The Effect of Visual Biofeedback on EMG Activity of Trunk Muscles and Endurance Holding Time for Correct Position During Whole-Body Tilt Exercise

전신 기울기 운동 시 시각적 바이오피드백이 올바른 자세 유지 시간과 체간 근육의 근활성도에 미치는 영향

  • Kang, Min-Hyeok (Dept. of Physical Therapy, The Graduate School, Inje University) ;
  • Yoon, Ji-Yeon (Motion Analysis Laboratory, Haeundae Paik Hospital, Inje University) ;
  • Yang, Jae-Lak (HANMED Co., Ltd.) ;
  • Jang, Jun-Hyeok (Dept. of Physical Therapy, Haeundae Jaseng Hospital of Oriental Medicine) ;
  • Jung, Doh-Heon (Dept. of Rehabilitation Therapy, The Graduate School, Yonsei University) ;
  • Oh, Jae-Seop (Dept. of Physical Therapy, College of Biomedical Science and Engineering, Inje University)
  • 강민혁 (인제대학교 대학원 물리치료학과) ;
  • 윤지연 (인제대학교 해운대 백병원 동작분석실) ;
  • 양재락 ((주)한메드) ;
  • 장준혁 (해운대 자생한방병원 물리치료실) ;
  • 정도헌 (연세대학교 대학원 재활학과) ;
  • 오재섭 (인제대학교 의생명공학대학 물리치료학과)
  • Received : 2010.12.17
  • Accepted : 2011.01.15
  • Published : 2011.02.19


The purpose of this study was to assess visual biofeedback's influence on trunk muscles' (EMG) activity and endurance holding time for correct position during whole-body tilt exercise. For the study, we recruited 14 volunteers who showed no symptom of lumbar disease during medical tests. We measured the EMG activity of their rectus abdominis, external abdominal oblique, internal abdominal oblique and erector spinae muscles, and their endurance holding time for correct position during $40^{\circ}$ anterior and posterior whole-body tilt under two conditions: whole-body tilt with and without visual biofeedback. Resistance with gravitational force on the trunk during whole-body tilt was applied by using a device that had a monitor on which the subjects could check their alignment and that sounded an alarm if a subject's alignment collapsed. The study showed an increase in the EMG activity of external abdominal oblique, internal abdominal oblique/rectus abdominis ratio and endurance holding time for correct position during both $40^{\circ}$ anterior and posterior whole-body tilt with visual biofeedback compared with without visual biofeedback (p<.05). We suggest that the whole-body tilt exercise with visual biofeedback could be a beneficial strategy for selectively strengthening the internal abdominal oblique muscle and minimizing the rectus abdominis muscle's activity while maintaining correct alignment during whole-body tilt exercise.



