A Critical Review of Trunk and Hip Exercise Prescription: Applying Evidence for a Modern Approach.
Steven Short, Gretchen Short, Greg Lehman and 2 others
PMID 40041532WHAT IT FOUND
The idea that 'core' exercises fix spinal instability is not supported by evidence.
Tests for instability are unreliable, and local muscle changes often result from pain rather than causing it. However, trunk and hip exercises remain valuable for pain relief, strength, and performance when included in broader, progressive programs.
Key findings
01Clinical tests for spinal instability lack validity and are better understood as pain provocation tests rather than accurate measures of mechanical instability.
02Muscle morphology and motor control deficits in the trunk are often consequences of pain and disability, not proven causes of injury or pain.
03Combined programs using both isolated and compound movements are superior to isolated exercises alone for improving pain, function, and performance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a narrative review, not a systematic review, so it may be subject to selection bias in the studies chosen. The authors advocate for a specific theoretical shift (away from instability) which may be interpreted as opinion rather than definitive proof. The review covers a wide range of populations (athletes, patients with LBP, general population), which may dilute specific findings for any single group.
Declared interests
No specific conflicts of interest or funding sources are declared in the provided text.
The easy way to misread this
Do not conclude that trunk and hip exercises are useless. The review states they are valuable for pain, strength, and performance, but it rejects the idea that they work by fixing 'spinal instability.' Avoid dismissing core work entirely; instead, shift the rationale from 'stabilization' to 'capacity building' and 'pain management.'