This study examined the electromyographic (EMG) response of the upper rectus abdominis (URA), lower rectus abdominis (LRA), internal obliques (IOs), external obliques (EOs), and the rectus femoris (RF) during various abdominal exercises (crunch, supine V-up, prone V-up on ball, prone V-up on slide board, prone V-up on TRX, and prone V-up on Power Wheel). The subjects (n = 21) performed an isometric contraction of the abdominal musculature while performing these exercises. Testing revealed no statistically significant differences between any of the exercises with respect to the EOs, the URA, or the LRA. However, when examining the IO muscle, the supine V-up exercise displayed significantly greater muscle activity than did the slide exercise. In addition, EMG activity of the RF during the crunch was significantly less than in any of the other 5 exercises. These results indicate that when performing isometric abdominal exercises, non-equipment-based exercises stressed the abdominal muscles similarly to equipment-based exercises. Based on the findings of the current study, the benefit of training the abdominal musculature in an isometric fashion using commercial equipment could be called into question.

Clinical Scenario: Habitual overuse of cellphones is on the rise among adolescents and young adults. Those who maintain a flexed neck posture when using a cellphone for extended periods possess an elevated risk for developing forward head posture (FHP). Chronic FHP can lead to painful medical disorders affecting the head, neck, and shoulders. Both stretching and strengthening exercises are advocated interventions to address this postural abnormality; however, due to a wide range of corrective exercise programming in the literature, the decision for which exercises to prescribe for this condition can be challenging for clinicians. Clinical Question: For adolescents and young adults without musculoskeletal pathology, what are the most frequent stretching and strengthening exercises incorporated into effective FHP intervention programs supported by current randomized control trials? Summary of Key Findings: A combined total of 5 stretches and 8 strengthening exercises were identified across 3 studies of level 1b evidence that successfully impacted FHP using a combined stretching and strengthening corrective exercise intervention. The supine chin tuck and a sternocleidomastoid stretch were utilized in all 3 studies, while scapular retraction and a pectoralis stretch were included in 2 of the 3 studies. Clinical Bottom Line: Based on the results of this appraisal, the most frequent stretches and strengthening exercises incorporated into effective FHP intervention programs supported by current randomized control trials focused on adolescents or young adults without musculoskeletal pathology include a sternocleidomastoid stretch, pectoralis stretch, the supine chin tuck, and scapular retraction. Strength of Recommendation: There is “Good” to “Excellent” evidence from 3 level 1b randomized control trials to support the inclusion of a sternocleidomastoid stretch, pectoralis stretch, the supine chin tuck, and scapular retraction exercises into a corrective exercise program to address forward head posture.

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