45 Journal of Exercise Physiologyonline February 2013 Volume 16 Number 1 Editor-in-Chief Official Research Journal of Tommy the American Boone, PhD, Society MBA of Review Board Exercise Physiologists Todd Astorino, PhD ISSN 1097-9751 Julien Baker, PhD Steve Brock, PhD Lance Dalleck, PhD Eric Goulet, PhD Robert Gotshall, PhD Alexander Hutchison, PhD M. Knight-Maloney, PhD Len Kravitz, PhD James Laskin, PhD Yit Aun Lim, PhD Lonnie Lowery, PhD Derek Marks, PhD Cristine Mermier, PhD Robert Robergs, PhD Chantal Vella, PhD Dale Wagner, PhD Frank Wyatt, PhD Ben Zhou, PhD Official Research Journal of the American Society of Exercise Physiologists ISSN 1097-9751 JEPonline Investigation of Core Muscle Function through Electromyography Activities in Healthy Young Men Sijie Tan1, Liquan Cao2, Whitney Schoenfisch3, Jianxiong Wang3 1Department of Health and Exercise Science, Tianjin University of Sport, Tianjin, China, 2Tianjin Physical Fitness Research Center, Tianjin University of Sport, Tianjin, China, 3Centre for Systems Biology, Department of Biological and Physical Sciences, Faculty of Sciences, University of Southern Queensland, Toowoomba, Australia ABSTRACT Tan S, Cao L, Schoenfisch W, Wang J. Investigation of Core Muscle Function through Electromyography Activities in Healthy Young Men. JEPonline 2013;16(1):45-52. The purpose of this study was to investigate the electromyography (EMG) signal during eight isometric core exercises. Eighty healthy men (average 24.9 ± 1.4 yrs with body mass 64 ± 5 kg) participated as subjects. The surface EMG of the core muscles of 30 subjects was measured during eight isometric contractions and the EMG signal was recorded from core muscles. The four actions with the higher integral EMG were further applied in another group of 50 subjects to test their reliability. The isometric exercise of 'side bridge with single-leg raise' resulted in a significantly higher EMG than those of other exercises. This exercise showed a good reliability (ICC=0.77). Three other exercises also presented high EMG and ICC. In conclusion, the 'side bridge with single-leg raise' exercise is the most suitable single body movement to measure the functional capacity of core muscles in healthy young men. Key words: Core Muscles, Isometric Activity, Electromyography, Young Men 46 INTRODUCTION Core muscles play a larger role in human physical activities than is often realized. The core muscles are at work allowing posture maintenance, bending, twisting, and providing a stable spine for various activities involving the extremities that are required in daily life and for most sports (7,10,15). Therefore, as well as maintaining body stability and performing safely, core strength plays an important role in preventing the development of lower back pain (LBP) and sports injuries during physical activities (2,3,7,9,23). There are 29 pairs of core muscles of the human body that are arranged within what can be considered as the core ‘box.’ The front of the box is formed by the abdominals, with paraspinals and gluteals as the back, the diaphragm forms the roof, and the pelvic floor and hip girdle musculature act as the base (1,9,10,14). The core muscles cooperate with each other to provide the spine and pelvis with stability, particularly when performing functional movements (10). This core stability has been summarized as “the ability to control the position and motion of the trunk over the pelvis and leg to allow optimum production, transfer and control of force and motion to the terminal segment in integrated kinetic chain activities” (15, p. 189), and refers to the stability of the spine rather than the strength of the actual muscles (9,27). While most research of the core musculature has focused on athletes (10,15,21,24) and people with LBP (9,17,22,26), it is also important to research in terms of maintaining body stability and decreasing injury among non-athletic individuals (6,13). However, the current lack of reliable and valid testing methods makes it difficult to measure core strength in the general population (1,9,10). The use of electromyography (EMG) may be a possible way to establish a valuable measurement method of core strength, as electrical activity of muscles has been associated with the forces produced by the muscles (11). Thus, the purpose of this study was to investigate the EMG signals during isometric muscle contractions, which are mainly achieved through the working of the core muscles in a group of healthy young men. The outcome of this study should contribute to the development of a useful method of measuring core strength. METHODS Subjects Eighty healthy men (average 24.9 ± 1.4 yrs, body mass 64 ± 5 kg, body height 174 ± 4 cm) from a college population participated in this study. None of the subjects engaged in regular exercise training when they were enrolled. Thirty of the subjects had the surface EMG of their core muscles measured during eight isometric contractions, while the remaining 50 subjects