Research J. Pharm. and Tech.

10(9): September 2017

ISSN 0974-3618 (Print) www.rjptonline.org

0974-360X (Online)

RESEARCH ARTICLE

The Effect of Strength Training Programme in the Enhancement of Trunk

and Hip Muscles Activations among Healthy Females Subject
Qais Gasibat1*, Nordin Simbak1*, Aniza Abd Aziz1, Rabiu Muazu Musa2
1
Faculty of Medicine, Universiti Sultan Zainal Abidin, Kota Campus, 20400 Jalan Sultan Mahmud,
Kuala Terengganu
2
Faculty of Applied Social Sciences, Universiti Sultan Zainal Abidin, 21300 Kuala Terengganu,
Terengganu, Malaysia
*Corresponding Author E-mail: nordinsimbak@unisza.edu.my

ABSTRACT:
Research has illustrated that the risk of lower back pain (LBP) among women population is significantly higher
owing to the hormonal and reproductive factors such as irregular or prolonged menstrual cycle and
hysterectomy. The trunk and hip muscles are regarded as the most affected muscles in LBP patients and as such
precise training of these muscles could be of value to the patients. Diverse exercises programmes exist, yet, the
appropriate training that could be suitable in stimulating certain groups of muscles for a specified gender remains
a challenge. As a result, this study aims to determine the efficacy of a strength training programme (STTP) in
improving and stimulating the trunk and hips muscles of female’s subjects. 25 healthy females with normal BMI
and ages range from 19 to 24 years performed five sets of strength exercises three times a week for five weeks.
Electromyography (EMG) data were collected from 5 muscles of rectus abdominis, external oblique, multifidus,
gluteus maximus and gluteus medius. The readings from the EMG were compared after the five weeks
interventions (pre and post). An independent t-test was administered to the data collected to study the
effectiveness of the STTP between pre and post on the trained muscles. A statistically significant difference of
muscle activations between the pre and post on all the assessed muscles were obtained p < 0.05. The finding
suggests that STTP intervention is effective in stimulating the females’ pelvic muscles activations. STTP could
be a viable means for prevention and rehabilitation of LBP.

KEYWORDS: Strength training, Muscle activations, Pelvic muscles, Lower back pain

INTRODUCTION: Researchers have indicated that the deepfibres of the

Muscle strength is a wide term that encompasses the
capacity of the contractile tissue to generate force and
resultant tension in relation to the demands placed upon
the muscle. Strength training programme (STTP) is
described as a systematic strategy of a tissue or muscle
group to sustain its vigor when lifting, lowering, or
controlling heavy loads (resistance) for a comparatively
lowamount of repetitions or over a short time span1.
Received on 22.06.2017 Modified on 21.07.2017
Accepted on 14.08.2017 © RJPT All right reserved
Research J. Pharm. and Tech. 2017; 10(9): 2845-2850.
DOI: 10.5958/0974-360X.2017.00501.7
2845
multifidus and transversus abdominis are among the
preliminary muscles to become active when there is a
postural change from rapid extremity movements2. The
rectus abdominis, external oblique, and internal oblique
muscles are large, multi-segmental global muscles and
are vital catalysts for supporting the spine against
postural perturbations. The transversus abdominis is the
deepest of the abdominal muscles and responds
exclusively to postural perturbations. It has been
demonstrated that activation and function of these
muscles could substantially improve through the STTP
interventions in patients with LBP2. Moreover, some
authors have similarly documented that STTP is useful
in the improvement of postural control and stability for a
long term benefit 3,25.
 Research J. Pharm. and Tech. 10(9): September 2017

