Rodney Imamura

Core Muscle Activation During Swiss Ball and Traditional Abdominal Exercises

STUDY DESIGN Controlled laboratory study using a repeated-measures, counterbalanced design. OBJECTIVES To test the ability of 8 Swiss ball exercises (roll-out, pike, knee-up, skier, hip extension right, hip extension left, decline push-up, and sitting march right) and 2 traditional abdominal exercises (crunch and bent-knee sit-up) on activating core (lumbopelvic hip complex) musculature. BACKGROUND Numerous Swiss ball abdominal exercises are employed for core muscle strengthening during training and rehabilitation, but there are minimal data to substantiate the ability of these exercises to recruit core muscles. It is also unknown how core muscle recruitment in many of these Swiss ball exercises compares to core muscle recruitment in traditional abdominal exercises such as the crunch and bent-knee sit-up. METHODS A convenience sample of 18 subjects performed 5 repetitions for each exercise. Electromyographic (EMG) data were recorded on the right side for upper and lower rectus abdominis, external and internal oblique, latissimus dorsi, lumbar paraspinals, and rectus femoris, and then normalized using maximum voluntary isometric contractions (MVICs). RESULTS EMG signals during the roll-out and pike exercises for the upper rectus abdominis (63% and 46% MVIC, respectively), lower rectus abdominis (53% and 55% MVIC, respectively), external oblique (46% and 84% MVIC, respectively), and internal oblique (46% and 56% MVIC, respectively) were significantly greater compared to most other exercises, where EMG signals ranged between 7% to 53% MVIC for the upper rectus abdominis, 7% to 44% MVIC for the lower rectus abdominis, 14% to 73% MVIC for the external oblique, and 16% to 47% MVIC for the internal oblique. The lowest EMG signals were consistently found in the sitting march right exercise. Latissimus dorsi EMG signals were greatest in the pike, knee-up, skier, hip extension right and left, and decline push-up (17%-25% MVIC), and least with the sitting march right, crunch, and bent-knee sit-up exercises (7%-8% MVIC). Rectus femoris EMG signal was greatest with the hip extension left exercise (35% MVIC), and least with the crunch, roll-out, hip extension right, and decline push-up exercises (6%-10% MVIC). Lumbar paraspinal EMG signal was relative low (less than 10% MVIC) for all exercises. CONCLUSIONS The roll-out and pike were the most effective exercises in activating upper and lower rectus abdominis, external and internal obliques, and latissimus dorsi muscles, while minimizing lumbar paraspinals and rectus femoris activity. J Orthop Sports Phys Ther 2010;40(5):265-276, Epub 22 April 2010. doi:10.2519/jospt.2010.3073.

Patellofemoral joint force and stress during the wall squat and one-leg squat.

PURPOSE To compare patellofemoral compressive force and stress during the one-leg squat and two variations of the wall squat. METHODS Eighteen subjects used their 12 repetition maximum (12 RM) weight while performing the wall squat with the feet closer to the wall (wall squat short), the wall squat with the feet farther away from the wall (wall squat long), and the one-leg squat. EMG, force platform, and kinematic variables were input into a biomechanical model to calculate patellofemoral compressive force and stress as a function of knee angle. To asses differences among exercises, a one-factor repeated-measure ANOVA (P = 0.0025) was used. RESULTS During the squat ascent, there were significant differences in patellofemoral force and stress among the three squat exercises at 90 degrees knee angle (P = 0.002), 80 degrees knee angle (P = 0.002), 70 degrees knee angle (P < 0.001), and 60 degrees knee angle (P = 0.001). Patellofemoral force and stress were significantly greater at 90 degrees knee angle in the wall squat short compared with wall squat long and one-leg squat, significantly greater at 70 degrees and 80 degrees knee angles in the wall squat short and long compared with the one-leg squat and significantly greater at 60 degrees knee angle in the wall squat long compared with the wall squat short and one-leg squat. CONCLUSIONS Except at 60 degrees and 90 degrees knee angles, patellofemoral compressive force and stress were similar between the wall squat short and the wall squat long. Between 60 degrees and 90 degrees knee angles, wall squat exercises generally produced greater patellofemoral compressive force and stress compared with the one-leg squat. When the goal is to minimize patellofemoral compressive force and stress, it may be prudent to use a smaller knee angle range between 0 degrees and 50 degrees compared with a larger knee angle range between 60 degrees and 90 degrees .

Cruciate ligament force during the wall squat and the one-leg squat.