performed the reliability tests of the four exercises which showed the highest integral EMG (iEMG) readings. Exclusion criteria for this investigation included any individuals with known acute or chronic LBP. The details of the study were described to the subjects, and a written informed consent was obtained from each subject. All methods and procedures of this study were approved by the Ethics Committee of Tianjin University of Sport, China. Measured Core Muscle Exercises Eight core muscle exercises are shown in Figure 1. There was a familiarization session during which the 30 subjects learned how to perform the exercises. The testing session took place at least 3 days after the familiarization session. Eight exercises were randomly tested on each subject with a 3-min rest between the tests. 47 Exercise 1. Front bridge Exercise 2. Front bridge with single-leg raise Exercise 3. Bird dog Exercise 4. Sit-up with double-leg raise Exercise 5. Supine bridge Exercise 6. Supine bridge with single-leg raise Exercise 7. Side bridge Exercise 8. Side bridge with single-leg raise Figure 1. Summary of the Eight Exercises. EMG Measurement EMG signals from eight points of the core muscles (rectus abdominis high and low parts, external oblique, latissimus dorsi, gluteus medius, gluteus maximus, longissimus, and multifidus) were recorded using the EMG equipment (Noraxon Inc. USA). The surface electrode placement area was shaved, abraded, and cleansed with alcohol to improve the conductivity of the EMG signal. The EMG signals of each action were recorded for 10 sec while the subject performed and maintained the exercise in the standard stable position. This 10-sec recording was analyzed for the iEMG using the MyoResearch XP software (Noraxon Inc. USA). Reliability Test The four exercises with the highest iEMG were chosen and further applied in another group of 50 subjects to test their core muscle strength with a brief introduction before the first test. The function of core strength was measured as the time period during which the subjects could maintain the standard 48 positions of the exercises. There was a 3-min rest period between action tests. Each subject of this group produced duplicate measurements. The 2nd test took place 3 days later. Data Analyses All of the values were presented as mean ± SD. Differences in the iEMG between the exercises were identified using one-way analyses of variance (ANOVA). When a significant F-ratio was obtained, a post-hoc analysis with Bonferroni adjustment was used to identify which pair of mean values had significant changes. The intraclass correlation coefficients (ICCs) for the reliability of the 4 exercises were calculated. All statistical analyses were performed using the SPSS Version 11.5 for Windows (SPSS Inc. USA). Alpha level was set 0.05. RESULTS The EMG for each of the core muscles during the 8 exercises is shown in Table 1. The Exercise 8: side bridge with single-leg raise, showed a significantly higher iEMG (5949.9 ± 1129 uV, P<0.01) than those of other exercises. The results of the other exercises were Exercise 7 (3878.9 ± 771.0 uV), Exercise 2 (3387.2 ± 755.1 uV), Exercise 4 (3325.4 ± 856.7 uV), Exercise 1 (2638.3 ± 689.6 uV), Exercise 3 (2055.4 ± 503.8 uV), Exercise 6 (1987.9 ± 509.5 uV), and Exercise 5 (1482.3 ± 501.6 uV). Table 1. EMG of Different Core Muscles during Eight Actions (uV·10s). Data (Mean ± SD) Ex 1 Ex 2 Ex 3 Ex 4 Ex 5 Ex 6 Ex 7 Ex 8 External oblique 369.3 ± 145.3 574.3 ± 277.4 164.2 ± 75.7 686.1 ± 352.7 26.9 ± 7.4 66.4 ± 24.6 1051.7 ± 315.2 1257.2 ± 340.9 Rectus abdominis (high) 1019.9 ± 365.8 568.2 ± 207.7 58.9 ± 22.8 1127.7 ± 327.0 34.8 ± 12.8 48.4 ± 18.7 686.7 ± 297.4 860.8 ± 311.7 Rectus abdominis (low) 913.1 ± 289.5 674.1 ± 240.4 35.1 ± 19.0 114.8 ± 353.9 22.5 ± 8.5 38.3 ± 13.2 553.2 ± 229.9 596.9 ± 244.9 Latissimus dorsi 176.6 ± 82.3 169.9 ± 77.8 139.5 ± 43.0 65.8 ± 21.7 128.7 ± 50.3 101.4 ± 69.4 190.9 ± 74.2 275.3 ± 96.7 Longissimus 48.8 ± 14.2 57.0 ± 21.5 227.5 ± 93.3 54.1 ± 21.7 353.7 ± 152.7 401.8 ± 144.1 287.6 ± 88.1 456.8 ± 222.7 Multifidus 43.4 ± 12.4 123.3 ± 46.6 415.6 ± 168.5 106 ± 43.9 496.4 ± 196.1 547.8 ± 209.5 302.4 ± 139.9 440.8 ± 169.4 Gluteus medius 39.4 ± 14.9 428.8 ± 188.6 314.3 ± 133.7 76.2 ± 36.9 140.3 ± 83.4 313.6 ± 190.4 455.4 ± 180.1 1231.1 ± 400.8 Gluteus maximus 27.8 ± 6.74 691.7 ± 204.6 700.4 ± 293.1 68.7 ± 21.2 338.5 ± 159.1 470.2 ± 173.9 351.4 ± 140.9 831.8 ± 263.9 49 The four exercises with the highest recorded iEMG (Exercise 8, 7, 2, and 4) were performed by 50 subjects on two occasions that were separated by at least 3 days. The average results and ICC between the two tests are listed in Table 2. Table 2. Reliability Test Results of Four Exercises. Test 1 (s) Test 2 (s) ICC Exercise 8 23.6 ± 6.8 25.3 ± 6.1 0.77** Exercise 7 43.2 ± 8.8 48.6 ± 9.1 0.85** Exercise 2 93.7 ± 20.5 106.4 ± 24.4 0.69* Exercise 4 22.1 ± 4.2 26.4 ± 5.8 0.71** All data are presented in Mean ± SD. *P<0.05; **P<0.01 DISCUSSION The theoretical