengthening exercises were performed in the supine position using a small roll placed between the knees or feet. Balance and proprioceptive training were incorporated using balance boards and functional tasks. Stretching exercises for the hamstrings, gluteal muscles, hip flexors, and iliotibial band were performed during the cool-down period. In addition, low-level laser therapy was applied for 10 minutes over the symptomatic adductor tendon insertion sites to reduce pain and local tenderness.

Also known as: conventional physiotherapy

Arm1(study group) , Arm2 (control group)

Eligibility Criteria

• Age: 7 Years - 10 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Young gymnastic athletes aged 7-10 years.
• Male or female participants who are actively practicing gymnastics.
• Clinically diagnosed with Grade I or Grade II adductor muscle strain by an orthopedic physician.
• Presence of groin pain reproduced during resisted hip adduction test.
• Positive adductor squeeze test indicating adductor-related groin pain.

You may not qualify if:

• Presence of radiological evidence of hip joint pathology or fracture.
• Neurological disorders affecting motor control or balance.
• History of previous hip or pelvic surgery.
• Presence of spinal pain involving the thoracolumbar region.
• Any medical condition that could interfere with participation in the rehabilitation program or outcome assessments.

Sponsors & Collaborators

• Aya Mohamed Elsheikh: lead
• Faculty of Physical Therapy, Cairo University, Egypt is not a recognized organization name.: collaborator

Study Sites (1)

the Faculty of Physical Therapy, Cairo University

Cairo, 1151, Egypt

Location

Related Publications (13)

• 29.Rodríguez-Perea Á, Reyes-Ferrada W, Jerez-Mayorga D, Chirosa Ríos L, Van den Tillar R, Chirosa Ríos I, et al. Core training and performance: a systematic review with meta-analysis. Biol Sport. 2023;40(4):975-992.

  BACKGROUND

• 28.McGill S. (2016). Ultimate back fitness and performance (7th ed.). Backfitpro.

  BACKGROUND

• 27.Cabrejas C, Solana-Tramunt M, Morales J, Campos-Rius J, Ortegón A, Nieto-Guisado A, et al. The effect of eight-week functional core training on core stability in young rhythmic gymnasts: A randomized clinical trial. Int J Environ Res Public Health. 2022;19(6):3509.

  BACKGROUND

• 21.Mahmoud WS, Ibrahim MM, Radwan NL. Efficacy of modified active physical therapy program on pain, muscle strength, and function in adolescent football players with osteitis pubis. Bull Fac Phys Ther. 2024;29:2. https://doi.org/10.1186/s43161-023-00170-7.

  BACKGROUND

• 20.Maestroni L, Read PJ, Bishop C, Turner AN. Strength and power training in rehabilitation: Underpinning principles and practical strategies to return athletes to high performance. Sports Medicine. 2019;50:239-252.

  BACKGROUND

• 19.Abdelwakel IAZ. Impact of rehabilitation exercises program on adductor muscle strain. Assiut Journal For Sport Science Arts. 2016;216(2):1-13.

  BACKGROUND

• 18.Harøy J, Bache-Mathiesen LK, Andersen TE. Lower HAGOS subscale scores associated with a longer duration of groin problems in football players in the subsequent season. BMJ Open Sport Exerc Med. 2024;10(2):e001812.

  BACKGROUND

• 16.Thorborg K, Hölmich P, Christensen R, Petersen J, Roos EM. The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist. Br J Sports Med. 2011;45(6):478-491. Johnson EW. Visual analog scale (VAS). Am J Phys Med Rehabil. 2001;80(10):717.

  BACKGROUND

• 15.Thorborg K, Petersen J, Magnusson SP, Hölmich P. Clinical assessment of hip strength using a hand-held dynamometer is reliable. Scand J Med Sci Sports. 2010;20(3):493-501.

  BACKGROUND

• 13.Beard MQ, Boland SA, Gribble PA. Reliability of the Hand-Held Dynamometer During Hip Isometric Strength Testing Both With and Without a Stabilization Strap. International Journal of Athletic Therapy and Training. 2020;25(1):37-42.

  BACKGROUND

• 12.Heijboer WMP, Weir A, Vuckovic Z, Tol JL, Hölmich P, Serner A. Clinical examination tests for adductor- and pubic-related groin pain in athletes with longstanding groin pain: Inter-examiner reliability and prevalence of positive tests. Phys Ther Sport. 2024;66: 9-16.

  BACKGROUND

• 11.Verrall GM, Slavotinek JP, Barnes PG, Fon GT. Description of pain provocation tests used for the diagnosis of sports-related chronic groin pain: relationship of tests to defined clinical (pain and tenderness) and MRI (pubic bone marrow oedema) criteria. Scand J Med Sci Sports. 2005;15(1):36-42.

  BACKGROUND

• Opara K, Pinkerman S, Kaiser K. Adductor Strain. [Updated 2025 Dec 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493166/

  BACKGROUND

MeSH Terms

Interventions

Control Groups

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Research Design; Methods

Study Officials

• Nanees Essam Mohamed, physiotherapy Professor

  Institutional Review Board of the Faculty of Physical Therapy, Cairo University, Egypt

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Due to the nature of the exercise-based rehabilitation interventions, blinding of participants and treating therapists was not feasible. Participants were aware of the type of treatment they received (traditional physiotherapy alone or traditional physiotherapy combined with core stability training). No additional parties were masked during the trial. Outcome assessments were performed using standardized procedures to minimize measurement bias
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Physiotherapist, Faculty of Physical Therapy, Cairo University.

Model Details: This study followed a parallel-group randomized controlled interventional design. Eligible participants were randomly assigned in a 1:1 allocation ratio to either the study group or the control group using a computer-generated randomization sequence. The control group received a traditional physiotherapy program, while the study group received the same traditional physiotherapy program with the addition of a structured core stability training (CST) program. The intervention period lasted eight weeks, with treatment sessions conducted three times per week. Outcome measures were assessed at two time points: baseline (pre-intervention) and after completion of the intervention (post-intervention). The primary outcome was the hip adduction to abduction (ADD:ABD) strength ratio, while secondary outcomes included pain intensity measured using the Visual Analog Scale (VAS) and hip and groin functional status assessed using the Hip and Groin Outcome Score (HAGOS). The study employed a repeate

Study Record Dates

• First Submitted: March 7, 2026
• First Posted: March 12, 2026
• Study Start: December 1, 2024
• Primary Completion: April 20, 2025
• Study Completion: August 1, 2025
• Last Updated: March 12, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)