Elsevier

Human Movement Science

Volume 54, August 2017, Pages 24-33
Human Movement Science

Full Length Article
Applying an active lumbopelvic control strategy during lumbar extension exercises: Effect on muscle recruitment patterns of the lumbopelvic region

https://doi.org/10.1016/j.humov.2017.03.002Get rights and content

Highlights

  • Prone extension exercises were studied with/without active lumbopelvic stabilization.

  • Effects on muscle recruitment and spinal kinematics were reported.

  • Posterior extensor muscle activity depends on the type of prone extension exercise.

  • The lumbar lordosis reduced when exercises were performed with stabilization.

  • Applying the stabilization strategy altered the muscle recruitment patterns.

Abstract

Objective

Examine whether implementing an active lumbopelvic control strategy during high load prone lumbar extension exercises affects posterior extensor chain recruitment and lumbopelvic kinematics.

Methods

Thirteen healthy adults acquired an optimal active lumbopelvic control strategy during guided/home-based training sessions. During the experimental session electromyography was used to evaluate the activity of the posterior extensor chain muscles during high load trunk/bilateral leg extension exercises with/without application of the strategy. Video-analysis was used to evaluate thoracic/lumbar/hip angles.

Results

Implementing the active lumbopelvic control strategy decreased the lordotic angle during trunk (p = 0.045; −3.2°) and leg extension exercises (p = 0.019; −10°). The hip angle was solely affected during trunk extension (p < 0.001; +9.2°). The posterior extensor chain (i.e. mean of the relative activity of all muscles (%MVIC) was recruited to a higher extent (p = 0.026; +9%) during trunk extension exercises performed with active lumbopelvic control. Applying the strategy during leg extension exercises lead to less activity of longissimus thoracic (p = 0.015; −10.2%) and latissimus dorsi (p = 0.010; −4.4%), and increased gluteus maximus activity (p  0.001; +16.8%).

Conclusions

When healthy people are taught/instructed to apply an active lumbopelvic control strategy, this will decrease the degree of lumbar (hyper)lordosis and this influences the recruitment patterns of trunk and hip extensors. Hence, the possible impact on predetermined training goals should be taken into account by trainers.

Introduction

Lumbar extension exercises are widely used in training regimens to enhance endurance, strength and functionality of the posterior extensor chain as this will enhance performance levels (Steele et al., 2015, Verna et al., 2002). This chain consists of the extensor muscles located in the thoracic, lumbar and pelvic region of the posterior side of the body. More specifically, the posterior extensor chain consists of the Latissimus Dorsi (LD), the Thoracic Erector Spinae (TES) which is formed by the Longissimus thoracis pars Thoracic (LT) and Iliocostalis lumborum pars Thoracis (IT), the Lumbar Erector Spinae (LES) which is formed by the Longissimus thoracis pars Lumborum (LL) and Iliocostalis lumborum pars Lumborum (IL), the Lumbar Multifidus (LM), the Gluteus Maximus (GM) and the Biceps Femoris (BF), which are functionally coupled via the thoracolumbar fascia (Vleeming, Pool-Goudzwaard, Stoeckart, van Wingerden, & Snijders, 1995). Despite the fact that only some of these muscles directly attach on to the lumbar vertebrae, a contraction of one of the muscles will influence the lumbar region, even if this is not the muscle its primary function. Although many different modalities of lumbar extension exercises exist (Mayer et al., 1999, Mayer et al., 2008, Mayer et al., 2002, Plamondon et al., 2002) trainers often implement modalities performed from prone position into training programs (Mayer et al., 2003, Verna et al., 2002). By extending either the trunk or the legs, lumbar extension and activation of the muscles generating this movement is induced. These exercises are ‘high load’ as they activate the muscles from the posterior extensor chain at high degrees, namely between 40 and 70% of their maximal voluntary isometric contraction (MVIC) (Clark et al., 2002, Dickx et al., 2010, Mayer et al., 1999, Mayer et al., 2002, Plamondon et al., 2002). Because these trunk and leg extension exercise modalities from prone position do not require expensive training devices they can be easily performed in the gym, at home, and during field training.

