International Journal of Research and Review

Vol.7; Issue: 2; February 2020

Website: www.ijrrjournal.com
Original Research Article E-ISSN: 2349-9788; P-ISSN: 2454-2237

Effect of Graded Plank Protocol on Core Stability in

Sedentary Dentists
Shraddha Patil1, Aashirwad Mahajan2
1
Physiotherapy Intern, 2Asst. Professor,
Dr A.P.J Abdul Kalam College of Physiotherapy, Pravara Institute of Medical Sciences, Loni,
Ahemadnagar-413736, Maharashtra, India.
Corresponding Author: Shraddha Patil

ABSTRACT requires energy. Physical fitness refers to a

physiological state of well being that allows
Background: Plank training can be an effective one to meet the demand of daily living or
exercise to improve the core stability. The aim that provides the basis for sport performance
of the current study was to study the effect of or both.1
graded plank protocol on core stability in
Those who do not exercise have
sedentary dentists.
Methodology: This was an experimental study been termed as sedentary. No exercise
done on 50 participants; they were given the behaviors can be differentiated into
intervention for 6 weeks, 3 days/week. Simple sedentary behavior and light intensity
random sampling was done on sedentary activity in that sedentary behavior is sitting,
dentists of, Rural Dental Collage PIMS. 50 lying down, and expending very little
sedentary dentists as measured from IPAQ with energy. And light-intensity activity can be
mean age (in years) 22.7 ±0.8, who scored <3 standing, self-care exercises, and slow
on dynamic abdominal endurance test, walking, which require low energy use2.
participated were given graded plank exercise Increasing rate of sedentary lifestyle, results
protocol for the period of 6 week 4 days per in the once strong muscle system which is
week on non consecutive days and the
conscientious for maintain the posture and
participants were assessed at the start of 1st week
and reassessed at the end of 6th week using the movement increasingly become more in
outcome measure active, which negatively impinges
Result: The mean values pre unilateral hip weakened lumbar core stability in many
bridging endurance test in sec was 20.6±11.50. individuals.3
The mean values of post unilateral hip bridging Core stability is the ability of the
endurance test in sec were 30.44±13.53. There person to stabilize their core muscles. The
was significant difference between pre and post term core has been used to refer to the trunk
values of unilateral hip bridging endurance test. especially the lumbopelvic region of the
Conclusion: this study concluded that 6 week body. The stability of the lumbopelvic
graded plank protocol was effective for region is critical to provide a basis for
improving the core stability in sedentary
movement of the upper and lower
dentists.
extremities, to support loads and to protect
Keywords: Plank, Sedentary Dentists, Physical the spinal cord and nerve root. Transverses
Activity, Unilateral Hip Bridging, Dynamic Hip abdominis, multifidus, internal and external
Endurance Test. oblique, rectus abdominis, erector spinae,
diaphragm these are the major muscles that
INTRODUCTION are involved in core stability. Latissimus
Physical activity is any body dorsi, gluteus maximus and trapezius are the
movement produced by skeletal muscle that minor muscles that are involved.4

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 Shraddha Patil et.al. Effect of graded plank protocol on core stability in sedentary dentists

The plank is an isometric core Procedure and Outcome Measure:

