Combined Effects of Dead Bug Exercise and Double Straight Leg Raises Versus Conventional Physical Therapy Exercise on Core Stability and Waist Circumference in Healthy Young Individuals

Core muscles are significantly important in maintaining the stability of spine and lumbopelvic region thus affecting balance and activities of everyday living . Rapid advancement in technology has led to an increase in sedentary lifestyle thereby decrease in physical activity leading to muscular imbalances which in turn significantly decreases core stability and increases the risk of disorders related to musculoskeletal system. Moreover due to sedentary living behaviors and unhealthy eating habits, a significant reduction has been seen in lean body mass and an increase in body fat.Correlation between body fat and waist circumference has been found to be positive.

Core stability is related to the active participation of local / deep segmental muscles which may include transversus abdominis, lumber multifidus etc. and global / superficial muscles which may include rectus abdominis, erector spinae etc. during high demanding physical activities. Core stabilization exercises appear to show good efficacy in preventing the incidence of injuries. Included in the components of core stability are flexibility, endurance, strength, motor control and function. The exercise that is considered a gold standard abdominal exercise is abdominal crunches. But recently it has come under debate as a potentially dangerous movement capable of increasing lumber lordosis thereby elevating the risk of low bachache thus public should avoid performing this exercise. Other recommended alternatives include Dead bug exercise, Double straight leg raises etc. The efficacy of dead bug exercise and double straight leg raises has been observed both in isolation and in combination with abdominal crunches but not in combination with each other.

As recently questions on the safety of abdominal crunches have been popping up therefore alternatives are required. Such alternatives that have the capability to provide same, nearly similar or if possible even better beneficial effects than traditional abdominal exercises such as abdominal stretches along with a promising component of safety. This research is expected to serve the society by providing public an efficient and easy to perform combination of exercises that has the capacity to improve core stability by targeting the entire abdominal musculature and the capacity to decrease waist circumference by targeting the abdominal adiposity.

The objective that lies behind conducting this research is to determine the combined effects of Dead Bug Exercise and Double Straight Leg Raises versus Conventional Physical Therapy Exercise on Abdominal Muscles Strength, Endurance, Flexibility and Waist Circumference in Healthy Young Individuals.

The study design will be a Randomized Controlled Trial, conducted in Physiotherapy Department of University of Health Sciences, Jinnah Campus, Lahore with a calculated sample size of 50 participants (25 participants per group) alongwith a dropout rate of 20%.

The study will be conducted according to CONSORT guidelines. The study will be a 2 arm parallel group single blinded/assessor blinded RCT.

Purposive sampling technique will be used to recruite participants on the basis of inclusion and exclusion criteria in the study. Random allocation to control and intervention groups will be done using computer-generated random sequence in Microsoft Excel.

Subjects in the control group will perform abdominal stretches 3 times per week for a duration of 6 weeks. Stretching exercises will be preceded by a 3 minutes long warm up period and followed by a cool down period.

Subjects in the intervention group will perform a combination of dead bug exercise and double straight leg raises in addition to abdominal stretching exercises 3 times per week for a duration of 6 weeks. Each session will be preceded by a 3 minutes long warm-up period and followed by a cool-down period.

The frequency, sets and intensity of exercises will be increased progressively in each group.

Baseline assessment will be done at week 0 and post assessment will be done at the end of 6 weeks.

Partial curl-up test will be used to assess abdominal muscles strength, Trunk flexion endurance test to assess abdominal muscles endurance, Core flexibility test/Active trunk extension test to assess abdominal muscles flexibility and Tape measurement method to assess waist circumference.

On the basis of data distribution (normal or not normal) statistical tests will be applied. p-value ≤ 0.05 will be considered statistically significant. Data will be analyzed using IBM SPSS 27.0.1.

Inclusion criteria

• Subjects having no prior history of exercise training and physical activity (apparently healthy untrained individuals)
• 18 to 30 years old individuals
• Both males and females

Exclusion criteria

• Subjects currently taking part in any sort of training program or physical activity (trained individuals)
• Subjects having known neurological or cardiovascular conditions
• Subjects having known musculoskeletal system related disorders especially of lumber spine such as chronic or acute low backache