  1. 김대훈, 김성수. 요추추간판탈출증 환자의 최소침습 현미경수술 후 조기의 3차원 요부 안정화 운동의 단기효과 연구. 대한스포츠의학회지. 2009;27(1):47-52.
  2. 김성호, 유병규, 이완희. 척추안정화 운동이 요통 환자의 요추부 심부근육의 근단면적, 요부근력, 주관적 통증지수에 미치는 영향. 한국사회체육학회지. 2010;40(2):527-536.
  3. Anders C, Brose G, Hofmann GO, et al. Evaluation of the EMG-force relationship of trunk muscles during whole body tilt. J Biomech. 2008;41(2):333-339.
  4. Anders C, Brose G, Hofmann Go, et al. Gender specific activation patterns of trunk muscles during whole body tilt. Eur J Appl Physiol. 2007;101(2):195-205.
  5. Bergmark A. Stability of the lumbar spine: A study in mechanical engineering. Acta Orthop Scand Suppl. 1989;230:1-54.
  6. Brumagne S, Cordo P, Lysens R, et al. The role of paraspinal muscle spindles in lumbosacral position sense in individuals with and without low back pain. Spine (Phila Pa 1076). 2000;25(8):989-994.
  7. Cholewicki J, VanVliet JJ, Relative contribution of trunk muscles to the stability of the lumbar spine during isometric exertions. Clin Biomech (Bristol, Avon). 2002;17(2):99-105.
  8. Comerford MJ, Mottram SL. Movement and stability dysfunction-contemporary developments. Man Ther. 2001;6(1):15-26.
  9. Desmurget M, Grafton S. Forward modeling allows feedback control for fast reaching movements. Trends Cogn Sci. 2000;4(11):423-431.
  10. Franca FR, Burke TN, Hanada ES, et. al. Stgmental stabilization and muscular strengthening in chronic low back pain: A comparative study. Clinics (Sao Paulo). 2010;65(10):1013-1017.
  11. Gardner-Morse MG, Stokes IA. The effects of abdominal muscle coactivation on lumbar spine stability. Spine (Phila Pa 1976). 1998;23(1):86-91.
  12. Gibbons SG, Comerford MJ. Strength versus stability-part 1 concept and terms. Orthopaedic Division Review. 2001:21-27.
  13. Grabiner MD, Jeziorowski JJ, Divekar AD. Isokinetic measurements of trunk extension and flexion performance collected with the biodex clinical data station. J Orthop Sports Phys Ther. 1990;11(12):590-598.
  14. Juker D, McGill S, Kropf P, et al. Quantitative intra-muscular myoelectric activity of lumbar portions of psoas and the abdominal wall during a wide variety of tasks. Med Sci Sports Exerc. 1998;30(2):301-310.
  15. Koldas Dogan S, Sonel Tur B, Kurtais Y, et al. Comparison of three different approaches in the treatment of chronic low back pain. Clin Rheumatol 2008;27(7):873-881.
  16. Loughlin PJ, Redfern MS. Spectral characteristics of visually induced postural sway in healthy elderly and healthy young subjects. IEEE Trans Neural Syst Rehabil Eng. 2001;9(1):24-30.
  17. Madhavan S, Shields RK. Movement accuracy changes muscle-activation strategies in female subjects during a novel single-leg weight-bearing task. PM R. 2009;1(4):319-328. Marshall P, Murphy B. Changes in muscle activity and perceived exertion during exercises performed on a swiss ball. Appl Physiol Nutr Metab. 2006 Aug;31(4):376-83.
  18. Marshall PW, Murphy BA. Core stability exercises on and off a Swiss ball. Arch Phys Med Rehabil. 2005;86(2):242-249.
  19. Ng JK, Richardson CA, Jull GA. Electromyographic amplitude and frequency changes in the iliocostalis lumborum and multifidus muscles during a trunk holding test. Phys Ther. 1997;77(9):954-961.
  20. Norris CM. Functional load abdominal training: Part 1. J Bedyw Mov Ther. 1999;3(3):150-108.
  21. O'Sullivan PB, Burnett A, Floyd AN, et al. Lumbar repositioning deficit in a specific low back pain population. Spine (Phila Pa 1976). 2003;28(10):1074-1079.
  22. O'Sullivan PB, Dankaerts W, Burnett AF, et al. Effect of different upright sitting postures on spinal-pelvic curvature and Dunk muscle activation in a pain-free population. Spine (Phila Pa 1976). 2006;31(19):E707-712.
  23. Panjabi MM. The stabilizing system of the spine. Part I . Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992;5(4):383-389;discussion 397.
  24. Queiroz BC, Cagliari MF, Amorim CF, et al. Muscle activation during four Pilates core stability exercises in quadruped position. Arch Phys Med Rehabil. 2010;91(1):86-92.
  25. Reeves NP, Cholewicki J, Milner T, et al. Trunk antagonist co-activation is associated with impaired neuromuscular performance. Exp Brain Res. 2008;188(3):457-463.
  26. Richardson C, Jull G, Toppenburg R, et al. Techniques for active lumbar stabilisation for spinal protection: A pilot study. Aust J Physiother. 1992;38(2):105-112.
  27. Sahrmann SA. Diagnosis and Treatment of Movement Impairment Syndromes. Mosby. 2002:69-71.
  28. Stevens VK, Bouche KG, Mahieu NN, et al. Trunk muscle activity in healthy subjects during bridging stabilization exercises. BMC Musculoskelet Disord. 2006;7:75.
  29. Tomita S, Arphorn S, Muto T, et al. Prevalence and risk factors of low back pain among Thai and Myanmar migrant seafood processing factory workers in Samut Sakorn Province, Thailand. Ind Health. 2010;48(3):283-291.
  30. Uchiyama M, Demura S. Low visual acuity is associated with the decrease in postural sway. Tohoku J Exp Med. 2008;216(3):277-285.
  31. Unlu Z, Tasci S, Tarhan S, et al. Comparison of 3 physical therapy modalities for acute pain in lumbar disc herniation measured by clinical evaluation and magnetic resonance imaging. J Manipulative Physiol Ther. 2008;31(3):191-198.