scholarly journals Effects of Cesarean Section and Vaginal Delivery on Abdominal Muscles and Fasciae

Medicina ◽  
2020 ◽  
Vol 56 (6) ◽  
pp. 260 ◽  
Author(s):  
Chenglei Fan ◽  
Diego Guidolin ◽  
Serena Ragazzo ◽  
Caterina Fede ◽  
Carmelo Pirri ◽  
...  

Background and objectives: Possible disorders after delivery may interfere with the quality of life. The aim of this study was to ascertain whether abdominal muscles and fasciae differ in women depending on whether they experienced transverse cesarean section (CS) or vaginal delivery (VA) in comparison with healthy nulliparous (NU). Materials and methods: The thicknesses of abdominal muscles and fasciae were evaluated by ultrasound in 13 CS, 10 VA, and 13 NU women (we examined rectus abdominis (RA); external oblique (EO); internal oblique (IO); transversus abdominis (TrA); total abdominal muscles (TAM = EO + IO + TrA); inter-rectus distance (IRD); thickness of linea alba (TLA); rectus sheath (RS), which includes anterior fascia of RS and posterior fascia of RS (P-RS); loose connective tissue between sublayers of P-RS (LCT); abdominal perimuscular fasciae (APF), which includes anterior fascia of EO, fasciae between EO, IO, and TrA, and posterior fascia of TrA). Data on pain intensity, duration, and location were collected. Results: Compared with NU women, CS women had wider IRD (p = 0.004), thinner left RA (p = 0.020), thicker right RS (p = 0.035) and APF (left: p = 0.001; right: p = 0.001), and IO dissymmetry (p = 0.009). VA women had thinner RA (left: p = 0.008, right: p = 0.043) and left TAM (p = 0.024), mainly due to left IO (p = 0.027) and RA dissymmetry (p = 0.035). However, CS women had thicker LCT (left: p = 0.036, right: p < 0.001), APF (left: p = 0.014; right: p = 0.007), and right IO (p = 0.028) than VA women. There were significant correlations between pain duration and the affected fasciae/muscles in CS women. Conclusions: CS women showed significant alterations in both abdominal fasciae and muscle thicknesses, whereas VA women showed alterations mainly in muscles. Thinner RA and/or dissymmetric IO, wider IRD, and thicker LCT and APF after CS may cause muscle deficits and alteration of fascial gliding, which may induce scar, abdominal, low back, and/or pelvic pain.

2019 ◽  
Vol 12 (3) ◽  
pp. 243-246
Author(s):  
Gonzalo Alfonso Quiroz Sandoval ◽  
Nathalie Tabilo ◽  
Cristóbal Bahamondes ◽  
Pilar Bralic

Objectives: Abdominal hypopressive gymnastics (AHG) is a little-researched method designed to train the muscles of the abdominal wall and pelvic floor under low stress. This study’s objective is to compare levels of muscle activation in AHG against prone bridge by surface electromyography (sEMG) of the abdominal wall muscles. Methods: Twenty healthy subjects were enrolled to measure the muscle activity of the rectus abdominis (RA), transversus abdominis/internal oblique (Tra/IO), and external oblique (EO) during three exercises: prone bridge (PB), orthostatic hypopressive (OH), and hypopressive bridge (HB). Root mean square values normalized to the PB (%PB) as a baseline were used to compare the PB against OH and HB. Results: The median PB ratio (%PB) for the Tra/IO showed –10.31% and +59.7% activation during OH and the HB, respectively, whereas the RA showed –77.8% and +19.3% and the EO –39.8% and +9.8%. Significant differences were found for all muscles except the Tra/IO during the OH. Conclusion: This study’s results suggest that hypopressive exercises facilitate the activation of the Tra/IO similar to bridge exercises while simultaneously reducing RA and EO activity. This suggests that hypopressive training is a valid alternative for activating the abdominal muscles, isolating the Tra/IO at low intra-abdominal pressure.


