Immediate Effects of Sprinter-Pattern Exercise on the Lordotic Curve and Abdominal Muscle Activity in Individuals with Hyperlordosis.

Background and Objectives: Abdominal muscle exercises with limb movements are more effective for trunk stabilization than traditional exercises involving trunk flexion alone. This study examined the effects of abdominal exercises incorporating sprinter pattern and crunch exercises on changes in the lordotic curve and abdominal muscle activation in individuals with low back pain caused by hyperlordosis resulting from weak abdominal muscles. Materials and Methods: In this single-blind, randomized controlled trial, a total of 40 participants with hyperlordosis were recruited and randomly assigned to perform either sprinter-pattern abdominal exercises or crunch exercises. The participants assigned to each group performed three sets of ten abdominal exercises. The lumbar lordotic angle (LLA) and sacrohorizontal angle (SHA) were assessed prior to and following the intervention, whereas abdominal muscle activity was gauged throughout the intervention period. Changes in the LLA and SHA were measured by radiography. Abdominal muscle activity was measured using electromyography. Results: The LLA and SHA decreased significantly in both groups (p < 0.001), while the sprinter-pattern exercise group showed a statistically significant decrease compared to the crunch exercise group (p < 0.001). In the activity of the abdominal muscles, there was no significant difference in the rectus abdominis muscle between the two groups (p > 0.005). However, a significant difference between the external and internal oblique muscles was observed, and the activities of both muscles were significantly higher in the sprinter-pattern exercise group than in the crunch exercise group (p < 0.005). Conclusions: Abdominal exercise using a sprinter pattern may be effective in reducing lumbar lordosis by strengthening the abdominal muscles in patients with hyperlordosis.

Relationship Between Muscle Activity and Force During Suspended Bridge Exercises.

CONTEXT: Isometric core stability exercises are commonly used to target muscles of the lumbopelvic-hip complex, including the rectus abdominis (RA) and erector spinae (ES). These exercises can be implemented in rehabilitation protocols to increase muscle strength and endurance. Difficulty can be progressed by modifying the base of support or adding an unstable element. Load cells can be affixed to suspension training devices to measure force exerted through the straps during exercise. The primary purpose of this study was to assess the relationship between activity of the RA and ES to force measured through a load cell fixed to suspension straps during bilateral and unilateral suspended bridge exercises. DESIGN: Forty asymptomatic, active individuals completed a single laboratory visit. METHODS: Participants completed 2 bilateral suspended bridges and 2 unilateral suspended bridges held to failure. Surface electromyography sensors were placed over the bilateral RA and ES to quantify muscle activity (% maximum voluntary isometric contraction). A load cell was affixed to the suspension straps to measure force exerted through the straps throughout the duration of the exercise. Pearson correlations were used to determine relationships between force and muscle activity of the RA and ES throughout exercise duration. RESULTS: Force was negatively related to RA muscle activity in bilateral suspended bridges (r = -.735 to -.842, P < .001) and unilateral suspended bridges (r = -.300 to -.707, P = .002 to <.001). Force had a positive relationship with ES muscle activity in bilateral suspended bridges (r = .689 to .791, P < .001) and unilateral suspended bridges (r = .418 to .448, P < .001). CONCLUSIONS: Suspended bridge exercises can be a valuable tool to target posterior abdominal musculature such as the ES to contribute to core stability and endurance. Load cells can be applied during suspension training to quantify the interaction between individuals and the exercise equipment.

Application of Feedback Type on Performance of Abdominal Drawing-In Maneuver in Healthy Adults: A Quasi-Experimental Study of Motor Control and Motor Learning.

