Coremuscleactivation
Coremuscleactivation
net/publication/314529858
CITATIONS READS
54 2,742
2 authors:
All content following this page was uploaded by Gennaro Boccia on 31 October 2017.
                                                   by
                                  Giovanni Cugliari1,2, Gennaro Boccia3,4
         A quantitative observational laboratory study was conducted to characterize and classify core training
exercises executed in a suspension modality on the base of muscle activation. In a prospective single-group repeated-
measures design, seventeen active male participants performed four suspension exercises typically associated with core
training (roll-out, bodysaw, pike and knee-tuck). Surface electromyographic signals were recorded from lower and
upper parts of rectus abdominis, external oblique, internal oblique, lower and upper parts of erector spinae muscles
using concentric bipolar electrodes. The average rectified values of electromyographic signals were normalized with
respect to individual maximum voluntary isometric contraction of each muscle. Roll-out exercise showed the highest
activation of rectus abdominis and oblique muscles compared to the other exercises. The rectus abdominis and external
oblique reached an activation higher than 60% of the maximal voluntary contraction (or very close to that threshold,
55%) in roll-out and bodysaw exercises. Findings from this study allow the selection of suspension core training
exercises on the basis of quantitative information about the activation of muscles of interest. Roll-out and bodysaw
exercises can be considered as suitable for strength training of rectus abdominis and external oblique muscles.
Key words: core stability, core strength, electromyography, abdominal muscles.
Introduction
         In recent years, core training has been                     region (such as shoulders and pelvic muscles).
widely studied since it has been considered a                        However, literature concerning core training
pivotal issue in health, rehabilitation and sports                   sometimes fails to distinguish between concepts
performance (Hibbs et al., 2008). However, the                       of core stability and core strength. Faries and
definition of the core varies with the                               Greenwood (in Hibbs and Thompson, 2008)
interpretation of the literature (Hibbs and                          formulated the following clear definitions: core
Thompson, 2008). Anatomically, the core region                       stability refers to the ability to stabilize the spine
has been described as the area bounded by the                        as a result of muscle activity, while core strength
abdominal muscles in the front, by paraspinal and                    refers to the ability of muscles’ contractions to
gluteal muscles in the back, by diaphragm on the                     produce and transfer force as a result of muscle
top and by pelvic floor and girdle musculature at                    activity. Since strength and motor control are
the bottom (Richardson et al., 1999). The core                       complementary qualities, the core training
represents the connection between lower and                          programmes can target mainly, but not
upper limbs and should be considered as a                            exclusively, at muscle strengthening and/or motor
functional unit in which different muscles                           control of core musculature. Motor control
interact, even if not located in the thoraco-lumbar                  training seems to require low intensity
1 - Department of Brain and Behavioral Sciences, Unit of Medical and Genomic Statistics, University of Pavia, Italy..
2 - Department of Medical Sciences, University of Torino, Torino, Italy.
3 - CeRiSM Research Center “Sport, Mountain, and Health”, Rovereto, (TN), Italy.
4 - Motor Science Research Center, School of Exercise & Sport Sciences, SUISM, Department of Medical Sciences, University of
stabilization exercises focused on efficient              and Esco, 2014), whereas others investigated the
integration of low threshold recruitment of local         effect of the application of suspension system on
and global muscle systems. Conversely, core               core muscle activity in push exercises (Calatayud
strength training seems to require high intensity         et al., 2014; McGill et al., 2014; Snarr and Esco,
and overload training of the global muscle                2013). Further investigation of these exercise
system. Vezina and Hubley-Kozey (2000)                    approaches is needed to understand their
suggested that core stability programmes should           influence on muscle activation and joint load
include muscle activation below 25% of maximum            levels.
voluntary contraction (MVC), while core strength                   The primary purpose of this study
training should include activation higher than            therefore, was to examine differences in core
60% of MVC to result in strength benefits.                muscle activation across four full-body linkage
          The available evidence suggests that to         exercises using a suspension training system.
