Journal of Sport Rehabilitation, 2012, 21, 264-271

© 2013 Human Kinetics, Inc.

Improvement in Dynamic Balance and Core Endurance

After a 6-Week Core-Stability-Training Program
in High School Track and Field Athletes
Michelle A. Sandrey and Jonathan G. Mitzel

Context: Core training specifically for track and field athletes is vague, and it is not clear how it affects dynamic
balance and core-endurance measures. Objective: To determine the effects of a 6-week core-stabilization-
training program for high school track and field athletes on dynamic balance and core endurance. Design:
Test–retest. Setting: High school in north central West Virginia. Participants: Thirteen healthy high school
student athletes from 1 track and field team volunteered for the study. Interventions: Subjects completed
pretesting 1 wk before data collection. They completed a 6-wk core-stabilization program designed specifi-
cally for track and field athletes. The program consisted of 3 levels with 6 exercises per level and lasted for
30 min each session 3 times per week. Subjects progressed to the next level at 2-wk intervals. After 6 wk,
posttesting was conducted Main Outcome Measures: The subjects were evaluated using the Star Excursion
Balance Test (SEBT) for posteromedial (PM), medial (M), and anteromedial (AM) directions; abdominal-
fatigue test (AFT); back-extensor test (BET); and side-bridge test (SBT) for the right and left sides. Results:
Posttest results significantly improved for all 3 directions of the SEBT (PM, M, and AM), AFT, BET, right
SBT, and left SBT. Effect size was large for all variables except for PM and AM, where a moderate effect was
noted. Minimal-detectable-change scores exceeded the error of the measurements for all dependent variables.
Conclusion: After the 6-wk core-stabilization-training program, measures of the SEBT, AFT, BET, and SBT
improved, thus advocating the use of this core-stabilization-training program for track and field athletes.

Keywords: postural control, star excursion balance test, trunk control, multiplanar movements

The gravitational center in the lumbopelvic region
is where all movements are initiated. During activity the
center of gravity is constantly shifting. The musculature
that surrounds the center of gravity plays a vital role in
motor function by maintaining a stable base to support
the body mass.1,2 Generally referred to as the core, these
global and local muscles are constantly working to main-
tain posture, absorb loads, protect neural structures, and
assist in changing postures and dynamic movements. The
core muscles transfer force and act as a bridge between
the upper and lower extremities.3 Perhaps more impor-
tant, the core muscles help passive structures protect
and support the spine. Considering the sensitivity and
quantity of nerves that run through the low back, limiting
displacement and maintaining the structural integrity of
this region is of great importance.
The concepts of core stabilization, strengthening,
or endurance training in the sports medicine community
have evolved throughout the years. Previously, core-
stability exercises were widely used for the prevention
Sandrey is with the College of Physical Activity and Sport
Sciences, West Virginia University, Morgantown, WV. Mitzel
is with Carolina West Sports Medicine, Sylva, NC.
and rehabilitation of injuries of the low back and lower
extremities.4–8 Recently, core-stability training has been
purported to enhance athletic performance, but the litera-
ture has not supported these claims and, in fact, reported a
small effect on performance.9–13 For aerobic performance,
Stanton et al9 noted no improvement in running economy
after a 6-week Swiss-ball training program, as did Sato
and Mokha11 on 5-km performance and Tse et al13 for
a 40-m sprint or 2000-m rowing test. When evaluating
performance or strength and power tests, Lewarchick et
al10 noted that a 7-week core-stability-training program in
college football athletes did not improve performance. Fur-
thermore, Nesser et al12 noted that there was no relationship
between core stability and several measures of strength and
power in college football athletes. In contrast, however, the
use of core-stability training improved dynamic postural
control11,14–16 and core endurance as noted using the Star
Excursion Balance Test (SEBT) and 3 core-endurance tests
including the abdominal-fatigue test, the back-extensor
test, and right and left side bridging.13,17–19 It appears that
the repeated activation of core musculature along with
extremity movements helps improve postural control.14
As core-stability training is becoming common for
all levels of athletes, track and field is no exception. The
rigors of athletic competition increase the risk of injury