OBJECTIVE: The aim of this study was to compare the effects of verbal, tactile-verbal, and visual feedback on muscle activation of the lumbar stabilizers relative to extremity movers during an abdominal drawing-in maneuver when feedback is withheld. METHODS: This quasi-experimental study equally divided 54 healthy adults into 3 feedback groups (verbal, tactile-verbal, and visual) who trained twice per week over a 4-week period to perform supine abdominal drawing-in maneuvers. The percentage of maximum voluntary isometric contraction of rectus abdominis, multifidus (MF), erector spinae, and hamstrings (HS) as an outcome measure was acquired using surface electromyography. A 2-way factorial analysis of variance with bootstrapping allowed for comparison of post-pre difference scores across the interaction of feedback and muscle groups. RESULTS: Hamstring activation decreased in those receiving tactile-verbal feedback relative to an increase in participants given visual feedback. Furthermore, when using verbal feedback, HS activity increased relative to a decline in rectus abdominis, and when presenting visual feedback, HS activity increased relative to a decrease in MF. However, no post-pre changes were seen across muscles with tactile-verbal feedback. CONCLUSION: Although tactile-verbal feedback did not increase MF recruitment, it produced less HS activity than visual feedback. Undesirable HS recruitment may reflect boredom or feedback dependency.

Changes in Trunk Muscle Activity during Unilateral Weight Bearing and Abnormal Postural Gait in Healthy Individuals.

Background and Objectives: Many people tend to carry their bags or baggage on only one side of their body. Due to smartphone use, people also tend to walk bent forward in a kyphotic posture. In this study, we aimed to assess trunk muscle activity changes due to weight-bearing, carried in the left or right hand, and using three different gait postures. Materials and Methods: We recruited 27 healthy participants (aged 19−75 years) with no history of LBP within the last 6 months before study participation. Electromyographic activities of the lower back and the abdominal muscles of the participants were evaluated using four-channel surface electromyography (EMG). Surface EMG recordings were obtained from four trunk muscles, including the flexor (rectus abdominis (RA), external oblique (EO)) and extensor muscles (lumbar erector spinae (LE), and the superficial lumbar multifidus (LM)), during unilateral weight-bearing tasks and with different gait postures (normal gait, with a sway back, and thoracic kyphosis). Results: In the "unilateral weight-bearing task", there was a significant difference in the activity of all the trunk muscles between the weight-bearing limb side and the opposite side (p < 0.05). The activation of the left trunk muscle was greater than that of the right trunk muscle when the dumbbell was lifted using the right hand. The other side showed the same result. In the "gait posture task" performed by the participants using a sway-back posture, the RA and EO had a higher level of activity in the stance and swing phases compared with that in a neutral gait (p < 0.05). Moreover, in the participants with a thoracic kyphosis posture, the LE and LM had a higher level of activity compared with that in a neutral gait (p < 0.05). Conclusions: Our results indicate that abnormal gait posture and unilateral weight-bearing tasks may impair the balance of trunk muscles, increasing the incidence of LBP. However, further large-scale, prospective, controlled studies are warranted to corroborate our results.

Side-To-Side Difference in Electromyographic Activity of Abdominal Muscles during Asymmetric Exercises.

A side-to-side difference in the muscle size of the rectus abdominis has been suggested to increase the strain injury risk. Attenuating the difference in size of the rectus abdominis may decrease the injury risk. To explore ways to highly activate one side of the rectus abdominis, we aimed to clarify the activity levels of both sides of the muscle during asymmetric abdominal exercises. Fifteen male sprinters performed the following five asymmetric exercises for the right and left sides: (i) sit-up twist, (ii) oblique leg raise, (iii) side bridge, (iv) side bridge roll out with the elbow, and (v) side bridge roll out with the foot. Side bridge roll out with the elbow and that with the foot were performed using a wheeled platform. During the exercises, electromyographic signals were recorded bilaterally from the upper, central, and lower portions of the rectus abdominis. We calculated the root mean square of electromyograms during the concentric and eccentric phases of the exercises and normalized to that during maximal voluntary contractions. In all portions of the rectus abdominis, the root mean squares of electromyograms were significantly higher in the moving side than in the non-moving side during the concentric and eccentric phases of the side bridge, the side bridge roll out with the elbow and that with the foot (all p < 0.01), but not in sit-up twist or oblique leg raise. The root mean squares of electromyograms of all portions of the rectus abdominis in the moving side were significantly higher in the side bridge roll out with the elbow and that with the foot than in the side bridge during both phases (all p < 0.01). The results suggest that the application of the wheeled platform to side bridge is useful to highly activate one side of the rectus abdominis.

