Trunk muscle activity in healthy subjects during bridging stabilization exercises
Tóm tắt
Trunk bridging exercises are often used as therapeutic exercises for lumbopelvic stabilization. These exercises focus on the retraining of muscle coordination patterns in which optimal ratios between local segmental stabilizing and global torque producing muscle activity are assumed to be essential. However, a description of such ratios is lacking. The purpose of this study was to investigate both relative (as a percentage of maximal voluntary isometric contraction) muscle activity levels and ratios of local to global muscle activity, during bridging stabilization exercises. Thirty healthy university students (15 men, 15 women) with a mean age of 19.6 year volunteered to perform 3 bridging exercises (single bridging, ball bridge and unilateral bridging). The surface electromyographic activity of different trunk muscles was evaluated on both sides. During all bridging exercises, the ratio of the internal oblique to the rectus abdominis was very high due to minimal relative activity of the rectus abdominis. In general, the ratio of the internal/external abdominal oblique activity was about 1. However, during the unilateral bridging exercise, the ipsilateral internal/external abdominal oblique activity ratio was 2.79 as a consequence of the significant higher relative activity of the internal oblique compared to the external oblique. The relative muscle activity and the ratios of the back muscles demonstrated similar activity levels for all back muscles, resulting in ratios about 1. Both the minimal relative activity of the rectus abdominis and the high internal oblique to the rectus abdominis activity ratio reported in the present study are in accordance with results of other trunk stabilization exercises. The relative muscle activity and the ratio of the abdominal obliques seem to alter depending on the task and the presumable need for stability. The findings concerning the relative muscle activity and the ratios of the back muscles support the assumption that during these bridging exercises, all back muscles contribute in a similar way to control spine positions and movements in a healthy population.
Tài liệu tham khảo
McGill SM: Low back disorders: evidence based prevention and rehabilitation. 2002, Human Kinetics Publishers, Champaign, III
McGill S, Grenier S, Kavcic N, Cholewicki J: Coordination of muscle activity to assure stability of the lumbar spine. J Electromyogr Kinesiol. 2003, 13 (4): 353-359. 10.1016/S1050-6411(03)00043-9.
Richardson CA, Jull GA: Muscle control – pain control. What exercises would you prescribe?. Man Ther. 1995, 1: 2-10. 10.1054/math.1995.0243.
Richardson C, Jull G, Hides J, Hodges P: Therapeutic exercise for spinal segmental stabilization in low back pain. Scientific basis and clinical approach. 1999, Churchil Livingstone, Harcourt Brace and Company Limited, London
Koumantakis GA, Watson PJ, Oldham JA: Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther. 2005, 85 (3): 209-225.
Niemisto L, Lahtinen-Suopanki T, Rissanen P, Lindgren KA, Sarna S, Hurri H: A randomized trial of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for chronic low back pain. Spine. 2003, 28 (19): 2185-2191. 10.1097/01.BRS.0000085096.62603.61.
Niemisto L, Rissanen P, Sarna S, Lahtinen-Suopanki T, Lindgren KA, Hurri H: Cost-effectiveness of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for chronic low back pain: a prospective randomized trial with 2-year follow-up. Spine. 2005, 30 (10): 1109-1115. 10.1097/01.brs.0000162569.00685.7b.
Sung PS: Multifidi muscles median frequency before and after spinal stabilization exercises. Arch Phys Med Rehabil. 2003, 84 (9): 1313-1318. 10.1016/S0003-9993(03)00139-4.
Stuge B, Lærum E, Kirkesola G, Vøllestad N: The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy. A randomized controlled trial. Spine. 2004, 29 (4): 351-359. 10.1097/01.BRS.0000090827.16926.1D.
Stuge B, Lærum E, Kirkesola G, Vøllestad N: The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy. A two-year follow-up of a randomized clinical trial. Spine. 2004, 29 (10): E197-203. 10.1097/00007632-200405150-00021.
Hides JA, Jull GA, Richardson CA: Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine. 2001, 26 (11): E243-E248. 10.1097/00007632-200106010-00004.
O'Sullivan PB, Twomey LT, Allison GT: Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997, 22 (24): 2959-2967. 10.1097/00007632-199712150-00020.
