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  • Review
  • Open Access

16 June 2020

Core Muscle Activity during Physical Fitness Exercises: A Systematic Review

and
1
Health Research Centre, University of Almería, 04120 Almería, Spain
2
Laboratory of Kinesiology, Biomechanics and Ergonomics (KIBIOMER Lab.), Research Central Services, University of Almería, 04120 Almería, Spain
*
Author to whom correspondence should be addressed.

Abstract

The aim of this study was to systematically review the current literature on the electromyographic (EMG) activity of six core muscles (the rectus abdominis, the internal and external oblique, the transversus abdominis, the lumbar multifidus, and the erector spinae) during core physical fitness exercises in healthy adults. A systematic review of the literature was conducted on the Cochrane, EBSCO, PubMed, Scopus, and Web of Science electronic databases for studies from January 2012 to March 2020. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used. The inclusion criteria were as follows: (a) the full text available in English; (b) a cross-sectional or longitudinal (experimental or cohorts) study design; (c) the reporting of electromyographic activity as a percentage of maximum voluntary contraction (% MVIC), millivolts or microvolts; (d) an analysis of the rectus abdominis (RA), transversus abdominis (TA), lumbar multifidus (MUL), erector spinae (ES), and the internal (IO) or external oblique (EO); (e) an analysis of physical fitness exercises for core training; and (f) healthy adult participants. The main findings indicate that the greatest activity of the RA, EO, and ES muscles was found in free-weight exercises. The greatest IO activity was observed in core stability exercises, while traditional exercises showed the greatest MUL activation. However, a lack of research regarding TA activation during core physical fitness exercises was revealed, in addition to a lack of consistency between the studies when applying methods to measure EMG activity.

1. Introduction

Fitness is defined as a state of health and well-being, which is characterized by the ability to perform daily physical activities or exercise [1]. Thus, the primary purpose of strength and conditioning coaches is to prescribe the right physical fitness exercises to their athletes and/or clients in order to achieve specific fitness goals [2]. Several studies have provided information on the importance of core training and testing in several populations [3,4] in order to improve performance [5] and reduce the risk of injury (e.g., back and lower extremity injury) [6,7]. In addition, core physical fitness exercises may contribute to decreasing the risk of other musculoskeletal disorders (e.g., excessive load on lumbar spine, imbalance of hip extensors, atrophy of paraspinal muscles), which are the consequence of faulty postures and sedentary lifestyles [8].
The core is defined as an anatomical box which consists of several muscle groups, such as the rectus abdominis at the front, the internal and external obliques on the lateral sides, the erector spinae, lumbar multifidus, and quadratus lumborum at the back, the diaphragm at the upper edge and the pelvic floor, and the iliac psoas at the bottom [9,10]. From a practical perspective, the core muscles are the center of the body where most kinetic chains transfer forces to the extremities [10]. However, the transversus abdominis, lumbar multifidus, and quadratus lumborum are considered the key core muscles for fitness and health professionals [2].
In recent years, the development of surface electromyography (sEMG) has allowed us to measure muscle activation patterns [11]. These muscle activation patterns should be considered when selecting and prescribing physical fitness exercises [12], since the force of the muscle contraction is regulated by the totality of motor units recruited [13,14]. In addition, the recruitment of low- or high-threshold motor units depends on the intensity of the exercise [14]. Thus, the amplitude of the sEMG signal, which is frequently reported as raw (millivolts) or relative to the maximum voluntary isometric contraction (% MVIC), is commonly used to analyze levels of muscle activation and fatigue [2,15]. Given that the greater the electromyographic (EMG) activity, the greater the challenge to the neuromuscular system, it is suggested that the core exercises that increase EMG may be useful for core strengthening [2].
Sit-ups and curl-ups have, for a long time, been the most common core physical fitness exercises [16]. However, new exercises have been developed by adding, for instance, unstable surfaces, such as Swiss balls, BOSU balls, or wobble balance board platforms in order to increase the proprioceptive demands of the exercises [16]. In addition, a recent systematic review on the EMG activity during core physical fitness exercises considered that free-weight exercises may be recommended, since these multi-joint exercises are more time-efficient than core exercises on the floor or on unstable surfaces [2]. Nevertheless, research to date has been limited on which core exercises should be performed based on muscle activity patterns, and there is a discernible lack of consensus. The only review on core muscle activity in physical fitness exercises for healthy adults was published seven years ago, in which the authors concluded that fitness specialists should focus on free weight exercises (e.g., the squat or deadlift) rather than other specific core exercises in order to train these muscles [2]. However, this review only included studies that analyzed the muscle activity of three core muscles (the transversus abdominis, lumbar multifidus, and quadratus lumborum) [2]. In addition, new exercises have since been evaluated (e.g., the suspension plank, roll-out, body saw, pike, and knee tuck) [17,18,19] so the literature is in need of an updated systematic review.
Consequently, the aim of this study was to systematically review the current literature on the electromyographic activity in six core muscles (the rectus abdominis, internal and external oblique, transversus abdominis, lumbar multifidus, and erector spinae) during core physical fitness exercises in healthy adults.