Cross-sectional areas of rectus abdominis and psoas muscles reduces following surgery in rectal cancer patients.

PURPOSE: To evaluate the trophic changes in rectus abdominis and psoas muscles in patients who underwent open or laparoscopic rectum resection for rectal cancer. METHODS: We retrospectively analyzed preoperative staging computerized tomographies (CT) and postoperative first oncological follow-up CTs of the patients who underwent low anterior resection (LAR) for rectal cancer from 2010 through 2015. We measured cross-sectional area of left and right rectus abdominis muscles from two levels (above and below umbilicus) where they are widest and psoas muscle at mid-level of the fourth lumbar vertebral body in axial CT images and compared preoperative and postoperative measurements. We investigated the effects of age, sex, administration of preoperative chemoradiotherapy (CRT), type of surgery (open or laparoscopic), or construction of a diverting ileostomy on cross-sectional muscle area changes. RESULTS: After applying inclusion and exclusion criteria 60 patients found to be eligible for the study. Muscle areas of all measurement sites were reduced postoperatively compared to paired preoperative values. There was no significant effect of age, sex, administration of preoperative CRT, type of surgery (open or laparoscopic), or construction of a diverting ileostomy to muscle cross-sectional area reductions. CONCLUSION: Cross-sectional areas of the rectus abdominis and the psoas muscles of rectal cancer patients reduces following rectum resection which indicates atrophy of these muscles. Clinicians should be aware of this problem and focus on prevention of muscle atrophy during the treatment of rectal cancer patients.

Trunk muscle activity during different types of low weighted squat exercises in normal and forefoot standing conditions.

Squats are considered a useful basic exercise for trunk muscle activation. To gain knowledge about trunk muscle activity patterns depending on the barbell position in beginners, we examined squats with low weights in the back, front, and overhead position. METHODS: Twelve healthy adults (6 women/6 men, age: 29.1 (SD 8.0) y, height: 173.4 (6.9) cm, body mass: 70.1 (9.1) kg) randomly performed the three barbell squats in normal and in forefoot standing. Surface electromyography from external (EO) and internal oblique, rectus abdominis, and erector spinae (ES) was recorded. The centre of pressure path length (CoP) and the motion of the lumbar spine were captured. RESULTS: The overhead squat revealed the highest percent muscle activity, where EO (p = 0.009) and ES (p = 0.03) showed the greatest activity. Forefoot standing did not change overall trunk muscle activities (.05< Hedges' g <.29, 0.17 < p < 0.95) although longer CoP path length (.45 < g < 1.3, p < 0.05) was measured. CONCLUSIONS: Squat exercises with low weight are useful to activate trunk muscles. Activity increases with the difficulty of the squat by frontal or overhead loading, but not by standing on the forefoot. The low weighted squat can target well core muscle activity in training with beginners or in rehabilitation.

Electromyographic and Kinematic Analysis of the Flexion-Rotation Trunk Test.

