University of Mary

INSTITUTIONAL REVIEW BOARD

Part 2: Human Subjects Review

[Must be attached to the IRB Cover Sheet]
1.

Background: The plank is an extremely common isometric exercise seen in

the exercise routine of many individuals, both casual exercisers as well as
elite athletes. It is used to help strengthen the abdominals and the gluteus
muscles and can also increase shoulder stability and bone strength in the
forearms and wrists. To the best of the researchers knowledge, there has
been no research found that identifies the effects of the plank on exercise
blood pressure (BP) mmHg), blood lactate (LA), electrocardiogram (EKG). As
the plank exercise is an isometric core exercise, the effects of HR and BP
should show similar results, however, this has never been tested. This study
is currently in progress with a graduate student in the University of Mary
MSCEP program, but is being conducted on males. This study will serve to
observe these responses in females and possibly combine results into one
data set that allows the researchers to statistically compare male and female
responses.
PURPOSE OF THE STUDY: To investigate the effects of the forearm plank and
the straight-arm plank on EKG, LA (mmol/L), and BP (mm/Hg) as well as the
duration of these effects and the influence of the number of sets done in
sequence on these variables in young normal weight and obese, but
otherwise healthy adult females. The results of this study may provide new
information for the field of Exercise Physiology, and may be used as a
comparative tool for future studies.

2.

DESIGN: This study consists of an experimental cross-over design comparing

outcomes between and within groups (between normal weight and obese;
within two different plank exercises). Subjects will undergo three (3) sessions
with a total of six (6) plank exercises

3.

PROTOCOL:
Subjects:
Subjects will be recruited via posting fliers, word of mouth, and addressing
University of Mary classes where the course instructor has approved 5
minutes of time at the end of the class for researchers to invite students to
participate.
Subjects (N=16: end number of subjects to finish the study after anyone has
been excluded for any reason) will be young, untrained (<30 minutes of
exercise/day, 3 days/week, for 3 months according to ACSM) adult females,
either normal weight (BMI of 18.5-24.9; N=8) or obese (BMI 30; N=8) from

the ages of 18-25 years from the University of Mary, Bismarck, ND, and the
surrounding community.
Each group of 8 subjects will undergo three (3) sessions resulting in a total of
six (6) plank exercise sets for every version of plank (12 in total for every
subject) in order to investigate any changes regarding Blood Pressure
(mmHg), Blood Lactate (mmol/L), EKG rate and rhythm and the duration of
the effects.
Subjects will meet with the research team a total of 4 times (1
informative/baseline measurement session and 3 testing sessions) during the
course of this study. During the study, the subjects will perform two different
plank exercises (forearm plank and straight-arm plank). Each variation of
the exercise will be performed 3 separate times, one variation each session.
During the duration of each session, the subjects heart rate and rhythm will
be monitored by a 12-lead EKG, as the body is in a state of little-to-no
movement. Subjects will be taught to breathe correctly during the planks.
Dependent Variables:
1. 12-Lead Electrocardiogram (EKG) Nihon Kohden Cardiofax, Model ECG9130K, will be used to measure heart rate (bpm), rhythm, and changes in
EKG waveforms.
2. Blood Lactate (LA) (mmol/L) will be obtained via fingertip Point of Care
(POC) lactate meter (NOVA Biomedical Lactate Plus) analyzer, involving a
finger stick to get the blood sample. Lactate will be measured at rest,
during, and immediate post.
3. Blood Pressure (BP) (mmHg) will be measured via a Prestige Medical
sphygmomanometer and a 3M Littmann Classic II SE stethoscope,
according to methods described in the ACSM Guidelines for Exercise
Testing and Prescription, 9th Edition, p.45.
Independent Variables:
1. Forearm Plank:

http://everything-home.usstoragesearch.com/wp-content/uploads/2013/02/forearmplank_ostill.jpg

2. Straight-Arm Plank:

http://www.fitnessrepublic.com/sites/default/files/imagecache/exercise_thickbox_700/exercise/plankpu
shbb.jpg

3. Normal Weight Condition: will be determined via calculation of body mass

index (BMI Kg/m2) using measures of weight (kg) and height (m). Normal
BMI = BMI 20 24.9 Kg/m2.
4. Obese Condition: will be determined via calculation of body mass index
(BMI Kg/m2) using measures of weight (kg) and height (m). Obese = BMI
> 30 Kg/m2.
Visit One: Familiarization, Forms, and BMI
The first visit will involve familiarizing the subjects with the purpose of the
study, protocol, and equipment used. Subjects will be asked to sign an
informed consent and complete a health history questionnaire. Exclusion
criteria will include males, females not within the BMI categories determined,
known cardiovascular, kidney, metabolic, or respiratory disease,
hypertension, known or observed shoulder, wrist, knee, hip, back, abdominal
or ankle problems, and any use of medications with effects on HR and BP.
Those who are allowed to participate will be measured for height (cm) and
weight (kg) to determine BMI qualifications, and if they are in one of the two
categories described above, will receive a detailed description and
explanation of the forearm and straight-arm plank exercises, including proper
technique for the exercises and measurements being taken at baseline,
during and post-testing (BP, LA, EKG rate and rhythm monitoring). Subjects
will be requested to arrive at testing sessions rested, restrain from ingesting
any caffeine prior to testing sessions, use restroom prior, and restrain from
any vigorous exercise during testing day prior to session.
Visit Two: First Testing
During the first testing session, the subject will report to the University of
Mary Exercise Science Lab in Bismarck, ND. The subject will be prepped with
a 12-lead EKG, then sit at rest for 5 minutes before baseline measures are
obtained.

