Shigeki Izumi

Trunk Muscle Activity During Lumbar Stabilization Exercises on Both a Stable and Unstable Surface

STUDY DESIGN Controlled laboratory study. OBJECTIVES To clarify whether differences in surface stability influence trunk muscle activity. BACKGROUND Lumbar stabilization exercises on unstable surfaces are performed widely. One perceived advantage in performing stabilization exercises on unstable surfaces is the potential for increased muscular demand. However, there is little evidence in the literature to help establish whether this assumption is correct. METHODS Nine healthy male subjects performed lumbar stabilization exercises. Pairs of intramuscular fine-wire or surface electrodes were used to record the electromyographic signal amplitude of the rectus abdominis, the external obliques, the transversus abdominis, the erector spinae, and lumbar multifidus. Five exercises were performed on the floor and on an unstable surface: elbow-toe, hand-knee, curl-up, side bridge, and back bridge. The EMG data were normalized as the percentage of the maximum voluntary contraction, and data between doing each exercise on the stable versus unstable surface were compared using a Wilcoxon signed-rank test. RESULTS With the elbow-toe exercise, the activity level for all muscles was enhanced when performed on the unstable surface. When performing the hand-knee and side bridge exercises, activity level of the more global muscles was enhanced when performed on an unstable surface. Performing the curl-up exercise on an unstable surface, increased the activity of the external obliques but reduced transversus abdominis activation. CONCLUSION This study indicates that lumbar stabilization exercises on an unstable surface enhanced the activities of trunk muscles, except for the back bridge exercise.

Electromyographic Analysis of Transversus Abdominis and Lumbar Multifidus Using Wire Electrodes During Lumbar Stabilization Exercises

STUDY DESIGN Experimental laboratory study. OBJECTIVES To measure trunk muscle activity using wire electrodes during lumbar stabilization exercises and to examine if more effective exercises to activate the deep trunk muscles (local muscles) exist. BACKGROUND Lumbar stabilization exercises are performed to improve motor control of trunk muscles. However, the magnitude of activation of local muscles during lumbar stabilization exercises is not clear. METHODS Nine healthy men with no history of lumbar spine disorders participated in the study. Fine-wire electrodes were inserted into the transversus abdominis (TrA) and lumbar multifidus, bilaterally. In addition, surface electrodes were attached to the rectus abdominis, external obliques, and erector spinae, bilaterally. Electromyographic signal amplitude was measured during the following exercises: elbow-toe, hand-knee, back bridge, side bridge, and curl-up. Two-way analyses of variance were used to compare muscle activity level among exercises and between sides for each muscle. RESULTS The exercise showing the greatest activity level for the TrA was elbow-toe exercise with contralateral arm and leg lift. In addition, for the TrA, a significant side-to-side difference in activation level was demonstrated for 7 of the 11 exercises that were performed. The activity level of the multifidus was greatest during the back bridge exercises. The curl-up exercise generated the highest activity level for the rectus abdominis and the back bridge, with single-leg lift exercises generating the highest erector spinae activity. CONCLUSIONS The exercises investigated in this study resulted in a wide range of effort level for all 5 muscles monitored. Many of the exercises also resulted in an asymmetrical (right versus left side) activation level for a muscle, including the TrA.

COMPARISON OF THE ACTIVITIES OF THE DEEP TRUNK MUSCLES MEASURED USING INTRAMUSCULAR AND SURFACE ELECTROMYOGRAPHY

Surface electromyography (EMG) has been used to estimate deep trunk muscle activity. However, it remains unknown whether surface EMG provides an accurate estimation of this activity. The purposes of this study were to compare surface and intramuscular EMG activity measurements and investigate the efficacy of surface EMG measurement for the transversus abdominis (TrA) and the multifidus (MF) muscles. Eight healthy men participated in the study. TrA and MF activities were simultaneously measured by both intramuscular and surface EMG during isometric trunk exercises. Spearman correlation coefficients for the relationship between the two activity measurements for the right TrA, left TrA, right MF, and left MF were 0.55, 0.36, 0.67, and 0.79, respectively. For the TrA, Bland–Altman plots revealed that mean differences between measurements obtained by intramuscular EMG and surface EMG were not close to zero, with a systematic bias toward higher surface EMG values. In conclusion, surface and intramuscular EMG ac...