García-Vaquero, MP, Ruiz-Pérez, I, Barbado, D, and Vera-Garcia, FJ. Electromyographic and kinematic analysis of the flexion-rotation trunk test. J Strength Cond Res 34(12): 3386-3394, 2020-Although most trunk endurance field protocols are performed in the sagittal or frontal planes, the flexion-rotation trunk (FRT) test combines trunk flexion with rotation, which may be relevant to rotation-related sports. The aim of this study was to describe the trunk and hip muscle activation and fatigue and the range of hip flexion of this test. Twenty-seven physically active males and females performed the FRT test after a period of practice. Electromyographic (EMG) signals were bilaterally collected from the rectus abdominis (RA), internal oblique (IO), and rectus femoris (RF), and hip flexion amplitude was measured using a biaxial electrogoniometer. Because the fast Fourier transform algorithm requires stationary EMG signals, subjects performed a 6-second isometric trunk flexion-rotation repetition just before and just after the test execution (preexecution and postexecution repetitions, respectively). Rectus abdominis showed the highest mean activation levels (approximately 30% maximal voluntary isometric contractions [MVC]) in the preexecution repetition, followed by IO (approximately 20% MVC). Also, the mean power frequency (MPF) significantly decreased from the pre-execution to the postexecution repetition for RA and IO, which shows abdominal muscle fatigue. Although each trunk flexion-rotation repetition involved an average 8-14° hip flexion, the RF activation was lower than 10% MVC, and no significant MPF reduction (i.e., no muscle fatigue) was observed for this muscle. In addition, significant negative correlations were found between the FRT test scores and the normalized EMG amplitudes of RF. Based on these results, the FRT test seems a valid field protocol to assess abdominal muscle endurance in trunk flexion-rotation exertions.

The Effect of Respiratory Phase on Abdominal Muscle Activity During Stable and Unstable Sitting Positions in Individuals With and Without Chronic Low Back Pain.

OBJECTIVE: The aim was to assess the abdominal muscle activities during inspiration and expiration at different sitting positions in individuals with and without chronic low back pain (CLBP). METHODS: This study was conducted on 36 participants (18 with CLBP and 18 healthy controls). Ultrasound imaging was used to assess thickness changes of the transverse abdominis, internal oblique, rectus abdominis, and external oblique muscles. Muscle thickness was measured during inspiration and expiration under 3 different stability levels: sitting on a chair, sitting on a gym ball, and sitting on a gym ball with lifting the left foot. The muscle thickness measured in these positions was normalized to the actual muscle thickness at rest in supine lying and presented as a percentage of thickness change. RESULTS: Both groups displayed greater abdominal muscle activities as the stability of the surface decreased during both respiratory phases. However, compared with the healthy controls, the CLBP group showed smaller muscle thickness changes in all abdominal muscles, except the external oblique, in both respiration phases while sitting on a gym ball with lifting the left foot. The CLBP group displayed overactivity of the rectus abdominis muscle relative to the healthy controls while sitting on a chair in both respiratory phases. CONCLUSION: The findings of the study indicate that as the stability of the support surface decreases, individuals with CLBP had more difficulty activating all abdominal muscles in a similar manner compared to healthy controls in both respiratory phases, which might affect both respiration and postural stability.

The Effect of Additional External Resistance on Inter-Set Changes in Abdominal Muscle Thickness during Bridging Exercise.

Bridging exercises with abdominal hollowing are often used as a regimen for improving spinal stability. Lately, this type of training has become very popular among elite athletes, creating a need for more demanding exercises. The purpose of this study was to investigate whether the use of additional external resistance is beneficial for abdominal muscle recruitment during bridge exercise. Tissue movement of the transversus abdominis (TrA) and the rectus abdominis (RA) was recorded with the use of two synchronized ultrasonic devices, in 20 healthy college students. From the hook-lying position participants were examined in eight different exercise conditions: a) rest, b) abdominal drawing-in maneuver (ADIM), c) bridge, d) bridge- ADIM, e) bridge with 10KG, f) bridge- ADIM with 10KG, g) bridge with 20KG and h) bridge-ADIM with 20KG. Analysis of variance (ANOVA) showed a statistically significant increase in TrA thickness when performing the bridge exercise combined with ADIM compared to rest mode (p < .05). RA thickness decreased when the ADIM was performed, compared to rest (p < 0.05). No significant difference in TrA and RA thickness when exercising with and without external resistance was observed (p > 0.05). The main outcome of this study was that external loading provided some extra level of difficulty, yet it was not beneficial for abdominal muscle recruitment, when performing a supine bridge exercise.

