• 대한물리의학회지
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• 제11권1호
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• pp.83-91
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• 2016

PURPOSE: There are several methods, such as the abdominal drawing-in maneuver (ADIM), maximal expiration (ME), and Kegel exercise, to strengthen the core muscles. However, to date no study has been conducted to compare the effects of the ADIM, ME, and Kegel exercise on the transverses abdominis (TrA), internal oblique (IO), external oblique (EO), and pelvic floor muscles (PFMs). The purpose of this study was to find out which of the three aforementioned exercises is most effective for contracting the core muscles. METHODS: The thickness of the TrA, IO, EO and PFMs was measured by ultrasonographic imaging during the ADIM, ME and Kegel exercise in 34 healthy participants. RESULTS: There was the significant difference between ADIM and Kegel exercise in the thickness of the TrA (p<0.05). There were the significant differences between ADIM and ME and between ME and Kegel exercise in the thickness of the IO and PFM (p<0.01). There was no significant activation in the thickness of the EO (p>0.05). Measurement reliability was assessed using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). An ICC value of >0.77 indicated that reliability measurements was good. CONCLUSION: Kegel exercise was the most effective exercise for the TrA and the PFM, and ME was the most effective exercise for the IO muscles.

• 대한물리의학회지
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• 제11권1호
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• pp.53-60
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• 2016

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.

• 한국전문물리치료학회지
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• 제22권1호
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• pp.37-48
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• 2015

This study aimed to investigate the effect of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) on trunk stabilization, as well as trunk muscle activities and differences in quadruple visual analogue scale, Korean Oswestry Disability Index, and Fear Avoidance Beliefs Questionnaire scores, in patients with chronic low back pain and lumbar spine instability. To increase intra-abdominal pressure during the trunk stabilization exercise, the technique of pushing the abdomen out using diaphragmatic abdominal breathing suggested by Pavel Koral was used, which we termed the AEM. Fifty patients who tested positive on more than three of the five lumbar spine instability tests were separated from 138 patients with chronic low back pain of these patients, 16 were placed in the control group (trunk stabilization exercise), 17 were placed in the ADIM group (trunk stabilization exercise with ADIM), and 17 were placed in the AEM group (trunk stabilization exercise with AEM). Each group participated in the study for 30 minutes three times weekly for 4 weeks. Surface electromyography was used to measure the trunk muscle activities during the kneeling forward and supine bridging positions, and one-way repeated analysis of variance was used to determine the statistical significance of the trunk muscle activities in the rectus abdominis, internal oblique (IO), erector spinae, and multifidus (MF) muscles. The ADIM and AEM groups showed relatively larger improvements in psychosocial and functional disability level than control group. There were significant changes among the three groups, those from the measured values of the AEM group was significantly higher than the other two groups in changes in IO and MF trunk muscle activities (p<.05). This finding demonstrates that trunk stabilization exercises with AEM is more effective than ADIM for increasing trunk deep muscle activity of chronic low back pain patients with lumbar spine instability.

• PNF and Movement
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• 제17권1호
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• pp.137-144
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• 2019

Purpose: This study examined the effects of the abdominal drawing-in maneuver (ADIM) on muscle activity in the trunk and legs while subjects walk on a ramp. Methods: The subjects were healthy adult males (n=15) and females (n=8) in their twenties. The subjects were asked to maintain the ADIM contraction for 15 minutes using a pressure biofeedback unit. Their muscle activity was then measured while ascending or descending the ramp with or without the ADIM contraction maintained. Activity in the sternocleidomastoid, splenius capitis, rectus abdominis, external oblique abdominal, transversus abdominis, erector spinae, vastus medialis, and vastus lateralis muscles was measured using surface electromyography (TM DTS, Noraxon, USA). A paired t-test was conducted using SPSS 18.0 (IBM) for statistical data processing. Results: Maintaining the ADIM contraction during ascension led to a significant increase (p<0.05) in muscle activity for the rectus abdominis, transversus abdominis, vastus medialis, and vastus lateralis, but a significant decrease (p<0.05) in muscle activity for the erector spinae, when compared to the same activity without the ADIM maintained. Furthermore, maintaining the ADIM contraction during descent led to a significant increase (p<0.05) in muscle activity for the rectus abdominis, external abdominal oblique, transversus abdominis, vastus medialis, and vastus lateralis, but a significant decrease (p<0.05) in muscle activity for the erector spinae, when compared to the same activity without the ADIM maintained. Conclusion: As a result of this study, it maintains the ADIM and reduces lumbar muscle activity at the waist and increases muscle activity in the legs when walking on a ramp. Therefore, maintaining the ADIM contraction during ramp walking is recommended as training to improve the function of patients' muscular skeleton.