264

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as the forces and loads acting on the body rise.2 Track
and field is a unique sport that includes running, jumping,
and throwing, as well as multievent athletes who must
perform in several different events. Sprinting, running,
and field events require controlled postures sustained
for extended periods of time and dynamic postural
control during single-limb events, as well as quick and
explosive movements. Multievent athletes with little to
no rest between events must have a well-conditioned
core, as well as other primary muscle groups. Thus,
core strength and endurance are paramount and may
help improve dynamic stability of the lower extremity.11
Core-stability-training programs for running exist,9,11
but we found only 1 core-stability-training program20 in
the literature for track and field athletes. Improvement in
core stability using the Sahrmann core-stability test and
a Swiss-ball prone stabilization core-stability test after a
6-week Swiss-ball exercise program9 and in Star Excur-
sion Balance Test (SEBT) reach directions using a 5-exer-
cise 6-week core-stability-training program were noted.
However, the track and field program20 was a review
article with only suggestions for exercises to include in a
core-stability-training program. Therefore, the purpose of
this study was to determine the effects of a 6-week core-
stabilization-training program for high school track and
field athletes on dynamic balance and core endurance.
We hypothesized that core endurance and SEBT reach
directions would improve after the implementation of a
6-week core-stability-training program designed to be of
benefit for track and field athletes.
Methods
The design of the study is a test–retest design with a con-
venience sample of high school track and field athletes
who completed a supervised core-stabilization program
designed for track and field athletes over a 6-week period.
Measures of the SEBT (anteromedial, medial, and pos-
teromedial), abdominal-fatigue test (AFT), back-extensor
test (BET), and right and left side-bridging test (SBT)
were assessed before and immediately after the 6-week
intervention period.
Subjects
Initially, 20 subjects started the study (10 male and 10
female) from the track and field program at a high school
in North Central WV. Thirteen student athletes completed
the study (7 males and 6 females, age = 15.38 ± 1.12 y,
height = 172.3 ± 10.42 cm, mass = 62.43 ± 9.01 kg).
The research sample was primarily made up of middle-
distance runners, distance runners, and sprinters. None
of the subjects who completed the study were throwing
athletes. To be included in this study subjects had to be
participating in track and field at the high school and have
a valid physical on file. Exclusion criteria consisted of
previous lower-extremity or lumbar-spine pathology or
surgery within the past 6 months; neurological, vestibular,
or visual disorder in the past 6 months; and taking any
Core-Stability Training for Track and Field   265
medications that could affect balance. Subjects were also
excluded if they were currently participating in a core-
stability-training program.
Before participation each subject’s parent or guard-
ian signed a parental consent form, while the subjects
completed an assent form. Subjects were also required
to answer a demographic/injury-history questionnaire,
which was used to obtain anthropometric measures and
injury history. The injury history was used to determine
exclusion criteria. The study was approved by the institu-
tion’s Office of Research Compliance.
Procedures
Once subjects were deemed eligible they were contacted
to attend an orientation meeting. During this meeting they
were provided with the guidelines of the testing and their
training and testing schedule. All subjects were tested
1 week before the beginning of the core-stabilization-
training program (pretest) and immediately after the
conclusion of the 6-week program (posttest). Pretesting
and posttesting consisted of the SEBT, the BET, the AFT,
and the SBT. The subjects completed the core-stability-
training program 3 times per week on days during their
regularly scheduled team practices. If the dates of a team
meet conflicted with the training program, the training
program was completed during the next practice session
for that week. The core-stabilization-training program
lasted approximately 30 min/session for 6 weeks for
a total of 18 sessions. To maintain consistency of the
exercises performed, all training-program sessions were
administered and supervised by the investigator in the
gymnasium at the high school.
Pretesting and Posttesting
The SEBT was used following the protocol to the exact
specifications as described in the literature21–23 The SEBT
has been shown to possess relatively high intratester
and intertester reliability.24–26 Validity testing remains
challenging because there is no dynamic functional test
that is considered the gold standard.27 For this test, the
subject balanced on the dominant leg in the center of a
star-pattern testing area. Before performing the test, a
leg-length measurement from the anterosuperior iliac
spine to the distal tip of the medial malleolus was taken
to normalize reach distance to leg length.28 Each subject
was then instructed to reach with the non-weight-bearing
leg as far as he or she could in each of the 3 directions
while maintaining single-leg stance.
During the practice session, each reach direction
(anteromedial, medial, and posteromedial) was performed
4 times.23,26 This practice session was followed by a
1-minute full rest period before testing began. After the
resting period, the subject performed 3 trials in each of the
3 directions. The starting direction was randomized by the
subject choosing 1 of the 3 index cards labeled with the 3
directions. Reach directions were completed in a clockwise
or counterclockwise direction depending on the dominant
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266  Sandrey and Mitzel
stance leg, clockwise for the right leg and counterclockwise
if standing on the left leg. The dominant leg was determined
by asking which leg would be the take-off leg or the first
leg out of the starting blocks. There was a 10-second rest
period between directions. At any time the athlete lost his