2. Materials and Methods

2.1. Search Strategy

A systematic review of the literature was conducted on the Cochrane, EBSCO, PubMed, Scopus, and Web of Science electronic databases, looking at studies from 12 January 2012, when the last systematic review was performed [2] up until 5 March 2020. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines [20] were used. The protocol for this systematic review was registered on PROSPERO (CRD42020176876) and is available in full on the National Institute for Health Research.
The keywords for the search strategy were (“core” OR “trunk” OR “abdominis” OR “abdominal” OR “low back” OR “rectus abdominis” OR “transversus abdominis” OR “multifid*” OR “lumbar” OR “quadratus lumborum” OR “erector spinae” OR “external oblique” OR “internal oblique”) AND (“resistance training” OR “strength training” OR “resistance exercise” OR “weight lifting” OR “weight-bearing” OR “stability” OR “strengthening” OR “training”) AND (“electromyography” OR “EMG” OR “muscle activation” OR “biofeedback” OR “myoelectrical”).

2.2. Study Selection

Only studies meeting the inclusion criteria were selected. These criteria were as follows: (a) the full text being available in English; (b) a cross-sectional or longitudinal (experimental or cohorts) study design; (c) a report on the electromyographic activity as a percentage of maximum voluntary contraction (% MVIC), millivolts or microvolts; (d) an analysis of the rectus abdominis (RA), transversus abdominis (TA), lumbar multifidus (MUL), erector spinae (ES), and internal (IO) or external oblique (EO); (e) an analysis of the physical fitness exercises for core training; (f) inclusion of healthy adult participants; and (g) being published as of 1st March 2020. Any studies that included a history of low back pain, spinal injury, or neurological deficits in any of the participants were excluded, along with any that included an analysis of aerobic exercises, books, theses, and/or congress abstracts.
The studies were selected by two independent reviewers based on the inclusion and exclusion criteria. All of these were stored in the Mendeley reference management system (Elsevier, Amsterdam, The Netherlands). Once the duplicates were removed, the titles and abstracts were examined. Following this, the full text of all the papers were read, and only studies meeting the inclusion criteria were selected. In the case of any disagreement between the two reviewers, a third collaborator participated in the decision-making process. Figure 1 shows a graphical description of the study selection process, which lasted for three weeks.
Figure 1. Flowchart of the selection process.

2.3. Data Abstraction

The following data were extracted from each study: the authors, country, year, sample size, gender, age, exercise(s) assessed and methods used, the muscles tested, the results (in % MVIC, microvolts or millivolts for each muscle during the exercise), and the conclusion. If a study reported the results in microvolts, it was converted into millivolts. Given the degree of heterogeneity between the studies (e.g., the sample characteristics, data collection methods, electrodes placement, data reporting in different units of measure), the data collected in this systematic review could not be used for the purposes of meta-analysis. For this reason, a systematic qualitative review and interpretation of the results was carried out.

