Effect of Isometric Upper-Extremity Exercises on the Activation of Core Stabilizing Muscles


      Tarnanen SP, Ylinen JJ, Siekkinen KM, Mälkiä EA, Kautiainen HJ, Häkkinen AH. Effect of isometric upper-extremity exercises on the activation of core stabilizing muscles.


      To evaluate whether isometric exercises for the upper extremities could sufficiently activate core stabilizing muscles to increase muscle strength.


      Cross-sectional study.


      Department of physical medicine and rehabilitation at a Finnish hospital.


      Healthy adult women (N=20).


      Not applicable.

      Main Outcome Measures

      Peak isometric strength of the back and abdominal muscles was measured and relative loading in 5 test exercises was evaluated by surface electromyography.


      The rectus abdominis and obliquus externus abdominis were activated to the greatest degree in a bilateral shoulder extension exercise and the average surface electromyographic activity was 114% and 101% compared with the amplitude elicited during the maximal isometric trunk flexion exercise. Horizontal shoulder extension elicited the greatest activation of the longissimus and multifidus muscles. In this exercise, the activity levels of the left side multifidus and longissimus muscles were 84% and 69%, respectively, compared with the level of activity elicited during trunk extension.


      Of all the exercises studied, bilaterally performed isometric shoulder extension and unilaterally performed horizontal shoulder extension elicited the greatest levels of activation of the trunk musculature. Thus, it can be assumed that these exercises elicit sufficient levels of contraction of the trunk muscles for the development of their endurance and strength characteristics in rehabilitation.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Abenhaim L.
        • Rossignol M.
        • Valat J.P.
        • et al.
        The role of activity in the therapeutic management of back pain.
        Spine. 2000; 25: 1S-33
        • Kool J.
        • de Bie R.
        • Oesch P.
        • Knusel O.
        • van den Brandt P.
        • Bachmann S.
        Exercise reduces sick leave in patients with non-acute non-specific low back pain: a meta-analysis.
        J Rehabil Med. 2004; 36: 49-62
        • Hayden J.A.
        • van Tulder M.W.
        • Malmivaara A.V.
        • Koes B.W.
        Meta-analysis: exercise therapy for nonspecific low back pain.
        Ann Intern Med. 2005; 142: 765-775
        • Hubley-Kozey C.L.
        • McCulloch T.A.
        • McFarland D.H.
        Chronic low back pain: a critical review of specific therapeutic exercise protocols on musculoskeletal and neuromuscular parameters.
        JMMT. 2003; 11: 78-87
        • Philadelphia Panel
        Philadelphia panel evidence-based clinical practice guidelines on selected rehabilitation interventions for low back pain.
        Phys Ther. 2001; 81: 1641-1674
        • Airaksinen O.
        • Brox J.I.
        • Cedraschi C.
        • et al.
        European guidelines for the management of chronic non-specific low back pain.
        (Accessed October 19, 2007)
        • Mälkiä E.
        • Ljunggren A.E.
        Exercise programs for subjects with low back disorders.
        Scand J Med Sports. 1996; 6: 73-81
        • Hilde G.
        • Bo K.
        Effect of exercise in the treatment of chronic low back pain: a systematic review, emphasising type and dose of exercise.
        Phys Ther Rev. 1998; 3: 107-117
        • Liddle S.D.
        • Baxter G.D.
        • Gracey J.H.
        Exercise and chronic low back pain: what works?.
        Pain. 2004; 107: 176-190
        • Mayer T.G.
        • Smith S.S.
        • Keeley J.
        • Mooney V.
        Quantification of lumbar function.
        Spine. 1985; 10: 765-772
        • Takemasa R.
        • Yamamoto H.
        • Tani T.
        Trunk muscle strength in and effects of trunk muscle exercises for patients with chronic low back pain.
        Spine. 1995; 20: 2522-2530
        • Lee J.-H.
        • Ooi Y.
        • Nakamura K.
        Measurement of muscle strength of the trunk and the lower extremities in subjects with history of low back pain.
        Spine. 1995; 20: 1994-1996
        • Holmström E.
        • Moriz U.
        • Andersson M.