or her balance or the investigator felt the other leg was
being used for support the trial was discarded and repeated.
After the SEBT the subjects were given a 5-minute
break before starting the BET.17,29 For this test the subjects
were placed on their stomach in a prone position with
the upper body cantilevered out over a roman chair. A
horizontal position was assumed with arms crossed across
the chest. The length of time this position was maintained
was timed using a stopwatch. The test was terminated
when the subject fell below the horizontal position. The
time was recorded in seconds. There was a 5-minute break
after completing the BET. In a study conducted by McGill
et al,17 a reliability coefficient of r = .98 was reported
when performing the test for 5 consecutive days. A reli-
ability coefficient was then reported for an 8-week and
5-day repeated sessions by adding these scores together
for a reliability coefficient of .99 for the BET.
For the AFT,17–19,29 the subject was placed at a 45°
angle, leaning slightly forward with an angled block
placed behind the low back while seated on a treatment
table. The test began when the block was removed. The
subject remained in this position for as long as possible.
The test was terminated when the upper body could
no longer remain at the 45° angle. Time was recorded
in seconds using a stopwatch. The subject was given a
5-minute break after completing the AFT. The coefficient
of variance of the 60° flexor test was significantly greater
(.67) than the coefficient of variance of the 45° flexor test
(.50). As a result, the 45° flexor test was determined to be
a better test of the trunk flexors than the 60° flexor test.19
The last test performed was the SBT.5,17–19,28 The side
tested first was determined by flipping a coin. The subject
assumed a side-lying position on a treatment table with
both legs extended and placed his or her top foot in front
with support using only the elbow, forearm, and feet. The
hips were raised off the table with the other arm and hand
across the chest resting on the opposite shoulder. The test
was terminated when the hips started to sag and the body
position could no longer be maintained. Time was recorded
in seconds using a stopwatch. The test was repeated using
the other side. McGill17 found reliability coefficients when
performing 5 consecutive days of testing. He found a reli-
ability coefficient of .99 for both the right and left SBT.17
After reliability scores from the 8 weeks and 5 consecutive
days of testing were compared, reliability coefficients of .96
for the right SBT and .99 for the left SBT were reported.5
Exercise Intervention
After the initial testing, the subject performed a 6-week
training period. The subjects performed exercises with
the researcher 3 times a week for a maximum of 30 min/
session. The 6-week protocol for the core-stabilization-
training program was 3 progressive levels of exercises
focusing on strengthening the abdominal, low-back, and
pelvic muscles while maintaining neuromuscular con-
trol.5,6,15,20,30 The level of difficulty for the exercises was
loosely based on the 5-level mastery program for core
training described by Jeffreys.31 Level 1 exercises consisted
of exercises in a stationary position with static contractions
and then progressed to slow movements in an unstable
environment. Level 2 exercises encompassed static con-
tractions in an unstable environment and progressed to
dynamic movements in a more stable environment. Finally,
the third-level exercises used dynamic movements in an
unstable environment followed by a progression of added
resistance to an unstable environment. Every 2 weeks the
subjects progressed to the next level of exercise difficulty.
With no previous core-stability-training protocol for
track and field athletes, exercises in the core-stability-
training program were included that would be of benefit
for track and field athletes.20 Exercises included trunk
flexion at the trunk in a sit-up position, as well as trunk
extension, lateral flexion on both sides, and rotation on
both sides. The exercises used the athlete’s own body
weight, Swiss balls, medicine balls, and therapeutic
resistance bands. The sets and repetitions and holding
times for each exercise for each week were fixed at 3
sets of 20 seconds for isometric holding activities and
20 repetitions for activities with isotonic contractions.
The subjects started at level 1 and progressed through
each level according to the protocol for that particular
week.31 Subjects progressed to the next level of the
core-stabilization-training program at 2-week intervals to
allow proper acclimation. Although subjects had to learn
new tasks each week, several of the exercises were pro-
gressed from the previous weeks by simply increasing the
difficulty by adding a movement or changing the surface
type. This made for a relatively easy transition between
weeks as all subjects completed new tasks without much
difficulty. Detailed progression can be found in Table 1.
Statistical Analysis
Descriptive analysis consisted of means and standard
deviations for pretest and posttest data for the SEBT,
AFT, BET, and left and right SBT. Paired-sample t tests
were used to compare pretest and posttest results for the
SEBT (posteromedial, medial, and anteromedial direc-
tions), BET, AFT, right SBT, and left SBT. The level of
significance was set at P = .05 for all analyses. No correc-
tion for multiple comparisons was made; instead Cohen d
measures of effect size were calculated based on the mean
differences of test scores (pretest and posttest) divided
by the reference SD (pretest) with corresponding 95%
confidence intervals (CI). The strength of effect sizes was
determined as small (≤.4), moderate (.41–.7) and large
(≥.71).32 Because no control group was used, minimal
detectable change (MDC) scores were calculated using
intraclass correlation coefficients ICC3,1 and the standard
error of measurement. MDC scores were calculated to
determine the minimal change required for the dependent
variables to obtain scores beyond the error of measure-
ment. IBM/SPSS software (IBM/SPSS, Inc, Chicago, IL)
version 19.0 was used for all analyses.
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 Core-Stability Training for Track and Field   267

