Muscle Onset Can Be Improved by Therapeutic Exercise: a Systematic Review

Objectives: To determine whether therapeutic exercise can improve the timing of muscle onset following musculoskeletal pathology, and examine what exercise prescription parameters are being used to achieve these effects.

Participants: People with a musculoskeletal pathology.

Main Outcome Measure: Muscle onset timing as measured by electromyography.

Results: Sixteen investigations were identified containing 19 therapeutic exercise groups. Three exercise modes were identified including: isolated muscle training, instability training, and general strength training. Isolated muscle training is consistently shown to have a positive effect on the muscle onset timing of transversus abdominus in people with low back pain. There is some evidence from cohort studies that instability training may change muscle onset timing in people with functional ankle instability, however controlled trials suggest that no effect is present. General strength training shows no effect on muscle onset timing in people with low back or neck pain, although one cohort study suggests that a positive effect on gluteus maximus may be present in people with low back pain.

Conclusion: Therapeutic exercise training is likely to improve muscle onset timing. Additionally, isolated muscle training appears to be the best exercise mode to use to achieve these effects.