        Trunk muscle strength and back muscle endurance in construction workers with and without low back disorders.
        Scand J Rehabil Med. 1992; 24: 3-10
        • Kankaanpää M.
        • Taimela S.
        • Laaksonen D.
        • Hänninen O.
        • Airaksinen O.
        Back and hip extensor fatigability in chronic low back pain patients and controls.
        Arch Phys Med Rehabil. 1998; 79: 412-417
        • Luoto S.
        • Taimela S.
        • Hurri H.
        • Aalto H.
        • Pyykkö I.
        • Alaranta H.
        Psychomotor speed and postural control in chronic low back pain patients.
        Spine. 1996; 21: 2621-2627
        • Luoto S.
        • Aalto H.
        • Taimela S.
        • Hurri H.
        • Pyykkö I.
        • Alaranta H.
        One-footed and externally disturbed two-footed postural control in patients with chronic low back pain and healthy control subjects.
        Spine. 1998; 23: 2081-2090
        • Gill K.P.
        • Callaghan M.J.
        The measurement of lumbar proprioception in individuals with and without low back pain.
        Spine. 1998; 23: 371-377
        • 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.
        • Cholowicki J.
        • Panjabi M.M.
        • Patel T.
        Muscle response pattern to sudden trunk loading in healthy individuals and in patients with chronic low back pain.
        Spine. 2000; 25: 947-954
        • Radebold A.
        • Cholowicki J.
        • Polzhofer G.K.
        • Greene H.S.
        Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain.
        Spine. 2001; 26: 724-730
        • van Dieën J.H.
        • Cholewicki J.
        • Radebold A.
        Trunk muscle recruitment patterns in patients with low back pain enhance the stability of the lumbar spine.
        Spine. 2003; 28: 834-841
        • Danneels L.A.
        • Vanderstraenten G.G.
        • Cambier D.C.
        • Witvrouw E.E.
        • DeCuyper H.J.
        CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects.
        Eur Spine J. 2000; 9: 266-272
        • Mannion A.F.
        Fibre type characteristics and function of the human paraspinal muscles: normal values and changes in association with low back pain.
        J Electromyogr Kinesiol. 1999; 9: 363-377
        • Hupli M.
        • Hurri H.
        • Luoto S.
        • Risteli L.
        • Vanharanta H.
        • Risteli J.
        Low synthesis rate of type I Procollagen is normalized during active back rehabilitation.
        Spine. 1997; 22: 850-854
        • Kannus P.
        • Jozsa L.
        • Renström P.
        • et al.
        The effects of training, immobilization and remobilization on musculoskeletal tissue.
        Scand J Med Sci Sports. 1992; 2: 100-118
        • Fleck S.J.
        • Kraemer W.J.
        Designing resistance training programs.
        3rd ed. Human Kinetics, Champaign2004
        • Kraemer W.J.
        • Adams K.
        • Cafarelli E.
        • Dudley G.A.
        • Dooly C.
        • Feigenbaum M.S.
        American College of Sports Medicine position stand.
        Med Sci Sports Exerc. 2002; 4: 364-380
        • Callaghan J.P.
        • Gunning J.L.
        • McGill S.M.
        The relationship between lumbar spine load and muscle activity during extensor exercises.
        Phys Ther. 1998; 78: 8-18
        • Arokoski J.P.
        • Kankaanpää M.
        • Valta T.
        • et al.
        Back and hip extensor muscle function during therapeutic exercises.
        Arch Phys Med Rehabil. 1999; 80: 842-850
        • Plamondon A.
        • Marceau C.
        • Stainton S.
        • Desjardins P.
        Toward a better prescription of the prone back extension exercise to strengthen the back muscles.
        Scand J Med Sci Sports. 1999; 9: 226-232
        • Arokoski J.P.
        • Valta T.
        • Airaksinen O.
        • Kankaanpää M.
        Back and abdominal muscle function during stabilization exercises.
        Arch Phys Med Rehabil. 2001; 82: 1089-1098
        • Souza G.M.
        • Baker L.L.
        • Powers C.M.
        Electromyographic activity of selected trunk muscles during dynamic spine stabilization exercises.
        Arch Phys Med Rehabil. 2001; 82: 1551-1557
        • Konrad P.
        • Schmitz K.
        • Denner A.
        Neuromuscular evaluation of trunk-training exercises.