2.4. Core Physical Fitness Exercises

The core exercises were based on prior classifications [2], these being: (a) traditional core exercises—low-load exercises which are usually performed on the floor in order to activate superficial muscles (e.g., the sit-up and back extension); (b) stability exercises—low load and low range of motion in order to activate deep core muscles (e.g., the front plank and side plank); (c) ball/device exercises—a combination of stability and traditional core exercises which might add unstable surfaces or devices (e.g., a crunch on a Swiss ball and the front plank on suspension systems); and (d) free-weight exercises—the addition of greater loads which tend to activate the upper or lower body and core muscles (e.g., the squat, deadlift, and shoulder press).

2.5. Methodological Quality Assessment

The Effective Public Health Practice Project (EPHPP) scale was used to assess the level of evidence of each study. Currently, there is no standard scale for the methodological quality assessment of observational investigations on EMG [21,22]. However, each study was assessed based on the EPHPP scale, which has been used as a standard tool for the assessment of methodological quality in previous research with similar aims [2,21]. In addition, the use of this scale may decrease the risk of bias when interpreting the results from this systematic review. The EPHPP scale has six components (selection bias, study design, confounders, blinding, data collection method, and withdrawals/dropouts) categorized by three ratings (weak, moderate, and strong) [23]. The level of evidence of each paper may be weak (two or more weak ratings), moderate (one weak rating), or strong (no weak ratings). Once the studies were included in this systematic review, two reviewers rated each study. If there was any hesitation or question related to one of the components being rated, the reviewers discussed: oversight (final decision: strong), different criteria interpretations (final decision: moderate), and different study interpretations (final decision: weak).

3. Results

3.1. Study Selection

A total of 2350 studies were identified following the search strategy; however, 603 were duplicates. Once these were removed, titles and abstracts were examined, and 219 were selected for full-text screening. Of these, 152 did not meet the inclusion criteria (e.g., most of these studies did not meet healthy adult participant criteria) so the remaining 67 studies were selected for the study (Figure 1).

3.2. Characteristics of the Selected Studies

A total of 1247 healthy participants were analyzed in all the selected studies (Table 1). There were studies that collected data from male-specific samples (n = 40), female-specific samples (n = 9), and samples from both genders (n = 18). The EMG activity from 233 exercises was collected. Table 2 shows a summarized description of the exercises. Based on prior core exercise classifications [2], 15 studies analyzed traditional core exercises, 23 analyzed core stability exercises, 26 analyzed core exercises with an additional ball/device, and 26 analyzed free-weight exercises (Table 1). Each study measured the EMG activity in different muscles: the RA (n = 51), EO (n = 45), ES (n = 37), IO (n = 23), MUL (n = 16), and TA (n = 3).
Table 1. Characteristics of the included studies.
Table 2. Description of core physical fitness exercises assessed in the included studies.
The methods used to measure EMG activity varied depending on the study, although the most frequent methods were: three sets of 5 s (n = 9), five repetitions (n = 6), three sets of 10 s (n = 5), 10 repetitions (n = 5), and six maximum repetitions (n = 4). This systematic review included studies with strong (n = 20), moderate (n = 38), and weak (n = 9) levels of evidence. In addition, a lack of unified criteria was found when reporting EMG values, since studies used % MVIC (n = 55) (Table 3), millivolts (n = 8), and microvolts (n = 4) (Table 4).
Table 3. Descriptive statistics of electromyographic activity (expressed as percentage of maximum voluntary contraction, % MVIC) in each study by exercise.
Table 4. Descriptive statistics of electromyographic activity (expressed as millivolts, mV) in each study by exercise.

