Abstract

Introduction The supine and prone sling exercise may facilitate activation of the local trunk muscles. Does the side-lying sling exercise activate trunk muscles more easily than the supine and prone training with sling settings? Clinical work has shown that the side-lying sling exercise could reduce pain in patients with unilateral low back pain (LBP), but the mechanism behind it is unclear. The fundamental purpose of this preliminary study was to examine the electromyography (EMG) characteristics of trunk muscles during different sling lumbar settings on sixteen healthy adults. Methods Amplitude and mean power frequency (MPF) of EMG signals were recorded from the transversus abdominis (TA), rectus abdominis (RA), multifidus (MF), erector spinae (ES), gluteus maximus (Gmax), and gluteus medius (Gmed) muscles while the subjects performed the supine lumbar setting (SLS), prone lumbar setting (PLS), left side-lying lumbar setting (LSLS), and right side-lying lumbar setting (RSLS). Results During SLS and PLS, TA and MF showed significantly higher activity than RA and ES on the same side, respectively. The EMG activities of ES, TA, MF, Gmax, and Gmed had significant differences between the different sides during LSLS and RSLS, and the dominant-side muscles showed higher activity than the other side. There was no significant difference in core trunk muscles between different sling lumbar settings—only that the SLS of the MF/ES ratio was significantly higher than LSLS and RSLS. Conclusions Sling exercises can be an effective measure to enhance MF and TA EMG activity, and the side-lying position can increase dominant-side Gmax and Gmed activity. Side-lying sling training does not activate more core muscles than the supine and prone training. Supine and prone exercise should be preferred over SLT to stabilize the lumbar region because of its high local/global muscle ratio.

Highlights

  • Low back pain (LBP) has a high prevalence and can be an underlying cause of physical disability

  • During supine lumbar setting (SLS) and prone lumbar setting (PLS), transversus abdominis (TA) and MF showed significantly higher activity than rectus abdominis (RA) and erector spinae (ES) on the same side, respectively. e EMG activities of ES, TA, MF, gluteus maximus (Gmax), and gluteus medius (Gmed) had significant differences between the different sides during LSLS and right side-lying lumbar setting (RSLS), and the dominant-side muscles showed higher activity than the other side. ere was no significant difference in core trunk muscles between different sling lumbar settings—only that the SLS of the MF/ES ratio was significantly higher than LSLS and RSLS

  • The dominant-side TA and Gmed both showed greater mean power frequency (MPF) compared to RA (LSLS: p < 0.001, Figure 5(c); RSLS: p < 0.001, Figure 5(d)) and Gmax (LSLS: p < 0.023; Figure 5(c); RSLS: p 0.001; Figure 5(d))

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Summary

Introduction

Low back pain (LBP) has a high prevalence and can be an underlying cause of physical disability. As such, it should receive adequate attention. LBP is related to decreased work ability and increased direct (health care) and indirect (lost production and lost household productivity) costs. E management of LBP is currently mainly based on the Panjabi theoretical model of the spinal stabilizing system [3]. Panjabi hypothesized that the neutral zone (NZ) is central to the phenomenon of instability and is critical to the range of motion extending beyond the NZ [4]. When the NZ region increases with injury or weakness of the muscles, it may result in spinal instability or low-back problems [4]

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