Professional Documents
Culture Documents
ABSTRACT INTRODUCTION
T
Gottschall, JS, Mills, J, and Hastings, B. Integration core he American College of Sports Medicine (2) and
exercises elicit greater muscle activation than isolation exer- the United States Department of Health and
cises. J Strength Cond Res 27(3): 590–596, 2013—The Human Services (15) recommend that healthy
American College of Sports Medicine and the United States adults, under 65 years of age, complete a strength
training routine that includes core exercises twice a week.
Department of Health and Human Services advocate core
They specifically advocate core training as a means to
training as a means to improve stability, reduce injury, and
improve stability and maintain mobility. There are countless
maintain mobility. There are countless exercises that target
exercises that target the primary core trunk muscles (abdom-
the primary core trunk muscles (abdominal and lumbar) with inal and lumbar) with the aim of providing these benefits.
the aim of providing these benefits. However, it is unknown as However, it is unknown as to which exercises elicit the
to which exercises elicit the greatest activation thereby maxi- greatest activation thereby enhancing functional gains and
mizing functional gains and peak performance. Thus, our pur- peak performance.
pose was to determine whether integration core exercises that Core exercises are also commonly implemented within
require activation of the distal trunk muscles (deltoid and both sport and rehabilitation objectives to maximize
gluteal) elicit greater activation of primary trunk muscles in strength, improve endurance, and reduce injury. Therefore,
comparison with isolation core exercises that only require ac- multiple past studies have focused on specific techniques to
tivation of the proximal trunk muscles. Twenty participants, 10 optimize trunk muscle activation (4,6,7,11,12,14). These
men and 10 women, completed 16 randomly assigned exer- studies are similar in that they all use surface electromyog-
raphy (EMG) to evaluate muscle activity of the core. But the
cises (e.g., crunch, upper body extension, and hover varia-
focus of each article differs with respect to the exercise
tions). We measured muscle activity with surface
type, position, support, plane, loads, and equipment.
electromyography of the anterior deltoid, rectus abdominus,
Monfort-Panego et al. (12) completed a literature synthesis
external abdominal oblique, lumbar erector spinae, thoracic
and concluded that there were 5 critical criteria when select-
erector spinae, and gluteus maximus. Our results indicate that ing optimal core-strengthening exercises; hip flexion, upper
the activation of the abdominal and lumbar muscles was the body assistance, lower body orientation, surface angle, and
greatest during the exercises that required deltoid and gluteal abdominal bracing. The majority of the reviewed studies
recruitment. In conclusion, when completing the core strength focus on isolation core exercises that target the primary
guidelines, an integrated routine that incorporates the activa- muscle of the anterior trunk, the rectus abdominus (RA).
tion of distal trunk musculature would be optimal in terms of We assume that isolation exercises would elicit the greatest
maximizing strength, improving endurance, enhancing stability, activity of this primary core muscle. However, no study has
reducing injury, and maintaining mobility. provided a clear demonstration that isolation exercises are
superior to integration exercises that also target the distal
KEY WORDS abdominal, back, strength, electromyography muscles of the core, such as the deltoid and gluteal groups.
In short, despite the extensive previous research, one
question that still remains is “Do isolation or integration
exercises elicit the greatest activation thereby optimizing
functional and performance gains (1)?” We define integration
core exercises as movements that require activation of the
Address correspondence to Dr. Jinger S. Gottschall, jinger@psu.edu. distal trunk muscles (deltoid and gluteal) and activation of
27(3)/590–596 the proximal trunk muscles (abdominal and lumbar) in com-
Journal of Strength and Conditioning Research parison with isolation core exercises that only require acti-
Ó 2013 National Strength and Conditioning Association vation of the proximal trunk muscles. Understanding the
the TM
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
the TM
METHODS
Figure 3. Integration with balance_mountain climber plank. The
participants were instructed to start with their shoulders, elbows, and Experimental Approach to the Problem
wrists aligned from superior to inferior with their feet hip width apart. We To demonstrate which type of exercise, isolation or integra-
provided the cue of flexing the knee to the opposite elbow at the
cadence of the metronome and maintaining a flat upper body while tion, elicits the greatest activation, we measured surface muscle
twisting the lower body. activity of 6 core muscles, both proximal and distal during
a randomized sequence of isolation and integration exercises.
