• PNF and Movement
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• 제15권3호
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• pp.217-226
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• 2017

Purpose: The purpose of this study was to determine the effects of a modified abdominal draw-in maneuver on trunk stability and functional capacity as well as pain in patients with chronic low back pain. Methods: The study included 3 patients with chronic low back pain who volunteered to participate. The modified abdominal draw-in maneuver included a posterior pelvic tilt, a traditional abdominal draw-in maneuver, and a vibration sensory feedback device. Voluntary abdominal contraction using the vibration sensory feedback device was performed by the subjects for more than 1 hour per day, 5 times per week, for 6 weeks along with common low back pain treatment. Electromyographic signals in the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) muscles were measured to compare muscle activation. The degree of pain was measured using the visual analogue scale (VAS), and functional capacity was measured using the Korea Oswestry Disability Index (K-ODI). All results were compared to the means before and after intervention. Results: After the intervention, the RA, EO, and IO showed increased muscle activation and the ES showed decreased muscle activation. The visual analogue scale decreased after intervention and the K-ODI decreased after intervention. Conclusion: Modified abdominal draw-in maneuvers in daily life combined with therapeutic exercises may be effective in relieving pain and dysfunctions in chronic low back pain patients.

• 대한물리의학회지
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• 제17권1호
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• pp.117-125
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• 2022

PURPOSE: This study was carried out to examine the changes in the trunk control ability and hand grip when the abdominal draw-in maneuver using breathing was applied to stroke patients, and provide basic data regarding the trunk stabilization exercise. METHOD: After randomly placing patients in group I-applying the existing abdominal draw-in exercise and group II -applying the abdominal draw-in exercise using breathing, the intervention program was performed ten times per set (five sets per session), once a day, four times a week, for a total of four weeks. For the pre-tests before the intervention, trunk damage and hand grip were measured. After the four weeks of intervention, post-tests were conducted in the same way as the pre-tests for analyzing the study results. RESULTS: Both groups had significant differences in trunk control ability and hand grip (p < .05). The comparison between the two groups showed, significant differences only in the trunk control a ability(p < .05). CONCLUSION: The abdominal draw-in exercise using breathing led to the efficient contraction of abdominal muscles, which implies this is a more effective intervention to improve the trunk control ability.

• PNF and Movement
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• 제13권1호
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• pp.25-30
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• 2015

Purpose: The aim of this study was to examine the effects of abdominal muscle contraction thickness using real-time ultrasound imaging while applying an abdominal draw-in maneuver (ADIM) and pelvic floor muscle contraction (PFC) to low back pain patients and healthy subjects. Methods: The subjects were 21 young adults; a group of 10 low back pain patients and a control group of 11 healthy subjects. Measurements were made with the subjects on a pillow in a supine position, with the knee joints flexed at 60 degrees. While the two groups conducted ADIM and PFC, their transverse abdominal muscle (TrA), internal abdominal oblique muscle (IO), and external abdominal oblique muscle (EO) thicknesses were measured using an ultrasound imaging system. Result: The TrA muscle contraction thickness ratio during PFC and ADIM was significantly lower in the low back pain group than in the healthy group (p<0.05). The EO muscle contraction thickness ratio during ADIM was also significantly lower in the low back pain group than in the healthy group. The healthy group's muscle contraction thickness ratio was significantly lower during PFC than during ADIM in the TrA, IO, and EO (p<0.05). The low back pain group's muscle contraction thickness ratio was lower during PFC than during ADIM in the TrA, IO, and EO, but the difference was not statistically significant. Conclusion: The results of this study indicate that oral direction during ADIM induced an appropriate contraction of the TrA. Therefore, the procedure reported here may be applied during rehabilitation for appropriate contraction of the TrA.

