title: Postural Cueing to Increase Lumbar Lordosis Increases Lumbar Multifidus Activation During Trunk Stabilization Exercises: Electromyographic Assessment Using Intramuscular Electrodes.
abstract: METHODS
  Controlled laboratory study, repeated-measures design.
  
  
  BACKGROUND
  Diminished multifidus activation and cross-sectional area are frequent findings in persons with low back pain. Increasing lumbar lordosis has been shown to increase activation of the multifidus with a minimal increase in activation of the long global extensors during unsupported sitting.
  
  
  OBJECTIVE
  To examine the influence of postural cueing to increase lumbar lordosis on lumbar extensor activation during trunk stabilization exercises.
  
  
  METHODS
  Thirteen asymptomatic participants (9 male, 4 female) were instructed to perform 6 trunk stabilization exercises using a neutral position and increasing lumbar lordosis. Electrical activity of the deep multifidus and longissimus thoracis was recorded using fine-wire intramuscular electrodes. The mean root-mean-square of the electromyography (EMG) signal obtained during each exercise was normalized to a maximum voluntary isometric contraction (MVIC). A 2-way, repeated-measures analysis of variance (posture by exercise) was performed for each muscle.
  
  
  RESULTS
  When averaged across the 6 exercises, postural cueing to increase lumbar lordosis resulted in greater multifidus EMG activity compared to performing the exercises in a neutral posture (35.3% ± 15.1% versus 29.5% ± 11.2% MVIC). No significant increase in longissimus thoracis EMG activity was observed when exercising with cueing to increase lumbar lordosis.
  
  
  CONCLUSIONS
  This study suggests that postural cueing to increase lumbar lordosis during trunk stabilization exercises may better promote multifidus activation than traditional stabilization exercises alone. Future studies are needed to determine whether increasing lumbar lordosis improves multifidus activation in persons with low back pain.
authors.forename: George J
authors.initials: GJ
authors.lastname: Beneck
authors.forename: John W
authors.initials: JW
authors.lastname: Story
authors.forename: Shelby
authors.initials: S
authors.lastname: Donald
mesh_terms: D004576:Electromyography; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007537:Isometric Contraction; D017116:Low Back Pain / Q000503:physiopathology; D008161:Lumbosacral Region / Q000502:physiology*; D008297:Male; D064170:Paraspinal Muscles / Q000502:physiology* / Q000503:physiopathology; D011187:Posture / Q000502:physiology*; D060726:Torso / Q000502:physiology*
keywords: electromyography; multifidus; trunk stabilization exercises