adequately train the core muscles in athletes,            These exercises were chosen from a spectrum of
strength and conditioning specialists should focus        whole body linkage exercises focused on the
on implementing multi-joint full body exercises,          anterior core musculature executed in instable
rather than core-specific exercises (Martuscello et       conditions, including a roll-out, bodysaw, pike,
al., 2013). Exercises involving the full body             and knee-up. Although the selected exercises
linkage such as plank exercises, have been                were mainly focused on anterior slings, we
advocated to enhance the capacity of transmitting         wanted to provide a comprehensive view of core
force through the body linkage (Schoenfeld et al.,        muscle     activation    by    monitoring    rectus
2014). Training with labile systems has been              abdominis, internal and external oblique, and
documented to offer unique opportunities for              paraspinal muscles. It was hypothesized that
linkage training challenges (McGill et al., 2015).        significant differences would be found in core
Several studies examined core muscle activation           muscles among exercises. The second aim of the
during the execution of various exercises on stable       study was to determine which of these exercises
and unstable surfaces (for a review see: Behm et          would reach the threshold of 60% of MVC,
al., 2010). The use of unstable surfaces contacting       expected to be high enough to increase muscle
the subject’s feet or hands is becoming popular in        strength. It was hypothesized that the four
strength training. Instability can be obtained            exercises would elicit muscle activity in excess of
through the use of many devices and techniques            60% of MVC in the rectus abdominis, i.e. the
including, but not limited to, unstable platforms         muscle on which the main focus was put
such as Bosu or Swiss balls. More recently,               considering the selected exercises.
suspension training systems have been added to
the list of instability training devices.
                                                          Material and Methods
          In suspension training, lower or upper                  Seventeen healthy participants were
limbs are hung with straps free to oscillate. Many        recruited (age 27.3±2.4 years, body height 172±5
core directed exercises are designed with such a          cm, body mass 69.2±9.3 kg). All participants were
device, creating a wide variety of challenges.            physically active, declaring three practice sessions
These exercises consist of multi-planar and multi-        per week of resistance training. The participants
joint movements, and are executed with complex            had no prior experience with suspension training
techniques. It is important to quantify the muscle        exercises. Inclusion criteria for study participation
contraction intensity since it is a key factor in         were as follows: no past or present neurological or
establishing training effects induced by this sort of     musculoskeletal trunk or limb pathology, no
exercises. Although considerable research has             cardiorespiratory     disease,     no   history    of
examined more traditional means of instability            abdominal, shoulder or back surgery, and no
training (Behm and Drinkwater, 2010), little              psychological problems. Participants were
previous research has evaluated the effects of            instructed to refrain from performing strenuous
suspension training on muscle activation. In              physical activity in the 24 hours preceding all
particular, some studies focused on core-directed         experimental sessions. All participants signed a
exercises (Atkins, 2014; Byrne et al., 2014;              written informed consent form. The study was
Czaprowski et al., 2014; Mok et al., 2014; Snarr          previously approved by the research ethics
committee of the Department of Medical Sciences,      asked to refrain from physical activity 24 hours
University of Turin.                                  before      the    measurements.        During      the
         The surface electromyographic (EMG)          measurement session, participants performed 4
signals were obtained from six trunk muscles with     exercises with the use of suspension straps (TRX®
concentric bipolar electrodes (CoDe, Spes Medica,     suspension trainer; Fitness Anywhere LCC, San
Battipaglia, Italy). Before the placement of the      Francisco, CA, USA) in random order. The
electrodes, the skin was slightly abraded with        exercises were selected based on a previous study
adhesive paste and cleaned with water in              (Behm and Drinkwater, 2010) that indicated them
accordance to SENIAM recommendation for skin          as important in developing core strength.
preparation (Hermens et al., 2000). The electrodes             At the beginning of the measurement
were placed according to the instructions             session, three MVC exercises were performed
described in previous methodological works            twice for 5 s, with 2 min rest between them. The
(Beretta Piccoli et al., 2014; Boccia and Rainoldi,   following standardized exercises (Ng et al., 2002)
2014) – lower rectus abdominis: on the lower part     were used to activate maximally the trunk
of the rectus abdominis, 3 cm lateral to the          muscles (Figure 1):
midline; upper rectus abdominis: on the upper                  1.       Upper rectus abdominis (URA)
part of the rectus abdominis, 3 cm lateral to the     and lower rectus abdominis (LRA): body supine
midline; external oblique: 14 cm lateral to the       with hips and knees flexed 90°, with feet locked.
umbilicus, above the anterior superior iliac spine    Participants flexed the trunk (i.e. crunch
(ASIS); internal oblique: 2 cm lower with respect     execution) against resistance at the level of the
to the most prominent point of the ASIS, just         shoulders;
medial and superior to the inguinal ligament;                  2.       External oblique (EO) and internal
lower erector spinae: 2 cm lateral to the L5-S1;      oblique (IO): side-lying with the hip at the edge of
upper erector spinae: 6 cm lateral to the L1-L2.      the bench and feet locked by a second operator.