3.3. Rectus Abdominis

Regarding the traditional core exercises, the static curl-up with the hands behind the neck, the hip flexed at 60°, and knees flexed at 90° was the exercise that elicited the highest EMG activity of the RA (81.00 ± 10.90% MVIC), followed by the static curl-up with the arms crossed over the chest, the hip flexed at 60°, and knees flexed at 90° (67.60 ± 15.70% MVIC) [24]. Based on the EMG activity reported as mV, the exercise with the highest RA activation was the sit-up, with lower RA activation being higher than upper RA activation (0.54 ± 0.24 mV vs. 0.27 ± 0.11 mV) [16].
V-sits [25], the front plank with scapular adduction and posterior pelvic tilt [26], and the side plank with maximum expiration [27] were the core stability exercises with the greatest % MVIC in the RA (V-sits: ~80%; Front plank: ~78%; Side plank: ~75%). The front plank with additional weight (20% BW) also showed the greatest mV (~0.25 mV) in the RA [28].
Three studies reported the following core exercises on a ball/device as the highest EMG related to % MVIC in the RA: the suspended roll-out plank (Upper RA: 145.00 ± 22.00% and Lower RA: 122.00 ± 32.00%; Upper RA: 67.00 ± 78.00% and Lower RA: 140.00 ± 89.00%) [19,29] and the suspended front plank (Upper RA: 145.00 ± 22.00% and Lower RA: 122.00 ± 32.00%) [29]. For those studies that reported EMG activity as mV, the highest values were obtained for sit-ups with upper instability on a BOSU ball (Upper RA: 0.33 ± 0.14 mV; Lower RA: 0.65 ± 0.33 mV) [16].
The unstable Bulgarian squat and the regular back squat over six maximum repetitions were the free-weight exercises with the highest EMG activity (~210% MVIC) [30].

3.4. Internal Oblique

Regarding traditional exercises, the static curl-up with the hands behind the neck, the hip flexed at 60°, and the knees flexed at 90° and at 45° was the exercise with the highest % MVIC (without twist: 61.70 ± 17.00% MVIC; with twist: 57.30 ± 12.40% MVIC) [24]. The crunch was the exercise with the highest mV values (~0.08 mV) [31].
In relation to core stability exercises, the front plank with scapular adduction and posterior pelvic tilt had the highest % MVIC for IO (119.92 ± 60.26% MVIC) [26], while the climax laughter exercises showed the highest mV values (~0.11 mV) [31].
The core exercises with the greatest activity performed on an additional ball/device were the front plank on a Swiss ball with hip extension (76.50 ± 37.00% MVIC) and the stir-the-pot (73.50 ± 31.30% MVIC) [32]. There were only three studies that examined IO activity during free-weight exercises [33,34,35], with the highest EMG values obtained on the kettlebell swing with kime (80.80 ± 43.70% MVIC) and the unilateral bench press (~0.05 mV).

3.5. External Oblique

The curl-up with the hip flexed at 90° had the highest activation within the traditional core group (with maximal expiration: 70.74 ± 20.57 % MVIC; with slow expiration: 65.18 ± 24.83 % MVIC) [47]. In addition, the sit-up exercise reached ~0.41 mV [16].
Within the core stability exercises, the front plank with scapular adduction and a posterior pelvic tilt elicited the highest EMG activity (110.78 ± 65.76% MVIC) [26]. Furthermore, the front plank with additional weight (20% body weight) reached ~0.2 mV [28].
When the core exercises were performed on an additional ball/device, the greatest EMG activity levels were found during the stir-the-pot (144.20 ± 108.10% MVIC) and the front plank on a Swiss ball with hip extension (109.40 ± 65.20% MVIC) [32]. Regarding the studies reporting EMG activity as mV, the highest values were reached during the sit-up with upper and lower limb instability achieved by placing the feet and lower back on a BOSU (0.44 ± 0.22 mV), or with only the lower back on the BOSU (0.42 ± 0.22 mV) [16].
The Bulgarian squat had the highest EMG activity (Stable: ~155% MVIC; Unstable: ~148% MVIC) in the free-weight exercise group [30]. Also, the standing unilateral dumbbell press achieved 0.4 mV in the EO [86].