However, it has been shown that lumbar extension exercises from prone position can cause high spinal compressive loads (up to 6000 N) due to excessive anterior pelvic tilt and hyperlordosis of the lumbar spine, which could diminish the positive training effects (Callaghan et al., 1998, Granata et al., 2005, McGill, 2002). It has been advocated that these disadvantages can be limited by applying active lumbopelvic control techniques during exercise (Oh, Cynn, Won, Kwon, & Yi, 2007). In normal trunk function co-contraction of the deep lumbopelvic muscles, i.e. LM, transversus abdominis (TA), and the pelvic floor muscles, precedes the activation of prime movers during movements which jeopardize the trunk stability, providing mechanical stability for spinal loads exceeding 1500 N (Demoulin et al., 2007, Panjabi, 2003). As contraction of this lumbopelvic muscle corset contributes significantly to lumbar segmental control, the use of these deep muscles should be optimized using training and implemented during lumbar extension exercises (Jull & Richardson, 1994). The lumbopelvic control training focuses on teaching subjects to actively co-contract the deep lumbopelvic muscles and to maintain this co-contraction while performing activities such as prone lumbar extension exercises (Cameron and Monroe, 2011, Oh et al., 2007). The continuous tonic low level activation of the deep lumbopelvic muscles will form a cylinder around the lumbar spine providing functional control during these activities and exercises (Cholewicki and VanVliet, 2002, Hodges, 1999, Hodges, 2003).

Currently, little is known on how active involvement of this lumbopelvic muscle corset during lumbar extension exercises influences the recruitment of the posterior extensor chain in healthy people. Several studies have demonstrated that contracting the lumbopelvic muscle corset alters the muscle recruitment patterns when performing low load exercises or daily activities (Oh et al., 2007, Stevens et al., 2007, Watanabe et al., 2007). For instance, it has been demonstrated that an abdominal drawing-in maneuver, used to facilitate activation of the TA, during prone unilateral leg extension reduces the LES activity but increases the activity of the hip extensors (Oh et al., 2007). On the other hand, it has been shown that contraction of the lumbopelvic muscle corset during active sitting enhances the activity of the LES and LM (Watanabe et al., 2007). As these studies have examined the recruitment patterns during different activities or positions, are limited to low load activities or exercises, and have not examined the activity of the thoracic extensors, it is difficult to compare findings and to conclude how recruitment of the posterior extensor chain is exactly influenced when an active lumbopelvic control strategy is implemented to high load lumbar extension exercises. In the same context, it is relevant to note that most studies investigating muscle recruitment patterns during lumbar extension exercises have overlooked the contribution of the hip extensors. A trunk extension consists of a combined extension movement of the thoracic and lumbar spine as well as anterior rotation of the pelvis and hips (Graves et al., 1994, Pollock et al., 1989), whereas a leg extension is composed of an extension of the lumbar spine and a rotation of the hips and pelvis (Oh et al., 2007). From this biomechanical perspective it is clear that lumbar extension exercises do not only require activation of the trunk extensor muscles but also of the hip extensor muscles (Arokoski et al., 1999, Kankaanpaa et al., 1998, Plamondon et al., 2002, Sparto and Parnianpour, 1998). Furthermore, it has been shown that the active lumbopelvic control strategy is able to reduce the degree of lumbar lordosis during sitting (Watanabe et al., 2007) and unilateral leg extension exercise (Oh et al., 2007), but no studies have examined whether this is also the case during high load lumbar extension exercises from prone position such as trunk and bilateral leg extension exercises.

To examine whether the implementation of an active lumbopelvic control strategy during high load prone lumbar extension exercises affects the lumbopelvic recruitment patterns and kinematics, the activation levels of the posterior extensor chain during prone trunk and leg extension exercises were studied with and without the implementation of an active lumbopelvic control strategy. Since the LES and (the deep fibers of) the LM contribute to lumbar spine control (Cholewicki and VanVliet, 2002, MacDonald et al., 2006, Wilke et al., 1995), we hypothesized an increased recruitment of these muscles and a reduced degree of lumbar lordosis when the lumbopelvic muscle corset is contracted during prone lumbar extension exercises.