• 한국전문물리치료학회지
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• 제20권2호
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• pp.38-45
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• 2013

This study was conducted in order to examine whether abdominal draw-in maneuver (ADIM) with isometric shoulder flexion, extension, adduction, and abduction selectively contracted deep abdominal muscles. This study's subjects were 13 males 17 females. In order to evaluate the comparison of effects of ADIM and ADIM with isometric shoulder flexion, extension, adduction and abduction, measurements were made on transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) using a real-time ultrasonic diagnostic imaging system. Each position was repetitively measured three times with a real-time ultrasonic diagnostic imaging system and their mean values were used for analysis. The ADIM with isometric shoulder flexion, extension, adduction and abduction significantly increased the thickness of TrA relative to the ADIM only (p<.05). The ADIM with isometric shoulder abduction significantly increased the thickness of IO compared to the ADIM only (p<.05). The ADIM with isometric shoulder extension and abduction significantly decreased the thickness of EO compared to the ADIM only and the ADIM with isometric shoulder extension significantly decreased the thickness of EO relative to the ADIM with isometric shoulder adduction (p<.05). ADIM with isometric shoulder abduction is an effective method to selectively strengthen deep abdominal muscles and therefore may be employed as an intervention for trunk stabilization.

• 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.

• 한국엔터테인먼트산업학회논문지
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• 제14권8호
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• pp.287-294
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• 2020

다리 움직임이 몸통 주위 근육에 효과적인 변화를 줄 수 있다는 근거를 바탕으로 다리 움직임을 동반한 복부 드로우-인 방법이 뇌졸중 환자들의 배가로근 두께와 몸통 조절 능력에 변화를 알아보고, 효율적인 복부 드로우-인 기법에 있어서 임상적 기초 자료를 제공하기 위해 시행하였다. 본 연구는 뇌졸중 환자 18명을 표본 추출하여, 기존의 복부 드로우-인 기법을 적용한 집단을 실험군I(n=9)로, 다리 움직임을 동반한 복부 드로우-인 기법을 적용한 집단은 실험군II(n=9)로 무작위 배치한 후 사전 검사로 초음파를 활용하여 마비측 배가로근의 두께를 측정하였고, 몸통 조절 능력은 몸통 손상 정도 평가지를 이용하여 측정하였다. 총 4주 간, 주 4일, 1일 1회, 30분씩 중재 프로그램을 시행한 후 사후검사를 사전검사와 동일하게 재 측정하여 분석하였다. 그 결과 두 집단 내 배가로근 두께 변화 비교에서는 두 집단 모두 복부 드로우-인 동작 시 유의한 차이가 있었으며(p<0.01), 몸통 조절 능력에서도 두 집단 모두 유의한 차이가 있었다(p<0.001). 그러나 두 집단 간 배가로근 두께와 몸통 조절 능력 변화 비교에서는 몸통 조절 능력에서만 유의한 차이가 있었다(p<0.05). 따라서 집단 간 배가로근의 두께는 차이가 없었지만, 다리의 움직임을 통해 자동 반사적인 골반 움직임이 나타나 복부 주위의 근육들에게도 효율적인 수축 반응이 나타나 더 효과적으로 몸통 조절 능력을 향상시킬 수 있는 중재방법임을 알 수 있었다.

• Physical Therapy Rehabilitation Science
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• 제5권3호
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• pp.113-119
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• 2016

Objective: The effect of abdominal expansion maneuver (AEM) and abdominal draw-in maneuver (ADIM) on postural control in an unsupported position in stroke patients. Design: Randomized controlled trial. Methods: A total of 36 persons with hemiplegic stroke participated in this study. The subjects were randomly divided into an AEM experimental group (n=12), an experimental ADIM group (n=12), and a control group (n=12). We collected the general characteristics of all subjects and the pre-test results before the intervention and after 4 weeks of the intervention. The trunk stabilization training of the ADIM and AEM group were performed 15 minutes a day, 3 times a week for 4 weeks, and general physical therapy was performed 2 times a day, 30 minutes per session, 5 times a week for all three groups. The control group received joint mobilizations, muscle strengthening, endurance strengthening, and gait exercises along with treatment of the central nervous system, such as neuro-developmental treatment, mat, and gait training. The AEM is an inspiratory phase of tidal breathing expanding the lateral lower ribcage in a lateral direction with minimal superior movements of the chest. Then the lower abdomen expands and the navel moves in an anterior-caudal direction. The ADIM is a repeated contraction and relaxation of the anal sphincter during inspiration. The navel pulls the lower abdomen to the direction of the spine without the movement of the trunk and pelvis. Results: Before and after the interventions, medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area 95% was a statistically significant change in all three groups (p<0.05). The post-hoc test showed a significant improvement in medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area in the AEM group compared with the control group, and in the ADIM group compared with the control group (p<0.05). Conclusions: In conclusion, both AEM training and ADIM training are necessary interventions to maintain the independent sitting position according to the characteristics of the patient.