3.6. Erector Spinae

Activation of the ES was greater in back extension exercises (~63% MVIC) than in the other exercises analyzed [25,68] in the traditional core exercise group.
In addition, back extension exercises showed the greatest activation in core stability exercises, not only on the floor (~63% MVIC) but also on the bench (~56% MVIC) [25]. One study, reporting in mV, also registered the front plank with additional weight (20% BW) at 0.1 mV [28].
Regarding core exercises on a ball/device, the suspended bridge showed the highest % MVIC (61.51 ± 13.85%) [50]. Only one study from this category reported EMG activity for the ES as mV (the 5-min Shaper device: 0.99 ± 0.06 mV) [37].
In relation to free-weight exercises, the greatest activation was found on the deadlift (barbell deadlift: ~90% MVIC; hex bar deadlift: ~80% MVIC) and hip-thrust exercise (~85% MVIC) [46]. Also, the back squat performed until failure and 2RM deadlift reported the highest mV values (~0.35 mV) [28,40].

3.7. Lumbar Multifidus

Only one study analyzed MUL activation in traditional exercises, which showed the highest % MVIC in prone trunk extensions and leg extensions with active lumbopelvic control (~64% MVIC) [56]. Concerning MUL activation for core stability, the highest % MVIC were found during the bridge exercise and bird dog (with light loads on the active hand and leg) (~39%) [71,82]. The highest mV were observed in bird dog (0.86 ± 1.01 mV) [85].
When it came to core exercises on a ball/device, the front plank on a Swiss ball with hip extension achieved ~62% MVIC for the MUL [32]. Three studies were conducted looking at free-weight exercises [44,59,70], with the greatest EMG activity found in the 45% body weight bent-over row (~58.20% MVIC), the 75% bodyweight deadlift (~57.90% MVIC) and the 75% body weight back squat (~54.80% MVIC) [44].

3.8. Transversus Abdominis

We found three studies analyzing this muscle [24,36,85]. Two studies examined TA activation based on % MVIC, in which the side-lying lumbar setting on a sling exercise reported the highest activation (58.65 ± 6.99%) [36] followed by the static curl-up with hands behind the neck (40.70 ± 26.50%) [24]. Based on mV values, a third study examined TA activation during the bird dog exercise (2.63 ± 3.11 mV) [85].

4. Discussion

The aim of this study was to systematically review the current literature on the electromyographic activity of six core muscles during core physical fitness exercises. Most of the studies on core muscle activation (55/67) reported EMG activity as % MVIC, with one of the main findings being that the greatest activity in the RA, EO and ES muscles was found in free-weight exercises. The greatest IO activity was observed in core stability exercises while the greatest MUL activation was found in traditional exercises. However, there was a lack of research on TA activation during core physical fitness exercises and a lack of consistency between studies in terms of the methods applied to measure EMG activity.

4.1. Rectus Abdominis

Free-weight exercises elicited the greatest EMG activity in the RA during the unstable Bulgarian squat (unilateral) and the regular back squat (bilateral) with six maximum repetitions [30]. The RA demand increased throughout the repetitions, suggesting that the difference between the Bulgarian squat and the regular back squat would increase as the muscle became fatigued [30]. The fact that these exercises achieved the highest EMG activity in the RA might be explained not only by the heavy weights leading to exhaustion but also to the biomechanics of these exercises themselves [30,88]. The trunk tilts forward during the squat phase to compensate for the hip moving further backwards and, consequently, the EMG activity increases [30,88].
Core exercises on a ball/device, such as the roll-out plank [19,29] and the suspended front plank [29] were also recommended for achieving high RA activation. Suspension training systems add instability to the exercise, potentially leading to increased EMG activity. Also, it is essential to highlight that EMG activity may vary depending on the type of suspension training system used. For example, a previous study showed that pulley-based suspension systems elicited the greatest RA activation [17]. This type of suspension system may require greater postural control and strength requirements to perform the exercise with the proper technique than other suspension systems [17]. It is also important to consider where the instability is added. For example, one study found that the greatest EMG activity was observed when adding instability with the BOSU, not only on the feet but also on the lower back during the sit-up exercise [16]. Since the RA is a trunk muscle, generating upper body instability would require greater activation to maintain postural control [17].