• 대한정형도수물리치료학회지
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• 제17권2호
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• pp.49-55
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• 2011

Background: The purpose of this study was to identify the effects of the abdominal drawing-in maneuver (ADIM) for contraction training of transversus abdominis (TrA) to the patient with chronic low back pain (CLBP). Methods: A 37-year female patient with CLBP participated in study. This study was fix to method of ADIM that maintain to draw in lower abdomen in sitting position on chair and fix 1 time protocol that perform rest for 1-min and ADIM for 1-min during 10-min. Hereunder the subject performed 2 times protocol during 30-min. Measurement method were visual analogue scale (VAS), Korean version of Oswestry disability index (KODI) and using ultrasound imaging. Results: VAS was decreased 5cm to 1cm after intervention 3 weeks, KODI was decreased 22% to 9% after intervention 3 weeks and changes in thickness of the TrA were increased 32% to 68% during ADIM. Conclusions: These findings suggest that performed the ADIM took effect for decreased pain and functional disability level with increased changes in thickness of the TrA. Therefore, patients with CLBP should be use for training of deep abdominal muscles apply to the ADIM.

• 재활복지공학회논문지
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• 제10권1호
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• pp.81-86
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• 2016

본 연구는 복부 동시수축 형태에 따라 하지의 근활성도에 어떤 영향을 미치는지에 대해 알아보고자 하였다. 연구대상자는 허리와 하지에 통증이 없고, 근골격계에 이상이 없는 건강한 20대 여성 30명을 대상으로 진행하였다. 복부 이완(Rest), 복부 당기기 기법(ADIM), 복부 브레이싱 기법(ABM)을 유지하는 각 자세에서 무릎의 굽힘없이 발을 능동적으로 바닥으로부터 20cm 올린 상태(ASLR)로 약 10초간 유지하도록 하여 하지의 5개 근육(중간볼기근, 엉덩긴모음근, 넙다리곧은근, 넙다리두갈래근, 앞정강근)의 근활성도를 측정하였다. 연구결과, Rest에서 ASLR을 유지하였을 때보다 ADIM 수축형태로 ASLR 유지할 때 하지의 모든 근육에서 근활성도가 높게 나타났다. 또한 Rest에서 ASLR을 유지하였을 때보다 ABM 수축형태로 ASLR을 유지하였을 때 중간볼기근을 제외한 나머지 근육에서 모두 근활성도가 높게 나타났다. ADIM과 ABM을 비교한 결과 중간볼기근과 앞정강근은 ADIM 수축형태에서, 엉덩긴모음근, 넙다리곧은근, 넙다리두갈래근은 ABM 수축형태에서 통계적으로 유의하게 높은 근활성도가 나타났다. 본 연구의 결과로 체간중심 안정화 운동이 필요한 요통 환자의 선제적 복부 수축형태로서 뿐만 아니라 하지의 선택적 근력강화가 필요한 환자들에게 개별화된 방법으로써 근거를 제시할 수 있을 것이다.

• Physical Therapy Rehabilitation Science
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• 제3권2호
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• pp.101-106
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• 2014

Objective: To investigate the appropriate position for abdominal drawing-in maneuver (ADIM) exercise by rehabilitative ultrasound image. Design: Cross-sectional study. Methods: Twenty-eight young adults with no history of low back pain participated in the study. Three positions compared were crook lying position with hip $60^{\circ}$ flexion, standing position with the feet hip width apart and knees straight, and saddle standing positionunsupported with the knees $20^{\circ}$ flexed. Once in the appropriate position, the subjects were verbally cued to draw in their abdominal wall, with the intention of pulling their navel inward toward their lower back. The thickness of each transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles were measured via ultrasound and recorded at the end of inspiration. Results: When compared to the TrA thickness of rest, the TrA thickness was significantly increased in all three positions (crook lying, standing, and saddle standing) during the ADIM (p<0.05). IO thickness was significantly greater in standing and saddle standing than in crook lying (p<0.05). EO thickness was constant in all the three positions. Conclusions: The present study suggests that standing and saddle standing positions could be recommended for the ADIM to maximize recruitment of the TrA and IO activation. Specifically, the saddle standing position with knees flexed to $20^{\circ}$ was observed to increase the TrA activation more than the standing position. These findings should be considered when core stability exercises such as the ADIM are conducted.

