Oosterwijck J, Ridder E, Vleeming A, Vanderstraeten G, Schouppe S, Danneels L. Applying an active lumbopelvic control strategy during lumbar extension exercises: Effect on muscle recruitment patterns of the lumbopelvic region. Human Movement Science. 2017;54:24-33.

Abstracted by Janis Henrickson Janis Henrickson, PT, DPT, COMT, CEEAA

SenMoCOR Concept: Locomotor Re-Activation

Overall, the authors provided support for use of a lumbopelvic control strategy created by activation of the transverse abdominis and the lumbar multifidi when performing prone lumbar extension or leg extension activities to decrease hyper-lordosis and alter the recruitment pattern of posterior chain muscles. The authors instructed 13 pain-free individuals in the active lumbopelvic control strategy over the course of three exercise sessions with feedback followed by time on their own to practice the exercises taught. Following the exercise sessions and confirmation that the individuals were correcting performing the technique via palpation, the authors collected EMG and kinematic data of the posterior chain extensor muscles during 4 conditions: prone leg extension with and without lumbar active control and prone lumbar extension with and without active lumbar control. Analysis of the data demonstrated the lumbar hyper-lordosis was decreased during prone active back extension exercises when the lumbopelvic strategy was used. Because the kinematics of the lumbar spine were changed, to reach the equivalent height of back extension, the subjects needed to perform more extension through the hip joints during this portion of the test. In order to achieve the end position when using the lumbopelvic control technique required increased activation of the posterior chain, including the gluteus maximus. When the lumbopelvic active control technique was used in bilateral leg extension, the hyper-lordosis in the lumbar spine did not occur and the gluteus maximus activation increased. In my practice, I am diligent about making sure my lumbar spine patients are actually performing the correct volition pre-emptive abdominal contraction (VPAC) strategy, either abdominal drawing in or abdominal bracing accompanied by resulting multifidus activation when performing hip extension. I have seen this technique reduce lumbar hyper-lordosis and my patient’s back pain provocation while strengthening the hip extensors to help manage spinal pain or instability conditions. 

Brent Denny PT, ScD, COMT Comments: This article clearly demonstrates the concept that volitional proximal trunk muscle activation provides a foundation for hip prime movers to become more efficient. I agree with Janis…clinical time tuning the local trunk muscular corset using a VPAC strategy is appropriate.  Clients can then use VPAC to train skilled movement and provide a foundation for lower quarter loading. 

Dr. Sizer PT PhD OCS FAAOMPT Comments: I really dig this study and am glad that Janis brought it to the group! This is yet another example of how VPAC use can help to improve the quality of functional movement control. We see this time and time again…during functional examination performance, corrective strategy engagement and general functional activities using full body, composite movements. We are learning a great deal about this in our clinic and lab, and it was great to see these very accomplished investigators weigh in on the impact of simultaneous, active lumbopelvic control on functional movement results.