Table 1  Core-Stability-Training Program

Week Exercises Sets, reps, time
1 Abdominal bracing, hollowing All exercises were held for 20 s before returning
to starting position
Prone bridge
Supine bridge
Side bridge
2 Supine bent-knee raise 20 reps
Quadruped alternate-arm leg raise
Supine bridge exercise with alternate leg extension
Seated marching on physioball
Crossover crunch
3 Dead bug 20 reps
Supine bridge on physioball Hold 20 s
Supine bridge on physioball with shoulder flexion 20 reps
Prone bridge on physioball Hold 20 s
Cobra extension on physioball Hold 20 s
Superman Hold 2 s/20 reps
4 Pelvic bridge alternating knee extension with physioball 20 reps
Medicine-ball floor twist 20 reps
Pelvic bridge with shoulder flexion on physioball 20 reps
Curl-up on physioball 20 reps
Pelvic bridge alternating knee extension and shoulder flexion 20 reps
Superman on Physioball Hold 2 s/20 reps
5 Lunge with medicine-ball twist 20 reps
Abdominal flexion on physioball with medicine ball 20 reps
Abdominal rollout 20 reps
Ball bridge with alternate knee extension Hold 2 s/20 reps
6 Physioball lunge 10 reps on each leg
Theraband-resisted march 10 reps on each side
Iron cross on physioball Total 20 reps alternating sides
Side bridge with shoulder abduction 15 reps each side
Physioball alternate superman Total of 20 reps

Results
SEBT
Descriptive statistics for the pretest and posttest data for
the SEBT can be found in Table 2 along with effect size,
95%CI, and MDC. There was a significant difference for
time for medial (t = –3.910, P = .002) and anteromedial (t
= –3.178, P = .008) as posttest reach distances increased.
The medial reach direction had a large effect size of .83.
Both posteromedial (0.46) and anteromedial (0.49) had
a moderate effect size. The MDC was exceeded for all
3 directions. Percent change scores ranged from 12.54
to 5.07 for the dominant leg (all subjects were right-leg
dominant), with medial direction demonstrating the most
change, followed by posteromedial and anteromedial.
Core-Endurance Tests
Descriptive statistics for the AFT, BET, right SBT, and
left SBT can be found in Table 3. There was a significant

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268  Sandrey and Mitzel

Table 2  Descriptive Statistics for the Star Excursion Balance Test

Direction R pre, mean ± SD R post, mean ± SD % change score MDC Effect Size 95%CI
PM 80.17 ± 11.29 85.32 ± 9.57 6.42 4.64* 0.46^ –0.32 to 1.23
M 63.13 ± 9.68 71.20 ± 5.11 12.78 1.71* 0.83# 0.03–1.64
AM 73.68 ± 7.71 77.42 ± 6.37 5.07 3.13* 0.49^ –0.29 to 1.27
Abbreviations: R pre, right leg pretest; R post, right leg posttest; MDC, minimal detectable change; 95%CI, confidence interval for effect size; PM,
posteromedial; M, medial; AM, anteromedial.
*MDC scores achieved. #Large effect size. ^Moderate effect size.

