Comparison of core stabilization techniques on ultrasound imaging of the diaphragm, and core muscle thickness and external abdominal oblique muscle electromyography activity

BACKGROUND: To restore core stability, abdominal drawing-in maneuver (ADIM), abdominal bracing (AB), and dynamic neuromuscular stabilization (DNS) have been employed but outcome measures varied and one intervention was not superior over another. OBJECTIVE: The purpose of this study was to compare the differential effects of ADIM, AB, and DNS on diaphragm movement, abdominal muscle thickness difference, and external abdominal oblique (EO) electromyography (EMG) amplitude. METHODS: Forty-one participants with core instability participated in this study. The subjects performed ADIM, AB, and DNS in random order. A Simi Aktisys and Pressure Biofeedback Unit (PBU) were utilized to measure core stability, an ultrasound was utilized to measure diaphragm movement and measure abdominal muscles thickness and EMG was utilized to measure EO amplitude. Analysis of variance (ANOVA) was conducted at P< 0.05. RESULTS: Diaphragm descending movement and transverse abdominis (TrA) and internal abdominal oblique (IO) thickness differences were significantly increased in DNS compared to ADIM and AB (P< 0.05). EO amplitude was significantly increased in AB compared to ADIM, and DNS. CONCLUSIONS: DNS was the best technique to provide balanced co-activation of the diaphragm and TrA with relatively less contraction of EO and subsequently producing motor control for efficient core stabilization.

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Impact of acute ascites on the action of the canine abdominal muscles

Journal of Applied Physiology ◽

10.1152/japplphysiol.01336.2007 ◽

2008 ◽

Vol 104 (6) ◽

pp. 1568-1573 ◽

Cited By ~ 4

Author(s):

Dimitri Leduc ◽

André De Troyer

Keyword(s):

Muscle Length ◽

Abdominal Muscle ◽

Transversus Abdominis ◽

Oblique Muscle ◽

Abdominal Muscles ◽

Cross Sectional ◽

Control Value ◽

Airway Opening ◽

Internal Oblique ◽

Resting Muscle

Although ascites causes abdominal expansion, its effects on abdominal muscle function are uncertain. In the present study, progressively increasing ascites was induced in supine anesthetized dogs, and the changes in abdominal (ΔPab) and airway opening (ΔPao) pressure obtained during stimulation of the internal oblique and transversus abdominis muscles were measured; the changes in internal oblique muscle length were also measured. As ascites increased from 0 to 100 ml/kg body wt, Pab and muscle length during relaxation increased. ΔPab also showed a threefold increase ( P < 0.001). However, ΔPao decreased ( P < 0.001). When ascites increased further to 200 ml/kg, resting muscle length continued to increase and muscle shortening during stimulation became very small so that active muscle length was 155% of the resting muscle length in the control condition. Concomitantly, ΔPab returned to the control value, and ΔPao continued to decrease. Similar results were obtained with the animals in the head-up posture, although the decrease in ΔPao appeared only when ascites was greater than 125 ml/kg. It is concluded that 1) ascites adversely affects the expiratory action of the abdominal muscles on the lung; 2) this effect results primarily from the increase in diaphragm elastance; and 3) when ascites is severe, the abdomen cross-sectional area is also increased and the abdominal muscles are excessively lengthened so that their active pressure-generating ability itself is reduced.

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Waist Circumference, a Clinical Measurement for the Activity of Transversus Abdominis

Iranian Rehabilitation Journal ◽

10.32598/irj.19.3.1391.1 ◽

2021 ◽

Vol 19 (3) ◽

pp. 273-278

Author(s):

Mojtaba Kamyab ◽

◽

Brendan McHugh ◽

Roy Bowers ◽

◽

...

Keyword(s):

