Quantification of Lumbar Stability by Using 2 Different Abdominal Activation Strategies

  • Sylvain G. Grenier
    Reprint requests to Sylvain G. Grenier, PhD, Biomechanics, Ergonomics and Kinesiology Laboratory, School of Human Kinetics, Laurentian University, Sudbury, ON P3E 2C6, Canada.
    Spine Biomechanics Laboratory, Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, ON, Canada.
    Search for articles by this author
  • Stuart M. McGill
    Spine Biomechanics Laboratory, Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, ON, Canada.
    Search for articles by this author


      Grenier SG, McGill SM. Quantification of lumbar stability by using 2 different abdominal activation strategies.


      To determine whether the abdominal hollowing technique is more effective for lumbar spine stabilization than a full abdominal muscle cocontraction.


      Within-subject, repeated-measures analysis of variance was used to examine the effect of combining each of 4 loading conditions with either the hollow or brace condition on the dependent variables of stability and compression. A simulation was also conducted to assess the outcome of a person activating just the transversus abdominis during the hollow.




      Eight healthy men (age range, 20−33y).


      Electromyography and spine kinematics were recorded during an abdominal brace and a hollow while supporting either a bilateral or asymmetric weight in the hands.

      Main Outcome Measures

      Spine stability index and lumbar compression were calculated.


      In the simulation “ideal case,” the brace technique improved stability by 32%, with a 15% increase in lumbar compression. The transversus abdominis contributed .14% of stability to the brace pattern with a less than 0.1% decrease in compression.


      Whatever the benefit underlying low-load transversus abdominis activation training, it is unlikely to be mechanical. There seems to be no mechanical rationale for using an abdominal hollow, or the transversus abdominis, to enhance stability. Bracing creates patterns that better enhance stability.

