"CORE Training for Musculoskeletal Health: A Study on Adaptive Exercise Protocols" (RCT-EMG-US-QoL)

Ioannis Tsartsapakis

Status: Not yet enrolling

Conditions: Functional Performance Limitation; Core Muscle Weakness; Trunk Stability Impairment; Postural Control Deficit

Treatments: Behavioral: - Core Training Protocol; Behavioral: Control Group Core Routine

Study type: Interventional

Funder types: Other

Identifiers

NCT07025395

AUTH-CORE-STUDY

Details and patient eligibility

About

This study aims to evaluate the effects of an adaptive core training protocol that integrates core stability, core strength, and high-intensity core power exercises on muscle activation, hypertrophy, balance, and quality of life. Forty recreationally active adults with a minimum of two years of consistent training experience will participate. The structured intervention will span multiple weeks and utilize electromyography (EMG), ultrasound imaging, and validated questionnaires to assess neuromuscular and functional adaptations.

Full description

Extended Detailed Description - Study Rationale and Objectives Core stability is a foundational component of human movement, contributing to postural control, balance, and force transmission. The deep and superficial muscle systems of the trunk function synergistically to enhance spinal alignment, movement efficiency, and musculoskeletal integrity.

In modern health science, core training has evolved into a key preventative strategy that supports spinal resilience and reduces functional limitations associated with sedentary lifestyles. Contemporary protocols often integrate trunk bracing, diaphragmatic engagement, and multi-planar control for comprehensive development.

This randomized, controlled trial evaluates the effects of an eight-week progressive core training program in recreationally active adults. The protocol combines components of neuromuscular control, strength development, and high-intensity power work, and aims to assess outcomes related to muscle activation, balance, segmental coordination, and perceived well-being.

Study Design & Participants Participants will be randomly assigned to an experimental group (receiving the full protocol) or a control group (minimal activity). All procedures will take place at the Neuromechanics Laboratory of the Aristotle University of Thessaloniki (Serres Campus). Forty adults between 25-35 years old who meet physical activity and health-related eligibility criteria will complete baseline and post-intervention assessments. Written informed consent will be obtained prior to randomization.

Core Training Structure The program consists of a warm-up (~6 min), a main core-focused session (~30-32 min), and a cool-down (~5 min). Training follows a triad structure in which each set includes one stability, one strength, and one power-based core exercise. Work intervals are set to 45 seconds, with progressive recovery. All sessions are designed to follow a logical kinetic chain progression: from motor control to peak force expression.

Measurements & Instrumentation Pre- and post-testing includes validated assessments of ground reaction force, muscle activation, ultrasound-measured hypertrophy, video-based kinematic analysis, body measurements, and psychometric indices of well-being. Instrumentation includes force platforms, surface EMG, ultrasound imaging systems, motion capture tools, and standardized questionnaires.

Anticipated Outcomes The intervention is expected to improve neuromuscular efficiency, postural control, force production, core muscle thickness, and overall movement confidence. Enhanced trunk function may contribute to greater kinetic chain integration and better quality of life.

Broader Impact and Applicability Due to its equipment-light structure and progressive difficulty, this training protocol is well-suited for application in clinical rehabilitation, fitness centers, or at-home settings under professional supervision. The triad design offers educational value for exercise professionals seeking to integrate functional core sequencing into their practice.

This trial contributes to ongoing research on motor control strategies, force adaptation, sensorimotor integration, and holistic well-being. Insights gained may inform interventions in athletic populations, workplace health promotion, and functional aging.

Enrollment: 40 estimated patients

Sex: All

Ages: 25 to 35 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Aged 25-35 years
• Physically active (≥3 sessions/week, ≥1 hour per session) for ≥2 years
• No known musculoskeletal, cardiovascular, or neurological disorders
• No engagement in structured core training programs
• Available to attend all evaluation appointments
• Able and willing to commit to the 8-week intervention program

Exclusion criteria

• Medical conditions that limit full-body or trunk movement
• Cardiovascular/metabolic conditions contraindicating high-intensity exercise
• Current participation in Pilates, CrossFit, or other core-specific protocols
• Recent musculoskeletal injury affecting training eligibility

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

40 participants in 2 patient groups

Experimental Group - Progressive Core Training Protocol

Experimental group

Description:

Participants in this arm will follow an eight-week structured core training protocol designed to enhance neuromuscular adaptations, core muscle hypertrophy, and biomechanical performance. The program incorporates progressive core stability, core strength, and high-intensity core power exercises, ensuring gradual intensity scaling and optimized movement efficiency. Training sessions include warm-up, eight structured triads of core exercises, and a cool-down phase. Assessments will track electromyographic activity, ultrasound muscle imaging, balance performance, and kinetic chain optimization.

Treatment:

Behavioral: - Core Training Protocol

Control Group - Standardized Core Routine

Active Comparator group

Description:

Participants in this arm will engage in a standardized core exercise routine performed twice per week. The intervention will not include progressive intensity or specialized neuromuscular activation techniques. Control group participants will perform basic abs and back exercises to maintain general core function without targeted adaptations. The purpose of this arm is to serve as a baseline comparison for neuromuscular, biomechanical, and psychological assessments between groups.

Treatment:

Behavioral: Control Group Core Routine