Waist Circumference ◽

Inverse Relationship ◽

Pearson Correlation ◽

Abdominal Muscle ◽

Transversus Abdominis ◽

Formal Training ◽

Abdominal Muscles ◽

Clinical Settings ◽

Spinal Stability ◽

Pressure Biofeedback

Objectives: Improving the timing and endurance of the deep abdominal muscles, notably transversus abdominis (TrA), is a known protocol for improving spinal stability. TrA is the deepest abdominal muscle, and monitoring its activity is a difficult task. Ultrasound and pressure biofeedback have been employed for monitoring the activity of TrA; however, these methods are expensive, not always available in all clinical settings, and their application requires formal training. The purpose of this study was to examine the use of a broadly known method, i.e., changes in the waist circumference, to monitor the activity of TrA. Methods: The study was carried out on 14 subjects following a pilot study of 5 participants. The thickness of TrA measured by ultrasound was considered the standard indicator for activity of TrA and was compared with simuObjectives: Improving the timing and endurance of the deep abdominal muscles, notably transversus abdominis (TrA), is a known protocol for improving spinal stability. TrA is the deepest abdominal muscle, and monitoring its activity is a difficult task. Ultrasound and pressure biofeedback have been employed for monitoring the activity of TrA; however, these methods are expensive, not always available in all clinical settings, and their application requires formal training. The purpose of this study was to examine the use of a broadly known method, i.e., changes in the waist circumference, to monitor the activity of TrA. Methods: The study was carried out on 14 subjects following a pilot study of 5 participants. The thickness of TrA measured by ultrasound was considered the standard indicator for activity of TrA and was compared with simultaneous measurement of waist circumference. Results: A significant criterion validity between the thickness of TrA and the waist circumference was established (Pearson correlation=-0.71, P=0.001), indicating an inverse relationship between changes in the thickness of the transversus abdominis muscle and waist circumference. Discussion: This result confirmed the hypothesis that changes in the waist circumference could be employed as a suitable indicator for the activity of TrA.ltaneous measurement of waist circumference. Results: A significant criterion validity between the thickness of TrA and the waist circumference was established (Pearson correlation=-0.71, P=0.001), indicating an inverse relationship between changes in the thickness of the transversus abdominis muscle and waist circumference. Discussion: This result confirmed the hypothesis that changes in the waist circumference could be employed as a suitable indicator for the activity of TrA.

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Effect of trunk stabilization exercise on abdominal muscle thickness, balance and gait abilities of patients with hemiplegic stroke: A randomized controlled trial

Neurorehabilitation ◽

10.3233/nre-203133 ◽

2020 ◽

Vol 47 (4) ◽

pp. 435-442 ◽

Cited By ~ 1

Author(s):

Jiyeon Lee ◽

Jeongwoo Jeon ◽

Dongyeop Lee ◽

Jiheon Hong ◽

Jaeho Yu ◽

...

Keyword(s):

Outcome Measures ◽

Muscle Thickness ◽

Abdominal Muscle ◽

Secondary Outcome ◽

Control Group ◽

Abdominal Muscles ◽

Stroke Patients ◽

Trunk Stability ◽

Functional Reach Test ◽

Stability Training

BACKGROUND: Trunk stability has been identified as an important prerequisite of functional movement. OBJECTIVE: To investigate the effectiveness of core muscle contraction training on abdominal muscle thickness, balance, and gait ability in stroke patients. METHODS: Thirty patients with stroke were randomly assigned to two experimental groups and a control group. All groups received conventional therapeutic exercise program for six weeks. The experimental groups additionally trained trunk stability exercise with abdominal hollowing or bracing maneuvers within training time. Primary outcome measures were evaluated abdominal muscle thickness using the sonography. Secondary outcome measures were evaluated by the Functional Reach Test (FRT), Berg Balance Scale (BBS), 10-meter walk test (10MWT), and Timed Up and Go test (TUG). RESULTS: Compared with the control group, the effect of trunk stability training for the experimental groups on the abdominal muscles thickness change was observed (p < 0.05). The values in balance and gait measures, BBS, FRT, 10MWT, and TUG, showed significant improvement after the intervention periods (p < 0.05), although no significant differences were found in scores of gait and balance scales among groups. CONCLUSIONS: Trunk stability training with selective abdominal muscles activation has beneficial effects on abdominal muscles, balance, and mobility in stroke patients. Our findings might provide support for introducing stroke rehabilitation.

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Exercising on Different Unstable Surfaces Increases Core Abdominal Muscle Thickness: An Observational Study Using Real-Time Ultrasound

Journal of Sport Rehabilitation ◽

10.1123/jsr.2017-0385 ◽

2019 ◽

Vol 28 (8) ◽

pp. 803-808

Author(s):

Timothy J. Gibbons ◽

Marie-Louise Bird

Keyword(s):