1991 ◽  
Vol 71 (5) ◽  
pp. 1723-1728 ◽  
Author(s):  
T. Chonan ◽  
S. Okabe ◽  
W. Hida ◽  
T. Izumiyama ◽  
Y. Kikuchi ◽  
...  

We assessed the effects of cooling the ventral medullary surface (VMS) on the activity of chest wall and abdominal expiratory muscles in eight anesthetized artificially ventilated dogs after vagotomy and denervation of the carotid sinus nerves. Electromyograms (EMGs) of the triangularis sterni, internal intercostal, abdominal external oblique, abdominal internal oblique, and transversus abdominis muscles were measured with EMG of the diaphragm as an index of inspiratory activity. Bilateral localized cooling (2 x 2 mm) in the thermosensitive intermediate part of the VMS produced temperature-dependent reduction in the EMG of diaphragm and abdominal muscles. The rib cage expiratory EMGs were little affected at 25 degrees C; their amplitudes decreased at lower VMS temperatures (less than 20 degrees C) but by significantly fewer degrees than the diaphragmatic and abdominal expiratory EMGs at a constant VMS temperature. With moderate to severe cooling (less than 20 degrees C) diaphragmatic EMG disappeared, but rib cage expiratory EMGs became tonic and resumed a phasic pattern shortly before the recovery of diaphragmatic EMG during rewarming of the VMS. These results indicate that the effects of cooling the VMS differ between the activity of rib cage and abdominal expiratory muscles. This variability may be due to inhomogeneous inputs from the VMS to expiratory motoneurons or to a different responsiveness of various expiratory motoneurons to the same input either from the VMS or the inspiratory neurons.


1999 ◽  
Vol 86 (6) ◽  
pp. 1994-2000 ◽  
Author(s):  
Tadashi Abe ◽  
Takumi Yamada ◽  
Tomoyuki Tomita ◽  
Paul A. Easton

In humans during stimulated ventilation, substantial abdominal muscle activity extends into the following inspiration as postexpiratory expiratory activity (PEEA) and commences again during late inspiration as preexpiratory expiratory activity (PREA). We hypothesized that the timing of PEEA and PREA would be changed systematically by posture. Fine-wire electrodes were inserted into the rectus abdominis, external oblique, internal oblique, and transversus abdominis in nine awake subjects. Airflow, end-tidal CO2, and moving average electromyogram (EMG) signals were recorded during resting and CO2-stimulated ventilation in both supine and standing postures. Phasic expiratory EMG activity (tidal EMG) of the four abdominal muscles at any level of CO2 stimulation was greater while standing. Abdominal muscle activities during inspiration, PEEA, and PREA, were observed with CO2stimulation, both supine and standing. Change in posture had a significant effect on intrabreath timing of expiratory muscle activation at any level of CO2stimulation. The transversus abdominis showed a significant increase in PEEA and a significant decrease in PREA while subjects were standing; similar changes were seen in the internal oblique. We conclude that changes in posture are associated with significant changes in phasic expiratory activity of the four abdominal muscles, with systematic changes in the timing of abdominal muscle activity during early and late inspiration.


1989 ◽  
Vol 66 (5) ◽  
pp. 2189-2195 ◽  
Author(s):  
A. M. Leevers ◽  
J. D. Road

Abdominal muscle length changes and activity were directly examined in vivo with the use of the techniques of sonomicrometry and electromyography, respectively, in nine supine anesthetized dogs. Expiratory threshold loading was utilized to stimulate recruitment of the abdominal muscles, and lung inflations produced the passive relationships. The internal layer, consisting of the internal oblique and transversus abdominis, shortened more in expiration than the external layer, consisting of the external oblique and rectus abdominis. The internal oblique shortened to approximately 83% of its length at functional residual capacity vs. 98% for the external oblique (P less than 0.05). The results obtained during passive lung inflation indicate these internal muscles are also more influenced by changes in lung volume. The internal oblique lengthened to 115% of its length at functional residual capacity vs. 103% for external oblique at total lung capacity (P less than 0.05). The results suggest that anatomic division of the abdominal muscles into external and internal layers corresponds to functional differences in terms of both passive lengthening and active shortening during ventilation and that these differences imply variable functions of the two layers.


