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Patient Profile:

  • 35 year old male
  • Presented to outpatient physical therapy 4 weeks ago with golf related LBP
  • Re-evaluation: 0/10 pain at rest, 2/10 pain with golf related activities, ODI: 12%
  • Completed goal of playing 18 holes of golf with a pain level no greater than 3/10

Patient Goals:

  • Improve golf performance (driving distance, iron distance, etc.)

PICO:

Is exercise effective in improving golf performance and sport specific strength in adult male golfing athletes?

  • search terms “Golf Performance” and “exercise” used in PubMed, Cinahl, and PEDro
  • 97 articles found
  • 3 duplicates removed
  • 94 abstracts screened
  • 80 irrelevant
  • 13 articles retrieved in full
  • 8 excluded after application of inclusion/exclusion criteria
  • 5 articles included

Inclusion Criteria:

  • male golfing athletes
  • adult population
  • preference given to RCT’s

Exclusion:

  • Case studies
  • Female
  • Pediatrics
  • Musculoskeletal injuries within last 6 months

Results:

Author Date and Country Patient Group Study Type and Level of Evidence Outcomes Key Results Study Weaknesses
Fletcher, 2004 United Kingdom 11 male golfers handicap 5.5 SD 3.7 (classified as very good) Randomized Control Trial

Level 2

PEDro: 6/10

Club head Speed (km/h)

Driving Distance (m)

Golfers showed a significant improvement in both club head speed and average drive distance following the completion of an 8 week sport specific training program when comparing pre and post treatment test outcome measures (1.5% and 4.3% increase respectively).

 

Golfers showed significant improvement in club head speed and driving distance following an 8 week training program when compared to the control, but club head speed improvements may not be considered clinically significant.

 

 

 

Extremely small sample size

No blinding of subjects or researchers

No long term follow up

Alvarez, 2012

Spain

10 right handed male golfers, age 24 SD 6.7 years, handicap below 5 Randomized Control Trial

Level 2

PEDro: 5/10

Ball Speed (km/h)

 

Club mean acceleration (m/s2)

Golfers who completed a supervised 18-week strength training program showed a statistically and clinically significant improvement in both ball speed and club mean acceleration upon program completion compared to pre-intervention test and compared to control group.

 

Golfers who completed 18-week strength training program showed significant decreases in improvements made to ball speed and club mean acceleration at 5-week post training follow up.

 

Ball speed improvements were still significant at 5 week follow up compared to pre-intervention, but club mean acceleration improvements were not significant at 5 week follow up when compared to pre-intervention outcome measures.

 

 

 

 

 

Very small sample size

Validity and reliability of outcome measures not reported

Many outcome measures considered for this experiment are not relevant to improved golf performance

Patient population extremely specific –male, right handed, elite level golfers, age = early-mid 20’s so results cannot be generalized to all golfing athletes

Weston, 2013

United Kingdom

36 male golfers Randomized Control Trial

Level 2

PEDro 6/10

Club-head speed (mph) Golfers who completed the 8 week isolated core training program showed a 3.6% mean increase in club head speed.

 

exercise program focused primarily on core isometric exercises with spine in neutral alignment.  This study produced results similar to those focusing on swing specific exercises and thus suggests these benefits can be achieved at a reduced cost to the spine.

Small sample size

Other outcomes considered not well correlated with improved performance

No long term follow up

Compliance of exercise program in experimental group not accounted for

 

 

Fradkin, 2004

Australia

20 male golfers of various age and ability levels (handicaps) Randomized Control Trial

Level 2

PEDro

Club-head speed (m/s) Mean club head speed in exercise group improved by 12.8% between weeks 1&2 and by 24% between weeks 1 and 7.

 

Mean club head speed improved in the exercise group both within each exercise session and between each exercise session in a linear fashion.  Suggests that a warm up routine may have immediate impact on club head speed and if continued may continue to improve club head speed over time.

Small sample size

Lack of long term follow up

Validity and reliability of outcome measures not reported

Only one outcome measure reported

Moran,

2009

Ireland

18 male, right handed golfers, handicap 6 or less, age 23 SD 3.2 Clinical Trial

Level 3

Pedro: 4/10

Club-head speed (m/s)

 

Ball speed (m/s)

Dynamic stretching offered the greatest improvements in club head speed and ball speed when compared to static stretching and no stretching at all.

Club head speed was approximately 5% faster following dynamic stretching compared to static and no stretching.  Ball speed was approximately 6% faster.

No control group for comparison

Small sample size

Validity and reliability of outcome measures not reported

No long term follow up

Results cannot be generalized to entire golfing population

Clinical Bottom Line:

  • Current literature suggests that there is limited, low quality evidence proposing that exercise is effective in improving golf performance in male golfers
  • All studies mentioned feature very small sample size, most lack long term follow up, and most are not generalizable to all male golfers
  • Outcome measures are only correlated with increased golf performance.
  • No literature on what constitutes clinically significant change in outcome measures.

Application of Evidence:

  • Two pronged approach-implement a warm up conditioning routine focusing on dynamic stretching to increase ROM along with sport specific strength training program with use of medicine ball plyometric
  • Conversation with client about available evidence – what increases do they consider significant to them

References:

1.Fletcher I, Hartwell M. EFFECT OF AN 8-WEEK COMBINED WEIGHTS AND PLYOMETRICS TRAINING PROGRAM ON GOLF DRIVE PERFORMANCE. Journal Of Strength & Conditioning Research (Allen Press Publishing Services Inc.) [serial online]. February 2004;18(1):59-62. Available from: SPORTDiscus with Full Text, Ipswich, MA. Accessed September 16, 2016.

2.ÁLvarez M, Sedano S, Cuadrado G, Redondo J. EFFECTS OF AN 18-WEEK STRENGTH TRAINING PROGRAM ON LOW-HANDICAP GOLFERS’ PERFORMANCE. Journal Of Strength & Conditioning Research (Lippincott Williams & Wilkins) [serial online]. April 2012;26(4):1110-1121. Available from: CINAHL, Ipswich, MA. Accessed October 21, 2016.

3.Weston M, Coleman N, Spears I. The Effect of Isolated Core Training on Selected Measures of Golf Swing Performance. Medicine & Science In Sports & Exercise [serial online]. December 2013;45(12):2292-2297. Available from: CINAHL, Ipswich, MA. Accessed September 19, 2016.

4.Fradkin A, Sherman C, Finch C. Improving golf performance with a warm up conditioning programme. British Journal Of Sports Medicine [serial online]. December 2004;38(6):762-765. Available from: CINAHL, Ipswich, MA. Accessed September 19, 2016.

5.Moran K, McGrath T, Marshall B, Wallace E. Dynamic Stretching and Golf Swing Performance. International Journal of Sports Medicine [serial online]. February 2009;30(2):113-118. Available from: Academic Search Complete, Ipswich, MA. Accessed September 19, 2016.