• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.513-523
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• 2013

PURPOSE: The purpose of this study was to investigate characteristics of the forced pulmonary function test effect and abdominal muscles activation by combined complex exercise with abdominal drawing-in maneuver training of chronic stroke patients. METHODS: 14 post stroke patients(10 males and 4 females) involved voluntary this study and we divided two groups into CEG(complex exercise group) and CEAG (complex exercise and abdominal drawing-in maneuver group).(n=7, per goup). Each groups implicated the 2 times, 30minute exercises for 6 weeks a day. The CEAG performed the complex exercise 15 minutes and 15 minutes of abdominal drawing-in maneuver. For data analysis, the mean and standard deviation were estimated; non-parametric independent t-test was carried out. RESULTS: According to the study, in the combined complex exercise with abdominal drawing-in maneuver group, FVC and activation of transversus abdominis/internal oblique were statistically significant difference compared to the complex exercise group. CONCLUSION: These results indicate that the combined complex with abdominal drawing-in maneuver was efficient in enhancing abdominal muscles activation and pulmonary function of chronic stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.33-38
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• 2015

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). The ratio of muscle thicknesses on the non-paretic side was greater during maximal expiration than during the abdominal drawing-in maneuver, although this difference was not significant (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.

• The Journal of Korean Physical Therapy
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• v.24 no.1
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• pp.1-6
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• 2012

Purpose: The grip strength is influenced by various factors, such as position of the upper extremity, characteristics of the hand, and general physical condition. In this study, we investigated whether abdominal muscle activity in combination with the abdominal drawing-in maneuver has any effect on the grip strength in healthy young adults. Methods: This study included 31 healthy subjects (16 males, 15 females). We used surface electromyography and pressure bio-feedback unit for this experiment. All Subjects were placed in a cock-lying position with comfort and the grip strength was measured. On the following day, the pressure bio-feedback unit was placed beneath their fifth lumbar vertebra, and the, grip strength was measured again. This time, the measurement was taken while drawing-in their abdomen below the navel gently and gradually, while maintaining a neutral pelvic position. Results: The grip strength was significantly increased when subjects performed the drawing-in maneuver than when they were comfortable (p<0.05). In addition, activations of the rectus abdominal muscles significantly increased (p<0.05). Conclusion: In the current study, we found that abdominal muscle activity, in combination with the abdominal drawing-in maneuver, affected the grip strength, positively. Therefore, we suggest that this result should be considered when evaluating the grip strength.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.79-87
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• 2021

Objective: To compare the effects of lumbar dysfunction and balance when office workers with chronic back pain performed the abdominal drawing-in maneuver. Methods: A total of 16 office workers with chronic low back pain were included in this study. The participants were randomly divided into two groups: the general and abdominal drawing-in maneuver groups. The intervention was applied for 6 weeks, 3 times a week, 70 min per day. Participants in the general exercise group(n=8) performed the general physical therapy and lumbar flexibility exercise, whereas those in the abdominal drawing-in maneuver group(n=8) performed the general physical therapy and lumbar stabilization exercise using abdominal drawing-in maneuver(3 times/week for 6 weeks). All tests, were the Korean Oswestry disability index (KODI) and balance ability, were completed pre and post-intervention. Results: Significant improvements in the KODI and balance ability test were observed in the abdominal drawing-in exercise group (p<.05), whereas no significant changes (p>.05) were observed in the general exercise group. Conclusion: This study revealed that abdominal drawing-in maneuver can effectively improve the lumbar dysfunction and balance ability of office workers with chronic back pain.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.2
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• pp.49-56
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• 2020