Simultaneous Changes in Abdominal Adipose and Muscle Tissues Following Treatments by High-Intensity Focused Electromagnetic (HIFEM) Technology-Based Device: Computed Tomography Evaluation

Objective: This study investigates the effects of high-intensity focused electromagnetic technology for induction of changes in abdominal muscles and abdominal subcutaneous fat. Methods: 22 male and female subjects (aged 34 to 64, mean BMI, 23.5kg/m2) underwent 8 treatments of the abdomen (2 per week) with a high-intensity focused electromagnetic field device. Subjects were scanned by computed tomography (CT) at baseline and 1 month after the eighth treatment. Sub-umbilical and epi-umbilical slices were used to measure the thickness of subcutaneous fat and abdominal muscles and the abdominal separation. In addition, standardized photographs, weight, and circumference measurements were collected. Results: While comparing baseline to follow-up measurements, CT data showed on average 17.5% (-3.1±1.9mm) reduction in subcutaneous fat and simultaneous 14.8% (+1.5±0.8mm) thickening of the rectus abdominis muscle. Subjects lost on average 3.9±3.1cm in the waist circumference. Most of the waist reduction effect was achieved after the fourth treatment. The width of abdominal separation decreased by 9.5% (-2.0±1.7mm). All results were highly significant (P<0.01) while weight change was insignificant (P<0.05). Digital photographs showed aesthetic improvement in most subjects. The treatments were painless and without adverse events. Conclusion: Results suggest that the investigated device is effective for abdominal body sculpting. This technology produced rectus muscle hypertrophy and a reduction in subcutaneous abdominal fat. Data suggests 4 treatments as the ideal protocol delivering 86% of the observed improvement. J Drugs Dermatol. 2019;18(11):1098-1102.

Trunk Muscle Activation in the Back and Hack Squat at the Same Relative Loads.

Clark, DR, Lambert, MI, and Hunter, AM. Trunk muscle activation in the back and hack squat at the same relative loads. J Strength Cond Res 33(7S): S60-S69, 2019-The hack squat (HS) is likely to produce a greater 1 repetition maximum (1RM) compared with the back squat (BS). This can be attributed to the support of the trunk during the HS compared with no support during BS. This support, however, may compromise trunk muscle activation (TMA), therefore producing different training adaptations. Accordingly, the purpose of this study was to compare 1RM in BS and HS and TMA at 4 relative loads, 65, 75, 85, and 95% of maximal system mass. Ten males completed 3 test sessions: (a) BS and HS 1RM, (b) HS and BS neuromuscular test familiarization, and (c) neuromuscular test for 3 reps at 4 loads for BS and HS. Back squat TMA was significantly greater (p ≤ 0.05) than HS for all muscles and phases except rectus abdominus in concentric phase. Trunk muscle activation increased (p ≤ 0.05) with load in all muscles for both exercises and phases apart from lumbar sacral erector spinae in HS eccentric phase. Mean HS 1RM and submaximal loads were significantly (p < 0.0001) higher than the equivalent BS loads. Duration of the eccentric phase was higher (p < 0.01) in HS than BS but not different in concentric phase. Duration increased significantly (p < 0.01) with load in both exercises and both phases. Despite higher absolute tests loads in HS, TMA was higher in BS. Trunk muscle activation is sensitive to load in both exercises. Back squat is more effective than HS in activating the muscles of the trunk and therefore, arguably more effective in developing trunk strength and stability for dynamic athletic performance.

Effects of the Safety Squat Bar on Trunk and Lower-Body Mechanics During a Back Squat.