4.2. Internal Oblique

The front plank with scapular adduction and posterior pelvic tilt, which belongs to the core stability exercise group, may be recommended for developing IO activation [26]. This isometric exercise showed the greatest activation values in the IO, perhaps due to the influence of the thoracolumbar fascia [26]. The IO is attached to the thoracolumbar fascia, and this plays an essential role in the transmission of load from the trunk to the shoulder and the arm [26,89]. In addition, the climax laughter exercise showed the highest mV values (~0.11 mV) [31]. This exercise, whose IO EMG activity was significantly greater than in the crunch exercise, requires high levels of internal muscular control [31]. Consequently, it is recommended as a core stability exercise for IO activation as well as for its psychological and hormonal benefits [31].
Although only a few studies have examined IO activation in free-weight exercises [33,34,35], kettlebell swings with the “Kime” variant registered the greatest EMG activity. The “Kime phase” involves a muscular pulse at the top of the kettlebell swing that trains quick muscle activation and relaxation. However, the same study showed that the large shear compression load ratio on the lumbar spine during the swing phase might be a reason to consider this exercise contraindicated in people with spine shear load intolerance [33].

4.3. External Oblique

Free-weight exercises, such as the Bulgarian squat, had the highest EMG activity [30]. The fact that this unilateral exercise showed such EO activity could be explained by the aim of this trunk rotation muscle, which is to prevent lateral flexion [90]. The exercise requires one foot in front of the other, and the greater the axial distance between them, the lower the stabilizing effect of the parallel legs and the greater the EO activity in preventing lateral sway [30]. In addition, another unilateral exercise (the standing unilateral dumbbell press) had the greatest EMG activity reported as mV [86]. A similar conclusion was drawn from this study—that the results may be explained by the EO’s contralateral effect in stabilizing the core and postural sway when performing the exercise [86]. In consequence, one can conclude that free-weight exercises are recommended for EO activation, especially those performed unilaterally due to the increases in EO activity.
Another possibility suggested by this systematic review is the addition of a ball or device to the core exercises. For example, it suggested front planks on a Swiss ball with the variant of moving the forearms in a continuous clockwise fashion (stir-the-pot), or doing a hip extension while maintaining stability, as being very intense EO exercises [32]. Adding stability balls leads to increased EMG [45,60,81]. Likewise, other researchers have observed increases in EMG activity in the EO when adding suspension training systems or whole-body wobble boards to the front plank exercise [45,78]. Since these instability systems challenge both proximal stability and distal mobility, exercises such as the front plank on a Swiss ball or stir-the-pot may be considered useful inclusions to core-strengthening programs [32].

4.4. Erector Spinae

One of the novel findings of this systematic review was that free-weight exercises (e.g., deadlift, hip-thrust, or back squat) showed the greatest ES muscle activation [38,46]. In this regard, some researchers [74] recommend adding destabilizing bars to free-weight exercises because when used with heavy weights, these bars have been designed to make the lifting action harder. Therefore, these exercises may be recommended since a high motor unit recruitment of the posterior chain is required to maintain a neutral posture regardless of the load’s center of mass and its effect on torque [74].
In addition, exercises such as a back extension on the floor showed high ES muscle activation [68]. A previous study observed that the ES activity was significantly higher in the hyperextension phase of the movement compared to the other exercise phases [91]. Hence, the one-legged back extension, which is another variant of this exercise, increases EMG activity in the ES and may also be recommended as a core physical fitness exercise [51].
Very similar EMG activities were found in the ES muscle when performing suspended bridge exercises [50]. The bridge is a traditional core exercise, but the addition of suspension training systems increased the recruitment of the abdominal, hamstring, gluteal, and trunk extensor muscles [50]. However, not all the devices that add instability increase ES activation. For example, previous studies found that performing the bridge on a Swiss ball, or a whole-body wobble-board platform, did not increase the activation of this muscle [45,82]. In consequence, these results suggest that the ES contributes to spinal control while maintaining a specific body posture, regardless of the type of exercise [82].

