Browse > Article
http://dx.doi.org/10.13066/kspm.2016.11.1.53

The effect of abdominal drawing-in maneuver and pelvic floor muscle contraction in individuals with and without low back pain  

Youn, Hye-Jin (Department of Physical Therapy, Bonifacio Hospital)
Kim, Ji-Seon (Department of Physical Therapy, College of Health, Kyungwoon University)
Publication Information
Journal of the Korean Society of Physical Medicine / v.11, no.1, 2016 , pp. 53-60 More about this Journal
Abstract
PURPOSE: This study aimed to identify differences in the thickness of the transverse abdominis (TrA) and pelvic floor muscles (PFM) between those with (LBP) and without low back pain (non-LBP). The standardized methods of contraction for the TrA and PFM were used to perform the abdominal draw-in maneuver (ADIM) and pelvic floor muscle contraction (PFC), respectively. METHODS: This study included 27 young men and women, who were verbally instructed regarding the maneuvers (LBP, n=14; non-LBP, n=13). For all subjects, TrA and PFM thickness were evaluated by ultrasonography during ADIM and PFC. RESULTS: The results of this study showed that TrA thickness increased during ADIM and PFC to a greater degree in the non-LBP group than in the LBP group (p < 0.01). PFM thickness increased more during PFC in the non-LBP group than in the LBP group (p < 0.05). Both groups showed greater increases in TrA thickness during ADIM than during PFC (p < 0.01), and greater increases in PFM thickness during PFC than during ADIM (p < 0.05). CONCLUSION: These results suggest that receiving verbal instructions on how to use each muscle for a specific maneuver was more beneficial than other verbal instruction. Further studies are needed determine how our results may be applied beneficially in research on this topic.
Keywords
Abdominal drawing-in maneuver; Low back pain; Pelvic floor muscle; Transverse abdominis; Ultrasonography;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Macedo LG, Maher CG, Latimer J et al. Motor control exercise for persistent, nonspecific low back pain: a systematic review. Phys Ther. 2009;89(1):9-25.   DOI
2 Maurits NM, Beenakker EA, van Schaik DE et al. Muscle ultrasound in children: normal values and application to neuromuscular disorders. Ultrasound Med Biol. 2004;30(8):1017-27.   DOI
3 McMeeken JM, Beith ID, Newham DJ et al. The relationship between EMG and change in thickness of transversus abdominis. Clin Biomech (Bristol, Avon). 2004;19(4):337-42.   DOI
4 Neumann P, Gill V. Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(2):125-32.   DOI
5 Nourbakhsh MR, Arab AM. Relationship between mechanical factors and incidence of low back pain. J Orthop Sports Phys Ther. 2002;32(9):447-60.   DOI
6 Richardson CA, Hides JA, Wilson S et al. Lumbo-pelvic joint protection against antigravity forces: motor control and segmental stiffness assessed with magnetic resonance imaging. J Gravit Physiol. 2004;11(2):pp.119-22.
7 Richardson CA, Jull GA. Muscle control-pain control. What exercises would you prescribe? Man Ther. 1995; 1(1):2-10.   DOI
8 Sapsford R. Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Man Ther. 2004;9(1):3-12.   DOI
9 Sapsford RR, Hodges PW. Contraction of the pelvic floor muscles during abdominal maneuvers. Arch Phys Med Rehabil. 2001;82(8):1081-8.   DOI
10 Sapsford RR, Hodges PW, Richardson CA et al. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn. 2001;20(1):31-42.   DOI
11 Sherburn M, Murphy CA, Carroll S et al. Investigation of transabdominal real-time ultrasound to visualise the muscles of the pelvic floor. Aust J Physiother. 2005;51(3):167-70.   DOI
12 Shumway-Cook A, Horak FB. Rehabilitation strategies for patients with vestibular deficits. Neurol Clin. 1990;8(2):441-57.   DOI
13 Tertti MO, Salminen JJ, Paajanen HE et al. Low-back pain and disk degeneration in children: a case-control MR imaging study. Radiology. 1991;180(2):503-7.   DOI
14 Teyhen DS, Miltenberger CE, Deiters HM et al. The use of ultrasound imaging of the abdominal drawing-in maneuver in subjects with low back pain. Orthop Sports Phys Ther. 2005;35(6):346-55.   DOI
15 Thompson JA, O'Sullivan PB, Briffa K et al. Assessment of pelvic floor movement using transabdominal and transperineal ultrasound. Int Urogynecol J Pelvic Floor Dysfunct. 2005;16(4):285-92.   DOI
16 Thompson JA, O'Sullivan PB, Briffa NK et al. Comparison of transperineal and transabdominal ultrasound in the assessment of voluntary pelvic floor muscle contractions and functional manoeuvres in continent and incontinent women. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(7):779-86.   DOI