2020 ◽  
Vol 33 (5) ◽  
pp. 857-863
Author(s):  
Sun-Young Ha ◽  
DooChul Shin

BACKGROUND: The curl-up exercise is widely used in clinical practice for strengthening abdominal muscles, but has been applied without a systematic method. OBJECTIVE: The purpose of this study was to determine the most effective method considering the angle and muscle contraction direction during the curl-up exercise. METHODS: Fourteen healthy males performed the curl-up exercise according to contraction direction (concentric and eccentric) and angle (30∘, 60∘, and 90∘). The muscle activity of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and iliopsoas (IP) was measured using electromyography (EMG), and the muscle thickness of transversus abdominis (TrA) was measured using ultrasonography. RESULTS: The activities of the abdominal muscles (RA, EO, and IO) decreased with increasing angles (30∘, 60∘, and 90∘) (p< 0.05). There was no significant difference between eccentric and concentric contractions. The thickness ratio of TrA was the largest at an eccentric curl-up at 30∘, and the smallest at a concentric curl-up at 30∘ (p< 0.05). CONCLUSIONS: The most effective angle for curl-up was 30∘. Although there is no difference in the direction of muscle contraction, eccentric curl-up at 30∘ could be considered the most effective posture for abdominal strengthening considering the importance of TrA.


Author(s):  
Iria Da Cuña-Carrera ◽  
Alejandra Alonso-Calvete ◽  
Eva M. Lantarón-Caeiro ◽  
Mercedes Soto-González

This study analyzes the effects of hypopressive exercises on the abdominal thickness of healthy subjects and compares the performance between women and men. We conducted a transversal observational study in 98 subjects (63% women). The muscle thickness is analyzed in transversus abdominis, internal oblique, external oblique, and rectus abdominis with ultrasound imaging at rest and during the hypopressive exercise (HE) in supine and standing position. Comparisons between rest and hypopressive exercise are carried out in the two different positions and between women and men. In the supine position, there is a significant activation of the transversus abdominis and internal oblique during hypopressive exercise (p < 0.001), and it is similar in both sexes, the external oblique is only activated significantly by men (p < 0.001) and rectus abdominis had no significant activation (p > 0.05). Our results show that standing transversus abdominis and external oblique significantly increased their thickness during HE with higher effects in men. Internal oblique also increased significantly, but with higher effects in women, and rectus abdominis had no significant increase. Men had similar effects to women during HE, with an activation of the deepest abdominal muscles. The unequal anatomy and the position could explain the different results obtained between the sexes.


1994 ◽  
Vol 77 (3) ◽  
pp. 1393-1398 ◽  
Author(s):  
A. M. Leevers ◽  
J. D. Road

We previously found the internal abdominal muscle layer to be preferentially recruited during expiratory threshold loading in anesthetized and awake dogs. Expiratory threshold loading increases end-expiratory lung volume and hence can activate reflex pathways such as tonic vagal reflexes, which could influence abdominal muscle recruitment. Our objectives in the present study were to determine the effects of hypercapnia on abdominal muscle activation and the pattern of recruitment in awake dogs. Five tracheotomized dogs were chronically implanted with sonomicrometer transducers and fine-wire electromyogram (EMG) electrodes in each of the four abdominal muscles: transversus abdominis, internal oblique, external oblique, and rectus abdominis. Muscle length changes and EMG activity were studied in the awake dog at rest and during CO2 rebreathing. CO2 rebreathing produced a tripling of tidal volume and activation of the abdominal muscles. Despite the increase in tidal volume, there was no significant change in abdominal muscle end-inspiratory length. Both tonic and phasic expiratory shortening were greater in the internal muscle layer (transversus abdominis and internal oblique) than in the external muscle layer (external oblique and rectus abdominis). We conclude that the internal abdominal muscles are preferentially recruited by hypercapnia and vagal reflexes probably do not contribute to this differential recruitment but that segmental reflexes may be involved. The mechanical consequences of this recruitment are discussed.