4.5. Lumbar Multifidus

The highest % MVIC for this muscle was observed during prone trunk extensions and prone leg extensions with active lumbopelvic control [56]. However, the muscle activity data from this study showed that the posterior extensor chain was more active when applying active lumbopelvic control strategies, which decreased the lumbar hyperlordosis [56]. Therefore, the exercise (e.g., trunk extensions) required greater hip extension and thus, the muscle activity increased [56].
The front plank on a Swiss ball with the hip extension exercise, which is one of the core exercises on a ball/device, can be recommended for developing MUL activation, given it had one of the highest % MVIC for this muscle [32]. The exercise elicited greater EMG activity than the static front plank on the floor, which suggests that adding the ball achieved the required instability to increase the EMG [32]. The activation levels of this muscle were high (>60% MVIC) during the exercise, which is in line with the definition of previous researchers that the MUL is a “local stabilizer” providing stability to the pelvis when performing the hip extension movement [92]. Consequently, this exercise is strongly recommended for strengthening purposes, given the high activity level that was observed not only in the core muscles, but also in the chest and lower limb [32].
Although only three studies were carried out on free-weight exercises [44,59,70], similar EMG activity to the front plank on a Swiss ball with the hip extension exercise was found for the MUL muscle in the 45% body weight bent-over row, the 75% bodyweight deadlift, and the 75% body weight back-squat exercises [44]. These are multi-joint exercises in which the trunk tilts forward during the squat phase to compensate for the hip motion, and the load is moved through the sagittal plane perpendicular to the position of the trunk. This position requires the back muscles to resist the high torques, which might explain the EMG activity results [93]. Despite observing that the above-mentioned exercises elicited the greatest EMG activity of the MUL, it should be pointed out that this systematic review found only 16 studies that examined this muscle.

4.6. Transversus Abdominis

The greatest activation of this muscle was reported with suspension training systems using the side-lying lumbar setting of the sling exercise [36]. This study explained that the sling exercise, which can be performed in the prone, supine, or side-lying positions, developed the activation of local trunk muscles, such as the TA and MUL [36]. Despite the higher levels of EMG activity of the TA during the side-lying position, the authors recommended prone and supine sling exercises for stabilizing the lumbar region, given its high local/global muscle ratio [36].
Core stability exercises have also been recommended for TA activation [73,85]. Specifically, this systematic review found that the bird dog elicited greater EMG activity in the TA than in the IO or MUL [85], which might be because the TA is a primary trunk stabilizer, which modulates intra-abdominal pressure, the tension of the thoracolumbar fascia, and the compression of sacroiliac joints [85]. However, the scarcity of research on this muscle was another finding of our systematic review; indeed, only two studies were found that analyzed this muscle [36,85]. This contradicts a previous systematic review, which cited 10 studies analyzing the TA [2]; nonetheless, a decrease in the recent studies examining this muscle’s activity has been found. Therefore, future studies are needed that evaluate the TA’s EMG activity during core physical fitness exercises.

4.7. Limitations of the Study

As in our case, previous systematic reviews found methodological limitations in the selected studies that limited the quantitative summarization of the findings [2,94]. For example, the method chosen for determining EMG activity is an important decision in the study design stage [95]. Our systematic review found that 12 out of the 67 studies did not report EMG activity as % MVIC. This lack of agreement between the methods used for reporting EMG activity was also observed in previous reviews [2,94]. We suggest that future studies use % MVIC, as this is considered a more individualized method for reporting EMG activity, which may also reduce the risk of bias when interpreting the results in systematic reviews.
In addition, we found a lack of consistency in applying methods to measure EMG activity. The methods used varied depending on the study, although the most frequent ones were designed with three sets of different durations (5–10 s). This methodological issue has also been pointed out as the main concern for the interpretation of EMG activity and the potential risk of bias [94]. Therefore, future studies need to reduce these differences in the methodology applied [94]. Furthermore, the level of evidence of the included studies was mainly moderate, which suggests that more high-quality research is necessary in order to the reduce the risk of bias and draw solid conclusions about core muscle activity [2]. In addition, the fact that the studies were included only if the full text was available in English, which is considered the universal language of science, may be another limitation of the study.
Our systematic review also only focused on healthy adults, whereas populations such as the elderly and low-back patients still need to be studied. Furthermore, it would be of interest to analyze the activation patterns in individuals with different body fat levels since this variable may also influence the EMG activity recorded [96], which may be a potential risk of bias. In this regard, none of the studies compared EMG activity between males and females. Also, the addition of kinematical parameters to the EMG analysis would provide a holistic approach for determining which exercises are recommended.