      Key Words

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        • Hides J.A.
        • Jull G.A.
        • Richardson C.A.
        Long-term effects of specific stabilizing exercises for first-episode low back pain.
        Spine. 2001; 26: E243-E248
        • O’Sullivan P.B.
        • Phyty G.D.
        • Twomey L.T.
        • Allison G.T.
        Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis.
        Spine. 1997; 22: 2959-2967
        • McGill S.M.
        Low back disorders: evidence-based prevention and rehabilitation. Human Kinetics, Champaign2002
        • Hodges P.W.
        Is there a role for transversus abdominis in lumbo-pelvic stability?.
        Man Ther. 1999; 4: 74-86
        • Hodges P.W.
        • Richardson C.A.
        Inefficient muscular stabilization of the lumbar spine associated with low back pain.
        Spine. 1996; 21: 2640-2650
        • Richardson C.A.
        • Snijders C.J.
        • Hides J.A.
        • Damen L.
        • Pas M.S.
        • Storm J.
        The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain.
        Spine. 2002; 27: 399-405
        • Allison G.T.
        • Henry S.M.
        The influence of fatigue on trunk muscle responses to sudden arm movements, a pilot study.
        Clin Biomech (Bristol, Avon). 2002; 17: 414-417
        • Newcomer K.L.
        • Jacobson T.D.
        • Gabriel D.A.
        • Larson D.R.
        • Brey R.H.
        • An K.N.
        Muscle activation patterns in subjects with and without low back pain.
        Arch Phys Med Rehabil. 2002; 83: 816-821
        • Hodges P.W.
        • Richardson C.A.
        Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds.
        Arch Phys Med Rehabil. 1999; 80: 1005-1012
        • Radebold A.
        • Cholewicki J.
        • Panjabi M.M.
        • Patel T.C.
        Muscle response pattern to sudden trunk loading in healthy individuals and in patients with chronic low back pain.
        Spine. 2000; 25: 947-954
        • Suter E.
        • Lindsay D.
        Back muscle fatigability is associated with knee extensor inhibition in subjects with low back pain.
        Spine. 2001; 26: E361-E366
        • McGill S.
        • Grenier S.
        • Bluhm M.
        • Preuss R.
        • Brown S.
        • Russell C.
        Previous history of LBP with work loss is related to lingering deficits in biomechanical, physiological, personal, psychosocial and motor control characteristics.
        Ergonomics. 2003; 46: 731-746
        • Juker D.
        • McGill S.
        • Kropf P.
        • Steffen T.
        Quantitative intramuscular myoelectric activity of lumbar portions of psoas and the abdominal wall during a wide variety of tasks.
        Med Sci Sports Exerc. 1998; 30: 301-310
        • Vezina M.J.
        • Hubley-Kozey C.L.
        Muscle activation in therapeutic exercises to improve trunk stability.
        Arch Phys Med Rehabil. 2000; 81: 1370-1379
        • Davidson K.L.
        • Hubley-Kozey C.L.
        Trunk muscle responses to demands of an exercise progression to improve dynamic spinal stability.
        Arch Phys Med Rehabil. 2005; 86: 216-223
        • Koumantakis G.A.
        • Watson P.J.
        • Oldham J.A.
        Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain.
        Phys Ther. 2005; 85: 209-225
        • Hicks G.E.
        • Fritz J.M.
        • Delitto A.
        • McGill S.M.
        Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program.
        Arch Phys Med Rehabil. 2005; 86: 1753-1762
        • Cholewicki J.
        • McGill S.M.
        Mechanical stability of the in vivo lumbar spine: implications for injury and chronic low back pain.
        Clin Biomech (Bristol, Avon). 1996; 11: 1-15
        • McGill S.M.
        Low back stability: from formal description to issues for performance and rehabilitation.
        Exerc Sport Sci Rev. 2001; 29: 26-31
        • Jull G.A.
        • Richardson C.A.
        Motor control problems in patients with spinal pain: a new direction for therapeutic exercise.
        J Manipulative Physiol Ther. 2000; 23: 115-117
        • Kavcic N.
        • Grenier S.
        • McGill S.M.
        Quantifying tissue loads and spine stability while performing commonly prescribed low back stabilization exercises.
        Spine. 2004; 29: 2319-2329
        • McGill S.M.
        • Grenier S.
        • Kavcic N.
        • Cholewicki J.
        Coordination of muscle activity to assure stability of the lumbar spine.
        J Electromyogr Kinesiol. 2003; 13: 353-359
        • McGill S.M.
        Ultimate back fitness and performance. Wabuno Publishers, Waterloo2004
        • McGill S.
        • Cholewicki J.
        • Peach J.P.
        Methodological considerations for using inductive sensors (3SPACE ISOTRAK) to monitor 3-D orthopaedic joint motion.
        Clin Biomech (Bristol, Avon). 1997; 12: 190-194
        • Basmajian J.V.
        • De Luca C.J.
        Muscles alive: their functions revealed by electromyography. 5th ed. Williams & Wilkins, Baltimore1985
        • McGill S.M.
        Electromyographic activity of the abdominal and low back musculature during the generation of isometric and dynamic axial trunk torque: implications for lumbar mechanics.
        J Orthop Res. 1991; 9: 91-103
        • Biering-Sorensen F.
        Physical measurements as risk indicators for low back trouble over a one year period.
        Spine. 1984; 9: 106-119
        • Cresswell A.G.
        • Thorstensson A.
        Changes in intra-abdominal pressure, trunk muscle activation and force during isokinetic lifting and lowering.
        Eur J Appl Physiol Occup Physiol. 1994; 68: 315-321
        • Simitses G.J.
        An introduction to the elastic stability of structures. RE Krieger, Malabar1986
        • Lucas D.B.
        • Bresler B.
        Stability of the ligamentous spine. Univ California, Biomechanics Laboratory, San Francisco1961 (Technical report no. 40.)
        • Crisco III, J.J.
        • Panjabi M.M.
        • Yamamoto I.
        • Oxland T.
        Euler stability of the human ligamentous lumbar spine.
        Clin Biomech. 1992; 7: 27-32
        • Crisco III, J.J.
        • Panjabi M.M.
        The intersegmental and multisegmental muscles of the lumbar spine.
        Spine. 1991; 16: 793-799
        • White A.A.
        • Panjabi M.
        Clinical biomechanics of the spine. Lippincott, Toronto1978
        • McGill S.
        • Seguin J.
        • Bennett G.
        Passive stiffness of the lumbar torso in flexion, extension, lateral bending, and axial rotation.
        Spine. 1994; 19: 696-704
        • Kavcic N.
        • Grenier S.
        • McGill S.M.
        Determining the stabilizing role of individual torso muscles during rehabilitation exercises.
        Spine. 2004; 29: 1254-1265
        • Ma S.
        • Zahalak G.I.
        A distribution-moment model of energetics in skeletal muscle.
        J Biomech. 1991; 24: 21-35
        • Tesh K.M.
        • Evans J.H.
        • Shaw Dunn J.
        • O’Brien J.P.
        The contribution of skin, fascia, and ligaments to resisting flexion and the lumbar spine.
        in: Whittle M. Harris D. Biomechanical measurement in orthopaedic practice. Clarendon Pr, Oxford1985: 179-187
        • Cholewicki J.
        • VanVliet IV, J.J.
        Relative contribution of trunk muscles to the stability of the lumbar spine during isometric exertions.
        Clin Biomech (Bristol, Avon). 2002; 17: 99-105
        • R Development Core Team
        R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna2006
        • Panjabi M.M.
        • Lydon C.
        • Vasavada A.
        • Grob D.
        • Crisco 3rd, J.J.
        • Dvorak J.
        On the understanding of clinical instability.
        Spine. 1994; 19: 2642-2650
        • Hodges P.
        • Kaigle Holm A.
        • Holm S.
        • et al.
        Intervertebral stiffness of the spine is increased by evoked contraction of transversus abdominis and the diaphragm: in vivo porcine studies.
        Spine. 2003; 28: 2594-2601
        • Hurwitz E.L.
        • Morgenstern H.
        • Chiao C.
        Effects of recreational physical activity and back exercises on low back pain and psychological distress: findings from the UCLA Low Back Pain Study.
        Am J Public Health. 2005; 95: 1817-1824
        • Cresswell A.G.
        Responses of intra-abdominal pressure and abdominal muscle activity during dynamic trunk loading in man [published erratum in: Eur J Appl Physiol 1993;67:97].
        Eur J Appl Physiol Occup Physiol. 1993; 66: 315-320
        • Grenier S.G.
        Stabilization strategies of the lumbar spine in vivo [PhD dissertation]. Faculty of Applied Health Sciences, Univ Waterloo, Waterloo2002: 170
        • Tesh K.M.
        • Shaw Dunn J.
        • Evans J.H.
        The abdominal muscles and vertebral stability.
        Spine. 1987; 12: 501-508
        • van Dieen J.H.
        • Thissen C.E.
        • van de Ven A.J.
        • Toussaint H.M.
        The electro-mechanical delay of the erector spinae muscle: influence of rate of force development, fatigue and electrode location.
        Eur J Appl Physiol Occup Physiol. 1991; 63: 216-222
        • Granata K.P.
        • Orishimo K.F.
        • Sanford A.H.
        Trunk muscle coactivation in preparation for sudden load.
        J Electromyogr Kinesiol. 2001; 11: 247-254
        • Howarth S.J.
        • Allison A.E.
        • Grenier S.G.
        • Cholewicki J.
        • McGill S.M.
        On the implications of interpreting the stability index: a spine example.
        J Biomech. 2004; 37: 1147-1154