The electrodes were placed only on the left           Participants performed side-bend exercise against
(randomly chosen) side of the body; the reference     resistance at the level of the shoulder;
electrode was positioned on the wrist.                         3.       Lower erector spinae (LES) and
         The signal of a biaxial electrogoniometer    upper erector spinae (UES): prone position with
(SG 150, Biometrics Ltd, Gwent, UK) positioned at     ASIS at the edge of the bench and feet locked by a
the level of the shoulders (for the roll-out and      second operator. Participants performed a back
bodysaw) or the hips (for the pike and knee-tuck),    extension against resistance at the level of the
depending on which joint was more involved            shoulders.
during the exercise, was used as a trigger to                  The suspension system handles were
highlight exercise repetitions. The electrodes were   positioned 15 cm from the ground. Participants
fixed using extensible dressing (Fixomull®,           were required to achieve a         range of motion
Beiersdorf). The EMG signals were synchronized        with the correct technique execution and to
with the electrogoniometer signal, amplified          maintain a neutral position of the spine and pelvis
(EMG-USB, OT Bioelettronica, Torino, Italy),          in each exercise. A certified strength and
sampled at 2048 Hz, bandpass filtered (3-dB           conditioning coach monitored the exercise
bandwidth, 10- 450 Hz, 12 dB/oct slope on each        performance to ensure that the exercise was
side), and converted to digital data by a 12-bit      properly executed considering its technique. Each
A/D converter. Samples were visualized during         exercise was repeated three times and lasted 6 s. A
acquisition and then stored in a personal             metronome set at 30 beats per minute was used to
computer using OT BioLab software (version 1.8,       ensure proper timing (with 4 beats for each
OT Bioelettronica, Torino, Italy) for further         repetition): 2 s from the initial position to the final
analysis.                                             position (concentric phase); 2 s of maintenance
         The participants recruited were instructed   (isometric phase); and 2 s returning to the starting
with regard to the correct technique of suspension    position (eccentric phase). The exercises were
exercise and the MVC procedure during the first       performed with 3 min of rest in-between to allow
experimental session conducted one week before        complete recovery. The random order of the
the measurement session. The participants were        exercises allowed to mitigate the effects of
cumulative fatigue on EMG estimates. Each                 Results are expressed as medians (Interquartile
session lasted approximately 90 min. The                  Range, IR).
following exercises were used (Figure 2):
         1) Roll-out: participants assumed an
                                                          Results
inclined standing position while placing each                      All participants managed to complete
hand on the strap handles, with elbows and wrists         each exercise trial and thus, were included in the
placed below the shoulders, arms perpendicular            data analysis. Figure 3 shows the box plots of the
to the floor and shoulders flexed approximately           activation values (% of MVC) of each muscle
45°; they then performed a shoulder flexion               during the four exercises. Muscle activation
moving the hands forward;                                 (Median, IR) expressed as percentage values of
         2) Bodysaw: participants assumed a prone         ARV normalized to MVCs is reported in Table 1.
position, they placed elbows below the shoulders,                  The normalized LRA activity was 140%
both forearms touching the floor, while placing           (IR, 89%) of MVC during the roll-out, 100% (IR,
each foot on the strap handle; participants then          42%) of MVC during the bodysaw, 57% (IR, 36%)
flexed the shoulders and extended the elbows              of MVC during the pike and 54% (IR, 50%) of
pushing the body backwards;                               MVC during the knee-tuck. The normalized LRA
         3) Pike: participants assumed a push-up          values were significantly higher (p < 0.01) during
position with the feet in strap handles, then they        the roll-out and bodysaw compared to the pike
flexed hips to approximately 90°, while keeping           and knee-tuck. The roll-out exercise showed
the knees fully extended;                                 significantly greater activation (p < 0.01) than the
         4) Knee-tuck: participants assumed a push-       bodysaw.