Table 3  Descriptive Statistics for Core-Endurance Tests

Test Pre, mean ± SD Post, mean ± SD % change score MDC Effect Size 95%CI
AFT 42.69 ± 21.33 149.79 ± 84.62 250.88 61.77* 1.27# 0.42–2.11
BET 46.73 ± 23.86 103.08 ± 32.63 120.58 38.12* 1.73# 0.83–2.63
RSBT 28.77 ± 14.36 77.20 ± 34.28 168.34 22.52* 1.41# 0.55–2.27
LSBT 26.77 ± 13.40 69.61 ± 27.12 160.03 21.76* 1.58# 0.70–2.46
Abbreviations: MDC, minimal detectable change; 95%CI, confidence interval for effect size; AFT, abdominal-fatigue test; BET, back-extensor test;
RSBT, right side-bridge test; LSBT, left side-bridge test.
*MDC scores achieved. #Large strong effect size.

difference for AFT (t = –4.917, P < .01) and BET (t =
–5.148, P < .01) as posttest times increased. Both the AFT
and BET had a large strong effect size (1.27 and 1.73,
respectively). MDC scores were exceeded for the AFT
and BET. The AFT and BET posttest scores increased
250.88% and 120.59%, respectively.
Both the right SBT (t = –6.067, P < .01) and the left
SBT (t = –4.800, P ≤ .01) were significant as posttest
times increased. Both the right SBT and left SBT had
a large strong effect size (1.41 and 1.58, respectively)
MDC scores were exceeded for the right SBT and left
SBT. The right SBT posttest scores increased 168.34%
while the left SBT posttest scores increased by 160.03%.
Discussion
The purpose of the current study was to examine the
effects of a 6-week core-stabilization-training program
in high school track and field athletes. Specifically, to
observe the effects of a 6-week core-stabilization-training
program on dynamic balance, and core endurance.
Dynamic balance was measured with the SEBT, and
core endurance was measured using the AFT, the BET,
and the SBT for the right and left sides. We hypothesized
that core endurance and SEBT reach directions would
improve after the 6-week core-stabilization-training
program designed to benefit track and field athletes.
Based on the large to moderate effect sizes and exceed-
ing the MDC, the medial and anteromedial directions
represented a true change from pretest to posttest and
were truly influenced by the core-stabilization-training
program. All core-endurance tests, specifically the AFT,
BET, and SBT for right and left sides, had a large strong
effect size and exceeded the MDC, thus indicating a
benefit from the core-stabilization-training program used
in this study, as well.
Dynamic-Balance Testing With the SEBT
The SEBT is a measure of dynamic balance and postural
control. The core becomes activated before gross body
movements as part of the postural control system. Since
the core is responsible for postural control, assessments
of dynamic balance are alternatives to assess core stabi-
lization. The 3 reach directions of the SEBT used in this
study were thought to best simulate multiplanar human
movement noted in track and field and would be able to
evaluate balance, stability, and precise functioning20 that
was incorporated in the core-stabilization-training pro-
gram. After the intervention, significant increases were
identified in the medial and anteromedial directions. This
may be attributed to the abdominal bracing incorporated
in the core-stabilization-training program that stabilized
the core for lower-limb movement33 or to the fact that
the subjects possessed neuromuscular control systems
that were better suited to their respective movements in
track and field.
Kahle and Gribble33 found that maximal reach dis-
tances improved for the SEBT at posttest using healthy
subjects compared with a control group after a 6-week
core-stability-training program. Maximum reach dis-
tances improved for anteromedial, medial, and postero-
medial at posttest for the exercise group. They surmised

