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1.  MUSCLE ACTIVITY DURING KNEE‐EXTENSION STRENGTHENING EXERCISE PERFORMED WITH ELASTIC TUBING AND ISOTONIC RESISTANCE 
Background/Purpose:
While elastic resistance training, targeting the upper body is effective for strength training, the effect of elastic resistance training on lower body muscle activity remains questionable. The purpose of this study was to evaluate the EMG‐angle relationship of the quadriceps muscle during 10‐RM knee‐extensions performed with elastic tubing and an isotonic strength training machine.
Methods:
7 women and 9 men aged 28‐67 years (mean age 44 and 41 years, respectively) participated. Electromyographic (EMG) activity was recorded in 10 muscles during the concentric and eccentric contraction phase of a knee extension exercise performed with elastic tubing and in training machine and normalized to maximal voluntary isometric contraction (MVC) EMG (nEMG). Knee joint angle was measured during the exercises using electronic inclinometers (range of motion 0‐90°).
Results:
When comparing the machine and elastic resistance exercises there were no significant differences in peak EMG of the rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM) during the concentric contraction phase. However, during the eccentric phase, peak EMG was significantly higher (p<0.01) in RF and VM when performing knee extensions using the training machine. In VL and VM the EMG‐angle pattern was different between the two training modalities (significant angle by exercise interaction). When using elastic resistance, the EMG‐angle pattern peaked towards full knee extension (0°), whereas angle at peak EMG occurred closer to knee flexion position (90°) during the machine exercise. Perceived loading (Borg CR10) was similar during knee extensions performed with elastic tubing (5.7±0.6) compared with knee extensions performed in training machine (5.9±0.5).
Conclusion:
Knee extensions performed with elastic tubing induces similar high (>70% nEMG) quadriceps muscle activity during the concentric contraction phase, but slightly lower during the eccentric contraction phase, as knee extensions performed using an isotonic training machine. During the concentric contraction phase the two different conditions displayed reciprocal EMG‐angle patterns during the range of motion.
Level of Evidence:
5
PMCID: PMC3537465  PMID: 23316424
Electromyography; strength training; quadriceps; perceived exertion
2.  Electromyographic Analysis of Four Popular Abdominal Exercises 
Journal of Athletic Training  1993;28(2):120-126.
This study was designed to evaluate the effects of four specific sit-up exercises on muscular activity of the rectus abdominis. Pairs of surface electrodes were placed unilaterally on four quadrants of the rectus abdominis, delimited by tendinous inscriptions, in four male subjects. Electromyographic (EMG) recordings were taken while the subjects performed four different abdominal exercises. Each abdominal exercise was hypothesized to have a specific effect on one of the four quadrants of the rectus abdominis. The four exercises analyzed were: 1) long lying crunch, 2) bent knee crunch, 3) leg raise, and 4) vertical leg crunch. Analysis of the standardized EMG recordings demonstrated no significant differences in the mean muscle activity between the four different quadrants, in the mean muscle activity between the four different exercises, and in interactions between the exercises and the quadrants of the rectus abdominis. We conclude that none of the four abdominal exercises studied are specific for strengthening individual muscle quadrants of the rectus abdominis.
PMCID: PMC1317695  PMID: 16558218
3.  PERCEIVED LOADING AND MUSCLE ACTIVITY DURING HIP STRENGTHENING EXERCISES: COMPARISON OF ELASTIC RESISTANCE AND MACHINE EXERCISES 
Objective:
Decreased hip muscle strength is frequently reported in patients with hip injury or pathology. Furthermore, soccer players suffering from groin injury show decreased strength of hip muscles. Estimating 10‐repetition maximum can be time‐consuming and difficult, thus, using the Borg category rating 10 scale (Borg CR10 scale) can be a useful tool for estimating the intensity of exercise. The aims of this study were 1) to investigate the feasibility of the use of the Borg CR10 scale for rating strength training intensity of the hip abductor and hip adductor muscles, and 2) to compare hip muscle activity during hip abduction and hip adduction exercises using elastic resistance and isotonic machines, using electromyography (EMG).
Methods:
EMG activity was recorded from 11 muscles at the hip, thigh and trunk during hip adduction and hip abduction exercises in 16 untrained women, using elastic resistance and isotonic exercise machines. These recordings were normalized to maximal voluntary contraction (MVC) EMG (nEMG). The exercises were performed at four levels of perceived loading reported using the Borg CR10: light (Borg ≤2), moderate (Borg >2–<5), heavy (Borg ≥5–<7) and near maximum (Borg ≥7).
Results:
Moderate to strong associations were observed between perceived loading and nEMG obtained during the adduction exercise with elastic resistance (r=0.8±0.3) as well as in machine (r=0.69±0.55) and the abduction exercise with elastic resistance (r=0.66±0.29) as well as in machine (r =0.62±0.54). The abduction exercise performed with elastic resistance displayed significantly higher gluteus medius nEMG recruitment than the in machine exercise.
Conclusions:
The results of this study show that the Borg CR10 scale can be a useful tool for estimating intensity levels during resistance training of the hip adductor and hip abductor muscles. Although elastic resistance and exercise machine seem equally effective for recruiting muscle activity of the hip adductors, the elastic resistance condition was able to demonstrate greater muscle recruitment than the exercise machine during hip abduction.