Hecker, KA, Carlson, LA, and Lawrence, MA. Effects of the safety squat bar on trunk and lower-body mechanics during a back squat. J Strength Cond Res 33(7S): S45-S51, 2019-The purpose of this study was to determine whether the safety squat bar (SSB) alters the mechanics and muscle activity of a back squat compared with a standard barbell (ST). Motion and muscle activation of the trunk and lower extremity were measured while 12 competitive powerlifters (8 males, 4 females, age 31.5 ± 6.3 years, body mass 88.1 ± 20.7 kg, competitive lifting experience 3.3 ± 2.8 years) squatted 3 sets of 5 repetitions at 75% of their 3 repetition maximum (3RM). Mean muscle activity and peak joint flexion angles were measured for the trunk and one lower extremity. A repeated-measures analysis of variance (p = 0.05) revealed an 11.3% decrease in 3RM when using the SSB. When using the SSB, there was a decrease in trunk and hip flexion (7.3 and 5.7° respectively) and a 50.3% increase in lower trapezius activation. However, using the SSB decreased activation of the rectus abdominis (46.3%), medial hamstring (17.1%), lateral hamstring (15.1%), vastus lateralis (9.3%), and medial gastrocnemius (18.8%). Squatting with the SSB resulted in a more upright trunk angle, which places less stress on the lower back, a commonly injured area when squatting. Decreases in lower-extremity muscle activation are likely due to the decreased load used, suggesting that the SSB may not be as effective as a standard bar to increase lower-extremity strength. However, the increase in the lower trapezius with the lighter load suggests that midback musculature may be challenged more by the SSB than a standard barbell.

Comparison of the Abdominal Wall Muscle Thickness in Female Rugby Players Versus Non-Athletic Women: A Cross-Sectional Study.

Background and Objectives: Rugby players engage in demanding, high loading muscular activity in the spine. Study of the abdominal wall architecture in female rugby athletes is relevant to the possible muscular asymmetry secondary to sport practice and the relationship between the abdominal wall and the pelvic floor muscles. Activation of the transversus abdominis (TrAb) generates an increase in the bladder neck muscle. Moreover, an increased interrecti distance (IRD) is related to urinary incontinence and has a higher prevalence in athletic women. The aim of the present study was to compare and quantify, with ultrasound imaging (USI), the thickness of the transversus abdominis (TrAb), external oblique (EO), internal oblique (IO), rectus abdominis (RA), and interrecti distance (IRD) in female rugby players versus non-athletic women in order to improve upon existing knowledge about abdominal wall configuration in female athletes. Materials and Methods: A sample of 32 women was recruited at the Universidad Europea Research Lab and divided in two groups: a rugby group (n = 16) and a non-athletic women group (n = 16). The thickness of the TrAb, EO, IO, RA, and IRD were assessed by USI in both groups. Results: There were statistically significant differences for the ultrasound evaluation thickness of the right TrAb (p = 0.011; d = 0.10), EO (p = 0.045; d = 0.74), IO (p = 0.003; d = 1.32), and RA (p = 0.001; d = 1.38) showing a thickness increase for the rugby group with respect to the control group. For the IRD thickness, there were no significant differences (p > 0.05) between groups. Conclusions: An increased TrAb, IO, EO, and RA thickness may be shown in female rugby players versus non-athletic women. Nevertheless, statistically relevant differences were not found for the IRD between both groups.

Correlation between Cycling Power and Muscle Thickness in Cyclists.

The aim of this study was to determine the correlation between muscle thickness (MT) and cycling power in varsity cyclists using ultrasonography (US) and to identify any differences in MT between short- and long-distance cyclists. Twelve cyclists participated in this study. Real-time two-dimensional B-mode US was used to measure the MT in the anterior thigh, anterior lower leg, and trunk, especially in the abdominal and lumbar regions. A cycle ergometer was used to measure cycling power parameters such as maximum anaerobic power (over 5 s), mean anaerobic power (over 30 s), and aerobic power (over 3 min). This study was approved by the Ethics Committee of Korea National Sports University. There was a significant relationship between the MT and cycling power for the rectus femoris (RF) and vastus lateralis (VL) in the thigh, the rectus abdominis (RA) in the abdominal region, and the erector spinae (ES) in the lower back. The MT values of the RF, VL, and ES were strongly associated with the maximum and mean anaerobic power. There were significant differences between short- and long-distance cyclists in the MT of the RF in the thigh, the RA, the external abdominal oblique, the internal abdominal oblique, and the transverse abdominis muscle in the abdomen. We suggest that training programs attempting to improve cycling performance focus on improving the VL and ES via resistance weight or cycle training and also the core muscles for short-distance cyclists. Clin. Anat. 31:899-906, 2018. © 2018 Wiley Periodicals, Inc.