Section snippets

Subjects

A convenience sample consisting of 13 healthy subjects (9 females, 4 males) of 22.6 ± 2.1 years participated in this study. Subjects their mean height and weight were 172 ± 7.3 cm and 61.3 ± 9.5 kg respectively. Subjects were excluded from participation if they; 1) reported previous back surgery or established spinal deformities, 2) had consulted a physician regarding low back pain (LBP) in the past year, 3) currently experienced LBP, neck or hip pain, 4) had a history of severe neurologic, respiratory,

Kinematics

The instruction to apply an active lumbopelvic control strategy during dynamic bilateral leg extension and dynamic trunk extension resulted in significant less lumbar lordosis (resp. −10°, t(3) = 4.7, p = 0.019, 95%CI [0.95, 6.23]; −3.2°, t(5) = 2.65, p = 0.045, 95%CI [4.32, 21.15]) compared to the same exercises during which this strategy was not used. The thoracic angle showed no significant differences between the lumbar extension exercises performed with or without the active lumbopelvic control

Discussion

This study is the first to demonstrate that an active control strategy of the lumbopelvic region during high load dynamic prone lumbar extension exercises affects the degree of lumbar lordosis and alters the recruitment patterns of the posterior extensor chain. The finding that this active control strategy is able to limit the increases in lumbar (hyper)lordosis which normally take place during the performance of lumbar extension exercises is an important element to consider in clinical

Conclusions

The present study showed that the instruction to apply an acquired active lumbopelvic control strategy, existing of co-contraction of the deep lumbopelvic muscles, is able to reduce lumbar (hyper)lordosis during high load dynamic trunk extension exercises and bilateral leg extension exercises performed by healthy people. The observation that an active lumbopelvic control strategy, as used in this study can diminish the degree of lumbar lordosis during prone extension exercises, is highly

Funding statement

Jessica Van Oosterwijck is a postdoctoral research fellow funded by the Special Research Fund of Ghent University. Stijn Schouppe is financially supported by an Interdisciplinary Research grant (BOF14/IOP/067) from the Special Research Fund of Ghent University.

Conflict of interest

The authors declare that there are no conflicts of interest to report.

Acknowledgements

The authors would like to thank Marieke De Simpelaere, Janis Demeurisse and Bram Van Wittenberge for their assistance during data collection.

References (45)

  • P.W. Hodges

    Core stability exercise in chronic low back pain

    Orthopedic Clinics of North America

    (2003)
  • M. Kankaanpaa et al.

    Age, sex, and body mass index as determinants of back and hip extensor fatigue in the isometric Sorensen back endurance test

    Archives of Physical Medicine and Rehabilitation

    (1998)
  • D.A. MacDonald et al.

    The lumbar multifidus: Does the evidence support clinical beliefs?

    Manual Therapy

    (2006)
  • J.M. Mayer et al.

    Electromyographic activity of the lumbar extensor muscles: Effect of angle and hand position during Roman chair exercise

    Archives of Physical Medicine and Rehabilitation

    (1999)
  • J. Mayer et al.

    Evidence-informed management of chronic low back pain with lumbar extensor strengthening exercises

    Spine Journal

    (2008)
  • J.M. Mayer et al.

    Electromyographic activity of the trunk extensor muscles: Effect of varying hip position and lumbar posture during Roman chair exercise

    Archives of Physical Medicine and Rehabilitation

    (2002)
  • P.B. O’Sullivan

    Lumbar segmental ‘instability’: Clinical presentation and specific stabilizing exercise management

    Manual Therapy

    (2000)
  • M.M. Panjabi

    Clinical spinal instability and low back pain

    Journal of Electromyography and Kinesiology

    (2003)
  • C.A. Richardson et al.

    Muscle control-pain control. What exercises would you prescribe?

    Manual Therapy

    (1995)
  • V.K. Stevens et al.

    The influence of specific training on trunk muscle recruitment patterns in healthy subjects during stabilization exercises

    Manual Therapy

    (2007)
  • F.J. Vera-Garcia et al.

    Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations

    Journal of Electromyography and Kinesiology

    (2007)
  • K.P. Barr et al.

    Lumbar stabilization: Core concepts and current literature, Part 1

    American Journal of Physical Medicine and Rehabilitation

    (2005)
  • Cited by (0)

    1

    The first 2 authors contributed equally to this manuscript.

    View full text