• 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.

• 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.

• 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.

• 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.

• Physical Therapy Korea
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• v.18 no.4
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• pp.26-33
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• 2011

The aim of this study was to investigate the effects of respiratory muscle training (RMT) with abdominal drawing-in maneuver (ADIM) on pulmonary function. Twenty-two subjects with restrictive breathing participated in this study. All the subjects were randomly assigned to three groups (7 subjects in RMT group, 7 subjects in RMT with ADIM group, 8 subjects in control group). The first group performed the RMT by using incentive respiratory spirometer (IRS). The second group performed the RMT by using IRS and the ADIM by using a Stabilizer. The exercises were conducted over four days. The pulmonary function was evaluated using the spirometer to measure the force exploratory volume in 1 second ($FEV_1$) and forced vital capacity (FVC). Measurements were conducted on the first day and the last day. A paired-t test was used for pre-post changes and the change rates in FVC and $FEV_1$ among each group were investigated by a one-way ANOVA. The findings of the the study were as follows: 1) There were significant differences of FVC and $FEV_1$ between pre and post in the two training groups (p<.05) 2) There was no significant difference of the change ratio the FVC and $FEV_1$ between the RMT group and RMT with ADIM group. Therefore, it is concluded that respiratory muscle and ADIM training, combined with two methods of treatment would suggest positive evidence for improving pulmonary function.

• PNF and Movement
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• v.18 no.1
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• pp.35-44
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• 2020

Purpose: The purpose of this study was to investigate the effect of the simultaneous abdominal drawing-in maneuver (ADIM) on the muscle activity of the ipsilateral trunk and leg during proprioceptive neuromuscular facilitation (PNF) leg flexion, adduction, and external rotation with knee flexion (D1) patterns. Methods: The participants were 20 healthy adult males and females (18 males and 2 females). The maneuvers were performed by a physical therapist who fully understands the PNF leg patterns (D1) and their application in clinical practice. The participants were trained and allowed to practice for 15 minutes prior to applying ADIM, to ensure adequate learning as evidenced by the pressure biofeedback unit. In this study, we measured the muscle activity of the trunk and leg when the PNF leg pattern (D1) was performed by the physical therapist either sustaining or releasing the ADIM. Muscle activity was measured on the right transverse abdominis muscle (TRA), the external abdominal oblique muscle (EO), the internal abdominal oblique muscle (IO), the erector spinae muscle (ES), the vastus medialis oblique muscle (VMO), the vastus lateralis oblique muscle (VLO), and the tibialis anterior muscle (TA) and compared using the mean values from averaging three repeated measurements. Results: The muscle activity of the transversus abdominis, the external abdominal oblique, the internal abdominal oblique, the vastus medialis oblique, and the vastus lateralis oblique was significantly greater (p < 0.05), and the muscle activity of the erector spinae was significantly less (p < 0.05) during PNF leg pattern (D1) when the ADIM contraction was sustained compared to when it was not. Conclusion: These results suggest that sustaining ADIM during PNF leg pattern (D1) training increases the trunk and leg muscle activity, resulting in more effective training.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.17 no.2
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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.

• Physical Therapy Korea
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• v.31 no.1
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• pp.79-88
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• 2024

Background: The abdominal drawing-in maneuver (ADIM), a method of lumbar stabilization training, is an effective neuromuscular intervention for lumbar instability associated with low back pain (LBP). Objects: The purpose of this study was to compare the effect of a 2-week period of the ADIM and tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching on lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity during active prone hip lateral rotation. Methods: Twenty-two subjects with lumbar extension rotation syndrome accompanying shortened TFL-ITB (16 males and 6 females) were recruited for this study. The subjects were instructed how to perform ADIM training or ADIM training plus TFL-ITB self-stretching program at home for a 2-week period. A 3-dimensional ultrasonic motion analysis system was used to measure the lumbopelvic rotation angle and lumbopelvic rotation movement onset. An independent t-test was used to determine between-group differences for each outcome measure (lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity). Results: The results showed that ADIM training plus TFL-ITB self-stretching decreased the lumbopelvic rotation angle, delayed the lumbopelvic rotation movement onset, and elongated the TFL-ITB significantly more than did ADIM training alone. Pain intensity was lower in the ADIM training plus TFL-ITB self-stretching group than the ADIM training alone group; however, the difference was not significant. Conclusion: ADIM training plus TFL-ITB self-stretching performed for a 2-week period at home may be an effective treatment for modifying lumbopelvic motion and reducing LBP.

• Physical Therapy Korea
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• v.16 no.1
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• pp.10-17
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• 2009

The aim of this study was to investigate the effect of abdominal drawing-in maneuver (ADIM) on peak exploratory flow (PEF), forced exploratory volume in 1 second ($FEV_1$), and low back pain during forced expiration. Twenty-two subjects (14 subjects in experimental group, 8 subjects in control group) participated in this study. The stabilizer was used for ADIM training for five consecutive days. Vitalograph PEF/$FEV_1$ DIARY and visual analogue scale (VAS) were used to determine forced expiratory pulmonary function and low back pain, respectively. Independent t-test and analysis of covariance were used for statistical analysis with a significance level of .05. The findings of this study were as follows: 1) There were no significant differences of ADIM effect on PEF and $FEV_1$ between experimental group and control group. 2) There was a significant pain reduction in experimental group with ADIM. 3) PEF and $FEV_1$ increased significantly in the fifth day compared with the first day pre-exercise baseline. Therefore, it is concluded that ADIM was effective in improving PEF and $FEV_1$, and reducing VAS during forced expiration in patients with chronic low back pain.