• PNF and Movement
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• 제15권2호
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• pp.159-166
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• 2017

Purpose: This study attempts to determine the effects of applying three kinds of breathing exercises for four weeks on the neck muscle activation of subjects with a forward head posture. Methods: A total of 30 adults aged in their twenties (15 men and 15 women) with a forward head posture who voluntarily agreed to participate after listening to the purpose and procedure of this research were chosen as the subjects of this study. The subjects were randomly divided into either the diaphragmatic breathing exercise (DBE) group, the abdominal drawing-in maneuver (ADIM) group, or the abdominal expansion method (AEM) group according to the breathing intervention scheme. Each group included ten subjects. The muscle activity of the sternocleidomastoid, scalenus anterior, and splenius capitis was measured in all the groups prior to the intervention, two weeks after the intervention, and four weeks after the intervention. All the interventions were implemented for 30 minutes a day, three times a week, for a total of four weeks. Results: No significant between-group difference was observed in terms of the change in neck muscle activity according to the four-week intervention scheme. Further, there was no interaction between the intervention period and the intervention scheme in relation to the change in neck muscle activity. Conclusion: The results of this study suggest that abdominal expansion exercise is as effective as other breathing exercise methods for subjects with a forward head posture. We therefore expect that abdominal expansion exercise can be used as a scheme for the prevention of symptoms as well as therapy for patients with a forward head posture.

• 한국전문물리치료학회지
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• 제21권2호
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• pp.1-7
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• 2014

Lumbopelvic stabilization exercise has become the most popular treatment method in lumbar rehabilitation since its effectiveness was shown in some aspects of pain and disability. The abdominal drawing-in maneuver (ADIM) has been extensively implemented to promote lumbopelvic stability. However, performing ADIM correctly is difficult even for healthy subjects, and it is time consuming to train people in ADIM. Thus, the purpose of this study was to compare abdominal muscle [rectus abdominalis (RA), external oblique (EO), and transverse abdominis/internal oblique (TrA/IO)] activity during lumbopelvic stabilization exercises (ADIM only, ADIM with a ball, maximum exhalation only, and maximum exhalation with a ball) performed in a supine position with feet against a wall. Fifteen healthy subjects were recruited for this study. Surface electromyography was used to measure abdominal muscle activity during lumbopelvic stabilization exercises. A one-way repeated-measures analysis of variance was used to determine the statistical significance of RA, EO, and TrA/IO muscle activity during four lumbopelvic stabilization exercises. Both-side TrA/IO muscle activity was significantly greater with maximum exhalation with a ball than with ADIM only or ADIM with a ball (p<.008). The results of this study suggest that maximum exhalation with a ball can be used as an effective lumbopelvic stabilization exercise to increase TrA/IO muscle activity in healthy subjects.

• 한국엔터테인먼트산업학회논문지
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• 제14권3호
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• pp.475-482
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• 2020

허리 안정화 근육들을 강화하기 위해 실시하는 복부 드로우인 기법(ADIM)은 복부내압을 상승시켜 배가로근(TrA)과 배속빗근(IO)을 선택적으로 수축시키는 운동법이다. 본 연구는 일상생활에서 많이 사용하는 자세인 앉은 자세에서 ADIM을 실시했을 때 파악력에 어떠한 영향을 미치는지 확인하고자 하였다. 정상 성인 30명을 대상으로 앉은 자세에서 ADIM을 실시하도록 한 후 실시하지 않은 상태와 실시한 상태에서 각각 파악력을 측정하여 앉은 자세에서 실시한 ADIM이 파악력에 미친 영향과 가장 많은 영향을 발휘하는 근육이 있는지 알아보았다. 측정에 동원된 근육은 RA, EO, IO/TrA, 그리고 ES로 ADIM 적용 시 가장 활성화된다고 알려진 허리 안정화 근육들이다. 연구 결과 앉은 자세에서 실시한 ADIM이 실시하지 않은 자세 보다 모든 근육들의 활성도가 유의하게 증가하였으며 파악력 또한 유의하게 증가하였다. 측정된 각 근육의 차이값을 비교해 어떤 근육이 파악력에 더 큰 영향을 알아보았으나 유의한 상관관계를 나타낸 근육은 보이지 않았다. 이는 특정 근육이 파악력에 영향을 미친 것이 아니라 복부내압의 증가가 파악력에 영향을 미친 것으로 사료된다. 따라서 앉아서 오랜 시간 생활하는 일반인들의 일상생활에 파악력 증가와 허리 안정성 향상을 위한 치료적 중재방법에 활용할 수 있을 것으로 제안할 수 있겠다.