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      Improving performance in golf: current research and implications from a clinical perspective

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          Abstract

          Golf, a global sport enjoyed by people of all ages and abilities, involves relatively long periods of low intensity exercise interspersed with short bursts of high intensity activity. To meet the physical demands of full swing shots and the mental and physical demands of putting and walking the course, it is frequently recommended that golfers undertake golf-specific exercise programs. Biomechanics, motor learning, and motor control research has increased the understanding of the physical requirements of the game, and using this knowledge, exercise programs aimed at improving golf performance have been developed. However, while it is generally accepted that an exercise program can improve a golfer's physical measurements and some golf performance variables, translating the findings from research into clinical practice to optimise an individual golfer's performance remains challenging. This paper discusses how biomechanical and motor control research has informed current practice and discusses how emerging sophisticated tools and research designs may better assist golfers improve their performance.

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          Exercise therapy for treatment of non-specific low back pain.

          Jill Alison Hayden, Maurits W van Tulder, Antti Malmivaara … (2005)
          Exercise therapy is widely used as an intervention in low-back pain. To evaluate the effectiveness of exercise therapy in adult non-specific acute, subacute and chronic low-back pain versus no treatment and other conservative treatments. The Cochrane Central Register of Controlled Trials (Issue 3, 2004), MEDLINE, EMBASE, PsychInfo, CINAHL databases to October 2004; citation searches and bibliographic reviews of previous systematic reviews. Randomized controlled trials evaluating exercise therapy for adult non-specific low-back pain and measuring pain, function, return-to-work/absenteeism, and/or global improvement outcomes. Two reviewers independently selected studies and extracted data on study characteristics, quality, and outcomes at short, intermediate, and long-term follow-up. Sixty-one randomized controlled trials (6390 participants) met inclusion criteria: acute (11), subacute (6) and chronic (43) low-back pain (1 unclear). Evidence was found of effectiveness in chronic populations relative to comparisons at all follow-up periods; pooled mean improvement was 7.3 points (95% CI, 3.7 to 10.9) for pain (out of 100), 2.5 points (1.0 to 3.9) for function (out of 100) at earliest follow-up. In studies investigating patients (i.e. presenting to healthcare providers) mean improvement was 13.3 points (5.5 to 21.1) for pain, 6.9 (2.2 to 11.7) for function, representing significantly greater improvement over studies where participants included those recruited from a general population (e.g. with advertisements). There is some evidence of effectiveness of graded-activity exercise program in subacute low-back pain in occupational settings, though the evidence for other types of exercise therapy in other populations is inconsistent. There was evidence of equal effectiveness relative to comparisons in acute populations [pain: 0.03 points (95% CI, -1.3 to 1.4)]. This review largely reflects limitations of the literature, including low quality studies with heterogeneous outcome measures, inconsistent and poor reporting, and possibility of publication bias. Exercise therapy appears to be slightly effective at decreasing pain and improving function in adults with chronic low-back pain, particularly in healthcare populations. In subacute low-back pain there is some evidence that a graded activity program improves absenteeism outcomes, though evidence for other types of exercise is unclear. In acute low-back pain, exercise therapy is as effective as either no treatment or other conservative treatments.
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            Is movement variability important for sports biomechanists?

            Jon Oskar Wheat, Charles Bartlett, Paul M Robins (2007)
            This paper overviews the importance for sports biomechanics of movement variability, which has been studied for some time by cognitive and ecological motor skills specialists but, until quite recently, had somewhat been overlooked by sports biomechanists. The paper considers biomechanics research reporting inter- and intra-individual movement variability in javelin and discus throwing, basketball shooting, and locomotion. The overview does not claim to be comprehensive and we exclude such issues as the theoretical background to movement and coordination variability and their measurement. We overview evidence, both theoretical and empirical, of inter-individual movement variability in seeking to achieve the same task goal, in contrast to the concept of "optimal" movement patterns. Furthermore, even elite athletes cannot reproduce identical movement patterns after many years of training, contradicting the ideas of motor invariance and "representative" trials. We contend that movement variability, far from being solely due to neuromuscular system or measurement "noise"--as sports biomechanists may have previously supposed--is, or could be, functional. Such functionality could allow environmental adaptations, reduce injury risk, and facilitate changes in coordination patterns. We conclude by recommending that sports biomechanists should focus more of their research on movement variability and on important related topics, such as control and coordination of movement, and implications for practice and skill learning.
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              Motor control exercise for persistent, nonspecific low back pain: a systematic review.