PMCID: PMC3867074  PMID: 24377067
Elastic resistance; hip adduction; hip abduction; strength training
4.  Selective Activation of the Rectus Abdominis Muscle During Low-Intensity and Fatiguing Tasks 
In order to understand the potential selective activation of the rectus abdominis muscle, we conducted two experiments. In the first, subjects performed two controlled isometric exercises: the curl up (supine trunk raise) and the leg raise (supine bent leg raise) at low intensity (in which only a few motor units are recruited). In the second experiment, subjects performed the same exercises, but they were required to maintain a certain force level in order to induce fatigue. We recorded the electromyographic (EMG) activities of the lower and upper portions of the rectus abdominis muscle during the exercises and used spatial-temporal and frequency analyses to describe muscle activation patterns. At low-intensity contractions, the ratio between the EMG intensities of the upper and lower portions during the curl up exercise was significantly larger than during the leg raise exercise (p = 0.02). A cross-correlation analysis indicated that the signals of the abdominal portions were related to each other and this relation did not differ between the tasks (p = 0.12). In the fatiguing condition, fatigue for the upper portion was higher than for the lower portion during the curl up exercise (p = 0.008). We conclude that different exercises evoked, to a certain degree, individualized activation of each part of the rectus abdominis muscle, but different portions of the rectus abdominis muscle contributed to the same task, acting like a functional unit. These results corroborate the relevance of varying exercise to modify activation patterns of the rectus abdominis muscle.
Key pointsSelective activation of the rectus abdominis muscle is possible because this muscle has different portions (which can have different motor fibers in series) which can be innervated by different nerves as well as by a common nerve branch.Changes in body position and exercise intensity cre-ate different demands for the different portions of the rectus abdominis muscle.Exercise variation seems to be valid to modify the activation patterns of the rectus abdominis muscle.
PMCID: PMC3761871  PMID: 24149878
Motor control; electromyography; biomechanics; exercise
5.  Trunk muscle activity during bridging exercises on and off a Swissball 
Background
A Swiss ball is often incorporated into trunk strengthening programs for injury rehabilitation and performance conditioning. It is often assumed that the use of a Swiss ball increases trunk muscle activity. The aim of this study was to determine whether the addition of a Swiss ball to trunk bridging exercises influences trunk muscle activity.
Methods
Surface electrodes recorded the myoelectric activity of trunk muscles during bridging exercises. Bridging exercises were performed on the floor as well as on a labile surface (Swiss ball).
Results and Discussion
During the prone bridge the addition of an exercise ball resulted in increased myoelectric activity in the rectus abdominis and external oblique. The internal oblique and erector spinae were not influenced. The addition of a swiss ball during supine bridging did not influence trunk muscle activity for any muscles studied.
Conclusion
The addition of a Swiss ball is capable of influencing trunk muscle activity in the rectus abdominis and external oblique musculature during prone bridge exercises. Modifying common bridging exercises can influence the amount of trunk muscle activity, suggesting that exercise routines can be designed to maximize or minimize trunk muscle exertion depending on the needs of the exercise population.
doi:10.1186/1746-1340-13-14
PMCID: PMC1187901  PMID: 16053529
EMG; trunk stability; exercise; swiss ball; rehabilitation
6.  Neuromuscular Evaluation of Trunk-Training Exercises 
Journal of Athletic Training  2001;36(2):109-118.
Objective:
To evaluate the neuromuscular activation profiles of trunk muscles in commonly used gymnastic strength exercises with a polymyographic set-up and to describe the training effects of each exercise.
Design and Setting:
Subjects performed 9 repetitions of each of 12 gymnastic exercises. Variations of 5 trunk flexions, 5 extensions, and 2 lateral-flexion movements were performed under standardized test conditions.
Subjects:
Ten healthy subjects (men and women) who were familiar with the exercises participated in the study.
Measurements:
We recorded surface electromyograms (EMGs) from the rectus abdominis, external oblique, rectus femoris, middle trapezius, erector spinae at T12 and L3, gluteus maximus, and semitendinosus and semimembranosus muscles. Recording of each repetition cycle was triggered by a flexible electronic goniometer attached to the trunk. The raw EMG signals were rectified, smoothed, amplitude normalized to maximal voluntary contraction (MVC), and averaged for the last 8 repetitions.
Results:
Pure spine-flexion exercises, such as a curl-up, produced sufficient and isolated activation (greater than 50% MVC) of the abdominal muscles. When flexion of the spine was combined with hip flexion (sit-up), the peak activation was increased. Lateral-flexion tasks targeted primarily the external oblique muscle, which demonstrated high activity in side-lying flexion tasks. Back- and hip-extension exercises, such as bridging and diagonal hip and shoulder extension, produced only moderate mean activities (less than 35% MVC) in the trunk-extensor muscles. Trunk-extension exercises with combined hip extension increased the EMG activity to 50% MVC but only at the end of the extension.
Conclusions:
Individual responses to each exercise varied markedly, which complicated the classification of exercise effects. However, within the limitations of the study, we found that the chosen abdominal exercises provided an effective training stimulus for the trunk-flexor muscles, whereas in the back- and hip-extension exercises, the neuromuscular activation tended to be too low or unspecific to qualify as muscle-specific training.
PMCID: PMC155519  PMID: 12937449
electromyography; activation profiles; EMG normalization; EMG variability; movement standardization; back muscles; abdominal muscles; hip muscles; training effectiveness
7.  Abdominal Muscle Activity While Performing Trunk-Flexion Exercises Using the Ab Roller, ABslide, FitBall, and Conventionally Performed Trunk Curls 
Journal of Athletic Training  2004;39(1):37-43.
Objective:
To compare the surface electromyographic activity of the abdominal musculature and rectus femoris (RF) muscle during trunk-flexion exercises using 3 abdominal exercise devices (Ab Roller, ABslide, and FitBall) and the traditional trunk curl.
Design and Setting:
Each subject performed approximately 15 repetitions for each exercise condition. A repeated-measures, one-way multivariate analysis of variance was used to compare the mean integrated electric activity value for each muscle during each exercise condition.
Subjects:
A total of 10 male and 13 female collegiate undergraduate students.
