Abstract

The current study explored whether (i) abdominal muscle thickness differed between non-painful supine and painful sitting positions and (ii) the sitting position was more reliable and useful than the supine position to discriminate between people with and without prolonged sitting-induced lower back pain (LBP). Participants with and without prolonged sitting-induced LBP participated. The thickness of the transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles was measured using ultrasonography in supine, usual sitting, and upright sitting positions. Analysis of variance was used to compare muscle thickness among the positions. Intraclass correlation coefficients and receiver operating characteristic curves were used to determine which position reliably identified between group. The group with LBP showed significantly greater EO muscle thickness than that without LBP only in the upright sitting position. In the group without LBP, the TrA thickness was significantly greater in the usual and upright sitting positions than in the supine position, but there was no significant difference in TrA thickness among three positions in LBP group. Only EO thickness in the upright sitting position significantly predicted prolonged sitting-induced LBP. The current study suggests that clinicians should assess abdominal activation patterns in the upright sitting rather than supine position before applying abdominal muscle motor control training for patients with prolonged sitting-induced LBP, and to distinguish between those with and without prolonged sitting-induced LBP.

Highlights

  • The current study explored whether (i) abdominal muscle thickness differed between non-painful supine and painful sitting positions and (ii) the sitting position was more reliable and useful than the supine position to discriminate between people with and without prolonged sitting-induced lower back pain (LBP)

  • An ultrasonographic study found that people without LBP showed greater automatic activation of the transversus abdominis (TrA) in an upright sitting position than in a supine position, whereas no difference in TrA thickness was found between people with and without LBP in the supine and upright sitting ­positions[6]

  • The differences in muscle thickness were notable in three main respects: (i) the LBP group showed greater external oblique (EO) thickness than healthy controls only in upright sitting, not in the non-painful supine position; (ii) measurement of EO thickness in the upright sitting position can reliably distinguish between individuals with and without LBP; and (iii) assessment of TrA activation motor control using ultrasonography should be performed in an upright sitting rather than supine position, especially in individuals with LBP provoked by prolonged sitting

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Summary

Introduction

The current study explored whether (i) abdominal muscle thickness differed between non-painful supine and painful sitting positions and (ii) the sitting position was more reliable and useful than the supine position to discriminate between people with and without prolonged sitting-induced lower back pain (LBP). No study has demonstrated that a sitting position is the most suitable pain-provoking position for assessing abdominal muscle activation patterns of people in whom LBP is provoked by prolonged sitting. The purpose of the current study was to (i) explore whether, for participants with LBP provoked by prolonged sitting, the thickness of the TrA, EO, and IO muscles differed between the supine (non-painful) and usual and upright sitting (painful) positions, and (ii) determine which position is most reliable for distinguishing between people with and without prolonged sitting-induced LBP

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