17 Urquhart DM, Hodges PW, Story IH. Postural activity of the abdominal muscles varies between regions of these muscles and between body positions. Gait Posture. 2005;22(4):295-301.   DOI
18 Waddell G. Low back pain: a twentieth century health care enigma. Spine. 1996;21(24):2820-5.   DOI
19 Arab AM, Behbahani RB, Lorestani L et al. Assessment of pelvic floor muscle function in women with and without low back pain using transabdominal ultrasound. Man Ther. 2010;15(3):235-9.   DOI
20 Arab AM, Behbahani RB, Lorestani L et al. Correlation of digital palpation and transabdominal ultrasound for assessment of pelvic floor muscle contraction. J Man Manip Ther. 2009;17(3):e75-9.   DOI
21 Barr KP, Griggs M, Cadby T. Lumbar stabilization: a review of core concepts and current literature, part 2. Am J Phys Med Rehabil. 2007;86(1):72-80.   DOI
22 Barr KP, Griggs M, Cadby T. Lumbar stabilization: core concepts and current literature, Part 1. Am J Phys Med Rehabil. 2005;84(6):473-80.   DOI
23 Beazell JR, Grindstaff TL, Hart JM et al. Changes in lateral abdominal muscle thickness during an abdominal drawing-in maneuver in individuals with and without low back pain. Res Sports Med. 2011;19(4):271-82.   DOI
24 Bo K, Sherburn M, Allen T. Transabdominal ultrasound measurement of pelvic floor muscle activity when activated directly or via a transversus abdominis muscle contraction. Neurourol Urodyn. 2003;22(6):582-8.   DOI
25 Bo K, Sherburn M. Evaluation of female pelvic-floor muscle function and strength. Phys Ther. 2005;85(3):269-82.
26 Fordyce WE, Brockway JA, Bergman JA et al. Acute back pain: a control-group comparison of behavioral vs traditional management methods. J Behav Med. 1986;9(2):127-40.   DOI
27 Cooper RG, St Clair Forbes W, Jayson MI. Radiographic demonstration of paraspinal muscle wasting in patients with chronic low back pain. Br J Rheumatol. 1992;31(6):389-94.   DOI
28 Deyo RA, Mirza SK, Martin BI. Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002. Spine. 2006;31(23):2724-7.   DOI
29 Ehrlich GE. Low back pain. Bull World Health Organ. 2003;81(9):671-6.
30 Gill K, Krag MH, Johnson GB et al. Repeatability of four clinical methods for assessment of lumbar spinal motion. Spine. 1988;13(1):50-3.   DOI
31 Graves JE, Pollock ML, Carpenter DM et al. Quantitative assessment of full range-of-motion isometric lumbar extension strength. Spine. 1990;15(4):289-94.   DOI
32 Henderson JW, Wang S, Egger MJ et al. Can women correctly contract their pelvic floor muscles without formal instruction? Female Pelvic Med Reconstr Surg. 2013;19(1):8-12.   DOI
33 Hides J, Wilson S, Stanton W et al. An MRI investigation into the function of the transversus abdominis muscle during "drawing-in" of the abdominal wall. Spine. 2006;31(6):E175-8.   DOI
34 Hodges PW, Eriksson AE, Shirley D et al. Intra-abdominal pressure increases stiffness of the lumbar spine. J Biomech. 2005;38(9):1873-80.   DOI
35 Hodges PW, Gandevia SC. Activation of the human diaphragm during a repetitive postural task. J Physiol. 2000;522 Pt 1:165-75.   DOI
36 Hodges PW, Sapsford R, Pengel LH. Postural and respiratory functions of the pelvic floor muscles. Neurourol Urodyn. 2007;26(3):362-71.   DOI
37 Hodges PW, Pengel LH, Herbert RD et al. Measurement of muscle contraction with ultrasound imaging. Muscle Nerve. 2003;27(6):682-92.   DOI
38 Hodges PW, Richardson CA. Contraction of the abdominal muscles associated with movement of the lower limb. Phys Ther. 1997;77(2):132-42; discussion 142-4.   DOI
39 Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine. 1996;21(22):2640-50.   DOI
40 Hodges PW. Is there a role for transversus abdominis in lumbo-pelvic stability? Man Ther. 1999;4(2):74-86.   DOI
41 Hodges PW. Ultrasound imaging in rehabilitation: just a fad? J Orthop Sports Phys Ther. 2005;35(6):333-7.   DOI
42 Johannsen F, Remvig L, Kryger P et al. Exercises for chronic low back pain: a clinical trial. J Orthop Sports Phys Ther. 1995;22(2):52-9.   DOI
43 Jull GA, Richardson CA. Motor control problems in patients with spinal pain: a new direction for therapeutic exercise. J Manipulative Physiol Ther. 2000;23(2):115-7.   DOI
44 Kelly M, Tan BK, Thompson J et al. Healthy adults can more easily elevate the pelvic floor in standing than in crook-lying: an experimental study. Aust J Physiother. 2007;53(3):187-91.   DOI
45 Loukas M, Shoja MM, Thurston T et al. Anatomy and biomechanics of the vertebral aponeurosis part of the posterior layer of the thoracolumbar fascia. Surg Radiol Anat. 2008;30(2):125-9.   DOI