Measurements:
Surface electromyographic activity was recorded for the upper rectus abdominis (URA), lower rectus abdominis (LRA), external oblique (EO), and RF during 5 consecutive repetitions of each exercise bout. The signal was amplified by a factor of 1000, rectified, and integrated. These integrated values were then divided by the time value for each exercise to give the mean integrated electromyography value.
Results:
A significant difference existed among exercise conditions for the RF (P < .0001), with the ABslide and the FitBall having greater electric activity than the other exercise conditions. Activity was significantly different (P < .0009) for the URA, with the ABslide having the least electric activity. For the EO, exercising with the ABslide produced significantly greater electric activity (P < .0001) than all other exercise conditions. No significant difference was found across exercise conditions for the LRA (P < .051).
Conclusions:
Performing abdominal exercises with the Ab Roller, ABslide, and FitBall did not elicit greater activity of the URA and LRA than performing traditional trunk curls. Use of the ABslide elicited greater EO activity and significantly less URA activity than the other 3 modes. Both the ABslide and FitBall resulted in greater involvement of the hip flexors, an undesirable feature of abdominal exercises.
PMCID: PMC385260  PMID: 15085210
electromyography; fitness; rehabilitation; sit-ups; abdominal crunches
8.  Surface Electromyographic Amplitude-to-Work Ratios During Isokinetic and Isotonic Muscle Actions 
Journal of Athletic Training  2006;41(3):314-320.
Context: Isokinetic and isotonic resistance training exercises are commonly used to increase strength during musculoskeletal rehabilitation programs. Our study was designed to examine the efficacy of isokinetic and isotonic muscle actions using surface electromyographic (EMG) amplitude-to-work ratios (EMG/WK) and to extend previous findings to include a range of isokinetic velocities and isotonic loads.
Objective: To examine work (WK), surface EMG amplitude, and EMG/WK during concentric-only maximal isokinetic muscle actions at 60, 120, 180, 240, and 300°/s and isotonic muscle actions at 10%, 20%, 30%, 40%, and 50% of the maximal voluntary isometric contraction (MVIC) torque during leg extension exercises.
Design: A randomized, counterbalanced, cross-sectional, repeated-measures design.
Setting: A university-based human muscle physiology research laboratory.
Patients or Other Participants: Ten women (mean age = 22.0 ± 2.6 years) and 10 men (mean age = 20.8 ± 1.7 years) who were apparently healthy and recreationally active.
Intervention(s): Using the dominant leg, each participant performed 5 maximal voluntary concentric isokinetic leg extension exercises at randomly ordered angular velocities of 60, 120, 180, 240, and 300°/s and 5 concentric isotonic leg extension exercises at randomly ordered loads of 10%, 20%, 30%, 40%, and 50% of the isometric MVIC.
Main Outcome Measure(s): Work was recorded by a Biodex System 3 dynamometer, and surface EMG was recorded from the superficial quadriceps femoris muscles (vastus lateralis, rectus femoris, and vastus medialis) during the testing and was normalized to the MVIC. The EMG/WK ratios were calculated as the quotient of EMG amplitude (μVrms) and WK (J) during the concentric phase of each exercise.
Results: Isotonic EMG/WK remained unchanged ( P > .05) from 10% to 50% MVIC, but isokinetic EMG/WK increased ( P < .05) from 60 to 300°/s. Isotonic EMG/WK was greater ( P < .05) than isokinetic EMG/WK for 50% MVIC versus 60°/s, 40% MVIC versus 120°/s, and 30% MVIC versus 180°/s; however, no differences were noted ( P > .05) between 20% MVIC versus 240°/s or 10% MVIC versus 300°/s. An 18% decrease in active range of motion was seen for the isotonic muscle actions, from 10% to 50% MVIC, and a 3% increase in range of motion for the isokinetic muscle actions from 60 to 300°/s was also observed. Furthermore, the peak angular velocities for the isotonic muscle actions ranged from 272.9 to 483.0°/s for 50% and 10% MVIC, respectively.
Conclusions: When considering EMG/WK, peak angular velocity, and range of motion together, our data indicate that maximal isokinetic muscle actions at 240°/s or controlled-velocity isotonic muscle actions at 10%, 20%, or 30% MVIC may maximize the amount of muscle activation per unit of WK done during the early stages of musculoskeletal rehabilitation. These results may be useful to allied health professionals who incorporate open-chain resistance training exercises during the early phases of rehabilitation and researchers who use isotonic or isokinetic modes of resistance exercise to examine muscle function.
PMCID: PMC1569550  PMID: 17043700
range of motion; angular velocity; muscle activation; leg extension; rehabilitation
9.  Shoulder muscle EMG activity during push up variations on and off a Swiss ball 
Dynamic Medicine  2006;5:7.
Background
Surface instability is a common addition to traditional rehabilitation and strength exercises with the aim of increasing muscle activity, increasing exercise difficulty and improving joint proprioception. The aim of the current study was to determine if performing upper body closed kinetic chain exercises on a labile surface (Swiss ball) influences myoelectric amplitude when compared with a stable surface.
Methods
Thirteen males were recruited from a convenience sample of college students. Surface electromyograms were recorded from the triceps, pectoralis major, latissimus dorsi, rectus abdominis and external oblique while performing push up exercises with the feet or hands placed on a bench and separately on a Swiss ball. A push up plus exercise was also evaluated with hands on the support surface.
Results and discussion
Not all muscles responded with an increase in muscle activity. The pectoralis major muscle was not influenced by surface stability. The triceps and rectus abdominis muscles showed increases in muscle activity only when the hands were on the unstable surface. The external oblique muscle was only influenced by surface stability during the performance of the push up plus exercise. No muscle showed a change in activation level when the legs were supported by the Swiss ball instead of the bench.
