Original article
Exercises for Spine Stabilization: Motion/Motor Patterns, Stability Progressions, and Clinical Technique

https://doi.org/10.1016/j.apmr.2008.06.026Get rights and content

Abstract

McGill SM, Karpowicz A. Exercises for spine stabilization: motion/motor patterns, stability progressions, and clinical technique.

Objective

To quantify several forms of the curl-up, side-bridge, and birddog exercises (muscle activity and 3-dimensional [3D] spine position) including some corrective techniques to assist clinical decision-making.

Design

A basic science study of a convenience sample with a retest of expert intervention.

Setting

Spine Biomechanics Laboratory/Research Clinic.

Participants

Healthy men (N=8) performed the exercises, and 5 subjects repeated the exercises as an expert applied corrective techniques.

Interventions

Not applicable.

Main Outcome Measures

Surface electromyography of selected trunk and hip muscles together with video analysis and 3D spine posture were collected.

Results

Comparison of muscle activation levels showed there were justifiable progressions in each exercise form. In general, bracing of the abdominal wall enhanced activation of the obliques, but different techniques caused migration of muscle activity to other muscles. Examples of specific findings include the following. Movement during these traditionally isometric exercises such as drawing squares with the hand/foot while in the birddog posture enhances activation of many muscle groups. Breathing while holding the isometric exercises had differing effects on muscle activation which was exercise dependent. Some corrective exercise techniques, such as fascial raking, substantially changed relative activation between muscles in the abdominal wall.

Conclusions

The data presented in this study may be used to guide the clinical decision process when choosing a specific exercise form together with selecting the correct starting level, a logical progression, suitable dosage, and possible corrective technique to enhance tolerance of a patient.

Section snippets

Methods

Recruitment procedures and experimental methods were approved by the university human research ethics committee.

Electromyographic signals and spine posture were collected from 8 healthy men age 21.6±4.1 years, 1.82±0.06m tall, with a mass of 74.6±10.7kg. Five of these subjects were reassessed by an expert clinician who performed some technique corrections to see whether technique in exercise form had any effect. This was conducted 3 months after the original study, and 3 of the original

Results

The results are organized to examine the effects of technique on each exercise, followed by an examination of the effect of expert correction.

Discussion

Clinicians choose techniques to help make an exercise tolerable for a patient that include muscle activation and posture changes. The corollary is that failure to do so can make the same exercise painful. The data presented here may be used to assist clinical decisions regarding the starting challenge, progression, corrective technique, and exercise selection. Basic features of these exercises have been assessed in the past for stability and spine load,3, 4 but more variations have been

Conclusions

The big 3 spine stabilization exercises have been quantified before to enhance spine stability in an environment that imposes low loads on the spine. The data presented here document progressions of these forms of exercise that can assist clinical decision-making. Further, some techniques to modify spine posture and muscle use were also described that will assist finding techniques to minimize pain and maximize function.

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Supported by the Natural Science and Engineering Research Council of Canada.

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

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