Abdominal Expansion versus Abdominal Drawing-In Strategy on Thickness and Electromyography of Lumbar Stabilizers in People with Nonspecific Low Back Pain: A Cross-Sectional Study.

Yi-Liang Kuo,Chieh-Yu Kao,Yi-Ju Tsai

doi:10.3390/ijerph18094487

Abstract

The abdominal expansion (AE) strategy, involving eccentric contraction of the abdominal muscles, has been increasingly used in clinical practices; however, its effects have not been rigorously investigated. This study aimed to investigate the immediate effects of the AE versus abdominal drawing-in (AD) strategy on lumbar stabilization muscles in people with nonspecific low back pain (LBP). Thirty adults with nonspecific LBP performed the AE, AD, and natural breathing (NB) strategies in three different body positions. Ultrasonography and surface electromyography (EMG) were, respectively, used to measure the thickness and activity of the lumbar multifidus and lateral abdominal wall muscles. The AE and AD strategies showed similar effects, producing higher EMG activity in the lumbar multifidus and lateral abdominal wall muscles when compared with the NB strategy. All muscles showed higher EMG activity in the quiet and single leg standing positions than in the lying position. Although the AE and AD strategies had similar effects on the thickness change of the lumbar multifidus muscle, the results of thickness changes of the lateral abdominal muscles were relatively inconsistent. The AE strategy may be used as an alternative method to facilitate co-contraction of lumbar stabilization muscles and improve spinal stability in people with nonspecific LBP.

Highlights

Spinal instability is an important cause of lower back pain (LBP) [1,2]
We examined the effects of the abdominal expansion (AE) strategy in different postural conditions because postural demand may influence muscle contractions
No significant differences were observed in MF muscle thickness and EMG activity during the AE and abdominal drawing-in (AD) strategies (Table 3)

Summary

Introduction

The abdominopelvic cavity is surrounded by the diaphragm superiorly, transverses abdominis (TrA) anteriorly, lumbar multifidus (MF) posteriorly, and pelvic floor muscles inferiorly. Once activated, these deep muscles can provide stability to the spine by increasing intraabdominal pressure [3]. Fatty infiltration, and neural inhibition of the TrA and MF muscles among people with LBP [4,5]. They reported reduced mobility of the diaphragm and reduced respiratory muscle endurance [6]. These changes have a destabilizing influence on the spine and may result in chronic and/or recurrent symptoms in people with LBP

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