Conclusion
Muscle activity can be influenced by the addition of surface instability however an increase in muscle activity does not influence all muscles in all conditions. The relationship between the participant's center of mass, the location of the unstable surface and the body part contacting the Swiss ball may be important factors in determining the muscle activation changes following changes in surface stability.
doi:10.1186/1476-5918-5-7
PMCID: PMC1508143  PMID: 16762080
10.  Replacing a Swiss ball for an exercise bench causes variable changes in trunk muscle activity during upper limb strength exercises 
Background
The addition of Swiss balls to conventional exercise programs has recently been adopted. Swiss balls are an unstable surface which may result in an increased need for force output from trunk muscles to provide adequate spinal stability or balance. The aim of the study was to determine whether the addition of a Swiss ball to upper body strength exercises results in consistent increases in trunk muscle activation levels.
Methods
The myoelectric activity of four trunk muscles was quantified during the performance of upper body resistance exercises while seated on both a stable (exercise bench) and labile (swiss ball) surface. Participants performed the supine chest press, shoulder press, lateral raise, biceps curl and overhead triceps extension. A repeated measures ANOVA with post-hoc Tukey test was used to determine the influence of seated surface type on muscle activity for each muscle.
Results & Discussion
There was no statistically significant (p < .05) difference in muscle activity between surface conditions. However, there was large degree of variability across subjects suggesting that some individuals respond differently to surface stability. These findings suggest that the incorporation of swiss balls instead of an exercise bench into upper body strength training regimes may not be justified based only on the belief that an increase spinal stabilizing musculature activity is inherent. Biomechanically justified ground based exercises have been researched and should form the basis for spinal stability training as preventative and therapeutic exercise training regimes.
Conclusion
Selected trunk muscle activity during certain upper limb strength training exercises is not consistently influenced by the replacement of an exercise bench with a swiss ball.
doi:10.1186/1476-5918-4-6
PMCID: PMC1177975  PMID: 15935097
EMG; exercise; spine stability; swiss balls; rehabilitation; low back pain
11.  Comparison of Trunk Muscle Activity During Bridging Exercises Using a Sling in Patients with Low Back Pain 
The aims of this study were to compare the activation of global and local muscles of the trunk during bridging with sling exercise (BSE), bridging with ball exercise (BBE), and normal bridging exercise (NBE) and to conduct and analyze these exercises in supine and prone positions to prove the effectiveness of sling exercises. Thirty patients with current low back pain (LBP) were recruited. In the supine and prone bridging exercise, each subject lifted their pelvis with their legs and feet in contact with the sling, ball, or normal surface. The electrical activities of the inferior oblique (IO), rectus abdominis (RA), multifidus (MF), and erector spinae (ES) muscles during the bridging exercises on the 3 surfaces were measured using surface electromyography (sEMG). For normalization, maximum sEMG signals were evaluated during each maximum voluntary isometric contraction (MVIC) maneuver. The root mean square during the exercise was normalized as a percentage of the MVIC (%MVIC). In the supine and prone positions, %MVIC of the IO, RA, MF, and ES during BSE was significantly higher than those during BBE and NBE (p < 0.05). In the supine position, %MVIC of the RA and ES during BBE was significantly higher than that during NBE (p < 0.05). In the prone position, all %MVIC during BBE were significantly higher than NBE (p < 0.05). These results verify the theory that the use of an unstable surface increases the activation of global and local trunk muscles during bridging exercises in the supine and prone positions. In conclusion, the use of BSE in a rehabilitation program may have therapeutic effects for patients with LBP by increasing trunk muscle activation.
Key pointsCompared with the BBE and NBE, the BSE increased the %MVIC values of the IO, RA, MF, and ES muscles in the supine and prone positions in the patients with LBP.We verified that activation of the global and local trunk muscles was increased by the use of unstable surfaces during the bridging exercises in the supine and prone positions.The BSE was shown to be an effective exercise method for patients with LBP in a rehabilitation program by increasing trunk muscle activation.
PMCID: PMC3737950  PMID: 24149361
Sling; bridging exercise; sEMG; local trunk muscle; global trunk muscle
12.  A study of passive weight-bearing lower limb exercise effects on local muscles and whole body oxidative metabolism: a comparison with simulated horse riding, bicycle, and walking exercise 
Background
We have developed an exercise machine prototype for increasing exercise intensity by means of passively exercising lower limb muscles. The purpose of the present study was to compare the passive exercise intensity of our newly-developed machine with the intensities of different types of exercises. We also attempted to measure muscle activity to study how these forms of exercise affected individual parts of the body.
Methods
Subjects were 14 healthy men with the following demographics: age 30 years, height 171.5 cm, weight 68.3 kg. They performed 4 types of exercise: Passive weight-bearing lower limb exercise (PWLLE), Simulated horse riding exercise (SHRE), Bicycle exercise, and Walking exercise, as described below at an interval of one week or longer. Oxygen uptake, blood pressure, heart rate, and electromyogram (EMG) were measured or recorded during exercise. At rest prior to exercise and immediately after the end of each exercise intensity, the oxygenated hemoglobin levels of the lower limb muscles were measured by near-infrared spectroscopy to calculate the rate of decline. This rate of decline was obtained immediately after exercise as well as at rest to calculate oxygen consumption of the lower limb muscles as expressed as a ratio of a post-exercise rate of decline to a resting one.
Results
The heart rate and oxygen uptake observed in PWLLE during maximal intensity were comparable to that of a 20-watt bicycle exercise or 2 km/hr walking exercise. Maximal intensity PWLLE was found to provoke muscle activity comparable to an 80-watt bicycle or 6 km/hr walking exercise. As was the case with the EMG results, during maximal intensity PWLLE, the rectus femoris muscle consumed oxygen in amounts identical to that of an 80-watt bicycle or a 6 km/hr walking exercise.
