Clinical reasoning framework for thoracic spine exercise prescription in sport: a systematic review and narrative synthesis

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Clinical reasoning framework for thoracic spine exercise prescription in sport : a systematic review and narrative synthesis. / Heneghan, Nicola; Lokhaug , Svein ; Tyros, Isaak; Longvastøl , Sigurd ; Rushton, Alison.

In: BMJ Open Sport & Exercise Medicine, Vol. 6, No. 1, e000713, 29.03.2020, p. 1-13.

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@article{7e6577feb94a48ef83bc554180ab8e0c,
title = "Clinical reasoning framework for thoracic spine exercise prescription in sport: a systematic review and narrative synthesis",
abstract = "Background The thoracic spine is critical for athletic kinetic chain functioning yet widely overlooked in terms of specific evidenced-based exercise prescription. Thoracic mobility, motor control and strength are required to optimise performance in sport and minimise excessive load/stress on other components of the kinetic chain.Objective To identify and evaluate mobility, motor control, work capacity and strength thoracic exercises for use in athletes.Design Systematic review involving expert reviewers at key stages: searches and screening (n=1), eligibility, evaluation, data extraction and evaluation (n=3). Key databases and social media sources were searched to 16 August 2019. Eligible exercises were thoracic exercises to promote mobility, motor control, work capacity and strength. A narrative synthesis enabled an outcome-based classification of exercises, with level of evidence of individual sources informing overall level of evidence for each outcome (Oxford Centre for Evidence-based Medicine).Results From 2348 sources (social media, database searches and other sources), 38 exercises were included. Sources included images, video clips and written descriptions of exercises. Exercises targeting all planes of motion were evaluated and classified according to outcome. Exercises comprised functional and non-functional exercises for mobility (n=9), work capacity (n=15), motor control (n=7) and strength (n=7). Overall level of evidence for each outcome was level 5.Conclusion This synthesis and evaluation of exercises has captured the scope of thoracic exercises used in {\textquoteleft}practice{\textquoteright}. Evaluation against an expert-derived outcome-based classification provides practitioners with a framework to facilitate exercise prescription. Evaluation of validity and effectiveness of exercises on outcomes is now required.",
keywords = "exercise rehabilitation, sports & exercise medicine, thoracic spine",
author = "Nicola Heneghan and Svein Lokhaug and Isaak Tyros and Sigurd Longvast{\o}l and Alison Rushton",
note = "{\textcopyright} Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2020",
month = mar,
day = "29",
doi = "10.1136/bmjsem-2019-000713",
language = "English",
volume = "6",
pages = "1--13",
journal = "BMJ Open Sport & Exercise Medicine",
issn = "2055-7647",
publisher = "BMJ Publishing Group",
number = "1",

}

RIS

TY - JOUR

T1 - Clinical reasoning framework for thoracic spine exercise prescription in sport

T2 - a systematic review and narrative synthesis

AU - Heneghan, Nicola

AU - Lokhaug , Svein

AU - Tyros, Isaak

AU - Longvastøl , Sigurd

AU - Rushton, Alison

N1 - © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2020/3/29

Y1 - 2020/3/29

N2 - Background The thoracic spine is critical for athletic kinetic chain functioning yet widely overlooked in terms of specific evidenced-based exercise prescription. Thoracic mobility, motor control and strength are required to optimise performance in sport and minimise excessive load/stress on other components of the kinetic chain.Objective To identify and evaluate mobility, motor control, work capacity and strength thoracic exercises for use in athletes.Design Systematic review involving expert reviewers at key stages: searches and screening (n=1), eligibility, evaluation, data extraction and evaluation (n=3). Key databases and social media sources were searched to 16 August 2019. Eligible exercises were thoracic exercises to promote mobility, motor control, work capacity and strength. A narrative synthesis enabled an outcome-based classification of exercises, with level of evidence of individual sources informing overall level of evidence for each outcome (Oxford Centre for Evidence-based Medicine).Results From 2348 sources (social media, database searches and other sources), 38 exercises were included. Sources included images, video clips and written descriptions of exercises. Exercises targeting all planes of motion were evaluated and classified according to outcome. Exercises comprised functional and non-functional exercises for mobility (n=9), work capacity (n=15), motor control (n=7) and strength (n=7). Overall level of evidence for each outcome was level 5.Conclusion This synthesis and evaluation of exercises has captured the scope of thoracic exercises used in ‘practice’. Evaluation against an expert-derived outcome-based classification provides practitioners with a framework to facilitate exercise prescription. Evaluation of validity and effectiveness of exercises on outcomes is now required.

AB - Background The thoracic spine is critical for athletic kinetic chain functioning yet widely overlooked in terms of specific evidenced-based exercise prescription. Thoracic mobility, motor control and strength are required to optimise performance in sport and minimise excessive load/stress on other components of the kinetic chain.Objective To identify and evaluate mobility, motor control, work capacity and strength thoracic exercises for use in athletes.Design Systematic review involving expert reviewers at key stages: searches and screening (n=1), eligibility, evaluation, data extraction and evaluation (n=3). Key databases and social media sources were searched to 16 August 2019. Eligible exercises were thoracic exercises to promote mobility, motor control, work capacity and strength. A narrative synthesis enabled an outcome-based classification of exercises, with level of evidence of individual sources informing overall level of evidence for each outcome (Oxford Centre for Evidence-based Medicine).Results From 2348 sources (social media, database searches and other sources), 38 exercises were included. Sources included images, video clips and written descriptions of exercises. Exercises targeting all planes of motion were evaluated and classified according to outcome. Exercises comprised functional and non-functional exercises for mobility (n=9), work capacity (n=15), motor control (n=7) and strength (n=7). Overall level of evidence for each outcome was level 5.Conclusion This synthesis and evaluation of exercises has captured the scope of thoracic exercises used in ‘practice’. Evaluation against an expert-derived outcome-based classification provides practitioners with a framework to facilitate exercise prescription. Evaluation of validity and effectiveness of exercises on outcomes is now required.

KW - exercise rehabilitation

KW - sports & exercise medicine

KW - thoracic spine

UR - http://www.scopus.com/inward/record.url?scp=85082852005&partnerID=8YFLogxK

U2 - 10.1136/bmjsem-2019-000713

DO - 10.1136/bmjsem-2019-000713

M3 - Article

C2 - 32341799

VL - 6

SP - 1

EP - 13

JO - BMJ Open Sport & Exercise Medicine

JF - BMJ Open Sport & Exercise Medicine

SN - 2055-7647

IS - 1

M1 - e000713

ER -