Comparison of Muscle Activity Using Unstable Devices During a Forward Lunge

in Journal of Sport Rehabilitation
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Context: Unstable devices in various forms are used as therapeutic adjuncts for prevention or following an injury. A slip-over-the-shoe design with inflatable domes (STEPRIGHT® Stability Trainer) was developed to improve balance. It is unknown how this unstable device affects muscle activity during a closed-chain exercise such as the forward lunge. Objective: To compare muscle activity across 3 surfaces (STEPRIGHT®, Both Sides Up [BOSU®] Balance Trainer, and firm) during a forward lunge. Design: Within-subject, repeated measures. Setting: University physical therapy research laboratory. Participants: A total of 20 healthy, recreationally active subjects (23.4 [1.47] y, 172.7 [14.7] cm, 71.6 [16.8] kg). Intervention: Each subject performed 1 set of 10 repetitions of forward lunge exercise in random order with STEPRIGHT®, BOSU®, and firm surface. Main Outcome Measures: Surface electromyography data, normalized to maximum voluntary isometric contractions (%MVIC), was used to assess muscle activity on rectus femoris, vastus medialis oblique (VMO), biceps femoris, lateral gastrocnemius, fibularis longus, and tibialis anterior. Results: The repeated-measures analysis of variance determined that there was a significant effect for surface type. During the descent of the lunge, the STEPRIGHT® elicited higher rectus femoris (33% [27%] MVIC) compared with BOSU® (22% [14%] MVIC) and VMO (44% [15%] MVIC) on STEPRIGHT® compared with firm (38% [11%] MVIC) (P < .05). During the ascent of the lunge, the rectus femoris (38% [27%] MVIC) using STEPRIGHT® was higher than BOSU® (24% [16%] MVIC), and STEPRIGHT® elicited higher VMO (65% [20%] MVIC) versus BOSU® (56% [19%] MVIC) (P ≤ .01). The STEPRIGHT® for fibularis longus was higher (descent: 51% [20%] MVIC, ascent: 52% [22%] MVIC) than BOSU® (descent: 36% [15%] MVIC, ascent: 33% [16%] MVIC) or firm (descent: 33% [12%] MVIC, ascent: 35% [15%] MVIC) (P < .001). Conclusions: Clinicians may choose to use the STEPRIGHT® for strengthening VMO and fibularis longus muscles, as these were over 41% MVIC or any of the 3 surfaces for endurance training (<25% MVIC) for biceps femoris muscle. This information may be helpful in exercise dosage for forward lunges when using STEPRIGHT®, BOSU®, or a firm surface.

The authors are with the Doctor of Physical Therapy Program, School of Exercise and Rehabilitation Sciences, College of Health and Human Services, The University of Toledo, Toledo, OH.

Bouillon (lucinda.bouillon@utoledo.edu) is corresponding author.
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