Research has demonstrated that the prevalence of LBP MATERIALS AND METHODS:
among women population is significantly higher due to Participants:
the Hormonal and reproductive factors such as irregular A total of 25 healthy female subjects with normal BMI
or prolonged menstrual cycle and hysterectomy as of 18.5 to 24.9 kg/m2 and without any record for current
compared to males4. In the other hand, it has been or previous lower extremity or back problems with ages
reported that to identify the effectiveness of a particular range of 19 to 24 years were recruited to participate in
intervention programme, the first way to begin could be the study. The participants who volunteered to take part
with healthy subjects after that the potential findings in this study were from the Faculty of Health Sciences of
could be safely applied to the patient's5,6. To this effect, the Universiti Sultan Zainal Abidin. Written consent was
the current study examined the effectiveness of STTP in obtained, and all the participants signed consent forms.
improving the said targeted muscles activations of All the exercises procedures, protocol, and equipment
healthy female subjects. The study aims at drawing the for this study were authorised by the Research Ethics
attention of the physiotherapist, trainers and other Board of the Universiti Sultan Zainal Abidin with an
stakeholders to determine the most appropriate training approval number of UniSZAC/628-1jld2 (02).
programme capable of given maximum effects in
developing and stimulating the lumber muscles of Selected Exercises for the study:
female’s subjects which will consequently serve as a The following stability based exercisewere selected and
guide for application to the reduction and rehabilitations applied in the study. The selections of the exercises were
of LBP amongst female patients. carefully made based on their ability in strengthening the
muscles under investigation.
Table 1: Selected exercises and the targeted muscles
Name of Muscle How to perform Reference
exercise
(a) Full Rectusabdominis Lay on your back on a workout mat or bed. Flex both knees until the feet are flat on the 6,7,25,26
crunches ground. With your feet away from the ground, raise your upper body and shoulders to
around 30 levels off the floor. Rise and stop whenever your elbows reach your upper
thighs. The entire curl up should take around 30s.
(b) side External oblique Begin by lying on your back again on the floor and turn both knees to the right. Slowly 8,9,25,26
crunches lift your shoulders off the floor and move your body straight up and then down again to
the floor as if you had been doing a regular crunch. Ensure that you keep your knees
turned to the best as you do the crunch.
(c) lumbar Multifidus Lie on your stomach and put your arms in front of your chest. Take your body up to a 10,11,28
fullextension fully extended position. Your legs should be fully extended.
(d) hip Gluteus maximus Lie down; you can put your forehead on your hand or put a towel underneath your 12,27
extension forehead. Lift your thigh off the ground and extend the leg.
(e) hip Gluteus medius Lay on your side on an exercise pad or bed in a beginning position. With knees 13,27
abduction completely extended, slowly abduct while keeping the knees extended. Look at 30% of
hip hold and slowly return.

(a) (b)

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 Research J. Pharm. and Tech. 10(9): September 2017
(c)
Figure 1. The strength exercises used in the study (a) Full crunches; (b) Side crunches; (c) Prone lumbar extension; (d) Hip extension; (e)
Hip abduction.
Experimental Protocol:
The participants were given a set of strength training as
shown in Fig 1 for a period of five weeks. Before the
beginning of the exercises, the initial measurement of the
muscles activations was taken at a zero week (pre).
Electromyography (EMG) data were collected from 5
muscles during the exercises performance (Rectus
abdominis, External oblique, Multifidus, Gluteus
maximus and medius), and the readings from the EMG
were compared after the five weeks interventions (pre
and post).
Data Collection Procedure:
Before electrode placement, each subject was
familiarised with the procedures by being instructed, and
by practising the muscle tests and exercises performed.
The researchers taught all the participants on how to
perform each exercise using explanations and pictures.
Dual disposable silver chloride surface area recording
electrodes were used. EMG data were gathered from the
rectus abdominis, exterior oblique, lumbar multifidus,
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(d)
(e)
gluteus maximus and gluteus medius. For the rectus
abdominis muscle, the electrodes were placed 3 cm
horizontal and 3 cm above the umbilicus. The electrodes
were positioned midway between the anterior fine iliac
spine and the ribs cage for the exterior oblique
abdominis muscle. Intended for the lumbar multifidus
muscle mass, the electrodes were put 2 cm lateral
towards the lumbosacral junction. The electrodes for the
gluteus medius muscle were placed above the gluteus
maximus muscle and closer to the iliac crest around the
lateral side of the pelvis. For the gluteus maximus
muscle, electrodes were placed in the centre from the
muscle belly between the extensive edge of the sacrum
as well as the posterosuperior edge of the higher
trochanter. The reference electrode was located over the
anterior superior iliac spine. All the procedures for the
electrodes placement were conducted by the
recommendations of the previous researchers14,15. A
detail description of the entire data collection procedure
is provided in Figure 2.
 Research J. Pharm. and Tech. 10(9): September 2017

Explaining the exercises (video

and show pictures) 10 minutes

Warm up 10 minutes Shaving of hair was performed when

necessary and the place was clean 2
minutes

Preparing the electrodes in the exact Exercise performed for the first cycle
place of muscle 1 minute 1minute

Rest period between cycle 10 Exercise performed for the second

seconds cycle 1minute

Rest period between cycle 10 Exercise performed for the third cycle
seconds 1minute