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
Intregration Greater Than Isolation
Figure 6. Isolation_extension. The participants were instructed to start in Figure 7. Integration Pointer with resistance bands. The participants
the prone position with arms above their head with chin toward the chest. started in a quadrupedal stance with both hands and knees flat on the
Next, matching the cadence of the metronome they lifted and lowered their surface. We then instructed them to contract their gluteal and deltoid
chest off the surface by contracting their erector spinae and gluteal muscles. muscles to lift a single leg and opposite arm to the height of their
shoulders at the cadence of the metronome.
Subjects
Twenty, healthy college students, 10 men and 10 women, Falls, VT, USA) with an interelectrode distance of 2 cm in
completed the protocol (age 22.47 6 3.00 years, height 1.70 the direction of the muscle fibers, over 6 muscles of the
6 1.00 m, mass 68.50 6 14.83 kg, mean 6 SD). The Penn- trunk. Before electrode placement, we prepared the skin
sylvania State University human participants Institutional and performed a series of measurements to locate the muscle
Board approved the research and appropriate consent was centers of the anterior deltoid (AD, 4 cm inferior to the
obtained pursuant to law. clavicle), RA (2 cm lateral from the umbilicus), external
In order to be included in the study, potential participants abdominal oblique (EO, directly superior from the anterior
were required to be currently meeting the American College superior iliac spine, halfway between the iliac crest and the
of Sports Medicine weekly guidelines for physical activity of ribs at a medially oblique angle), lumbar erector spinae (LE,
150 minutes of moderate-intensity cardiorespiratory exercise, 2 cm lateral from the lumbar-3 vertebra), thoracic erector
2–3 days of major muscle group resistance exercise, and 1–2 spinae (TE, 2 cm lateral from the thoracic-12 vertebra), and
days of flexibility exercises (2). After screening, testing was gluteus maximus (GM, half the distance between the greater
completed within an 8-week period during the fall academic trochanter and the sacral vertebra at a laterally oblique
semester. All the tests started
between 9 AM and 11 AM, and
the participants were instructed
to eat breakfast and hydrate ad-
equately before attending the
single session.
Procedures
We measured EMG signals
using a wired amplifier system
(Bortec Octopus AMT-8, Cal-
gary, AB, Canada) with a band-
pass filter setting of 5–500 Hz
and collected the data at 1,000
Hz using EVaRT software. The
preamplifiers achieve a com-
mon mode rejection ratio of
115 dB at 60 Hz and the input
impedance was ,10 kV with
our gel electrodes. We placed
1-cm 3 1.5-cm bipolar, silver- Figure 8. Mean 6 SD normalized surface electromyography amplitudes for the isolation crunch exercise for all
silver chloride, surface electro- the 20 participants.
des (Vermed, A10041, Bellows
the TM
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
the TM
RESULTS
Overall, our results demon-
strated that the activation of
the abdominal and lumbar
muscles was greatest during the
integration exercises that re-
quired activation of deltoid and
gluteal muscles. One straightfor-
ward example of this is the
comparison between a traditional
isolation exercise of a crunch
and an integration exercise of
Figure 10. Mean 6 SD normalized surface electromyography amplitudes for the integration with balance
mountain climber plank exercise for all the 20 participants. The star indicates a significant difference (p , 0.05) the hover with hand reach.
between the integration exercise and the integration with balance exercise for that particular muscle. During the isolation and in-
tegration exercises of a crunch
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
Intregration Greater Than Isolation
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
the TM
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
Intregration Greater Than Isolation
intensity for individuals with varying levels of experience and they thank Dan Cohen and Susan Trainor for directing the
strength. Thus a personal trainer or rehabilitation specialist CXWORX by Les Mills program and Corey Baird for
could begin the program with simple isolation exercises as providing the instructional video.
the client or patient gains strength and progress to more
integrated, complex variations.
One of the most compelling reasons to complete a core- REFERENCES
strengthening program as an aging adult, recreational 1. Akuthota, V, Ferreiro, A, Moore, T, and Fredericson, M. Core
stability exercise principles. Curr Sports Med Rep 7: 39–44, 2008.
athlete, or sports professional is to reduce the chance of
2. American College of Sports Medicine. ACSM’s Guidelines for
injury. Leeton et al. (10) reported that injured collegiate ath- Exercise Testing and Prescription (8th ed.). Thompson, WR, ed.
letes had significantly less strength in the core musculature, Philadelphia, PA: Lippincott, Williams & Wilkins, 2010.