up position while placing each foot in the strap                   The normalized URA activity was 67%
handle, then they flexed both hips and knees to           (IR, 78%) of MVC during the roll-out, 57% (IR,
approximately 90°, bringing the knees forward.            52%) of MVC during the bodysaw, 41% (IR, 48%)
         The average rectified value (ARV) of EMG         of MVC during the pike and 44% (IR, 41%) of
signals was computed off-line with numerical              MVC during the knee-tuck. The normalized URA
algorithms using non-overlapping signal epochs            values were significantly higher (p < 0.01) during
of 0.5 s (Hibbs et al., 2011). The epoch with the         the roll-out compared to the pike and knee-tuck.
highest ARV was chosen as reference in the                         The normalized EO activity was 71% (IR,
MVCs. The second and third repetitions of each            44%) of MVC during the roll-out, 59% (IR, 33%) of
exercise were analyzed. The mean value of ARV             MVC during the bodysaw, 55% (IR, 21%) of MVC
over the two repetitions was calculated for each          during the pike and 42% (IR, 7%) of MVC during
muscle and normalized with respect to the                 the knee-tuck. The normalized EO values were
maximum        ARV       obtained      during    the      significantly higher (p < 0.01) during the roll-out
correspondent MVC.                                        compared to the knee-tuck.
         The normality assumption of the data was                  The normalized IO activity was 40% (IR,
evaluated      with     the    Shapiro-Wilk     test;     31%) of MVC during the roll-out, 32% (IR, 20%) of
homoscedasticity and autocorrelation of the               MVC during the bodysaw, 23% (IR, 20%) of MVC
variables were assessed using the Breusch-Pagan           during the pike and 18% (IR, 26%) of MVC during
and Durbin-Watson tests. The differences                  the knee-tuck. During all exercises the normalized
between exercises (pike – bodysaw – knee-tuck –           IO values were not significantly higher (p < 0.01).
roll-out) and between muscles (LRA – URA – EO                      The normalized LES activity was 9% (IR,
– IO – LES – UES) were compared with the 2-way            5%) of MVC during the roll-out, 4% (IR, 3%) of
analysis of variance (ANOVA). For the purpose of          MVC during the bodysaw, 12% (IR, 7%) of MVC
this report, only the results concerning differences      during the pike and 8% (IR, 5%) of MVC during
between exercises were presented. For multiple            the knee-tuck. During all exercises the normalized
comparisons, the Tukey test was used. The level           LES values were not significantly higher (p < 0.01).
of significance was set at p < 0.01. Statistical                   The normalized UES activity was 11% (IR,
analyses were conducted using the R statistical           6%) of MVC during the roll-out, 8% (IR, 6%) of
package (version 3.0.3, R Core Team, Foundation           MVC during the bodysaw, 9% (IR, 4%) of MVC
for Statistical Computing, Vienna, Austria).              during the pike and 6% (IR, 5%) of MVC during
the knee-tuck. During all exercises the normalized                        The roll-out exercise showed significantly
UES values were not significantly higher (p <                    (p < 0.01) higher activation compared to the
0.01).                                                           bodysaw (16%, CI 8-23%), pike (26%, CI 18-33%)
        Table 2 shows the estimate (difference of                and knee-tuck (29%, CI 21-37%). Pike and knee-
means) at 95% of the confidence interval after                   tuck exercises showed significantly higher
Tukey multiple comparisons; in this case only                    activation compared to the bodysaw of 10% (2-
"exercise factor" was considered.                                8%) and 13% (6-21%).
                Figure 1
                           Standardized exercises used to maximally activate trunk muscles:
                              Lower rectus abdominis and upper rectus abdominis (left);
                                   Internal oblique and external oblique (middle);
                                Lower erector spinae and upper erector spinae (right).
                Figure 2
              Initial and final positions of each exercise: 1) Roll-out; 2) Bodysaw; 3) Pike; 4) Knee-tuck.
                   Figure 3
                         Each box plot shows the muscle activation (as percentage of maximum
                                        voluntary contraction) during exercise.
                           Whiskers indicate variability outside the upper and lower quartiles.
                                                                                        Table 1
                                   Muscle activation (Median, IR) expressed as percentage values
                     of electromyographic amplitude normalized to maximum voluntary contraction.
                             Results of the two-way ANOVA after Tukey multiple comparisons
                                               are reported as symbols; p<0.01.
