Introduction: The supine and prone sling exercise may facilitate activation of the local trunk muscles.

Does the side-lying sling exercise activate trunk muscles more easily than the supine and prone training with sling settings? Clinical work has shown that the side-lying sling exercise could reduce pain in patients with unilateral low back pain (LBP), but the mechanism behind it is unclear.

The fundamental purpose of this preliminary study was to examine the electromyography (EMG) characteristics of trunk muscles during different sling lumbar settings on sixteen healthy adults.

Methods: Amplitude and mean power frequency (MPF) of EMG signals were recorded from the transversus abdominis (TA), rectus abdominis (RA), multifidus (MF), erector spinae (ES), gluteus maximus (Gmax), and gluteus medius (Gmed) muscles while the subjects performed the supine lumbar setting (SLS), prone lumbar setting (PLS), left side-lying lumbar setting (LSLS), and right sidelying lumbar setting (RSLS).

Results: During SLS and PLS, TA and MF showed significantly higher activity than RA and ES on the same side, respectively. The EMG activities of ES, TA, MF, Gmax, and Gmed had significant  differences between the different sides during LSLS and RSLS, and the dominant-side muscles showed higher activity than the other side. There was no significant difference in core trunk muscles between different sling lumbar settings-only that the SLS of the MF/ES ratio was significantly higher than LSLS and RSLS.

Conclusions: Sling exercises can be an effective measure to enhance MF and TA EMG activity, and the side-lying position can increase dominant-side Gmax and Gmed activity. Side-lying sling training does not activate more core muscles than the supine and prone training. Supine and prone exercise should be preferred over SLT to stabilize the lumbar region because of its high local/global muscle ratio.