PURPOSE To compare cruciate ligament forces during wall squat and one-leg squat exercises. METHODS Eighteen subjects performed the wall squat with feet closer to the wall (wall squat short), the wall squat with feet farther from the wall (wall squat long), and the one-leg squat. EMG, force, and kinematic variables were input into a biomechanical model using optimization. A three-factor repeated-measure ANOVA (P < 0.05) with planned comparisons was used. RESULTS Mean posterior cruciate ligament (PCL) forces were significantly greater in 1) wall squat long compared with wall squat short (0 degrees -80 degrees knee angles) and one-leg squat (0 degrees -90 degrees knee angles); 2) wall squat short compared with one-leg squat between 0 degrees -20 degrees and 90 degrees knee angles; 3) wall squat long compared with wall squat short (70 degrees -0 degrees knee angles) and one-leg squat (90 degrees -60 degrees and 20 degrees -0 degrees knee angles); and 4) wall squat short compared with one-leg squat between 90 degrees -70 degrees and 0 degrees knee angles. Peak PCL force magnitudes occurred between 80 degrees and 90 degrees knee angles and were 723 +/- 127 N for wall squat long, 786 +/- 197 N for wall squat short, and 414 +/- 133 N for one-leg squat. Anterior cruciate ligament (ACL) forces during one-leg squat occurred between 0 degrees and 40 degrees knee angles, with a peak magnitude of 59 +/- 52 N at 30 degrees knee angle. Quadriceps force ranged approximately between 30 and 720 N, whereas hamstring force ranged approximately between 15 and 190 N. CONCLUSIONS Throughout the 0 degrees -90 degrees knee angles, the wall squat long generally exhibited significantly greater PCL forces compared with the wall squat short and one-leg squat. PCL forces were similar between the wall squat short and the one-leg squat. ACL forces were generated only in the one-leg squat. All exercises appear to load the ACL and the PCL within a safe range in healthy individuals.

Patellofemoral compressive force and stress during the forward and side lunges with and without a stride.

BACKGROUND Although weight bearing lunge exercises are frequently employed during patellofemoral rehabilitation, patellofemoral compressive force and stress are currently unknown for these exercises. METHODS Eighteen subjects used their 12 repetition maximum weight while performing forward and side lunges with and without a stride. EMG, force platform, and kinematic variables were input into a biomechanical model, and patellofemoral compressive force and stress were calculated as a function of knee angle. FINDINGS Patellofemoral force and stress progressively decreased as knee flexion increased and progressively increased as knee flexion decreased. Patellofemoral force and stress were greater in the side lunge compared to the forward lunge between 80 degrees and 90 degrees knee angles, and greater with a stride compared to without a stride between 10 degrees and 50 degrees knee angles. There were no significant interactions between lunge variations and stride variations. INTERPRETATION A more functional knee flexion range between 0 degrees and 50 degrees may be appropriate during the early phases of patellofemoral rehabilitation due to lower patellofemoral compressive force and stress during this range compared to higher knee angles between 60 degrees and 90 degrees. Moreover, when the goal is to minimize patellofemoral compressive force and stress, it may be prudent to employ forward and side lunges without a stride compared to with a stride, especially at lower knee angles between 0 degrees and 50 degrees. Understanding differences in patellofemoral compressive force and stress among lunge variations may help clinicians prescribe safer and more effective exercise interventions.

Patellofemoral Joint Force and Stress Between a Short- and Long-Step Forward Lunge

STUDY DESIGN Controlled laboratory biomechanics study using a repeated-measures, counterbalanced design. OBJECTIVES To compare patellofemoral joint force and stress between a short- and long-step forward lunge both with and without a stride. BACKGROUND Although weight-bearing forward-lunge exercises are frequently employed during rehabilitation for individuals with patellofemoral joint syndrome, patellofemoral joint force and stress and how they change with variations of the lunge exercise are currently unknown. METHODS AND MEASURES Eighteen subjects used their 12-repetition maximum weight while performing a short- and long-step forward lunge both with and without a stride. Electromyography, ground reaction force, and kinematic variables were put into a biomechanical optimization model, and patellofemoral joint force and stress were calculated as a function of knee angle. RESULTS Visual observation of the data show that during the forward lunge, patellofemoral joint force and stress increased progressively as knee flexion increased, and decreased progressively as knee flexion decreased. Between 70 degrees and 90 degrees of knee flexion, patellofemoral joint force and stress were significantly greater when performing a forward lunge with a short step compared to a long step (P<.025). Between 10 degrees and 40 degrees of knee flexion, patellofemoral joint force and stress were significantly greater when performing a forward lunge with a stride compared to without a stride (P<.025). CONCLUSIONS When the goal is to minimize patellofemoral joint force and stress during the forward lunge performed between 0 degrees to 90 degrees knee angles, it may be prudent to perform the lunge with a long step compared to a short step and without a stride compared to with a stride, because patellofemoral joint force and stress magnitudes were greater with a short step compared to a long step at higher knee flexion angles and were greater with a stride compared to without a stride at lower knee flexion angles.

Cruciate ligament forces between short-step and long-step forward lunge.