Conclusion
Passive weight-bearing lower limb exercise using our trial machine could provide approximately 3 MET of exercise and the thigh exhibited muscle activity equivalent to that of 80-watt bicycle or 6 km/hr walking exercise. Namely, given the same oxygen uptake, PWLLE exceeded bicycle or walking exercise in muscle activity, thus PWLLE is believed to strengthen muscle power while reducing the load imposed on the cardiopulmonary system.
doi:10.1186/1476-5918-8-4
PMCID: PMC2780382  PMID: 19900292
13.  Trunk muscle activity in healthy subjects during bridging stabilization exercises 
Background
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.
Methods
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.
Results
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.
Conclusion
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.
doi:10.1186/1471-2474-7-75
PMCID: PMC1599724  PMID: 16987410
14.  Cocontraction of Ankle Dorsiflexors and Transversus Abdominis Function in Patients With Low Back Pain 
Journal of Athletic Training  2012;47(4):379-389.
Context
The abdominal draw-in maneuver (ADIM) with cocontraction has been shown to be a more effective method of activating the transversus abdominis (TrA) in healthy adults than the ADIM alone. Whether such an augmented core stabilization exercise is effective in managing low back pain (LBP) remains uncertain.
Objective
To determine the effect of 2 weeks of ADIM and cocontraction training on abdominal muscle thickness and activation timing and to monitor pain and function in patients with LBP.
Design
Case-control study.
Setting
Local orthopaedic clinic and research laboratory.
Patients or Other Participants
Twenty patients with mechanical LBP (age = 27.20 ± 6.46 years, height = 166.25 ± 8.70 cm, mass = 58.10 ± 11.81 kg) and 20 healthy, age-matched people (age = 24.25 ± 1.59 years, height = 168.00 ± 8.89 cm, mass = 60.65 ± 11.99 kg) volunteered for the study.
Intervention(s)
Both the LBP and control groups received ten 30-minute sessions of ADIM and cocontraction training of the tibialis anterior (TA) and rectus femoris (RF) muscles over a 2-week period.
Main Outcome Measure(s)
A separate, mixed-model analysis of variance was computed for the thicknesses of the TrA, internal oblique (IO), and external oblique muscles. The differences in mean and peak electromyographic (EMG) amplitudes, onset time, and latency were compared between the groups. The visual analog pain scale, Pain Disability Index, and LBP rating scale were used to assess pain in the LBP group before and after the intervention.
Results
We found an interaction between the LBP and control groups and a main effect from pretest to posttest for only TrA muscle thickness change (F1,38 = 6.57, P = .01). Reductions in all pain measures were observed after training (P < .05). Group differences in peak and mean EMG amplitudes and onset time values for TrA/IO and TA were achieved (P < .05). The RF peak (t38 = −3.12, P = .003) and mean (t38 = −4.12, P = .001) EMG amplitudes were different, but no group difference was observed in RF onset time (t38 = 1.63, P = .11) or the cocontracted TrA/IO peak (t38 = −1.90, P = .07) and mean (t38 = −1.81, P = .08). The test-retest reliability for the muscle thickness measure revealed excellent correlations (intraclass correlation coefficient range, 0.95–0.99).
Conclusions
We are the first to demonstrate that a cocontraction of the ankle dorsiflexors with ADIM training might result in a thickness change in the TrA muscle and associated pain management in patients with chronic LBP.
PMCID: PMC3396297  PMID: 22889653
core stability; electromyographic sequencing; ultrasound imaging
15.  Neuromuscular adaptations to concurrent training in the elderly: effects of intrasession exercise sequence 
Age  2012;35(3):891-903.
The aim of this study was investigate the effects of different intrasession exercise orders in the neuromuscular adaptations induced by concurrent training in elderly. Twenty-six healthy elderly men (64.7 ± 4.1 years), were placed into two concurrent training groups: strength prior to (SE, n = 13) or after (ES, n = 13) endurance training. Subjects trained strength and endurance training during 12 weeks, three times per week performing both exercise types in the same training session. Upper and lower body one maximum repetition test (1RM) and lower-body isometric peak torque (PTiso) and rate of force development were evaluated as strength parameters. Upper and lower body muscle thickness (MT) was determined by ultrasonography. Lower-body maximal surface electromyographic activity of vastus lateralis and rectus femoris muscles (maximal electromyographic (EMG) amplitude) and neuromuscular economy (normalized EMG at 50 % of pretraining PTiso) were determined. Both SE and ES groups increased the upper- and lower-body 1RM, but the lower-body 1RM increases observed in the SE was higher than ES (35.1 ± 12.8 vs. 21.9 ± 10.6 %, respectively; P < 0.01). Both SE and ES showed MT increases in all muscles evaluated, with no differences between groups. In addition, there were increases in the maximal EMG and neuromuscular economy of vastus lateralis in both SE and ES, but the neuromuscular economy of rectus femoris was improved only in SE (P < 0.001). Performing strength prior to endurance exercise during concurrent training resulted in greater lower-body strength gains as well as greater changes in the neuromuscular economy (rectus femoris) in elderly.