                        Lower rectus     Upper rectus     External      Internal    Lower erector    Upper erector
                         abdominis        abdominis       oblique       oblique        spinae          spinae
        Pike              57 (36) ǂ §      41 (48) ǂ       55 (21)       23 (20)        12 (7)           9 (4)
                                                                                          Table 2
                        Estimate at 95% of the confidence interval after Tukey multiple comparisons
                              with the "exercise factor" considered. The estimate shows
                         the difference of means (% of maximum voluntary contraction).
                           * indicates the statistical significance of the adjusted p-value.
levels (41-60% MVC). While strengthening of the          levels were higher than previously reported
core is important, an activation level below 60%         values obtained during the execution of the roll-
might be beneficial in increasing muscle                 out with the Swiss-ball (about 50-60% for rectus
endurance within the core. Since the core muscles        abdominis) (Escamilla and Lewis, 2010; Marshall
are primarily composed of type I fibres                  and Desai, 2010) and similar to the values
(Haggmark and Thorstensson, 1979), muscular              reported with the use of the Power Wheel, being
endurance should also be a major concern when            very high for URA (76%) and LRA (81%)
designing strength and conditioning programmes           (Escamilla et al., 2006). In the pike, we found high
(Vezina and Hubley-Kozey, 2000). Due to large            activation of LRA (57%) and URA (41%). The
demand for muscle activation, all the proposed           values reported for the pike executed with the
exercises might be appropriate for extremely fit         Swiss ball (Escamilla and Lewis, 2010) and Power
individuals in the latter stages of a progressive        Wheel (Escamilla and Babb, 2006) were similar for
abdominal strengthening           or rehabilitation      URA (Swiss ball 47%; Power Wheel 41%) and
programme.                                               LRA (Swiss ball 55%; Power Wheel 53%). In the
         Erector spinae muscles resulted in being        knee-tuck, we observed high activation of LRA
activated at low and very low intensity. This is an      (54%) and URA (44%). Otherwise, the values
expected result as all exercises focused on anterior     reported for the knee-tuck executed with the
abdominal wall muscles. This finding confirms            Swiss ball (Escamilla and Lewis, 2010) and Power
that in the herein selected whole-body linkage           Wheel (Escamilla and Babb, 2006) were lower for
exercises, the activation of core muscles can be         both URA (Swiss ball 32%; Power Wheel 41%)
mainly focused on abdominal muscles while                and LRA (Swiss ball 35%; Power Wheel 45%).
keeping the paraspinal muscles involved with low                  Our findings suggest that the two parts of
intensity.                                               the rectus abdominis can be activated differently
         Although no direct comparison can be            according to the needs of the motor task (Kibler et
made between the selected suspension exercises           al., 2006). This finding could be explained by the
compared to previously reported similar                  possibility to (voluntary or involuntary) modulate
exercises, it is possible to highlight the following     the activation ratio between rectus abdominis
differences. We can compare only the activation of       parts in order to achieve the best control of the
the rectus abdominis, since for oblique muscles          core region. This could be justified by the
we used a different normalization exercise than          metameric innervation of rectus abdominis
the other three studies. Plank exercises are             muscles (Duchateau et al., 1988), although this
frequently included in spine stabilization               issue is still controversial (Monfort-Panego et al.,
programmes as a means of improving motor                 2009). However, LRA muscles were generally
control for spine stabilization. When plank              more active than URA because of confounding
exercises are performed on stable or unstable            methodological factors. MVCs of the LRA and
support surfaces, the reported activation level of       URA in fact were estimated by a standardized
the rectus abdominis and EO ranges from low to           exercise to activate maximally the trunk muscles:
moderate (Garcia-Vaquero et al., 2012). When             it could be argued that the same exercise fully
executed in suspension condition, rectus                 activated URA whereas it failed to fully activate
abdominis muscles also showed moderate                   LRA. Hence, the EMG amplitude recorded during
activation (Byrne and Bishop, 2014). Only when           MVC was not the maximum achievable.
the planks were performed with a similar                 Consequently, throughout experimental exercises,
technique (instability on lower limb and shoulder        LRA seemed relatively more active than URA
flexion) was the activation similar to that reported     because its reference value of MVC was
here, which was very high for the rectus                 underestimated.
abdominis (McGill and Andersen, 2015).                            A few methodological limitations of our
Therefore, we can assume that our exercises were         study warrant further consideration. In some
more challenging than an isometric plank in a            cases, ARV estimates of EMG signals exceeded the
stable condition.                                        MVC reference values (ARV higher than 100%).