PURPOSE The purpose of this study was to compare cruciate ligament forces between the forward lunge with a short step (forward lunge short) and the forward lunge with a long step (forward lunge long). METHODS Eighteen subjects used their 12-repetition maximum weight while performing the forward lunge short and long with and without a stride. EMG, force, and kinematic variables were input into a biomechanical model using optimization, and cruciate ligament forces were calculated as a function of knee angle. A two-factor repeated-measure ANOVA was used with a Bonferroni adjustment (P < 0.0025) to assess differences in cruciate forces between lunging techniques. RESULTS Mean posterior cruciate ligament (PCL) forces (69-765 N range) were significantly greater (P < 0.001) in the forward lunge long compared with the forward lunge short between 0 degrees and 80 degrees knee flexion angles. Mean PCL forces (86-691 N range) were significantly greater (P < 0.001) without a stride compared with those with a stride between 0 degrees and 20 degrees knee flexion angles. Mean anterior cruciate ligament (ACL) forces were generated (0-50 N range between 0 degrees and 10 degrees knee flexion angles) only in the forward lunge short with stride. CONCLUSIONS All lunge variations appear appropriate and safe during ACL rehabilitation because of minimal ACL loading. ACL loading occurred only in the forward lunge short with stride. Clinicians should be cautious in prescribing forward lunge exercises during early phases of PCL rehabilitation, especially at higher knee flexion angles and during the forward lunge long, which generated the highest PCL forces. Understanding how varying lunging techniques affect cruciate ligament loading may help clinicians prescribe lunging exercises in a safe manner during ACL and PCL rehabilitation.

Cruciate ligament tensile forces during the forward and side lunge

BACKGROUND Although weight bearing lunge exercises are frequently employed during anterior cruciate ligament and posterior cruciate ligament rehabilitation, cruciate ligament tensile forces are currently unknown while performing forward and side lunge exercises with and without a stride. METHODS Eighteen subjects used their 12 repetition maximum weight while performing a forward lunge and side lunge with and without a stride. A motion analysis system and biomechanical model were used to estimate cruciate ligament forces during lunging as a function of 0-90 degrees knee angles. FINDINGS Comparing the forward lunge to the side lunge across stride variations, mean posterior cruciate ligament forces ranged between 205 and 765N and were significantly greater (P<0.0025) in the forward lunge long at 40 degrees , 50 degrees , 60 degrees , 70 degrees , and 80 degrees knee angles of the descent phase and at 80 degrees , 70 degrees , 60 degrees knee angles of the ascent phase. There were no significant differences (P<0.0025) in mean posterior cruciate ligament forces between with and without stride differences across lunging variations. There were no anterior cruciate ligament forces quantified while performing forward and side lunge exercises. INTERPRETATION Clinicians should be cautious in prescribing forward and side lunge exercises during early phases of posterior cruciate ligament rehabilitation due to relatively high posterior cruciate ligament forces that are generated, especially during the forward lunge at knee angles between 40 degrees and 90 degrees knee angles. Both the forward and side lunges appear appropriate during all phases of anterior cruciate ligament rehabilitation. Understanding how forward and side lunging affect cruciate ligament loading over varying knee angles may help clinicians better prescribe lunging exercises in a safe manner during anterior cruciate ligament and posterior cruciate ligament rehabilitation.

Muscle Activation Among Supine, Prone, and Side Position Exercises With and Without a Swiss Ball

Background: Prone, supine, and side position exercises are employed to enhance core stability. Hypothesis: Overall core muscle activity would be greater in prone position exercises compared with supine and side position exercises. Study Design: Controlled laboratory study. Methods: Eighteen men and women between 23 and 45 years of age served as subjects. Surface electrodes were positioned over the upper and lower rectus abdominis, external and internal obliques, rectus femoris, latissimus dorsi, and lumbar paraspinals. Electromyography data were collected during 5 repetitions of 10 exercises, then normalized by maximum voluntary isometric contractions (MVIC). Differences in muscle activity were assessed using 1-way repeated-measures analysis of variance, while t tests with a Bonferroni correction were employed to assess pairwise comparisons. Results: Upper and lower rectus abdominis activity was generally significantly greater in the crunch, bent-knee sit-up, and prone position exercises compared with side position exercises. External oblique activity was significantly greater in the prone on ball with right hip extension, side crunch on ball, and side bridge (plank) on toes compared with the prone and side bridge (plank) on knees, the crunch, or the bent-knee sit-up positions. Internal oblique activity was significantly greater in the prone bridge (plank) on ball and prone on ball with left and right hip extension compared with the side crunch on ball and prone and side bridge (plank) on knees positions. Lumbar paraspinal activity was significantly greater in the 3 side position exercises compared with all remaining exercises. Latissimus dorsi activity was significantly greater in the prone on ball with left and right hip extension and prone bridge (plank) on ball and on toes compared with the crunch, bent-knee sit-up, and prone and side bridge (plank) on knees positions. Rectus femoris activity was significantly greater in the prone on ball with left hip extension, bent-knee sit-up, or prone bridge (plank) on toes compared with the remaining exercises. Conclusion: Prone position exercises are good alternatives to supine position exercises for recruiting core musculature. Side position exercises are better for oblique and lumbar paraspinal recruitment. Clinical Relevance: Because high core muscle activity is associated with high spinal compressive loading, muscle activation patterns should be considered when prescribing trunk exercises to those in which high spinal compressive loading may be deleterious.