Abdominal SEMG Feedback for Diaphragmatic Breathing: A Methodological Note

Abstract

Diaphragmatic breathing from a developmental perspective is a whole-body process. During exhalation, the abdominal wall contracts, and during inhalation, the abdominal wall relaxes. This pattern is often absent in many clients who tend to lift their chest when they inhale and do not expand their abdomen. Even if their breathing includes some abdominal movement, in many cases only the upper abdomen above the belly button moves while the lower abdomen shows limited or no movement. This article describes factors that contribute to the lack of abdominal movement during breathing, as well as a methodology to record the surface electromyography (SEMG) activity from the lower abdominal muscles (external/internal abdominal oblique and transverse abdominis). Strategies are presented to teach clients how to engage the lower abdominal muscles to facilitate effortless breathing. For example, when the person exhales, the lower abdominal muscles contract to flatten the abdomen and push the diaphragm upward, and these muscle relax during inhalation to allow the diaphragm to descend. Lower abdominal SEMG recording can also be used as a surrogate indicator for SEMG activity from the pelvic floor. To enhance activation of the lower abdominal muscles during a breathing cycle, specific exercises are described. In summary, lower abdominal SEMG feedback is a useful strategy to facilitate complete abdominal involvement during breathing.

Pulmonary rehabilitation in the intensive care unit using surface electromyography in a patient with diaphragmatic injury: A case report

“…[ 14 ] Our aim was not to record the muscle activity of the diaphragm but to provide visual biofeedback to the patient by confirming the muscle contraction and relaxation of the abdomen in real time instead of the contraction and relaxation of the diaphragm that occurs during the DB. According to Peper et al,[ 9 ] DB can be effectively performed using visual sEMG biofeedback. The patient was unaware of shoulder and chest lifting with inhalation during conventional DB training, and control was difficult.…”

“…Electrodes were placed bilaterally over the lower abdominal muscles 1 cm medial to the anterior superior iliac spines. [ 9 ] Electrodes were not attached to the diaphragm since it is difficult to record the signal when noise occurs due to ICU monitoring devices and equipment. Moreover, it was challenging to secure an electrode attachment site due to dressings after exploratory laparotomy for the abdomen.…”

How a Chronic Headache Condition Became Resolved with One Session of Breathing and Posture Coaching

“…With verbal and tactile coaching, she learned slower diaphragmatic breathing, where she gently and slowly exhaled by making a sound of pssssssst (exhaling through pursed lips), which tends to activate transverse and oblique abdominal muscles as well as tighten the pelvic floor muscles so that her lower abdomen would slightly come in at the end of the exhalation (Peper et al, 2016b). The inhalation occurred by allowing the lower abdomen and pelvic floor to relax so that the abdomen would expand in 360 degrees 1 .…”

Piv

“…-Abdomen. When a practitioner teaches abdominal breathing, they often touch the patient's abdomen or encourage them to place their hands on their abdomen to feel if it is moving [62]. We adopted this idea, and chose points roughly one-third of the way along a line from the umbilicus to the anterior superior iliac spine.…”