Rest periods between exercises

1minute

Figure 2: A flow chart during the data collection process

Figure 2 projects the flow chart organisation during the selected muscles were treated as the dependent variables.
data collection process. The time for the warm up, All the statistical analysis was conducted using XLSTAT
preparation of the sites attachment of the electrodes, the add in software version 2014 for Windows at a
time taken for each exercise as well as the rest period confidence level of p ≤ 0.05.
interval are displayed. The procedures for all the steps
were performed in accordance with the RESULTS:
recommendations by the previous researchers8,16. Table 2 demonstrates the descriptive statistics of the pre
and post STTP on the muscles evaluated. The period of
Statistical Analysis: the intervention (pre and post) the number of the
An independent t-test analysis was employed in this participants, the minimum, maximum scores, mean as
study to determine whether there is a significant well as the standard deviation of each variable is shown.
difference between the pre and post of the training It can be observed from the table that the mean of the
modalities as well as to compare the efficacy of the post-intervention measurement is greater than the pre-
interventions training in the improvement of the muscle measurement indicating that the mean muscle activations
activations between the pre and the post measurement. of the post are considerably higher as compared to the
The periods (pre and post) were used as the independent pre.
variables while the average electrical activities of all the
Table 2: Descriptive Statistics of the strength training intervention programme on the muscles.
Muscle type Intervention Period N Min. Max. M SD
Rectus abdominis Pre 25.00 19.76 128.55 80.31 24.26
Post 25.00 94.01 169.47 142.53 18.08
Pre 25.00 35.14 119.30 76.51 23.94
External oblique
Post 25.00 93.31 178.56 141.79 24.99
Pre 25.00 53.48 122.26 83.79 17.37
Multifidus
Post 25.00 92.45 154.96 133.73 22.39
Pre 25.00 12.32 130.58 83.61 21.07
Gluteus maximus
Post 25.00 99.05 174.78 134.74 23.29
Pre 25.00 18.34 126.32 83.12 23.00
Gluteus medius
Post 25.00 86.29 169.34 145.86 19.95

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 Research J. Pharm. and Tech. 10(9): September 2017
Table 3 reveals the inferential statistics of the pair wise
comparison performed as a follow-up for the t-test. From
the table t observed, t critical, the degree of freedom the
difference between the pre and post evaluations as well
as the significant levels are highlighted. It can be
seenthat there is a statistically significant difference
between the pre and post on the muscle activations in all
the evaluated muscles of Rectus abdominis, External
oblique, Multifidus, Gluteus maximus and Gluteus
medius p < 0.001. This result suggests that STTP is
intervention is effective in improving the said selected
muscles activations of the participants examined in the
study.
Table 3: Inferential Statistics of the strength training intervention These investigations are in agreement with the findings
programme on the muscles examined.
Muscle types t(obs.) t(crtcl) DF D Sig
Rectus abdomens -10.28 2.01 48 -62.22 0.001*
External oblique -9.433 2.01 48 -65.28 0.001*
Multifidus -8.81 2.01 48 -49.94 0.001*
Gluteus maximus -8.14 2.01 48 -51.13 0.001*
Gluteus medius -10.3 2.01 48 -62.74 0.001*
*Significant p < 0.001
DISCUSSION:
The general result of the present study has indicated that
the STTP is effective in the improvement of the selected
muscles of the participants. The evidence provided in
Table 2 and 3 has suggested that trunk and hip muscles
of the females’ participants in the study have responded
to the training programme implemented. The results
further indicated that STTP could be useful as
rehabilitation exercises in females subjects.
The results obtained from this study agrees to that of the
previous researcher who explained that back extensors
serve as the crucial muscles during raising and bending
actions. These muscles act both to stretch the spine and
to stabilise the flexion motion created by the trunk when
weightis being raised17. Muscular strength is perceived
to be the ability of a muscle or group of muscles to
produce force and hence muscular strength is enhanced
with STTP. Moreover, research has shown that STTP is
applied in physical fitness as well as in the prevention
and restoration of musculoskeletal impairments18. For
example, low back extensor muscle strength is a
significant determinant of low back health and
consequently STTP serve as means for rehabilitation of
the lower back, avoidance of injury, and as a constituent
of physical fitness exercise programmes to improve
performance standards15,19. The finding of the current
study has further indicated that STTP intervention is
effective in increasing the muscles activations among
healthy females subject. An increase in muscles
activations is associated with the capacity of the muscles
to respond effectively to the demands placed upon them.
This explanation could be comprehended because many
2849
people with LBP possessed weak low back muscles
which hinder or restricts higher muscle activations20,21.
As such the current findings could be extended to cater
for the LBP patients in enhancing the strength of their
activities. In another perspective, some researchers
examined the value of specific trunk, hip, muscles
strengthening and back training for the prevention of
injuries22. It was concluded from their findings that
strength training is vital in reducing the prevalence of
injury occurrence of the LBP patients. It has also been
reported that weakness and poor stamina from the
lumbar and gluteus muscle tissue in people with lower
extremity accidental injuries and LBP could be
effectively improved through STTP interventions 23,24.
of the present study in determining that the STTP is
efficient in enhancing the muscles activities among
healthy females’ subjects which could likewise be
alluded in the rehabilitation of LBP patients.
CONCLUSION:
The outcomes of the present research have indicated that
the strength training programme adopted in the study
was useful in increasing the muscles activations of the
participants within the five weeks interventions period.
The strength intervention programme is shown to be
capable of stimulating the rectus abdominis, external
oblique, multifidus, gluteus maximus and gluteus medius
muscles. Furthermore, the study reveals that the
utilisation of surface electromyography signals in
detecting muscles activations is nontrivial as it allows
the researchers to establish that STTP intervention
programme could improve the activations of the lumber
muscles amongst healthy female’s subjects which would,
consequently, be useful to the female’s patients with
history of LBP as well as prevent its occurrence to those
at risk. Trainers and physiotherapist could consider
STTP as a practical measure for rehabilitation and
prevention of LBP.
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