2000 ◽  
Vol 88 (4) ◽  
pp. 1207-1214 ◽  
Author(s):  
Donald C. Bolser ◽  
Paul J. Reier ◽  
Paul W. Davenport

The present study was conducted to determine the pattern of activation of the anterolateral abdominal muscles during the cough reflex. Electromyograms (EMGs) of the rectus abdominis, external oblique, internal oblique, transversus abdominis, and parasternal muscles were recorded along with gastric pressure in anesthetized cats. Cough was produced by mechanical stimulation of the lumen of the intrathoracic trachea or larynx. The pattern of EMG activation of these muscles during cough was compared with that during graded expiratory threshold loading (ETL; 1–30 cmH2O). ETL elicited differential recruitment of abdominal muscle EMG activity (transversus abdominis > internal oblique > rectus abdominis ≅ external oblique). In contrast, both laryngeal and tracheobronchial cough resulted in simultaneous activation of all four anterolateral abdominal muscles with peak EMG amplitudes 3- to 10-fold greater than those observed during the largest ETL. Gastric pressures during laryngeal and tracheobronchial cough were at least eightfold greater than those produced by the largest ETL. These results suggest that, unlike their behavior during expiratory loading, the anterolateral abdominal muscles act as a unit during cough.


1993 ◽  
Vol 75 (4) ◽  
pp. 1452-1459 ◽  
Author(s):  
A. M. Leevers ◽  
J. D. Road

The objective of this study was to examine the effects of posture on tonic and phasic expiratory activity of the abdominal muscles in awake dogs. Six tracheostomized dogs were chronically instrumented with sonomicrometer transducers and bipolar electromyographic electrodes placed in each of the four abdominal muscles. To determine the effects of posture on tonic and phasic activity of individual abdominal muscles, muscle resting length (Lr) and tidal length changes (%Lr), respectively, were measured in awake dogs in the left lateral decubitus (LLD), sitting, and standing (STAND) positions. The transversus abdominis Lr consistently shortened when the dog was moved from LLD to STAND and lengthened when the dog was moved from LLD to the sitting position, and the external oblique Lr consistently lengthened when the dog went from LLD to STAND. The internal oblique and rectus abdominis had no consistent changes in Lr with a change in position. All four abdominal muscles actively shortened (%Lr) more in the upright positions. In addition, the internal layer (transversus abdominis and internal oblique) actively shortened more than the external layer (rectus abdominis and external oblique). In conclusion, both tonic and phasic respiratory activity of the abdominal muscles, reflected by changes in Lr and %Lr, respectively, were affected by changes in posture.


Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 702
Author(s):  
Iria Da Cuña-Carrera ◽  
Alejandra Alonso-Calvete ◽  
Mercedes Soto-González ◽  
Eva M. Lantarón-Caeiro

Background and objective: Prior studies have reported an activation of abdominal muscles during hypopressive exercises in women with pelvic floor disfunction. However, no previous research analyzed the effects of hypopressive exercise on abdominal muscles in healthy populations to understand the normal biomechanics of this area. The aim of this study was to examine the thickness of abdominal muscles at rest and during hypopressive exercise in supine and standing positions with ultrasound imaging in healthy adults. Methods: A cross-sectional study was carried out in 99 healthy university students. The thickness of the abdominal muscles at rest and during hypopressive exercise was assessed with ultrasound imaging in supine and standing positions. Results: During hypopressive exercise, there was a significant increase in the muscle thickness of transversus abdominis (p < 0.001) and internal oblique (p < 0.001) in supine and standing positions. External oblique only increased its thickness significantly in the standing position (p < 0.001) and rectus abdominis did not change during the hypopressive exercise in any position (p > 0.05). In conclusion, hypopressive exercises seem to increase the thickness of the deepest and most stabilized muscles such as transversus abdominis and internal oblique. Conclusion: These findings should be considered for future interventions with hypopressive exercises in healthy subjects.


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