Rasmussen-Barr E, Nilsson-Wikmar , Arvidsson I: Stabilizing training compared with manual treatment in sub-acute and chronic low-back pain. Man Ther. 2003, 8 (4): 233-241. 10.1016/S1356-689X(03)00053-5.
Bergmark A: Stability of the lumbar spine, A study in mechanical engineering. Acta Orthop Scand. 1989, 230 (Suppl): 20-24.
Kavcic N, Grenier S, McGill SM: Determining the stabilizing role of individual torso muscles during rehabilitation exercises. Spine. 2004, 29 (11): 1254-1265. 10.1097/00007632-200406010-00016.
Cholewicki J, Van Vliet JJ: Relative contribution of trunk muscles to the stability of the lumbar spine during isometric exertions. Clin Biomech. 2002, 17: 99-105. 10.1016/S0268-0033(01)00118-8.
Marshall PW, Murphy BA: Core stability exercises on and off a swiss ball. Arch Phys Med Rehabil. 2005, 86 (2): 242-249. 10.1016/j.apmr.2004.05.004.
Hodges PW, Moseley GL: Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electrom Kines. 2003, 13: 361-370. 10.1016/S1050-6411(03)00042-7.
Richardson CA, Hodges PW, Hides JA: Therapeutic exercise for lumbopelvic stabilization. A motor control approach for the treatment and prevention of low back pain. 2004, Churchill Livingstone, Harcourt Brace and Company Limited, London, Second
O'Sullivan PB, Twomey L, Allison GT: Altered abdominal muscle recruitment in patients with chronic back pain following a specific exercise intervention. J Orthop Sports Phys Ther. 1998, 27 (2): 114-124.
Van Dieën JH, Cholewicki J, Radebold A: Trunk muscle recruitment patterns in patients with low back pain enhance the stability of the lumbar spine. Spine. 2003, 28 (8): 834-841. 10.1097/00007632-200304150-00018.
Janda V: Evaluation of muscular imbalance. Rehabilitation of the spine: a practitioner's manual. Edited by: Liebenson C. 1996, Williams & Wilkins, Baltimore, MD, 97-112.
Liebenson C: Functional training, Part 1: new advances. J Bodywork Movement Ther. 2002, 6: 248-254.
Behm DG, Leonard AM, Young WB, Bonsey AC, MacKinnon SN: Trunk muscle electromyographic activity with unstable and unilateral exercises. J Strength Cond Res. 2005, 19 (1): 193-201. 10.1519/1533-4287(2005)19<193:TMEAWU>2.0.CO;2.
Lehman GJ, Hoda W, Oliver S: Trunk muscle activity during bridging exercises on and off a Swissball. Chiropr Osteopat. 2005, 13: 14-10.1186/1746-1340-13-14.
Anderson K, Behm DG: Maintenance of EMG activity and loss of force output with instability. J Strength Cond Res. 2004, 18 (3): 637-640. 10.1519/1533-4287(2004)18<637:MOEAAL>2.0.CO;2.
Drake JDM, Fischer SL, Brown SHM, Callaghan JP: Do exercise balls provide a training advantage for trunk extensor exercises? A biomechanical evaluation. J Manipulative Physiol Ther. 2006, 29 (5): 354-362. 10.1016/j.jmpt.2006.04.011.
Baecke JAH, Burema J, Frijters JER: A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr. 1982, 36 (5): 936-942.
Vera-Garcia FJ, Grenier SG, McGill SM: Abdominal muscle response during curl-ups on both stable and labile surfaces. Phys Ther. 2000, 80 (6): 564-569.
Danneels LA, Vanderstraeten GG, Cambier DC, Witvrouw EE, Stevens VK, De Cuyper HJ: A functional subdivision of hip, abdominal, and back muscles during asymmetric lifting. Spine. 2001, 26 (6): E114-E121. 10.1097/00007632-200103150-00003.
Danneels LA, Coorevits PL, Cools AM, Vanderstraeten GG, Cambier DC, Witvrouw EE, De Cuyper HJ: Differences in electromyographic activity in multifidus muscle and the iliocostalis lumborum between healthy subjects and patients with subacute and chronic low back pain. Eur Spine J. 2002, 11 (1): 13-19. 10.1007/s005860100314.