         In the roll-out, we found very high             This inconsistency might be due to incomplete
activation of LRA (140%) and URA (67%). These            activation during MVC (as in the case of the lower
rectus abdominis) and other confounding factors          systems and reducing the problem of crosstalk
related to EMG technique (relative shift of muscle       from nearby muscles (Farina and Cescon, 2001).
belly with respect to electrodes occurring in                    Conclusions
dynamic tasks and different activation between                   Findings from this study, based on
isometric and dynamic tasks, among others).              electromyographic analysis, showed that roll-out
         As widely reported, variability of              exercise was the most challenging. Moreover, roll-
muscular activation between participants was             out and bodysaw exercises executed in
high. This suggests that performing these                suspension activated the rectus abdominis and
exercises, some individuals might produce more           external oblique muscles at intensities higher
or less activation than the average activity             than, or very close to, 60% of the maximum
indicated here. Although 17 individuals                  voluntary contraction. Based on these findings,
participated in this research, the differences in        we can assume that roll-out and bodysaw
their fitness level and exercise experience could        exercises can be used to adequately strengthen the
have affected the performance of the exercises and       antero-lateral, superficial aspect of the core
the resulting activation levels.                         region, and thus they can be considered core
         Crosstalk     between    muscles      was       strength exercises. These findings appear to have
minimized by using an innovative detection               particular relevance for well-trained individuals
system based on concentric-ring electrodes which         given the high demand imposed by these
had been reported as having higher spatial               exercises.
selectivity compared to the traditional detection
Acknowledgements
    This work was supported by Funding for Innovation Projects under grant Project HExEC, PQR FESR
2007/1013
References
 Atkins S. Electromyographic response of global abdominal stabilisers in response to stable- and unstable-
     base isometric exercise. J Strength Cond Res, 2015; 29: 1609-1615
 Behm DG, Drinkwater EJ, Willardson JM, Cowley PM. The use of instability to train the core musculature.
     Appl Physiol Nutr Metab, 2010; 35: 91-108
 Beretta Piccoli M, Rainoldi A, Heitz C, Wuthrich M, Boccia G, Tomasoni E, Spirolazzi C, Egloff M, Barbero
      M. Innervation zone locations in 43 superficial muscles: toward a standardization of electrode
      positioning. Muscle Nerve, 2014; 49: 413-21
 Blanchard S, Glasgow P. A theoretical model to describe progressions and regressions for exercise
     rehabilitation. Phys Ther Sport, 2014; 15: 131-5
 Boccia G, Rainoldi A. Innervation zones location and optimal electrodes position of obliquus internus and
     obliquus externus abdominis muscles. J Electromyogr Kinesiol, 2014; 24: 25-30
 Byrne JM, Bishop NS, Caines AM, Crane KA, Feaver AM, Pearcey GE. Effect of using a suspension training
     system on muscle activation during the performance of a front plank exercise. J Strength Cond Res,
     2014; 28: 3049-55
 Calatayud J, Borreani S, Colado JC, Martin FF, Rogers ME, Behm DG, Andersen LL. Muscle Activation
     during Push-Ups with Different Suspension Training Systems. J Sports Sci Med, 2014; 13: 502-10
 Czaprowski D, Afeltowicz A, Gebicka A, Pawlowska P, Kedra A, Barrios C, Hadała M. Abdominal muscle
     EMG-activity during bridge exercises on stable and unstable surfaces. Phys Ther Sport, 2014; 15: 162-8
 Duchateau J, Declety A, Lejour M. Innervation of the rectus abdominis muscle: implications for rectus
   Corresponding author:
   Gennaro Boccia,
   1) CeRiSM Research Center “Sport, Mountain, and Health”, via del Ben 5/b, 38068, Rovereto, (TN), Italy.
   2) Motor Science Research Center, School of Exercise & Sport Sciences, SUISM, Department of Medical
   Sciences, University of Turin. 12, piazza Bernini, 10143, Torino, Italy.
   Address: 12, piazza Bernini, 10143, Torino, Italy;
   Telephone: +39 0117764708
   Fax: +39 011748251
   E-mail gennaro.boccia@unito.it