              Luciana G Macedo, Christopher G Maher, Jane Latimer … (2009)
              Previous systematic reviews have concluded that the effectiveness of motor control exercise for persistent low back pain has not been clearly established. The objective of this study was to systematically review randomized controlled trials evaluating the effectiveness of motor control exercises for persistent low back pain. Electronic databases were searched to June 2008. Pain, disability, and quality-of-life outcomes were extracted and converted to a common 0 to 100 scale. Where possible, trials were pooled using Revman 4.2. Fourteen trials were included. Seven trials compared motor control exercise with minimal intervention or evaluated it as a supplement to another treatment. Four trials compared motor control exercise with manual therapy. Five trials compared motor control exercise with another form of exercise. One trial compared motor control exercise with lumbar fusion surgery. The pooling revealed that motor control exercise was better than minimal intervention in reducing pain at short-term follow-up (weighted mean difference=-14.3 points, 95% confidence interval [CI]=-20.4 to -8.1), at intermediate follow-up (weighted mean difference=-13.6 points, 95% CI=-22.4 to -4.1), and at long-term follow-up (weighted mean difference=-14.4 points, 95% CI=-23.1 to -5.7) and in reducing disability at long-term follow-up (weighted mean difference=-10.8 points, 95% CI=-18.7 to -2.8). Motor control exercise was better than manual therapy for pain (weighted mean difference=-5.7 points, 95% CI=-10.7 to -0.8), disability (weighted mean difference=-4.0 points, 95% CI=-7.6 to -0.4), and quality-of-life outcomes (weighted mean difference=-6.0 points, 95% CI=-11.2 to -0.8) at intermediate follow-up and better than other forms of exercise in reducing disability at short-term follow-up (weighted mean difference=-5.1 points, 95% CI=-8.7 to -1.4). Motor control exercise is superior to minimal intervention and confers benefit when added to another therapy for pain at all time points and for disability at long-term follow-up. Motor control exercise is not more effective than manual therapy or other forms of exercise.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Braz J Phys Ther
                Journal ID (iso-abbrev): Braz J Phys Ther
                Title: Brazilian Journal of Physical Therapy
                Publisher: Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
                ISSN (Print): 1413-3555
                ISSN (Electronic): 1809-9246
                Publication date (Electronic): 06 October 2015
                Publication date (Print): Sep-Oct 2015
                Volume: 19
                Issue: 5
                Pages: 381-389
                Affiliations
                [1 ]School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Queensland, Australia
                Author notes
                Correspondence Kerrie Evans Griffith University School of Allied Health Sciences Gold Coast Campus PMB 50, Gold Coast Mail Centre QLD, 9726, Australia e-mail: kerrie.evans@ 123456griffith.edu.au
                Article
                DOI: 10.1590/bjpt-rbf.2014.0122
                PMC ID: 4647149
                PubMed ID: 26537808
                SO-VID: 440d8a8b-4b31-4e92-800a-18c068f14087
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 17 March 2015
                Date revision received : 12 June 2015
                Date accepted : 25 June 2015
                Page count
                Figures: 2, Tables: 0, Equations: 0, References: 89, Pages: 9
                Categories
                Subject: Review Article

                Keywords: golf swing,kinematics,exercise programs,movement variability,biomechanics
                Data availability:
                Keywords: golf swing, kinematics, exercise programs, movement variability, biomechanics

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