doi:10.1007/s11357-012-9405-y
PMCID: PMC3636398  PMID: 22453934
Combined training; Electromiography; Muscle thickness; Aerobic exercise; Resistance exercise
16.  The Impact of Ergometer Design on Hip and Trunk Muscle Activity Patterns in Elite Rowers: An Electromyographic Assessment 
This study used surface electromyography (sEMG) to examine whether there were differences in hip and trunk muscle activation during the rowing cycle on two of the most widely used air braked ergometers: the Concept 2C and the Rowperfect. sEMG methods were used to record the muscle activity patterns from the right: m. Erector spinae (ES), m. Rectus Abdominus (RA), m. Rectus Femoris (RF) and m. Biceps Femoris (BF) for their contributions as agonist-antagonist pairs underlying hip and trunk extension/flexion. The sEMG activity patterns of these muscles were examined in six young male elite rowers completing a 2 minute set at a moderate training intensity (23 stroke·min-1 and 1:47.500 m-1 split time, 300W). The rowers closely maintained the required target pace through visual inspection of the standard LCD display of each ergometer. The measurements of duration of each rowing cycle and onset of each stroke during the test were recorded simultaneously with the sEMG activity through the additional instrumentation of a foot-pressure switch and handle accelerometry. There were no significant differences between the two ergometer designs in group means for: work rate (i.e., rowing speed and stroke rate), metabolic load as measured by mean heart rate, rowing cycle duration, or timing of the stroke in the cycle. 2-D motion analysis of hip and knee motion for the rowing cycle from the video footage taken during the test also revealed no significant differences in the joint range of motion between the ergometers. Ensemble average sEMG activity profiles based on 30+ strokes were obtained for each participant and normalised per 10% intervals of the cycle duration as well as for peak mean sEMG amplitude for each muscle. A repeated measures ANOVA on the sEMG activity per 10% interval for the four muscles contributing to hip and trunk motion during the rowing cycle revealed no significant differences between the Concept 2C and Rowperfect (F = 0.070, df = 1,5, p = 0.802). The outcome of this study suggests that the two different ergometer designs are equally useful for dry land training.
Key PointsThe effects of endurance training on HR recovery after exercise and cardiac ANS modulation were investigated in female marathon runners by comparing with untrained controls.Time and frequency domain analysis of HRV was used to investigate cardiac ANS modulation.As compared with untrained controls, the female marathon runners showed faster HR recovery after exercise, which should result from their higher levels of HRV, higher aerobic capacity and exaggerated blood pressure response to exercise.
PMCID: PMC3880080  PMID: 24431957
Flexion; extension; land-based training
17.  Comparison of Abdominal Muscle Activity During a Single-Legged Hold in the Hook-Lying Position on the Floor and on a Round Foam Roll 
Journal of Athletic Training  2011;46(4):403-408.
Context:
To improve trunk stability or trunk muscle strength, many athletic trainers and physiotherapists use various types of unstable equipment for training. The round foam roll is one of those unstable pieces of equipment and may be useful for improving trunk stability.
Objective:
To assess the effect of the supporting surface (floor versus round foam roll) on the activity of abdominal muscles during a single-legged hold exercise performed in the hook-lying position on the floor and on a round foam roll.
Design:
Crossover study.
Setting:
University research laboratory.
Patients or Other Participants:
Nineteen healthy volunteers (11 men, 8 women) from a university population.
Interventions :
The participants were instructed to perform a single-legged hold exercise while in the hook-lying position on the floor (stable surface) and on a round foam roll (unstable surface).
Main Outcome Measure(s):
Surface electromyography (EMG) signals were recorded from the bilateral rectus abdominis, internal oblique, and external oblique muscles. Dependent variables were examined with a paired t test.
Results:
The EMG activities in all abdominal muscles were greater during the single-legged hold exercise performed on the round foam roll than on the stable surface.
Conclusions:
The single-legged hold exercise in the hook-lying position on an unstable supporting surface induced greater abdominal muscle EMG amplitude than the same exercise performed on a stable supporting surface. These results suggest that performing the single-legged hold exercise while in the hook-lying position on a round foam roll is useful for activating the abdominal muscles.
PMCID: PMC3419152  PMID: 21944072
trunk stability; low back pain; electromyography; injury prevention
18.  Trunk Muscle Activities During Abdominal Bracing: Comparison Among Muscles and Exercises 
Abdominal bracing is often adopted in fitness and sports conditioning programs. However, there is little information on how muscular activities during the task differ among the muscle groups located in the trunk and from those during other trunk exercises. The present study aimed to quantify muscular activity levels during abdominal bracing with respect to muscle- and exercise-related differences. Ten healthy young adult men performed five static (abdominal bracing, abdominal hollowing, prone, side, and supine plank) and five dynamic (V- sits, curl-ups, sit-ups, and back extensions on the floor and on a bench) exercises. Surface electromyogram (EMG) activities of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) muscles were recorded in each of the exercises. The EMG data were normalized to those obtained during maximal voluntary contraction of each muscle (% EMGmax). The % EMGmax value during abdominal bracing was significantly higher in IO (60%) than in the other muscles (RA: 18%, EO: 27%, ES: 19%). The % EMGmax values for RA, EO, and ES were significantly lower in the abdominal bracing than in some of the other exercises such as V-sits and sit-ups for RA and EO and back extensions for ES muscle. However, the % EMGmax value for IO during the abdominal bracing was significantly higher than those in most of the other exercises including dynamic ones such as curl-ups and sit-ups. These results suggest that abdominal bracing is one of the most effective techniques for inducing a higher activation in deep abdominal muscles, such as IO muscle, even compared to dynamic exercises involving trunk flexion/extension movements.
Key PointsTrunk muscle activities during abdominal bracing was examined with regard to muscle- and exercise-related differences.Abdominal bracing preferentially activates internal oblique muscles even compared to dynamic exercises involving trunk flexion/extension movements.Abdominal bracing should be included in exercise programs when the goal is to improve spine stability.