Macintosh JE, Bogduk N: Volvo award in basic science. The morphology of the lumbar erector spinae. Spine. 1987, 12 (7): 658-668. 10.1097/00007632-198709000-00004.
Marshall PW, Murphy BA: The validity and reliability of surface EMG to assess the neuromuscular response of the abdominal muscles to rapid limb movement. J Electromyogr Kinesiol. 2003, 13 (5): 477-489. 10.1016/S1050-6411(03)00027-0.
Callaghan JP, Gunning JL, McGill SM: The relationship between lumbar spine load and muscle activity during extensor exercises. Phys Ther. 1998, 78 (1): 8-18.
Vezina MJ, Hubley-Kozey CL: Muscle activation in therapeutic exercises to improve trunk stability. Arch Phys Med Rehabil. 2000, 81 (10): 1370-1379. 10.1053/apmr.2000.16349.
Arokoski JP, Valta T, Airaksinen O, Kankaanpää M: Back and abdominal muscle function during stabilization exercises. Arch Phys Med Rehabil. 2001, 82 (8): 1089-1098. 10.1053/apmr.2001.23819.
Souza GM, Baker LL, Powers CM: Electromyographic activity of selected trunk muscles during dynamic spine stabilization exercises. Arch Phys Med Rehabil. 2001, 82 (11): 1551-1557. 10.1053/apmr.2001.26082.
Ng JK, Kippers V, Richardson CA: Muscle fibre orientation of abdominal muscles and suggested surface EMG electrode positions. Electromyogr Clin Neurophysiol. 1998, 38 (1): 51-58.
Beith ID, Synnott E, Newman A: Abdominal muscle activity during the abdominal hallowing manoeuvre in the four point kneeling and prone positions. Man Ther. 2001, 6 (2): 82-87. 10.1054/math.2000.0376.
Cholewicki J, Panjabi MM, Khachatryan A: Stabilizing function of trunk flexor-extensor muscles around a neutral spine posture. Spine. 1997, 22 (19): 2207-2212. 10.1097/00007632-199710010-00003.
Hubley-Kozey CL, Vezina MJ: Muscle activation during exercises to improve trunk stability in men with low back pain. Arch Phys Med Rehabil. 2002, 83 (8): 1100-08. 10.1053/apmr.2002.33063.
Juker D, McGill S, Kropf P, Steffen T: Quantative intramuscular myoelectric activity of lumbar portions of psoas and abdominal wall during a wide variety of tasks. Med Sci Sports Exerc. 1998, 30 (2): 301-310.
Plamondon A, Serresse O, Boyd K, Ladouceur D, Desjardins P: Estimated moments at L5/S1 level and muscular activation of back extensors for six prone back extension exercises in healthy individuals. Scand J Med Sci Sports. 2002, 12 (2): 81-89. 10.1034/j.1600-0838.2002.120204.x.
Arokoski JP, Kankaanpää M, Valta T, Juvonen I, Partanen J, Taimela S, Lindgren KA, Airaksinen O: Back and hip extensor function during therapeutic exercises. Arch Phys Med Rehabil. 1999, 80 (7): 842-850. 10.1016/S0003-9993(99)90237-X.
Hodges PW: Is there a role for transversus abdominis in lumbo-pelvic stability?. Man Ther. 1999, 4 (2): 74-86. 10.1054/math.1999.0169.
O'Sullivan PB: Lumbar segmental 'instability': clinical presentation and specific stabilizing exercise management. Man Ther. 2000, 5 (1): 2-12. 10.1054/math.1999.0213.
O'Sullivan PB, Twomey LT, Allison GT: Dynamic stabilization of the lumbar spine. Crit Rev Phys Rehabil Med. 1997, 9 (3&4): 315-330.
Mori A: Electromyographic activity of selected trunk muscles during stabilization exercises using a gym ball. Electromyogr Clin Neurophysiol. 2004, 44: 57-64.
van Dieën JH, Selen LPJ, Cholewicki J: Trunk muscle activation in low-back pain patients, an analysis of the literature. J Electromyogr Kinesiol. 2003, 13: 333-351. 10.1016/S1050-6411(03)00041-5.
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