strength exercise that involves the person to An approved by the IEC at Dr. A.P.J. Abdul
maintain a position similar to push up for Kalam College of Physiotherapy at Pravara
the maximum possible time. The plank Institution of Medical Sciences. The dentists
exercise estimate and strengthens the from Rural dental college were screened for
stability of the core muscles. Core muscle sedentary lifestyle on the bases of
stability is crucial for preventing injuries to International Physical Activity
the knee joints, hip joints, and the lumbar Questionnaire (IPAQ). 50 dentists from
spine. Moreover, core muscle stability Rural Dental College, both males and
relieves back pain by maintaining proper females with low score in International
position for posture and gait.5 Physical Activity Questionnaire (IPAQ) and
Low back pain and extremity willing where included in the study.
injuries are known to be risk factors for poor Dentists with recent abdominal surgery,
core stability. Lower back pain complain is trauma, choric orthopedic condition where
very commonly seen in dentists. A study excluded from the study. The 50 dentists
conducted on prevalence and risk factor for were then assessed for two outcome
low back pain among dentist was shown to measures Dynamic Abdominal Endurance
be 70% prevalence.6 Test and Unilateral Hip Bridging Endurance
There have been studies done on Test. Dynamic abdominal endurance test is
plank exercises in atheletes.7 However, very a test that checks the endurance of the
less literature is available regarding effect of abdominal. It consists of 5 grades. Normal
plank exercise in sedentary dentists. (5): hands behind neck, until scapula clear.
Moreover this study will test the effect of a Good(4): arms crossed over chest, until
simple and time saving graded protocol scapula clear table. Fair (3): Arms straight,
which will be individually tailored and may until scapula clear table. Poor (2): arms
provide benefit to improve core stability and extended, towards knee , until scapula is
might lead to prevention of back pain. lifted from table. Trace(1): unable to raise
Therefore the purpose of this study is to see more than head off table.10
the effect of graded plank on sedentary In Unilateral hip bridging endurance
dentist. test subjects are told to perform a double-leg
As low back pain prevalence is more hip bridge, and once a neutral spine and
in dentists it can be the reason of weak core pelvis position are achieved the subject are
8
so plank can be a useful method to instructed to extend one knee (randomly
improve core stability and reduce back pain. determined) so their leg will be straight and
The prevalence of posture related problems their thighs will be parallel to one another.
in dentists is very high. As numbers of The test is terminated once the patient is not
dental patients are increasing so the time able to maintain neural pelvic position.
sitting in chair of the dentists is increasing. UHBE test was developed to clinically
Dentists require lot of precision so take long assess core stability.11
time for treatment. Bad posture during the All subjects were tested before the
dental procedure is totally a risk factor in beginning of the core-stabilization- training
increasing prevalence of musculoskeletal program (pretest) and immediately after the
problems9. As dentists are sedentary in conclusion of the 6-week program
nature as they sit on chair for a longer time (posttest). After this each participant has
so after working for a longer time they received the intervention as follows:
adopt bad posture which leads to week core
muscles in them. As plank exercise INTERVENTION
improves core stability so plank is given as The exercise was given to the participants 4
an intervention in this. times a week for 6 weeks.

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 Shraddha Patil et.al. Effect of graded plank protocol on core stability in sedentary dentists

1. The plank is started in the plank exercise

position. This is parallel to the ground with
your trunk straight and rigid, resting your
weight on your toes and forearms. You
should not be sagging or bending.
2. Lie face down with legs extended and
elbow bent and directly under shoulder. Feet
should be hip width apart. The participants
are asked to contract their abdominal
muscles, and then tuck their toes to lift the
body keeping the forearm
on the ground.
3. Start with 15-20 sec hold. Till the
participant feels comfortable the plank C. COMPARSION OF PRE and POST
should be held initially. UNILATERAL HIP BRIDGING
4. The second week of plank hold will be ENDURANCE TEST.
multiplied by 1.5 times of the first week and Unilateral hip bridging endurance
then it will be continued to be multiplied it test was outcome measure in this study. The
in subsequent weeks. mean of pre intervention of unilateral hip
bridging endurance test is 20.6±
11.50687461. The mean of post intervention
of unilateral hip bridging endurance test is
30.44±13.53930032. The variance of pre
unilateral hip bridging endurance test is
132.4. The variance of post unilateral hip
bridging endurance test is 183.3. The value
of z test is -3.916001141. The p value is
<0.001. The comparison of pre and post
intervention scores suggests that the study is
extremely significant
RESULT PRE POST
DATA ANALYSIS MEAN 20.6 30.44
VARIANCE 132.4 183.3
STANDARD DEVIATION 11.506874 13.539300
A. DEMOGRAPHIC Z TEST -3.916001141
P VALUE <0.001
AGE: 50 Participants were taken who
fulfilled the criteria. The mean age of
participant’s ±22.7±0.8

B. PRE AND POST DYNAMIC

ABDOMINAL ENDURANCE TEST
The median of pre intervention dynamic
endurance test in study population is 1. The
median for post intervention dynamic
endurance test in study population is 2.