PMCID: PMC3772590  PMID: 24149153
Static and dynamic exercises; electromyogram; voluntary co-contraction; muscle- and exercise-related differences
19.  Altered muscle coordination when pedaling with independent cranks 
Pedaling with independent cranks ensures each leg cycles independently of the other, and thus eliminates the contribution of the contralateral leg during the upstroke phase. Consequently the subject is required to actively pull-up the pedal to complete the cycle. The present study aimed to determine the acute effect of the use of independent cranks on muscle coordination during a submaximal pedaling exercise. Ten healthy males were asked to perform submaximal pedaling exercises at 100 Watts with normal fixed cranks (control condition) or independent cranks. Both 2-D pedal forces and electromyographic (EMG) SIGNALS of 10 lower limb muscles were recorded. When the mean EMG activity across the cycle was considered, the use of independent cranks significantly increased the activity level compared to control for Tibialis anterior (TA) (P = 0.0017; +336 ± 302%), Gastrocnemius medialis (GM) (P = 0.0005; +47 ± 25%), Rectus femoris (RF) (P = 0.005; +123 ± 153%), Biceps femoris (BF)—long head (P = 0.0001; +162 ± 97%), Semimembranosus (SM) (P = 0.0001; +304 ± 192%), and Tensor fascia latae (P = 0.0001; +586 ± 262%). The analysis of the four pedaling sectors revealed that the increased activity of hip and knee flexors mainly occurred during the top dead center and the upstroke phase. In addition, a high inter-individual variability was found in the way the participants adapted to pedaling with independent cranks. The present results showed that the enforced pull-up action required when using independent cranks was achieved by increasing the activation of hip and knee flexors. Further studies are needed to determine whether training with independent cranks has the potential to induce long-term changes in muscle coordination, and, if so, whether these changes are beneficial for cycling performance.
doi:10.3389/fphys.2013.00232
PMCID: PMC3755179  PMID: 24009587
electromyography; cycling; training; pedaling; muscle contraction
20.  Rectus abdominis overuse injury in a tennis athlete treated with traumeel 
Summary
Background:
Rectus abdominis injuries are common in tennis players at all levels of competition. Traumeel® injection can be used for treatment of muscle strains and hematomas.
Case Report:
A 21-year-old female tennis athlete was injured on the non-dominant rectus abdominis during the cocking phase of the service motion. She suffered from pain and tenderness. One week later, during a serve, she experienced severe pain on the contralateral side of her abdomen. Conservative treatment was performed by the team physician with rest, ice therapy and analgesics for 20 days, but she had recurrent injuries. The ultrasonography and MRI showed hematoma of the rectus abdominis muscle. She was treated with 2 injections of Traumeel® on the 2nd, 4th, 6th post-traumatic day and received 1 injection on the 10th post-traumatic day. She also modified her serve technique. On the fourth post-treatment week the athlete had pain-free function and both the MRI appearance and the size of rectus abdominal muscle were normal. She returned to her sport activities. There is no recurrence of her injury 2 years later.
Conclusions:
Rectus abdominis hematoma must be diagnosed early. Traumeel® injections are effective, safe and well-tolerated for the treatment of overuse injury of the rectus abdominis following strain.
doi:10.12659/AJCR.882235
PMCID: PMC3616070  PMID: 23569472
rectus abdominis; overuse injury; Traumeel® injection
21.  MUSCLE ACTIVATION OF THE TORSO DURING THE MODIFIED RAZOR CURL HAMSTRING EXERCISE 
Purpose/Background:
The RAZOR curl has been introduced as a hamstring exercise. However, modifications to the exercise have been developed which are proposed to utilize some of the muscles of the lumbo-pelvic-hip complex. Thus, it was the purpose of this study to quantitatively examine the modified RAZOR curl using surface electromyography (sEMG), as an exercise that may recruit the trunk muscles of the lumbo-pelvic-hip complex.
Methods:
Twenty-eight active male and female graduate students (24.2±1.3 years; 174.8±9.9 cm; 74.9±14.9 kg), consented to participate. Dependent variables were muscle activation of trunk musculature (dominant side gluteus medius, gluteus maximus, multifidus, longissimus, lower rectus abdominis, upper rectus abdominis, external obliques) reported as percent of maximum voluntary isometric contraction (%MVIC) during the exercise while the independent variable was the muscle selected.
Results:
The multifidus and longissimus demonstrated moderately strong activation (35-50%MVIC) while the upper rectus abdominis demonstrated strong activation (20-35%MVIC) and the gluteus medius, gluteus maximus, lower rectus abdominis, and external obliques had minimal activation.
Conclusions:
These findings allow the practitioner to utilize an exercise that provides a functional training stimulus that activates not only the hamstrings but also some musculature of the trunk muscles of the lumbopelvic-hip complex at strong to moderately strong levels.
Level of Evidence:
5
PMCID: PMC3273882  PMID: 22319680
core control; core stabilization; functional exercises; sEMG
22.  Effects of a Bridging Exercise with Hip Adduction on the EMG Activities of the Abdominal and Hip Extensor Muscles in Females 
Journal of Physical Therapy Science  2013;25(9):1147-1149.
