Spinal-Exercise Prescription in Sport: Classifying Physical Training and Rehabilitation by Intention and Outcome.
BACKGROUND
Identification of strategies to prevent spinal injury, optimize rehabilitation, and enhance performance is a priority for practitioners. Different exercises produce different effects on neuromuscular performance. Clarity of the purpose of a prescribed exercise is central to a successful outcome. Spinal exercises need to be classified according to the objective of the exercise and planned physical outcome.


OBJECTIVE
To define the modifiable spinal abilities that underpin optimal function during skilled athletic performance, clarify the effect of spinal pain and pathologic conditions, and classify spinal exercises according to the objective of the exercise and intended physical outcomes to inform training and rehabilitation.


METHODS
Qualitative study.


METHODS
We conducted a qualitative consensus method of 4 iterative phases. An exploratory panel carried out an extended review of the English-language literature using CINAHL, EMBASE, MEDLINE, and PubMed to identify key themes and subthemes to inform the definitions of exercise categories, physical abilities, and physical outcomes. An expert project group reviewed panel findings. A draft classification was discussed with physiotherapists (n = 49) and international experts. Lead physiotherapy and strength and conditioning teams (n = 17) reviewed a revised classification. Consensus was defined as unanimous agreement.


RESULTS
After the literature review and subsequent analysis, we defined spinal abilities in 4 categories: mobility, motor control, work capacity, and strength. Exercises were subclassified by functionality as nonfunctional or functional and by spinal displacement as either static (neutral spinal posture with no segmental displacement) or dynamic (dynamic segmental movement). The proposed terminology and classification support commonality of language for practitioners.


CONCLUSIONS
The spinal-exercise classification will support clinical reasoning through a framework of spinal-exercise objectives that clearly define the nature of the exercise prescription required to deliver intended physical outcomes.
The English Institute of Sport, The Manchester Institute of Health and Performance, Manchester, United Kingdom.
Simon
S
Spencer
The English Institute of Sport, The Manchester Institute of Health and Performance, Manchester, United Kingdom.|Department of Surgery and Cancer, Imperial College, London, Charing Cross Hospital, United Kingdom.
Alex
A
Wolf
University of Birmingham, United Kingdom.
Alison
A
Rushton
D005081:Exercise Therapy / Q000145:classification* / Q000379:methods; D006040:Goals; D006801:Humans; D033182:Intention; D010806:Physical Education and Training / Q000145:classification* / Q000379:methods; D011187:Posture; D013124:Spinal Injuries / Q000517:prevention & control* / Q000534:rehabilitation*; D009626:Terminology as Topic
back; classification; spine
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