Functional postural-stabilization tests according to Dynamic Neuromuscular Stabilization approach: Proposal of novel examination protocol

Kobesová, Alena; Davidek, Pavel; Morris, Craig E.; Andel, Ross; Maxwell, Michael; Oplatkova, Lenka; Šafářová, Marcela; Kumagai, Kathy; Kolář, Pavel

doi:10.1016/j.jbmt.2020.01.009

Cited by 16 publications

(19 citation statements)

References 34 publications

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“…In clinical practice, palpation of the abdominal wall tension (AWT), especially in the area above the inguinal ligament and in the upper trigonum lumbale is used to evaluate an individual's ability to regulate their IAP (Kobesova et al, 2020). Available studies suggest that the AWT occurs as a result of increased IAP (Cresswell, 1993;Kumar et al, 2012;Tayebi et al, 2021;van Ramshorst et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Intra-abdominal pressure correlates with abdominal wall tension during clinical evaluation tests

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Jačiško

Busch

et al. 2021

Clinical Biomechanics

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Background:The abdominal muscles play an important respiratory and stabilization role, and in coordination with other muscles regulate the intra-abdominal pressure stabilizing the spine. The evaluation of postural trunk muscle function is critical in clinical assessments of patients with musculoskeletal pain and dysfunction. This study evaluates the relationship between intra-abdominal pressure measured as anorectal pressure with objective abdominal wall tension recorded by mechanical-pneumatic-electronic sensors. Methods: In a cross-sectional observational study, thirty-one asymptomatic participants (mean age = 26.77 ± 3.01 years) underwent testing to measure intra-abdominal pressure via anorectal manometry, along with abdominal wall tension measured by sensors attached to a trunk brace (DNS Brace). They were evaluated in five different standing postural-respiratory situations: resting breathing, Valsalva maneuver, Müller's maneuver, instructed breathing, loaded breathing when holding a dumbbell. Findings: Strong correlations were demonstrated between anorectal manometry and DNS Brace measurements in all scenarios; and DNS Brace values significantly predicted intra-abdominal pressure values for all scenarios: resting breathing (r = 0.735, r 2 = 0.541, p < 0.001), Valsalva maneuver (r = 0.836, r 2 = 0.699, p < 0.001), Müller's maneuver (r = 0.651, r 2 = 0.423, p < 0.001), instructed breathing (r = 0.708, r 2 = 0.501, p < 0.001), and loaded breathing (r = 0.921, r 2 = 0.848, p < 0.001). Interpretation: Intra-abdominal pressure is strongly correlated with, and predicted by abdominal wall tension monitored above the inguinal ligament and in the area of superior trigonum lumbale. This study demonstrates that intra-abdominal pressure can be evaluated indirectly by monitoring the abdominal wall tension.

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Section: Introductionmentioning

confidence: 99%

Intra-abdominal pressure correlates with abdominal wall tension during clinical evaluation tests

Novák

Jačiško

Busch

et al. 2021

Clinical Biomechanics

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“…Although some of these methods can measure the core activity or even IAP quite accurately, most of them serve for research purpose rather than clinical practice because the procedures may be uncomfortable for the patient, invasive, time consuming and often difficult to interpret the results. In routine clinical practice subjective assessment via various clinical tests is the most common way to evaluate postural function of the trunk muscles [12,13].…”

Section: Introductionmentioning

confidence: 99%

“…One concept offering a complete set of clinical tests to evaluate closely inter-related postural-respiratory functions [14] is Dynamic Neuromuscular Stabilization (DNS) [13]. DNS is a functional diagnostic and therapeutic approach based on human ontogenesis applying principles of movement and posture development during the first years of a healthy individual's life [15,16].…”

Section: Introductionmentioning

confidence: 99%

“…DNS is a functional diagnostic and therapeutic approach based on human ontogenesis applying principles of movement and posture development during the first years of a healthy individual's life [15,16]. The complete set of DNS testing [13] captures the stereotype of postural stabilization and movement [17], respiratory pattern [14,18], functional joint centration [15] and segmental movement [19] The study was approved by the local ethics commit-56 tee (Protocol number 17954, 8.1. 2020, Ethics commit-57 tee of the Second Faculty of Medicine, Charles Uni-58 versity and University Hospital Motol, Prague, Czech 59 Republic).…”

Section: Introductionmentioning

confidence: 99%

“…tailed procedures described byKobesova et al 2020, 187 which include all signs of optimal and abnormal presentations[13].…”

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confidence: 99%

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Correlation between palpatory assessment and pressure sensors in response to postural trunk tests

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Stribrny

Novák

et al. 2021

IES

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BACKGROUND: The evaluation of postural trunk muscle function is a critical component of clinical assessment in patients with musculoskeletal pain and dysfunction. Postural activation of the trunk muscles has been evaluated by various methods. This study evaluates the correlation between subjective assessment of postural trunk muscle function with an objective measurement of abdominal wall expansion. METHODS: Twenty-five healthy participants (16 women, 9 men, age 22.4 years) were assessed. The subjective assessment was performed by two experienced Dynamic Neuromuscular Stabilization (DNS) clinicians evaluating the quality of trunk stabilization using five postural stability tests through palpation and observation. Interrater reliability was determined using an intraclass correlation coefficients (ICC). Objective measurement was performed using a new device (DNS Brace) which externally measures abdominal wall pressure. Spearman rank correlations were calculated for both palpation and observation measures with DNS Brace data. RESULTS: The interrater reliability (ICC2,k) estimates demonstrated moderate reliability in palpation measures for three DNS tests: Hip flexion test, Diaphragm test, & Intra-abdominal pressure regulation test (IAPRT) (ICC = 0.645–0.707). For observation measures, good reliability was found in IAPRT (ICC = 0.835), and three tests demonstrated moderate reliability: Hip flexion test, Diaphragm test, & Breathing Stereotype (ICC = 0.577–0.695). For the individual assessors, the correlations were largely smaller. CONCLUSION: Based on inter-rater reliability and DNS brace correlations with trained DNS professionals, the IAPRT, Diaphragm test, and Hip Flexion test may prove useful when assessing asymptomatic individuals. More research is needed in order to establish the utility of DNS brace and clinical testing both in asymptomatic and back pain populations. DNS tests must be supplemented by further examinations for definitive clinical decision making.

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The influence of rotational movement exercise on the abdominal muscle thickness and trunk mobility – Randomized control trial

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Szuścik-Niewiadomy

Kuszewski

et al. 2021

Journal of Bodywork and Movement Therapies

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Functional postural-stabilization tests according to Dynamic Neuromuscular Stabilization approach: Proposal of novel examination protocol

Cited by 16 publications

References 34 publications

Intra-abdominal pressure correlates with abdominal wall tension during clinical evaluation tests

Intra-abdominal pressure correlates with abdominal wall tension during clinical evaluation tests

Correlation between palpatory assessment and pressure sensors in response to postural trunk tests

The influence of rotational movement exercise on the abdominal muscle thickness and trunk mobility – Randomized control trial

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