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that the improvements were related to contraction of the
transverse abdominis, internal and external obliques, and
the rectus abdominis to provide stabilization to the spine
and provide a stronger base of support for lower-extremity
movement. This stabilization occurs because of initiation
of limb movement.14 Furthermore, the core-stabilization-
training program improved the strength and recruitment
of trunk musculature to such an extent that standing on
1 limb during the SEBT while using the opposite limb to
reach may have activated the core muscles and perhaps
led to greater reach distances posttest.
Sato and Mokha11 also evaluated dynamic postural
control and performance in competitive and recreational
runners after a core-stabilization-training program. They
did not observe statistical significance for SEBT direc-
tions despite the improvement after 6 weeks but, rather,
noted a significant interaction as the core-stabilization-
training group improved average 5000-m times compared
with the control group. How this improvement would
help running speed or prevent injuries was not known,
but a more stable base could provide more consistent
movement control. Aggarwal et al16 compared a core-
stabilization-training program with a balance-training
program in recreationally active subjects using the SEBT.
They also noted improvement with the medial and antero-
medial directions, which was attributed to improved trunk
control and improved control of the center of gravity due
to activation of the local muscles and cocontraction of
these muscles rather than global muscle activation that
occurs during lower-extremity movement. They also had
the most improvement in the medial direction. Reach
directions also improved for the balance-training group,
which was attributed to improved proprioception and
better static control of the ankle muscles. Other studies
that incorporated athletes also noted improvement in
dynamic postural control. Samson et al15 noted this in
tennis athletes compared with a group of nonathletes.
The current study used a variety of core-stabilization-
training methods that included using unstable surfaces,
using limb movement to challenge the postural-control
system, and performing some exercises in a weight-
bearing position, which may be why reach distances
improved. In addition, the core-stabilization-training
program did not specifically train for postural control and
dynamic stability in a standing position. While postural
control and dynamic stability were challenged throughout
the training program, only 3 of the positions involved
standing. Most often the subject was positioned in supine,
prone, side-lying, or other like positions. Similarly while
the latter levels of the 6-week core-stabilization-training
program used exercises that involved multiplanar move-
ments, much of the program was dedicated to uniplanar
movements and stabilizations.
Core-Endurance Testing
The core-training groups saw improvements for the AFT,
BET, right SBT, and left SBT, with a large effect size and
percent change scores. The large improvement in posttest
Core-Stability Training for Track and Field   269
differences in times on the AFT, BET, right SBT, and left
SBT can therefore be attributed to the 6-week core-stabi-
lization-training program. While certain track and field
events such as throwing, hurdling, or jumping events may
require similar patterns of core-muscle activation,11 the
majority of the research sample did not include subjects
who specifically performed these types of events, let alone
on a consistent basis. The research sample was primarily
made up of middle-distance runners, distance runners,
and sprinters. During these running events the core is
relegated to a role as a stabilizer rather than producing
gross movements of the trunk and hip. The core muscles
act to stabilize the spine and pelvis to decrease excessive
movement and to help absorb ground-reaction forces.34
Tse et al13 conducted similar research on 34 subjects
with an average of 1 year of rowing experience from
university rowing clubs. The BET and AFT performed
at 60° were used to study the effects of an 8-week core-
endurance-training program using 20 subjects. Similar to
the findings of this study, subjects’ mean scores improved
between pretest and posttest for the AFT and BET. Tse
et al attributed the lack of change to dissimilarities
between the training program and the testing methods.
Their training program used little static training, whereas
the 4 trunk-endurance tests are static and isometric in
nature. However, the program used by Tse et al13 was not
dissimilar to the one used in the current study. Although
it did incorporate a good portion of activities that were
static in nature, the program used in the current study
became increasingly dynamic in nature by the end of the
6-week period. Stanton et al9 used the Sahrmann test of
core stability after a 6-week Swiss-ball training program.
Differences were noted with the experimental group that
were related to Swiss-ball training’s improving core sta-
bility by recruitment of the core musculature regardless
of the measurement technique.
It has been observed that 4-week core-training pro-
grams8 are not enough to produce significant changes in
core-stabilization measures, and 6-week programs like
the current study have produced some improvements.13,30
Whether using programs that are longer in duration will
be able to produce such results is unclear. Most of the
confusion is the result of the lack of standardization in
the literature. There are a multitude of different training
protocols or methods that may be used, but there is little
research stating which methods are ideal. There has
only been research that provides suggestions as to what
should be included in a training protocol.5,6,20 This may
be at least part of the reason why clinical trials struggle
to find significant differences between training groups.
In the current study, the SBT produced better results
with the right side than left. This may be related to the
fact that all subjects were right-side dominant. The find-
ings of Lust et al30 and McGill et al17 contrast those of
the current study in that their subjects performed better