especially the hip abductors. Similarly, Hewitt and 3. Arokoski, JP, Valta, T, Airaksinen, O, and Kankaanpaa, M. Back and
colleagues (8,9,13) conducted multiple studies with a focus abdominal muscle function during stabilization exercises. Arch Phys
on the connection between neuromuscular trunk training Med Rehabil 82: 1089–1098, 2001.
and knee injury. They concluded that for collegiate athletes 4. Clark, KM, Holt, LE, and Sinyard, J. Electromyographic comparison
of the upper and lower rectus abdominis during abdominal
non-contact knee injuries were less frequent in the group of
exercises. J Strength Cond Res 17: 475–483, 2003.
participants that completed preseason core exercises. These
5. Cram, JR and Kasman, GS, Electrode placement. Introduction to
previous studies emphasize the importance of completing Surface Electromyography. Cram, JR, Kasman, GS, and Holz, J, eds.
a core-strengthening program, and our current results aid Gaithersburg, MD: Aspen, 1998. pp. 371–375.
in refining the physical activity recommendations by dem- 6. Guimaraes, AC, Vaz, MA, De Campos, MI, and Marantes, R. The
onstrating the enhanced muscle activity during integration contribution of the rectus abdominis and rectus femoris in twelve
exercises. selected abdominal exercises. An electromyographic study. J Sports
Med Phys Fitness 31: 222–230, 1991.
PRACTICAL APPLICATIONS 7. Gutin, B and Lipetz, S. An electromyographic investigation of the
rectus abdominis in abdominal exercises. Res Q 42: 256–263, 1971.
In summary, a comprehensive, core-strengthening program
8. Hewett, TE, Lindenfeld, TN, Riccobene, JV, and Noyes, FR. The
would incorporate a unique combination of both isolation effect of neuromuscular training on the incidence of knee injury in
and integration exercises. Isolation exercises are simple, female athletes. A prospective study. Am J Sports Med 27: 699–706,
single joint movements, which target proximal trunk muscles 1999.
and are easy to complete. Integration exercises are complex, 9. Hewett, TE, Myer, GD, and Ford, KR. Reducing knee and anterior
cruciate ligament injuries among female athletes: A systematic
multijoint movements that elicit greater proximal trunk
review of neuromuscular training interventions. J Knee Surg 18:
muscles activity and distal trunk muscles activity. Because 82–88, 2005.
of the nature of the exercises, integration exercises elicit 10. Leeton, DT, Ireland, ML, and Willson, JD. Core stability measures
activity from a broader range of muscle groups while as risk factors for lower extremity injury in athletes. Med Sci Sports
challenging the sensory systems for balance simultaneously. Exerc 36: 926–934, 2004.
In short, we suggest that personal trainers, sport coaches, 11. Lipetz, S and Gutin, B. An electromyographic study of four
and medical providers incorporate integration exercises into abdominal exercises. Med Sci Sports 2: 35–38, 1970.
their prescription of core-strengthening exercises. This is 12. Monfort-Panego, M, Vera-Garcia, FJ, Sanchez-Zuriaga, D, and Sarti-
Martinez, MA. Electromyographic studies in abdominal exercises: A
particularly critical as many clients, athletes, and patients are literature synthesis. J Manipulative Physiol Ther 32: 232–244, 2009.
searching to minimize the time of training by completing 13. Myer, GD, Chu, DA, Brent, JL, and Hewett, TE. Trunk and hip
a quality, efficient regimen. Thus, when completing the core control neuromuscular training for the prevention of knee joint
strength guidelines, a routine that incorporates integration injury. Clin Sports Med 27: 425–448, 2008.
exercises with the activation of distal trunk musculature 14. Schoffstall, JE, Titcomb, DA, and Kilbourne, BF. Electromyographic
would be optimal in terms of maximizing strength, improv- response of the abdominal musculature to varying abdominal
exercises. J Strength Cond Res 24: 3422–3426, 2010.
ing endurance, enhancing stability, reducing injury, and
15. US Department of Health and Human Services. 2008 Physical
maintaining mobility.
Activity Guidelines for Americans. Services, H.a.H, ed. Washington,
ACKNOWLEDGMENTS DC: U.S. Department of Health and Human Services, 2008.
16. Winter, DA, Fuglevand, AJ, and Archer, SE. Crosstalk in surface
The authors thank Zach Clark and Riley Sheehan for elctromyography: Theoretical and practical estimates.
assistance with data collection and processing. In addition, J Electromyogr Kinesiol 4: 15–26, 1994.
the TM
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.