Positive Impact ◽

Exercise Adherence ◽

Muscle Thickness ◽

Abdominal Muscle ◽

Healthy Adults ◽

Transversus Abdominis ◽

Abdominal Muscles ◽

Linear Modeling ◽

Internal Oblique ◽

Ultrasound Investigation

Background: The training of abdominal muscles has a positive impact on the functional capacity of healthy adults, being applied practically in fields of athletics and fitness through rehabilitation for lower back pain. Objective: The study compares abdominal muscle activity while performing graded isometric exercises on stable and unstable surfaces. The authors also examined perceived stability and comfort for the different surfaces. Methods: A total of 30 young, healthy adults performed 3 graded isometric exercises on a Pilates table, foam roller, and Oov (a newly developed tool). Ultrasound investigation measured transversus abdominis, internal oblique abdominis, and external oblique abdominis thickness during each task, comparing muscle thickness between conditions using general linear modeling. Results: Core abdominal activation was greater on the foam roller than the Oov and Pilates table during crook lying (bilateral leg support). Both Oov and foam roller elicited greater contralateral transversus abdominis and internal oblique abdominis thickness than the Pilates table during tabletop and straight leg raises (unilateral leg exercises). For transversus abdominis only, the foam roller elicited more muscle thickness than the Oov during straight leg raises. The Oov was rated more comfortable than the foam roller. Discussion: Exercises performed on the Oov and foam roller elicit core greater abdominal muscle thickness than those performed on a Pilates table. Unilateral leg exercises in a supine position elicit more contralateral muscle thickness than those with bilateral leg support. Conclusions: These results provide information to support choices in exercise progression from flat stable to more unstable surfaces and from those with bilateral foot support to unilateral foot support. The Oov was more comfortable that the foam roller, and this may help with exercise adherence.

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The effect of core stability and general exercise on abdominal muscle thickness in non-specific chronic low back pain using ultrasound imaging

Physiotherapy Theory and Practice ◽

10.3109/09593985.2016.1138559 ◽

2016 ◽

Vol 32 (4) ◽

pp. 277-283 ◽

Cited By ~ 13

Author(s):

MohammadBagher Shamsi ◽

Javad Sarrafzadeh ◽

Aliashraf Jamshidi ◽

Vida Zarabi ◽

Mohammad Reza Pourahmadi

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Ultrasound Imaging ◽

Chronic Low Back Pain ◽

Muscle Thickness ◽

Abdominal Muscle ◽

Core Stability ◽

Low Back ◽

General Exercise

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The effects of abdominal hollowing and bracing on abdominal muscle thicknesses and pelvic rotation during active straight leg raise

Isokinetics and Exercise Science ◽

10.3233/ies-203204 ◽

2021 ◽

pp. 1-6

Author(s):

Eun-Joo Jung ◽

Jin-Wook Sung ◽

In-Joon Uh ◽

Jae-Seop Oh

Keyword(s):

Rotation Angle ◽

Muscle Thickness ◽

Abdominal Muscle ◽

Abdominal Muscles ◽

Pelvic Rotation ◽

Maximum Benefit ◽

Correct Execution ◽

External Oblique ◽

Straight Leg Raise ◽

Internal Oblique

BACKGROUND: Active straight leg-raise (ASLR) is often performed to strengthen abdominal muscles. The correct execution and maximum benefit of the ASLR can be achieved using abdominal hollowing (AH) and abdominal bracing (AB) exercises. OBJECTIVE: To compare the effects of AH and AB on transverse abdominis (TrA), internal oblique, and external oblique thicknesses, as well as on the pelvic rotation angle, in healthy women during active ASLR. METHODS: The participants in this study were assigned randomly to either the AH (n= 15) or AB groups (n= 15). During ASLR, abdominal muscle thickness was measured using ultrasound and pelvic rotation was measured using a Smart KEMA device. Each trial was repeated three times for 5 s each. RESULTS: The thickness of the TrA was significantly greater during ASLR with AH than during ASLR with AB (p< 0.001). In contrast, there was no respective significant change in the thickness of the external oblique (p> 0.0.311) or internal oblique (p> 0.818). Pelvic rotation angle was significantly reduced during ASLR with AB, compared with ASLR with AH (p< 0.018). CONCLUSIONS: We recommend that AH be performed for the selective contraction of TrA during ASLR, and that AB be performed for the prevention of the pelvic rotation during ASLR. Therefore, AH and AB should be separately done in stabilization exercises.