on the SBT with their nondominant left side. Lust et al30
observed that mean times were higher for the left SBT
for the baseball training group, despite not performing
exercises to strengthen the quadratus lumborum.
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270  Sandrey and Mitzel
Clinical Implications and Limitations
The core-stabilization program was developed based on
commonly used exercises in the literature.5,6,15,20,30 We
took special care to use exercises that could be easily
described and would require minimal instruction, supervi-
sion, and feedback regarding technique. We attempted to
include exercises in the program that would directly be
of benefit to track and field athletes. However, this was
limited by the lack of literature explicitly describing core
training for track and field athletes. Exercises prescribed
by Fredericson and Moore20 that would particularly be
of benefit to middle-distance and distance runners were
specifically included. This would entail the maintenance
of abdominal bracing to promote stability of pelvis and
spine and to enhance coordination and timing of the deep
core musculature.20 Different types of bridging and other
techniques that reported varying levels of success were
included from previous studies15,30 Many of the exercises
selected involved static isometric holds that mirrored the
core-endurance tests. Modeling the core-training program
in this way resulted in greater improvements in core
endurance and dynamic balance as observed in this study.
Furthermore, clinical relevance was noted as all variables
exceeded MDC values after the intervention. These results
show that the improvements were beyond the instrument
error and represent meaningful improvement to the subject
for dynamic-postural control and core endurance.
The core-stabilization-training used in this study
would be a good training program to use in high school
track and field athletes. Based loosely on the 5-level
mastery program for core training as described by Jef-
ferys,3 this core-stabilization-training program relied on
level of exercise difficulty to improve core endurance and
dynamic-postural control. Three levels of exercise dif-
ficulty were progressed every 2 weeks. Level 1 consisted
of static contractions progressing to slow movements in
an unstable environment. Level 2 consisted of an unstable
environment and progressed to dynamic movements in a
more stable environment. The third level encompassed
exercises that used dynamic movements in an unstable
environment followed by added resistance to an unstable
environment. Progression based on exercise difficulty
is certainly one possible way for any type of track and
field athlete to use supplemental strength training and
dynamic movements in unstable environments with
added resistance to optimize dynamic-postural stability
and core endurance Although this study used a relatively
short training period (6 weeks), a full year of continuous
core-stabilization training could add additional improve-
ments. This aspect should be further evaluated.
Limitations do exist and are based on the number of
subjects completing the study, the lack of a control group,
and the selection of sets, repetitions, and holding times.
As this is the first study to use a core-stabilization-training
program for track and field athletes, only an estimation
of the number of subjects needed to find significant dif-
ferences can be made The sample size was indeed small,
but increasing the sample size to 300 for the SEBT using
80% power may not contribute to clinical importance. A
control group of track and field athletes was not included
to evaluate the core-stabilization training. However, it
was noted with moderate to large effect sizes and MDC
exceeding the error of the measurements for all depen-
dent variables that postural control and core endurance
were enhanced. Further investigation is warranted with
a control group to verify that the changes were indeed
related to the core-stabilization-training program. Sets,
repetitions, and holding times of each exercise for each
week were fixed at 3 sets of 20 seconds for isometric
holding activities and 20 repetitions for activities with
isotonic contractions. The reasoning for the number
of sets and repetitions was not based on evidence but
merely on our previous knowledge of sport training and
best clinical practice. Future studies should address this
aspect, as limited standardization is evident for sets, reps,
and progression in core-stabilization-training programs.
As the core-stabilization-training program was per-
formed in-season, the improvements that were observed
between pretesting and posttesting could be due or partly
due to the athletes’ regular training rather than the direct
result of the core program. However, subjects did progress
without much difficulty. On the other hand, all training
bouts and testing were performed after the subjects had
participated in their regularly scheduled practices. This
may have fatigued them and prevented them from putting
forth a true maximal effort during training and testing.
Furthermore, not requiring subjects to master each level
of the core-stabilization-training program may have
resulted in suboptimal training and negatively affected
performance on the posttest. Further studies using this
training program should be conducted during the off-
season using track and field athletes.
Conclusion
The 6-week core-stabilization-training program designed
to benefit track and field athletes resulted in significant
improvements in medial and anteromedial reach direc-
tions and core endurance. With significant differences
and moderate to large effect sizes, with only 2 effect
sizes that crossed zero, meaningful clinical improvement
pretraining to posttraining was evident. Furthermore,
progression based on exercise difficulty is certainly one
possible way for any type of track and field athlete to
use supplemental strength training and dynamic move-
ments in unstable environments with added resistance to
optimize dynamic-postural stability and core endurance.
However, with the small sample size used and no control
group, well-designed randomized controlled trials are
warranted for further investigation.
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