Ultrasound Evaluation of the Abdominal Wall and Lumbar Multifidus Muscles in Participants Who Practice Pilates: A 1-year Follow-up Case Series.

OBJECTIVE: The purpose of this study was to describe ultrasound (US) changes in muscle thickness produced during automatic activation of the transversus abdominis (TrAb), internal oblique (IO), external oblique (EO), and rectus abdominis (RA), as well as the cross-sectional area (CSA) of the lumbar multifidus (LM), after 1 year of Pilates practice. METHODS: A 1-year follow-up case series study with a convenience sample of 17 participants was performed. Indeed, TrAb, IO, EO, and RA thickness, as well as LM CSA changes during automatic tests were measured by US scanning before and after 1 year of Pilates practice twice per week. Furthermore, quality of life changes using the 36-Item Short Form Health Survey and US measurement comparisons of participants who practiced exercises other than Pilates were described. RESULTS: Statistically significant changes were observed for the RA muscle thickness reduction during the active straight leg raise test (P = .007). Participants who practiced other exercises presented a larger LM CSA and IO thickness, which was statistically significant (P < .05). Statistically significant changes were not observed for the domains of the analyzed 36-Item Short Form Health Survey (P > .05). A direct moderate correlation was observed (r = 0.562, P = .019) between the TrAb thickness before and after a 1-year follow-up. CONCLUSIONS: Long-term Pilates practice may reduce the RA thickness automatic activation during active straight leg raise. Furthermore, LM CSA and IO thickness increases were observed in participants who practice other exercise types in conjunction with Pilates. Despite a moderate positive correlation observed for TrAb thickness, the quality of life did not seem to be modified after long-term Pilates practice.

Effects of backpack load on critical changes of trunk muscle activation and lumbar spine loading during walking.

This study investigated the effects of carrying a backpack while walking. Critical changes featuring the disproportionality of increases in trunk muscle activation and lumbar joint loading between light and heavy backpack carriage weight may reveal the load-bearing strategy (LBS) of the lumbar spine. This was investigated using an integrated system equipped with a motion analysis, a force platform and a wireless surface electromyography (EMG) system to measure the trunk muscle EMG amplitudes and lumbar joint component forces. A predictive goal programming model was developed to determine the most critical changes in trunk muscle activation and lumbar joint loading. Results suggested that lightweight backpack carriage at approximately 3% of body weight (BW) might reduce the peak lumbosacral compression force by 3% during walking compared with no load condition. The most critical changes in both trunk muscle activation and lumbosacral joint loading were found at a backpack load of 10% of BW. Practitioner Summary: This study investigated the effects of backpack load on the LBS of lumbar spine while walking. A backpack load of 3% of BW might reduce the peak lumbosacral compression force by 3 and 10% of BW induced the most critical changes in LBS of lumbar spine.

Development of a lumbar EMG-based coactivation index for the assessment of complex dynamic tasks.

The objective of this study was to develop and test an EMG-based coactivation index and compare it to a coactivation index defined by a biologically assisted lumbar spine model to differentiate between tasks. The purpose was to provide a universal approach to assess coactivation of a multi-muscle system when a computational model is not accessible. The EMG-based index developed utilised anthropometric-defined muscle characteristics driven by torso kinematics and EMG. Muscles were classified as agonists/antagonists based upon 'simulated' moments of the muscles relative to the total 'simulated' moment. Different tasks were used to test the range of the index including lifting, pushing and Valsalva. Results showed that the EMG-based index was comparable to the index defined by a biologically assisted model (r2 = 0.78). Overall, the EMG-based index provides a universal, usable method to assess the neuromuscular effort associated with coactivation for complex dynamic tasks when the benefit of a biomechanical model is not available. Practitioner Summary: A universal coactivation index for the lumbar spine was developed to assess complex dynamic tasks. This method was validated relative to a model-based index for use when a high-end computational model is not available. Its simplicity allows for fewer inputs and usability for assessment of task ergonomics and rehabilitation.