Sitting EKG, BP and LA will be taken (in that order), followed by standing EKG
and BP.
The subject will then perform one set of either the straight-arm or the
forearm plank (randomly assigned) for one minute. EKG and BP will be
measured 30 seconds into the plank exercise.
Immediately post, EKG, BP and LA measurements will be taken (in that
order). EKG and BP measurements will be taken again +5 min, +10 min, and
at +15 min post testing EKG, BP, and LA will be measured.
EKG and BP will be assessed until measures have returned to near baseline
and the subject is asymptomatic. Once the subjects EKG and BP values have
returned to at or near resting pre-testing levels and the subject is showing no
signs or symptoms of dizziness, shortness of breath, or extreme fatigue, she
will continue on to perform one set of the other plank (if started with forearm
plank, will now do straight-arm plank and vice versa) for one (1) minute.
The same measurements of EKG, BP, and LA will be taken correspondingly
before, during, and after. Once HR and BP values have returned to at or near
resting pre-testing levels and the subject is showing no signs or symptoms of
dizziness, shortness of breath, or extreme fatigue, the subject will be
released.
Visit Three: Second Testing
During the second testing session, the subject will report to the University of
Mary Exercise Science Lab in Bismarck, ND. The subject will be prepped with
a 12-lead EKG, then sit at rest for 5 minutes before baseline measures are
obtained.
Sitting EKG, BP and LA will be taken (in that order), followed by standing EKG
and BP.
The subject will then perform 2 sets of either plank (per randomly assigned)
for 1 minute each set with a period of rest lasting 1 minute in between sets.
EKG and BP will be measured 30 seconds into the second set of the plank
exercise .
Immediately post second set, EKG, BP and LA measurements will be taken (in
that order). EKG and BP measurements will be taken again +5 min, +10 min,
and at +15 min post testing EKG, BP, and LA will be measured.
EKG and BP will be assessed until measures have returned to near baseline
and the subject is asymptomatic. Once the subjects EKG and BP values have
returned to at or near resting pre-testing levels and the subject is showing no
signs or symptoms of dizziness, shortness of breath, or extreme fatigue, she
will continue on to perform two sets of the other plank (if started with forearm
plank, will now do straight-arm plank and vice versa) for one minute.

The same measurements of EKG, BP, and LA will be taken correspondingly

before, during, and after. Once HR and BP values have returned to at or near
resting pre-testing levels and the subject is showing no signs or symptoms of
dizziness, shortness of breath, or extreme fatigue, the subject will be
released.
Visit Four: Third Test
During the third testing session, the subject will report to the University of
Mary Exercise Science Lab in Bismarck, ND. The subject will be prepped with
a 12-lead EKG, then sit at rest for 5 minutes before baseline measures are
obtained.
Sitting EKG, BP and LA will be taken (in that order), followed by standing EKG
and BP.
The subject will then perform 3 sets of either plank (per randomly assigned)
for 1 minute each set with a period of rest lasting 1 minute in between sets.
EKG and BP will be measured 30 seconds into the third set of the plank
exercise.
Immediately post third set, EKG, BP and LA measurements will be taken (in
that order). EKG and BP measurements will be taken again +5 min, +10 min,
and at +15 min post testing EKG, BP, and LA will be measured.
EKG and BP will be assessed until measures have returned to near baseline
and the subject is asymptomatic. Once the subjects EKG and BP values have
returned to at or near resting pre-testing levels and the subject is showing no
signs or symptoms of dizziness, shortness of breath, or extreme fatigue, she
will continue on to perform three sets of the other plank (if started with
forearm plank, will now do straight-arm plank and vice versa) for one minute.
The same measurements of EKG, BP, and LA will be taken correspondingly
before, during, and after. Once HR and BP values have returned to at or near
resting pre-testing levels and the subject is showing no signs or symptoms of
dizziness, shortness of breath, or extreme fatigue, the subject will be
released.
4.

BENEFITS: The primary benefit of this study is the addition of new knowledge
to the field of practice. This will be a valuable assessment of physiological
responses (HR, BP, LA and Heart Rhythm), experienced in female normal
weight versus obese conditions, as a result of performing two commonly used
variations of the straight-arm and forearm plank exercise as well as the
duration of these changes 15 minutes post.

5.

RISKS: The plank exercise testing is primarily a moderate-to-high intensity

exercise varying with the general fitness level of the subject being tested as
well as prior familiarity to the plank exercise. Symptoms may include
dizziness, general discomfort, musculoskeletal injury, muscle soreness, joint
injury (particularly wrist and elbow). As the plank maneuver is an isometric

exercise, increases in heart rate and blood pressure may/should occur.

Psychological risks such as anxiety and stress may occur as well due to
exercise testing. If dizziness, high blood pressure, or high heart rate occur
where they compromise the health and safety of the participant, the testing
will be put on hold while until symptoms dissipate. If any abnormal or
harmful EKG changes are observed, testing will be concluded and patients
heart rhythm will be monitored with an AED while he is seated at rest. If
patient loses consciousness, the patient will be checked for breathing and a
HR while the tester activates the Emergency Response System (ERS) and
follows instructions with the AED in order to begin shocking the heart back
into a normal rhythm. An AED will be accessible in testing area.
6.

USE OF DATA: SPSS 23.0 for Windows will be used for data analysis. The
One-Way MANOVA test in SPSS will be utilized to analyze and present the
data. Data will be presented as meanSD, significance, F value when
appropriate and via a scatterplot. Data will be stored on individual record
sheets and on secure computer files to maintain subject confidentiality.
Results will be presented in public forum at the University of Mary School of
Health Sciences Scholarship Colloquium and may be submitted for
publication.

INSTITUTIONAL REVIEW BOARD

Dr. Kimberly Long, AVP for Academic Affairs
Office of Academic Affairs
University of Mary
7500 University Drive
Bismarck, ND 58504