A comparison of the Effects on Abdominal Muscles between the Abdominal Drawing-in Maneuver and Maximal Expiration in Chronic Stroke Patients

Abstract

PURPOSE: Although the abdominal drawing-in maneuver is commonly used in clinical training for trunk stability, performing this procedure in stroke patients is difficult; instead, maximal expiration can be much easily performed in stroke patients. In the present study, we first aimed to demonstrate the effects of the abdominal drawing-in maneuver and maximal expiration on trunk stability in stroke patients. Moreover, we compared the thickness of the transverse abdominal, internal oblique, and external oblique muscles on the paretic and non-paretic sides. METHODS: We used ultrasonography to measure the change in the thickness of the transverse abdominal, internal oblique, and external oblique muscles on the paretic and non-paretic sides at rest, while performing the abdominal drawing-in maneuver, and while performing maximal expiration in 23 stroke patients. The ratio of muscle thickness between different conditions was estimated and included in the data analysis (abdominal drawing-in maneuver / at rest and, maximal expiration / at rest). RESULTS: The ratio of the thickness of the transverse abdominal, internal oblique and external oblique muscles during maximal expiration was significantly different on the paretic side (p 0.05). CONCLUSION: Our results suggest that maximal expiration more effectively increased the abdominal muscle thickness on the paretic side. Hence, we recommend the application of maximal expiration in clinical trunk stability training on the paretic side of stroke patients.