PURPOSE: This study examined the difference in muscle activity of the trunk and legs during flat walking with or without an abdominal drawing-in maneuver. METHODS: This study was conducted on 15 healthy males and eight females who were attending D University in Busan. This experiment was conducted after 15 minutes of abdominal drawing-in training using a pressure biofeedback unit before the experiment, and the difference in the muscle activity of the trunk and legs during flat walking with or without an abdominal drawing-in technique was investigated. Surface electromyography was used, and the electrode attachment site was the right sternocleidomastoid muscle, splenius capitis muscle, rectus abdominis muscle, external abdominal oblique muscle, transverse abdominis muscle, erector spinae muscle, vastus medialis muscle, and vastus lateralis muscle (TM DTS, Noraxon, USA). The data were analyzed statistically using a paired t-test on SPSS version 18.0 (IBM). RESULTS: The muscle activity of the rectus abdominis muscle, external abdominal oblique muscle, transverse abdominis muscle, vastus medialis muscle were increased significantly and maintained more than walking without maintaining an abdominal drawing-in maneuver (p < .05). Moreover, muscle activity of the erector spinae muscle was decreased significantly and maintained more than walking without maintaining an abdominal drawing-in maneuver (p < .05). CONCLUSION: Maintaining an abdominal drawing-in maneuver during flat walking is more effective during walking training.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.33-40
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• 2016

PURPOSE: The purpose of this study was to determine the impact of stable and unstable surfaces on abdominal muscle thickness and changes in trunk muscle thickness in accordance with breathing methods during bridging exercises. METHODS: Bridging exercise on a stable surface, bridging exercise on an unstable surface, bridging exercise using a drawing-in maneuver on a stable surface, bridging exercise using a drawing-in maneuver on an unstable surface, bridging exercise using bracing on a stable surface, bridging exercise using bracing on an unstable surface. In sequence, the muscles' thickness was measured three times before and after each exercise, and the measured value was averaged. RESULTS: There were significant differences in internal oblique and transversus abdominis muscles' thickness in the drawing-in maneuver in both stable and unstable surface (p<0.05). There were no significant differences in external oblique muscle's thickness in the bridging exercise in both stable and unstable surface. The type of surface did not have a significant influence on the abdominal muscles' thickness. CONCLUSION: As a result of the study, the drawing-in maneuver had a greater effect than bridging or bracing maneuver on muscle thickness. We suggest that drawing-in maneuver will be more effective in a person with a weak abdominal muscle.

• The Journal of Korean Physical Therapy
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• v.34 no.5
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• pp.205-211
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• 2022

Purpose: This study investigated the effects of an intervention that combined the abdominal drawing-in maneuver and frequency-specific neuromuscular electrical stimulation on changes in trunk muscle activity, muscle fatigue, and balance in stroke patients. Methods: Thirty stroke patients were randomly assigned to two groups. Fifteen subjects were assigned to group I which performed the abdominal drawing-in maneuver combined with low-frequency neuromuscular electrical stimulation and the other 15 subjects to group II where the abdominal drawing-in maneuver was combined with high-frequency neuromuscular electrical stimulation. Muscle activity and fatigue were measured using surface electromyography before the intervention. Balance was measured using the Trunk Impairment Scale and re-measured after six weeks of intervention for comparative analysis. Results: Both groups showed a significant increase in muscle activity and balance (p<0.05), and there was no significant difference between the groups (p>0.05). In the changes in muscle fatigue, only the experimental group II showed a significant increase in muscle fatigue (p<0.05). The difference between the groups was statistically significant (p<0.05). Conclusion: It was confirmed that among stroke patients, the combination of the abdominal drawing-in maneuver and low-frequency neuromuscular electrical stimulation was more effective in changing the muscle activity and balance of the trunk by minimizing the occurrence of muscle fatigue compared to the combination of the abdominal drawing-in maneuver and high-frequency stimulation. These results can be used as basic data for clinical trunk stabilization training.

