Effect of the Abdominal Draw-In Maneuver and Bracing on Abdominal Muscle Thickness and the Associated Subjective Difficulty in Healthy Individuals.

Sachiko Madokoro,Masami Yokogawa,Hiroichi Miaki

doi:10.3390/healthcare8040496

Abstract

We evaluated the trunk abdominal muscle thickness while performing different exercises to identify the most effective training and to investigate the subjective difficulty associated with exercising. Twenty-eight men (mean age: 21.6 ± 0.9 years) without orthopedic diseases were enrolled. Ultrasonic imaging was used to measure the thickness of the transversus abdominis (TA), internal oblique, and external oblique muscles while at rest and while performing the abdominal draw-in maneuver and abdominal bracing. Measurements were made in the supine and sitting positions, and the subjective difficulty in performing each exercise was examined using a 5-level evaluation scale. The TA and internal oblique muscle thicknesses were significantly greater during the abdominal draw-in maneuver (ADIM) than during bracing or resting, in the supine and sitting positions. The subjective difficulty of abdominal bracing (AB) was graded significantly higher than that of ADIM. Additionally, a correlation between subjective difficulty and muscle thickness was found for the TA and IO. Our results may contribute to the choice of more effective exercises for spinal stability.

Highlights

Spinal stabilization exercises improve spinal stability by improving trunk muscle coordination and anchoring the deep musculature, which prevents overactivity by the superficial musculature [1,2].Meta-analyses have shown that spinal stabilization exercises are among the most effective forms of physiotherapy for improving lower back pain [3,4]
In both the supine and sittign positions, abdominal bracing (AB) exercise was rated as significantly more difficult compared to abdominal draw-in maneuver (ADIM) (Table 1)
We predicted that the subjective difficulty of stability exercises would vary widely, but the results of this study showed that AB exercise was more difficult

Summary

Introduction

Spinal stabilization exercises improve spinal stability by improving trunk muscle coordination and anchoring the deep musculature, which prevents overactivity by the superficial musculature [1,2]. Meta-analyses have shown that spinal stabilization exercises are among the most effective forms of physiotherapy for improving lower back pain [3,4]. The deep musculature consists of the transversus abdominis (TA), internal oblique (IO) muscles, multifidus, diaphragm, and pelvic floor muscles, which comprise the so-called “inner unit” [5]. Various spinal stabilization exercises have been proposed. Abdominal draw-in maneuver (ADIM) is one such exercise that increases the activity of these muscles. Many previous studies have shown that it is effective for alleviating back pain [6,7,8]. Gorbet et al [9] divided their participants into asymptomatic low back pain patients and healthy individuals using the Oswestry

Objectives

Discussion

Conclusion