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Comparison of Lateral Abdominal Muscle Thickness and Cross-Sectional Area of Multifidus in Adults with and without Scoliosis

10.21203/rs.2.18602/v1 ◽

2019 ◽

Author(s):

Nahid Rahmani

Keyword(s):

Functional Disability ◽

Muscle Thickness ◽

Abdominal Muscle ◽

Transversus Abdominis ◽

Muscle Size ◽

Abdominal Muscles ◽

Multifidus Muscle ◽

Cross Sectional ◽

Lumbar Multifidus ◽

Significant Difference

Abstract Background: Scoliosis is common in students with a prevalence of 1-2% in teenagers and more than 50% in adults ≥ 60 years. The aim was to compare the abdominal and multifidus muscles size in adults with and without scoliosis. Methods: Forty men with and without scoliosis were recruited. The Visual Analogue Scale and the Oswestry Disability Questionnaire were used to evaluate the pain intensity and functional disability in the patients’ group, respectively. Subjects were asked to lie down in a supine position with their knees bent to measure abdominal muscles using sonography. The linear transducer was placed vertically on the anterolateral abdominal wall to record images of the abdominal muscles (Transversus abdominis, internal oblique, external oblique). To assess the lumbar multifidus muscle size, the curvilinear head was used horizontally on the multifidus muscle at the L5-S1 level in a prone lying position. Results: No significant difference was found between the two groups for demographic variables. A significant difference was found between the healthy subjects and patients with scoliosis for right and left abdominal and multifidus muscles size (p<0.05). No significant difference was reported between the two sides of the convexity and concavity on muscles size in patients with scoliosis (p>0.05). Conclusions: According to the results, patients with scoliosis had smaller abdominal and lumbar multifidus muscles size, but no significant differences were found between the muscle size of the concave and convex sides in the scoliosis group. Future work is needed to support the findings of the current study.

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Intensive Abdominal Drawing-In Maneuver After Unipedal Postural Stability in Nonathletes With Core Instability

Journal of Athletic Training ◽

10.4085/1062-6050-49.3.91 ◽

2015 ◽

Vol 50 (2) ◽

pp. 147-155 ◽

Cited By ~ 7

Author(s):

Nam G. Lee ◽

Joshua (Sung) H. You ◽

Tae H. Kim ◽

Bong S. Choi

Keyword(s):

Postural Stability ◽

Center Of Pressure ◽

Muscle Thickness ◽

Erector Spinae ◽

Medial Gastrocnemius ◽

Oblique Muscle ◽

Electromyographic Activity ◽

External Oblique ◽

Pressure Biofeedback ◽

Formal Test

Context: The exact neuromechanical nature and relative contribution of the abdominal drawing-in maneuver (ADIM) to postural instability warrants further investigation in uninjured and injured populations. Objective: To determine the effects of the ADIM on static core and unipedal postural stability in nonathletes with core instability. Design: Controlled laboratory study. Setting: University research laboratory. Patients or Other Participants: A total of 19 nonathletes (4 women: age = 22.3 ± 1.3 years, height = 164.0 ± 1.7 cm, mass = 56.0 ± 4.6 kg; 15 men: age = 24.6 ± 2.8 years, height = 172.6 ± 4.7 cm, mass = 66.8 ± 7.6 kg) with core instability. Intervention(s): Participants received ADIM training with visual feedback 20 minutes each day for 7 days each week over a 2-week period. Main Outcome Measures(s): Core instability was determined using a prone formal test and measured by a pressure biofeedback unit. Unipedal postural stability was determined by measuring the center-of-pressure sway and associated changes in the abdominal muscle-thickness ratios. Electromyographic activity was measured concurrently in the external oblique, erector spinae, gluteus medius, vastus medialis oblique, tibialis anterior, and medial gastrocnemius muscles. Results: All participants initially were unable to complete the formal test. However, after the 2-week ADIM training period, all participants were able to reduce the pressure biofeedback unit by a range of 4 to 10 mm Hg from an initial 70 mm Hg and maintain it at 60 to 66 mm Hg with minimal activation of the external oblique (t18 = 3.691, P = .002) and erector spinae (t18 = 2.823, P = .01) muscles. Monitoring of the pressure biofeedback unit and other muscle activations confirmed that the correct muscle contraction defining the ADIM was accomplished. This core stabilization was well maintained in the unipedal-stance position, as evidenced by a decrease in the center-of-pressure sway measures (t18 range, 3.953–5.775, P < .001), an increased muscle-thickness ratio for the transverse abdominis (t18 = −2.327, P = .03), and a reduction in external oblique muscle activity (t18 = 3.172, P = .005). Conclusions: We provide the first evidence to highlight the positive effects of ADIM training on core and postural stability in nonathletes with core instability.

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