• The Journal of Korean Physical Therapy
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• v.27 no.3
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• pp.147-153
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• 2015

Purpose: The purpose was to determine whether the application of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) to stroke patients would affects their trunk stability, balance, pulmonary function, and grip strength. Methods: The subjects were 36 stroke patients who were randomly and equally assigned to an ADIM group (n=12), an AEM group (n=12), and a control group (n=12). The intervention was applied to each group three times per week, 30 minutes each time, for four weeks. Outcome measures were grip strength, modified functional reach test (mFRT) and pulmonary function. Pulmonary function were measured force expiratory volume at one second (FEV1), forced vital capacity (FVC), FEV1/FVC and peak expiratory flow (PEF) values. Results: The results of the three groups showed statistically significant improvements in grip strength. The AEM group showed significantly greater differences in grip strength than either the ADIM group or the control group. In the anterior mFRT, the ADIM group showed significantly improvements than the control group. The ADIM and AEM groups were showed statistically significant greater improvements in PEF between the baseline and post-intervention and the post-analysis revealed that the AEM group showed significantly greater improvements than the control group. Conclusion: The results of this study indicate that the ADIM and AEM were effective in improving the PEF of pulmonary function. The ADIM was more effective than AEM in trunk stabilization.

• Physical Therapy Korea
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• v.13 no.4
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• pp.56-63
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• 2006

This study examined the effects of the abdominal drawing-in (ADI) maneuver using a pressure biofeedback on muscle recruitment pattern of erector spinae and hip extensors and anterior pelvic tilt during hip extension in the prone position. Fourteen able-bodied volunteers, who had no medical history of lower extremity or lumbar spine disease, were recruited for this study. The muscle onset time of erector spinae, gluteus maximus, and medial hamstring and angle of anterior pelvic tilt during hip extension in prone position were measured in two conditions: ADI maneuver condition and non-ADI maneuver condition. Muscle onset time was measured using a surface electromyography (EMG). Kinematic data for angle of anterior pelvic tilt were measured using a motion analysis system. The muscle onset time and angle of anterior pelvic tilt were compared using a paired t-test. The study showed that in ADI maneuver during hip extension in prone position, the muscle onset time for the erector spinae was delayed significantly by a mean of 43.20 ms (SD 43.12), and the onset time for the gluteus maximus preceded significantly by a mean of -4.83 ms (SD 14.10) compared to non-ADI maneuver condition (p<.05). The angle of anterior pelvic tilt was significantly lower in the ADI maneuver condition by a mean of 7.03 degrees (SD 2.59) compared to non-ADI maneuver condition (15.01 degrees) (p<.05). The findings of this study indicated that prone hip extension with the ADI maneuver was an effective method to recruit the gluteus maximus earlier than erector spinae and to decrease anterior pelvic tilting.

• Physical Therapy Korea
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• v.24 no.3
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• pp.10-20
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• 2017

Background: Patients with chronic stroke often shows decreased trunk muscle activity and trunk performance. To resolve these problems, many trunk stabilizing techniques including the abdominal drawing-in maneuver (ADIM) and the diaphragmatic breathing maneuver (DBM) are used to improve trunk muscle strength. Objects: To compare the effects of the ADIM and the DBM on abdominal muscle thickness, trunk control, and balance in patients with chronic stroke. Methods: This was a randomized controlled trial. Nineteen patients were randomly allocated to the ADIM ($n_1=10$) and DBM ($n_2=9$) groups. The ADIM and DBM techniques were performed three times per week for 4 weeks. The thicknesses of the transversus abdominis (TrA), internal oblique muscle, and external oblique muscles on the paretic and non-paretic sides, Trunk Impairment Scale (TIS) score, and Berg Balance Scale (BBS) score were used to assess changes in motor development after 4 weeks of training. Results: After the training periods, the TrA thickness on the paretic side, TIS score, and BBS score improved significantly in both groups compared to baseline (p<.05). TIS score was significantly greater in the DBM group than in the ADIM group (p<.05). Conclusion: This study demonstrated that ADIM and DBM are beneficial for improving TrA muscle thickness in the paretic side, trunk control, and balance ability. Intergroup comparison revealed that TIS score was significantly improved in the DBM group versus the ADIM group. Thus, DBM may be an effective treatment for low trunk muscle activity and performance in patients with chronic stroke.