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

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.