        J Athl Train. 2001; 36: 109-118
        • 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
        • Vera-Garcia F.J.
        • Grenier S.G.
        • McGill S.M.
        Abdominal muscle response during curl-ups on both stable and labile surfaces.
        Phys Ther. 2000; 80: 564-569
        • Mori A.
        Electromyographic activity of selected trunk muscles during stabilization exercises using a gym ball.
        Electromyogr Clin Neurophysiol. 2004; 4: 57-64
        • Behm D.G.
        • Leonard A.M.
        • Young W.B.
        • Bonsey A.C.
        • MacKinnon S.N.
        Trunk muscle electromyographic activity with unstable and unilateral exercises.
        J Strength Cond Res. 2005; 19: 193-201
        • Marshall P.W.
        • Murphy B.A.
        Core stability exercises on and off a Swiss ball.
        Arch Phys Med Rehabil. 2005; 86: 242-249
        • Weir J.
        • Wagner L.
        • Housh T.
        The effect of rest interval length on repeated maximal bench press.
        J Strength Cond Res. 1994; 8: 58-60
        • Matuszak M.E.
        • Fry A.C.
        • Weiss L.W.
        • Ireland T.R.
        • McKnight M.M.
        Effect of rest interval length on repeated 1 repetition maximum back squat.
        J Strength Cond Res. 2003; 17: 634-637
        • Hutten M.M.
        • Hermend H.J.
        Reliability of lumbar dynamometry measurements in patients with chronic low back pain with test-retest measurements on different days.
        Eur Spine J. 1997; 6: 54-62
        • Kumar S.
        • Narayan Y.
        • Garand D.
        Isometric axial rotation of the human trunk from pre-rotated postures.
        Eur J Appl Physiol. 2002; 87: 7-16
        • Roy A.L.
        • Keller T.S.
        • Colloca C.J.
        Posture-dependent trunk extensor EMG activity during maximum isometrics exertions in normal male and female subjects.
        J Electromyogr Kinesiol. 2003; 13: 469-476
        • Häkkinen A.
        • Kuukkanen T.
        • Tarvainen U.
        • Ylinen J.
        Trunk muscle strength in flexion, extension and axial rotation in patients managed with lumbar disc herniation surgery and in healthy control subjects.
        Spine. 2003; 28: 1068-1073
        • Winter D.A.
        Biomechanics and motor control of human movement.
        3rd ed. Wiley, Hoboken2004
        • Ng J.K.
        • Kippers V.
        • Richardson C.A.
        Muscle fibre orientation of abdominal muscles and suggested surface EMG electrode position.
        Electromyogr Clin Neurophysiol. 1998; 38: 51-58
        • Urquhart D.M.
        • Hodges P.W.
        Differential activity of regions of transversus abdominis during trunk rotation.
        Eur Spine J. 2005; 14: 393-400
        • Stokes I.A.F.
        • Sharon M.H.
        • Single R.M.
        Surface EMG electrodes do not accurately record from lumbar multifidus muscles.
        Clin Biomech (Bristol, Avon). 2003; 18: 9-13
        • Moseley G.L.
        • Hodges P.W.
        • Gandevia S.C.
        Deep and superficial fibers of the lumbar multifidus muscle are differentially active during voluntary arm movements.
        Spine. 2001; 27: E29-E36
        • McGill S.M.
        Low back exercises: evidence for improving exercise regimens.
        Phys Ther. 1998; 78: 754-765
        • McGill S.M.
        Low back stability: from formal description to issues for performance and rehabilitation.
        Exerc Sports Sci Rev. 2001; 29: 26-31
        • Cholewicki J.
        • Van Vliett J.J.
        Relative contribution of trunk muscles to the stability of the lumbar spine during isometric exertion.
        Clin Biomech (Bristol, Avon). 2002; 17: 99-105
        • Kavcic N.
        • Grenier S.
        • McGill S.M.
        Determining the stabilizing role of individual torso muscles during rehabilitation exercises.
        Spine. 2004; 29: 1254-1265
        • Hermens H.J.
        • Freriks B.
        • Merletti R.
        European recommendations for surface electromyography: deliverable of the SENIAM project.
        Roessingh Research and Development, Enschede1999
        • DeFoa J.L.
        • Forrest W.
        • Biedermann H.J.
        Muscle fibre direction of longissimus, iliocostalis and multifidus: landmark-derived reference lines.
        J Anat. 1989; 163: 243-247