Pre Post
Median 1 2

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Vol.7; Issue: 2; February 2020
 Shraddha Patil et.al. Effect of graded plank protocol on core stability in sedentary dentists

DISCUSSION that plank helps in reducing low back with

The present study was aimed to improving core stability13.
observe the effectiveness of graded plank A study was done by Min Yong
protocol in sedentary dentists to check the Eom et al effect of exercise on transverse
improvement in core stability. abdominis on bridging exercise. In that they
Musculoskeletal pain in dentist may be due stated that bridging is generally done in
to static faulty posture and lack of core patients with lower back pain and it
strength and stability. According to the stabilizes transverse abdominis internal
study conducted by Vishwas Madaan et. al oblique, external oblique and erector spinae
students musculoskeletal pain in dentists is muscle14. Unilateral hip bridging is one of
mainly due to repetitive work movements, the variations of bridging which stabilizes
working in static posture and have less core same muscles as that of bridging. So
strength. 78 % dental interns in the study unilateral hip bridging was taken as an
reported pain in lower back and hands as outcome measure in your study. As plank
they have more strained position and also strengthens transverse abdominis,
prolonged static posture. Musculoskeletal rector abdominis, and erector spine.15 it
disorder are often are the direct result of might be the reason that the hold time of
failure by dentists to maintain neural posture unilateral hip bridging endurance test was
in their daily work. In that study about 80% increased in our study after 6 weeks graded
of dental professionals had a complain of plank protocol.
upper body and back may be due to Usually in sedentary individuals
prolonged strained posture.12 As dentist abdominal muscles are undertrained.
have awkward posture which leads to bad According to an article by Sarah L. Strand
posture as they adapt shorting position et al on norms for an isometric muscle
which leads to pain and damage so the endurance test. If the abdominals are under
prevalence of low back pain is high in trained they would be the weak-link in the
dentists it might may be because of weak abdominal plank and therefore can produce
core and bad posture. discomfort due to fatigue earlier than if they
The present study was conducted on were adequately trained.16 Dynamic
interns of Rural Dental College which abdominal endurance test is a test that
included 50 participants that fit in inclusion checks the endurance of the abdominals.10
criteria. The results of the study came out be Abdominal consists of external oblique,
positive as the time of the unilateral hip internal oblique , rectus abdominis and
bridging in dentists increased. This showed transverse abdominis. Dynamic abdominal
that the study was extremely significant. . A endurance consists of 5 grades10. The
previous study was done by P.W. Hodges present study reported in the improvement
et.al on core stability exercise which were in the grade of dynamic abdominal
performed in participants with chronic low endurance test. Dynamic abdominal
back pain in that they stated that there are endurance test utilizes following muscles
many exercises which have been developed external oblique, internal oblique, rectus
as components of core stability some of abdominis and transverse abdominis.
them include Pilates exercise, exercise with Graded plank also involves the activation of
lumbar spine and pelvis in neutral position, transverse abdominis, rector abdominis, and
Swiss ball exercise and many more. But the erector spine15. This result might be
key feature varies between lumbopelvic attributed due to involvement of similar
position in neural and on closed chain task muscles in graded plank and dynamic
and resisted movements. And in plank abdominal endurance test. As the
lumbopelvic position is in neutral it is a participants were sedentary this may have
closed chain task which might be a reason lead to dramatic improvement in dynamic

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Vol.7; Issue: 2; February 2020
 Shraddha Patil et.al. Effect of graded plank protocol on core stability in sedentary dentists

abdominal endurance test in the present pain among dentists. Journal of physical
study. therapy science. 2015; 27(9):2803-6.
In conclusion it can be stated that 7. Imai A, Kaneoka K. The relationship
graded plank protocol can be an effective between trunk endurance plank tests and
and time saving strategy to improve core athletic performance tests in adolescent
soccer players. International journal of
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pain in sedentary dentists. 8. Rodriguez R. (2019 January 3 Publised)
exercises dentist should regularly retrieved
CONCLUSION from http://www.oralhealthgroup.com
Results of the present study revealed that 9. Akhil Gupta, Sudha Gupta. Prevention of
graded plank exercise has shown significant implication of poor posture and physical
improvement in core stability in sedentary inactivity among dentists. 2018;2 (6)
dentist for 6 weeks, 4 days per week on non 10. Magee DJ. Orthopedic physical assessment.
consecutive days. Elsevier Health Sciences; 2013 Dec 4.
11. Butowicz CM, Ebaugh DD, Noehren B,
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Prevalence of and risk factors for low back Effect of graded plank protocol on core stability
in sedentary dentists. International Journal of
Research and Review. 2020; 7(2): 407-411.

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