5. Practical Applications

This systematic review provided a selection of exercises for greater activation of each core muscle group based on four different types of exercise (traditional core exercises, stability exercises, core exercises on a ball/device, and free-weight exercises) to assist strength and conditioning coaches, as well as fitness professionals. For example, free-weight exercises, such as the unstable Bulgarian squat, the regular back squat, roll-out plank, and the suspended front plank are suggested for RA activation. The front plank with scapular adduction and the posterior pelvic tilt, which belongs to the core stability exercise group, can be recommended for developing IO activation. Climax laughter exercises and kettlebell swings with “Kime” could be another alternative for IO activation (although swing exercises may be contraindicated for people with spine shear load intolerance). With regard to EO, unilateral free-weight exercises, such as the Bulgarian squat or the standing unilateral dumbbell press are recommended. Likewise, the front plank on a Swiss ball with the variant of moving the forearms in a continuous clockwise fashion (stir-the-pot) or doing a hip extension while maintaining stability are alternative exercises for this purpose. When it comes to the ES, free-weight exercises (e.g., the deadlift, hip-thrust, or back squat), the back extension on the floor, or the variant one-legged back extension, along with suspended bridge exercises, significantly increase EMG activity. To increase MUL activation, we suggest trunk extensions (with active lumbopelvic control), the front plank on a Swiss ball with the hip extension exercise, and free-weight exercises, such as the 45% bodyweight bent-over row, the 75% bodyweight deadlift, and 75% body weight back-squat exercises. Even though the greatest activation of the TA was reported with suspension training systems using the side-lying lumbar setting in the sling exercise, we instead suggest prone and supine sling exercises in order to stabilize the lumbar region, given its high local/global muscle ratio.

6. Conclusions

This study systematically reviewed the current literature on the EMG activity in six core muscles during core physical fitness exercises. The greatest activity in the RA, EO, and ES muscles was found in free-weight exercises. The greatest IO activity was found in core stability exercises, while traditional exercises showed the greatest MUL activation. However, there was a lack of research on TA activation during core physical fitness exercises and a lack of consistency between studies when applying methods to measure EMG activity. In addition, the level of evidence of the included studies was mainly moderate, which suggests that more high-quality research is necessary in order to the reduce the risk of bias and draw solid conclusions about core muscle activity.

Author Contributions

Conceptualization, J.M.O.-L. and J.M.M.; methodology, J.M.O.-L. and J.M.M.; validation, J.M.O.-L. and J.M.M.; investigation, J.M.O.-L. and J.M.M.; writing—original draft preparation, J.M.O.-L.; writing—review and editing, J.M.O.-L. and J.M.M.; visualization, J.M.O.-L. and J.M.M.; supervision J.M.M.; project administration, J.M.M.; funding acquisition, J.M.M. All authors have read and agreed to the published version of the manuscript.

Funding

This work was supported by the Proyectos I+D+I Ministerio de Economía y Competitividad. Gobierno de España. Referencia: DEP 2016-80296-R (AEI/FEDER,UE). José M. Oliva-Lozano was supported by a grant funded by the Spanish Ministry of Science, Innovation and Universities (FPU18/04434).

Conflicts of Interest

The authors declare no conflict of interest.

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