principle of using EMG to measure core strength came from Fuglevand’s report (11), in which it has been stated that muscle electrical activities are closely associated with muscle forces in isometric contractions, indicating that body movements which recruited more motor units from the muscles would show a greater level of accumulated EMG activity. In the present study, we found that Exercise 8, the side bridge with single-leg raise, showed the highest iEMG among the 8 exercises. It indicates that Exercise 8 acts with the highest level of the core muscle recruitment, and its performance reflects the functional capacity of the core muscles. This exercise can be performed by healthy young people without difficulty. The average performance time is <30 sec, which is very efficient to be tested, in particular, for the measurement of the core muscle function in large physical education classes. The ICC of this exercise reached 0.77, which indicates that Exercise 8 has a high testing reliability and can be used as a standard method of measurement of core muscle strength in healthy young men. In addition, Exercise 7, 2, and 4 also demonstrated significantly high test-retest reliability and, therefore, they are usable for core muscle strength measurement in young healthy men as well. Previous studies investigating the side bridge also indicated that the exercise had a high EMG. One study (8) of 30 healthy subjects, males and females of ages 27 ± 8, demonstrated that the side bridge could produce larger percentages of the maximum voluntary isometric contraction in certain core muscles than other exercise, including the prone bridge (front bridge), unilateral-bridge (supine with single-leg raise), bridge (supine), and quadruped (bird-dog). Ekstrom and colleagues (8) reported that the side bridge produced the largest percentage of EMG activity in the gluteus medius, longissimus thoracis, and external oblique abdominis, as well as the second and third highest percentage in the rectus abdominis and lumbar multifidus, respectively. The findings by García-Vaquero and colleagues (12) regarding healthy men and women aged 24.22 ± 5.23 and 22 ± 2.93, respectively, were similar to ours, in that compared to the front and supine bridge actions, the side bridge elicited some of the highest EMG activity in the external and internal obliques of the respective side being tested. The EMG values increased when a leg was raised off of the underlying leg as for Exercise 8 of our study. Numerous research studies suggest that a poorly developed core is linked to an increased risk of injury and LBP (2,7,10,13,14,27). Conversely, when core is well developed, there is a statistical decrease in the risk of injury and LBP (3,5,8,21,22,26). Having a strong and stable core is important, especially for individuals who want to avert injury and/or pain. However, to study the function of the core muscles requires the ability to reliably measure the capabilities of the musculature in the 50 subjects. This highlights the importance of the present study as our purpose was to investigate the EMG signals during isometric muscle contractions and obtain information which may be useful in the development of methods of measuring the activity of the core. It was found that Exercise 8: the side bridge with single-leg raise produced the most activity within the core, and thus was the best indicator in this investigation of the total capability of the core. Exercises 7, 2, and 4 produced the next highest iEMG results and would also be effective indicators of core strength. Limitations of the present study are that surface electrodes were used and the exchange of signals between different core muscles could not be fully prevented (8). In this study, only the core muscle from healthy young men was examined. As skeletal muscle strength and endurance vary largely among different age and sex groups, it is not possible to have a single measurement method suitable to all people. Therefore, the current outcome is only applicable to the sample subjects. Other age groups, children in particular, would be studied in the future in an attempt to fill the knowledge gap around the core musculature of children. The link between core muscle activation and LBP and other injuries needs to be studied further to determine whether the results from the core activation produced during certain exercises can provide an indication of a person’s risk of LBP or injury. Our results were measured from solid-base exercises and did not employ the use of unstable devices or surfaces. One study (4) reported that more EMG activity could be obtained from the exercises performed on unstable surfaces. Such muscle actions should be considered with additional research. CONCLUSION Exercise 8 (side bridge with single-leg raise) showed the highest iEMG. Of all the exercises, it would be the most suitable single body movement to measure the core muscle function. 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