Influence of Scapular Position on the Core Musculature Activation in the Prone Plank Exercise.

Cortell-Tormo, JM, García-Jaén, M, Chulvi-Medrano, I, Hernández-Sánchez, S, Lucas-Cuevas, ÁG, and Tortosa-Martínez, J. Influence of scapular position on the core musculature activation in the prone plank exercise. J Strength Cond Res 31(8): 2255-2262, 2017-Prone plank is a widely used exercise in core stability training. Research has shown that pelvic tilt plays an important role on the electromyographic (EMG) activation of core musculature. However, the influence of scapular position on EMG activation is currently unknown. Therefore, this study evaluated the influence of scapular position on the core muscles during a prone plank. Surface EMG of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) was collected in 15 participants (10 men and 5 women). Four variations of the prone plank were evaluated: scapular abduction with anterior (ABANT) and posterior (ABRET) pelvic tilt; and scapular adduction with anterior (ADANT), and posterior (ADRET) pelvic tilt. Individual muscle EMG and overall EMG for each plank exercise was analyzed. Joint positions were controlled with a 2D kinematic analysis. Ratings of perceived exertion (RPE) were also registered. The ADRET resulted in higher overall EMG activity compared with ABANT (p = 0.04) and ADANT (p = 0.04). Moreover, ADRET resulted in greater EMG activity compared with ADANT, ABANT, and ABRET for EO (p = 0.000; p = 0.000; p = 0.035), IO (p = 0.000; p = 0.000; p = 0.005), and ES (p = 0.019; p = 0.001; p = 0.014). Regarding RA, ADRET was significantly higher compared with ADANT (p = 0.002) and ABANT (p = 0.005). Finally, ADRET provoked a higher RPE compared with ABANT (p = 0.000), ABRET (p = 0.001), and ADANT (p = 0.015). These findings demonstrate the influence of the scapular and pelvic position on the EMG response of the core muscle groups analyzed in this study, and highlight the greater contribution of these muscles to the postural stabilizing demands during posterior pelvic tilt positions, particularly when the scapulae are in adduction.

Extracorporal Shock Wave Therapy as a Delay Procedure to Improve Viability of Zone 4: An Experimental Study in a Rat TRAM Flap Model.

BACKGROUND: The purpose of this study was to test our hypothesis that preoperative application of radial extracorporeal shock wave therapy (rESWT) as a delay procedure would improve the survival of zone 4 of transverse rectus abdominis musculocutaneous (TRAM) flap and reduce the resulting necrotic area. METHODS: Twenty-four Wistar rats were randomized and divided into 3 experimental groups (n = 8 each). Caudally based TRAM flap model, with the right rectus abdominis muscle as the carrier and right inferior epigastric vessels as the vascular pedicle, was used in this study. In group 1 (control), after being raised, the TRAM flap was sutured back to its bed without any further intervention. In group 2, the TRAM flap was raised, and rESWT was administered immediately after the flap was sutured back to its bed. In group 3, rESWT was applied 7 days before the elevation of the flap, as a delay procedure. Seven days after the administration of rESWT, TRAM flap was raised and then sutured back to its bed. RESULTS: At postoperative day 5, the mean percentage of skin flap survival was 61.82 ± 12.22 for group 1, 77.65 ± 4.62 for group 2, and 79.89 ± 5.86 for group 3. Groups 2 and 3 revealed higher survival areas when compared with control group (P = 0.02). In rESWT applied groups 2 and 3, the increase in capillary density and dilatation of microvessels in the skin flap survival areas were obvious. Histologic analysis revealed significantly higher neovascularization and less inflammation in zone 4 of rESWT applied groups (P < 0.001 and P = 0.042, respectively). CONCLUSIONS: ESWT appears to be a cheap, practical, and promising option for improving the viability of zone 4 of TRAM flap and may also be used as a delay procedure in the clinical setting.