[Purpose] This study compared the activities of the abdominal and hip extensor muscles between the bridging exercise (BE) and bridging exercise with hip adduction (BEHA) positions in women using electromyography (EMG). [Subjects] We recruited 14 healthy adult females with no history of low back pain. [Methods] The subjects performed bridging exercises with and without hip adduction. The EMG activities of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and gluteus maximus (GM) muscles were recorded. [Result] The EMG activities of all muscles were significantly increased during the BEHA compared to the BE. [Conclusion] The bridging exercise with hip adduction produced greater activation of the abdominal and hip extensor muscles.
doi:10.1589/jpts.25.1147
PMCID: PMC3818763  PMID: 24259933
Bridging exercise; EMG; Hip adduction
23.  Analysis of the aerobic-anaerobic transition in elite cyclists during incremental exercise with the use of electromyography 
OBJECTIVES: To investigate the validity and reliability of surface electromyography (EMG) as a new non-invasive determinant of the metabolic response to incremental exercise in elite cyclists. The relation between EMG activity and other more conventional methods for analysing the aerobic-anaerobic transition such as blood lactate measurements (lactate threshold (LT) and onset of blood lactate accumulation (OBLA)) and ventilatory parameters (ventilatory thresholds 1 and 2 (VT1 and VT2)) was studied. METHODS: Twenty eight elite road cyclists (age 24 (4) years; VO2MAX 69.9 (6.4) ml/kg/min; values mean (SD)) were selected as subjects. Each of them performed a ramp protocol (starting at 0 W, with increases of 5 W every 12 seconds) on a cycle ergometer (validity study). In addition, 15 of them performed the same test twice (reliability study). During the tests, data on gas exchange and blood lactate levels were collected to determine VT1, VT2, LT, and OBLA. The root mean squares of EMG signals (rms-EMG) were recorded from both the vastus lateralis and the rectus femoris at each intensity using surface electrodes. RESULTS: A two threshold response was detected in the rms-EMG recordings from both muscles in 90% of subjects, with two breakpoints, EMGT1 and EMGT2, at around 60-70% and 80-90% of VO2MAX respectively. The results of the reliability study showed no significant differences (p > 0.05) between mean values of EMGT1 and EMGT2 obtained in both tests. Furthermore, no significant differences (p > 0.05) existed between mean values of EMGT1, in the vastus lateralis and rectus femoris, and VT1 and LT (62.8 (14.5) and 69.0 (6.2) and 64.6 (6.4) and 68.7 (8.2)% of VO2MAX respectively), or between mean values of EMGT2, in the vastus lateralis and rectus femoris, and VT2 and OBLA (86.9 (9.0) and 88.0 (6.2) and 84.6 (6.5) and 87.7 (6.4)% of VO2MAX respectively). CONCLUSION: rms-EMG may be a useful complementary non-invasive method for analysing the aerobic- anaerobic transition (ventilatory and lactate thresholds) in elite cyclists. 



PMCID: PMC1756168  PMID: 10378070
24.  ELECTROMYOGRAPHY DURING PEDALING ON UPRIGHT AND RECUMBENT ERGOMETER 
Background:
Ergometers are used during rehabilitation and fitness to restore range of motion, muscular strength, and cardiovascular fitness. The primary difference between upright and recumbent ergometers is that the seat and crank spindle are aligned nearly vertically on upright bicycles and nearly horizontally on recumbent ergometers. In addition, recumbent ergometers are characterized by large seats with backrests to provide support for the upper body and are low to the ground, permitting easier access for wheelchair users and individuals with mobility impairments. Despite the great utility of the recumbent bike, it has not been studied with regard to energy costs or muscular output. This is the first study to investigate the differences between two commercial ergometers by analyzing of lower limb EMG in participants who are not habitual cyclers.
Methods:
Ten non‐cyclist males with no history of musculoskeletal lower limb injury pedaled on standard recumbent and upright ergometers. EMG data were recorded from the volunteers’ lower limb muscles (rectus femoris, semitendinosus, tibialis anterior, and medial gastrocnemius muscles). EMG signals were normalized to the highest EMG signals recorded for the maximum voluntary isometric contractions (MVIC). The peak normalized EMG value of the studied muscles over the average of the 10 pedal cycles was analyzed.
Results:
The differences in average peak muscle activity were not statistically significant for any of the four muscles tested. Pedaling a recumbent ergometer resulted in greater activity in two (semitendinosus and tibialis anterior) of the four muscles studied. Only the rectus femoris muscle demonstrated greater activity during upright pedaling.
Conclusion:
There were no differences in the EMG activity of the muscles studied during pedaling on a standard recumbent and an upright stationary exercise ergometer at moderate workload. This increased understanding of muscle activity during pedaling may be useful in the development of new exercise protocols and therapeutic approaches.
Level of Evidence:
2c
PMCID: PMC3924611  PMID: 24567858
Bicycling; electromyography; ergometry; lower extremity; pedaling
25.  Differential activity of regions of transversus abdominis during trunk rotation 
European Spine Journal  2004;14(4):393-400.
The role of the abdominal muscles in trunk rotation is not comprehensively understood. This study investigated the electromyographic (EMG) activity of anatomically distinct regions of the abdominal muscles during trunk rotation in six subjects with no history of spinal pain. Fine-wire electrodes were inserted into the right abdominal wall; upper region of transversus abdominis (TrA), middle region of TrA, obliquus internus abdominis (OI) and obliquus externus abdominis (OE), and lower region of TrA and OI. Surface electrodes were placed over right rectus abdominis (RA). Subjects performed trunk rotation to the left and right in sitting by rotating their pelvis relative to a fixed thorax. EMG activity was recorded in relaxed supine and sitting, and during an isometric hold at end range. TrA was consistently active during trunk rotation, with the recruitment patterns of the upper fascicles opposite to that of the middle and lower fascicles. During left rotation, there was greater activity of the lower and middle regions of contralateral TrA and the lower region of contralateral OI. The upper region of ipsilateral TrA and OE were predominately active during right rotation. In contrast, there was no difference in activity of RA and middle OI between directions (although middle OI was different between directions for all but one subject). This study indicates that TrA is active during trunk rotation, but this activity varies between muscle regions. These normative data will assist in understanding the role of TrA in lumbopelvic control and movement, and the effect of spinal pain on abdominal muscle recruitment.
doi:10.1007/s00586-004-0799-9
PMCID: PMC3489203  PMID: 15940481
Transversus abdominis; Trunk rotation; Regional recruitment; Abdominal muscles; Electromyography

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