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

Abstract

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.

Electromyographic Comparison of an Abdominal Rise on a Ball with a Traditional Crunch

“…When performing an ARB, the lifting of the body is due to the coordinated work of the IO, EO, and TrA muscles, which form the abdominal wall at the front of the trunk and, together with the pelvic floor muscles and diaphragm, control intra-abdominal pressure (IAP) [10,20,34]. Due to the high activity levels of IO, EO, and TrA in the ARB, it can be argued that the IAP is large during exercise and can reduce or even neutralize the influence of EC on the compressive force in the lumbar spine in the upright body position, as shown by Stokes, Gardener-Morse, and Henry [35].…”

“…When you lie prone on the ball, your body weight pushes your abdominal wall against your spine. As you increase IAP, the outward tension shifts the abdominal wall outward [20] and lifts the body. This means that the abdominal muscles work as in dynamic exercises, while the spine is loaded as in static exercises and maintains its neutral posture.…”

Comparison of yoga and dynamic neuromuscular stabilization exercise in chronic low back pain on magnetic resonance imaging of lumbar multifidus- protocol for a randomized controlled trial

“…It will involve a supine 3month Position, side-lying Position, Quadruped, oblique sitting, bear position, squat Position. Each position will be performed for 30–60 s for five reps, active exercise 5–10 reps under supervision for two days/week, and unsupervised for two days/week for 12 weeks [ [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] ].…”

Postural-respiratory function of the diaphragm assessed by M-mode ultrasonography

“…Furthermore, ultrasound imaging of the diaphragm is highly operator-dependent and position-dependent, and therefore the experience of the operator is crucial for obtaining suitable images. For a more complete understanding, we combined ultrasonographic assessment with spirometry and evaluation of abdominal wall tension (AWT) by a device called DNS Brace, which is designed to indirectly monitor IAP changes [ 34 , 35 ].…”