Changes in Transversus Abdominis Thickness With Use of the Abdominal Drawing‐In Maneuver During a Functional Task

Abstract

Subjects in this study demonstrated the ability to voluntarily activate the TrA during upright static and functional tasks. Additionally, the TrA thickness may change in a direction-specific manner. These findings support a protective role of the ADIM during functional activity and may add information to ways for promoting low back pain prevention. Future studies should include the effectiveness in the use of ADIM during functional tasks for the prevention of low back pain.

Changes in Muscle Thickness After Exercise and Biofeedback in People With Low Back Pain

“…The ADIM has been found to increase muscle thickness during a standing task and may provide additional stabilization. 27 We are unable to conclude if multiple training sessions or voluntary activation of the abdominal muscles would provide additional support to the lumbar spine. Ultrasound imaging was using in the current study to measure muscle thickness, and while ultrasound has been found to be correlated with electromyographic activity, 24 ultrasound imaging is only able to observe muscle activation through thickness changes and may not provide information about the onset or timing of muscle activation.…”

“…Standing measures of muscle function of abdominal-muscle thickness in gravity-loaded positions have been observed to be both reproducible 33 and reliable. 26,27,32,33 Since the PAR is a ratio of the TrA thickness in comparison with the entire lateral wall between contracted and resting states, any increase in PAR could indicate an increased ability to activate the TrA independently from the other abdominal muscles. The current findings indicate that individuals with a history of LBP can increase TrA PAR in a standing position after a single bout of exercise, and the addition of biofeedback may have a greater effect on TrA PAR (Table 5).…”

“…Incorporation of the ADIM while standing in healthy individuals has been previously shown to increase TrA thickness in a functional task. 27 The current participants were not asked to perform the ADIM in the standing position, so it is unknown if the voluntary activation during weightbearing positions would have additional influence on TrA PAR in patients with a history of LBP. The current results provide preliminary evidence to support the use of measuring muscle function in standing positions in individuals with a history of LBP that could lead to the development of rehabilitation strategies incorporating TrA-activation training during functional positions.…”

“…Resting standing measurements of the TrA and LM were taken bilaterally with participants positioned in quiet standing with their arms at their sides ( Figure 3). 27 Ultrasound-transducer placements for the TrA and LM were applied using the markings from the tabletop positions. Measurements for the TrA occurred when the fascial border of the TrA was on the lateral portion of the ultrasound screen, as previously measured in the tabletop position.…”

“…24 Clinical methods for improving activation of the TrA and LM using several forms of biofeedback increase activation of the TrA and LM during non-weight-bearing positions 25 ; however, the current literature regarding activation of local stabilizing musculature during functional tasks is limited. 21,[26][27][28][29][30][31][32][33][34][35][36] Translation of activation patterns learned during tabletop exercises to weight-bearing positions is an important component of rehabilitation progression in patients with LBP. The purpose of this study was to determine if exercise in isolation or the use of visual, verbal, and tactile biofeedback during TrA and LM muscle-activation exercises would increase TrA PAR and LM-muscle thickness in patients with a history of LBP during functional weight-bearing positions.…”