Effect of the abdominal draw-in manoeuvre in combination with ankle dorsiflexion in strengthening the transverse abdominal muscle in healthy young adults: A preliminary, randomised, controlled study

Journal of Athletic Training

Kim

et al. 2015

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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 ¼ 22.3 6 1.3 years, height ¼ 164.0 6 1.7 cm, mass ¼ 56.0 6 4.6 kg; 15 men: age ¼ 24.6 6 2.8 years, height ¼ 172.6 6 4.7 cm, mass ¼ 66.8 6 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 (t 18 ¼ 3.691, P ¼ .002) and erector spinae (t 18 ¼ 2.823, P ¼ .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 (t 18 range, 3.953-5.775, P , .001), an increased muscle-thickness ratio for the transverse abdominis (t 18 ¼ À2.327, P ¼ .03), and a reduction in external oblique muscle activity (t 18 ¼ 3.172, P ¼ .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.Key Words: center of pressure, core stabilization, formal test Key PointsStatic core stability and unipedal postural stability were enhanced in nonathletes with core instability after abdominal drawing-in maneuver training augmented with rehabilitation ultrasound imaging and electromyographic feedback. Abdominal drawing-in maneuver training using rehabilitation ultrasound imaging and electromyography effectively improved morphologic changes in transverse abdominis muscle thickness and the neuromuscular pattern of an overactive superficial external oblique muscle, contributing to static core stability and unipedal postural stability. Researchers should further investigate the relationship between dynamic core and unipedal postural sta...

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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

Lee

Journal of Athletic Training

Kim

et al. 2015

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“…Prior to electrode placement, the surface of the skin was cleaned with alcohol. EMG electrodes (with 1-cm inter-electrode spacing) were placed approximately 3 cm lateral to the umbilicus to record rectus abdominis activity, approximately 2 cm horizontally inward and distal to the anterior superior iliac spine (ASIS) to record TrA/IO activity, and laterally halfway between the lower rib cage and the iliac crest to record EO activity on the dominant side [8,9]. EMG data were acquired at a sampling rate of 1500 Hz and band-pass filtered at 20-450 Hz.…”

Section: Materials and Proceduresmentioning

confidence: 99%

Reflex-mediated dynamic neuromuscular stabilization in stroke patients: EMG processing and ultrasound imaging

Hyun-Sun

2017

THC

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Abstract. BACKGROUND:Postural core instability is associated with poor dynamic balance and a high risk of serious falls. Both neurodevelopmental treatment (NDT) and dynamic neuromuscular stabilization (DNS) core stabilization exercises have been used to improve core stability, but the outcomes of these treatments remain unclear. OBJECTIVE: This study was undertaken to examine the therapeutic effects of NDT and DNS core stabilization exercises on muscular activity, core stability, and core muscle thickness. METHODS: Ten participants (5 healthy adults; 5 hemiparetic stroke patients) were recruited. Surface electromyography (EMG) was used to determine core muscle activity of the transversus abdominis/internal oblique (TrA/IO), external oblique (EO), and rectus abdominis (RA) muscles. Ultrasound imaging was used to measure transversus abdominals/internal oblique (TrA/IO) thickness, and a pressure biofeedback unit (PBU) was used to measure core stability during the DNS and NDT core exercise conditions. Data are reported as median and range and were compared using nonparametric Mann -Whitney U test and Wilcoxon signed rank test at p < 0.05. RESULTS: Both healthy and hemiparetic stroke groups showed greater median EMG amplitude in the TrA/IO muscles, core stability, and muscle thickness values during the DNS exercise condition than during the NDT core exercise condition, respectively (p < 0.05). However, the relative changes in the EMG amplitude, core stability, and muscle thickness values were greater during the DNS exercise condition than during the NDT core exercise condition in the hemiparetic stroke patient group (p < 0.05). CONCLUSIONS: Our novel results provide the first clinical evidence that DNS is more effective than NDT in both healthy and hemiparetic stroke subjects to provide superior deep core muscle activation, core stabilization, and muscle thickness. Moreover, such advantageous therapeutic benefits of the DNS core stabilization exercise over the NDT exercise were more apparent in the hemiparetis stroke patients than normal controls.

“…16 This approach was derived from the concept of irradiation in proprioceptive neuromuscular facilitation, which emphasizes the important contribution of the relatively stronger distal muscle group by increasing the number of potential motor-unit recruit-ments involved or weakened. Chon et al 16 reported that the coactivation of the ankle dorsiflexors and rectus femoris (RF) muscles effectively augmented the selective activation of the TrA muscle, as demonstrated by an increased mean electromyographic (EMG) amplitude of the TrA/IO muscles after the resisted ankle dorsiflexion. The EMG analysis showed that a strong contraction of the dorsiflexion muscles, specifically the tibialis anterior (TA), improved motor recruitment of the TrA/IO muscles during the ADIM.…”

mentioning

confidence: 99%

Cocontraction of Ankle Dorsiflexors and Transversus Abdominis Function in Patients With Low Back Pain

Journal of Athletic Training

Saliba

2012

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