• 한국전문물리치료학회지
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• 제24권4호
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• pp.60-67
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• 2017

Background: Scapular downward rotation syndrome (SDRS) is a common scapular alignment impairment that causes insufficient upward rotation and muscle imbalance, shortened levator scapulae (LS) and rhomboid, and lengthened serratus anterior (SA) and trapezius. A modified shrug exercise (MSE), performing a shrug exercise with the shoulders at $150^{\circ}$ abduction, is known as an effective exercise to increase scapular stabilizer muscle activation. Previous studies revealed that scapular exercise are more effective when combined with trunk stabilization exercises in decreasing scapular winging and increasing scapular stabilizer muscle activation. Objects: The purpose of our study was to clarify the effect of MSE with or without trunk stabilization exercises in subjects with SDRS. Methods: Eighteen volunteer subjects (male=10, female=8) with SDRS were recruited for this experiment. All subjects performed MSE under 3 different conditions: (1) MSE, (2) MSE with an abdominal draw-in maneuver (ADIM), and (3) MSE with an abdominal expansion maneuver (AEM). The muscle thickness of the lower trapezius (LT) and the SA were measured using an ultrasonography in each condition. Electromyography (EMG) data were collected from the LT, LS, SA, and upper trapezius (UT) muscle activities. Data were statistically analysed using one-way repeated analysis of variance at a significance level of .05. Results: The muscle thickness of the LT and the SA were the significant different in the MSE, MSE with ADIM (MSE+ADIM) and MSE with AEM (MSE+AEM) conditions (p<.05) In both LT and SA, the order of thick muscle thickness was MSE+AEM, MSE+ADIM, and MSE alone. No significant differences were found in the EMG activities of the SA, UT, LS, and LT in all condition. Conclusion: In conclusion, MSE is more beneficial to people with SDRS when combined with trunk stabilization exercises by increased thickness of scapular stabilizer muscles.

• 대한물리의학회지
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• 제17권4호
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• pp.15-25
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• 2022

PURPOSE: This study examined the effect of bridge exercise-abdominal draw-in maneuver (ADIM) with hip adductor co-contraction on the TrA thickness and whether it is effective as a core stability exercise. METHODS: The subjects of this study, 33 men with no history in the past and who provided prior consent, were selected through interviews with male students of S University. The subjects performed five movements, including bridge exercise and ADIM, and performed two demonstrations and two exercises in advance. The abdominal muscles were measured using ultrasonography once in each movement, and the abdominal muscle tone was measured using a soft tissue tone measurement. RESULTS: There was a significant difference in the thickness between the TrA and Internal Oblique Muscles at various bridge positions (p < .05), and no significant difference with the External Oblique Muscle (p < .05). There was no significant difference in muscle tone in the Rectus abdominis part (p > .05), but a significant difference in the Oblique Muscle part (p < .05). The muscle tone of the Oblique Muscles by position showed a significant difference in Bridge, BHa, and BA compared to the rest position (p < .05), but no significant difference with BHaA (p > .05). CONCLUSION: The thickness of TrA could be increased through bridge exercise, and TrA could be activated properly using ADIM and may be an effective exercise for core stabilization.

• 한국전문물리치료학회지
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• 제25권1호
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• pp.22-30
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• 2018

Background: Improvement of lumbo-pelvic stability can reduce the compensatory action of the quadratus lumborum (QL) and selectively strengthen the gluteus medius (GM) during side-lying hip abduction (SHA). There are abdominal draw-in maneuver (ADIM) and abdominal bracing (AB) as active ways, and pelvic compression belt (PCB) as a passive way to increase of lumbo-pelvic stability. It is necessary to compare how these stabilization methods affect the selective strengthening of the GM. Objects: To investigate the effects of ADIM, AB, and PCB during SHA on the electromyography (EMG) activity of the GM, QL, external oblique (EO) and internal oblique (IO), and the GM/QL EMG activity ratio. Methods: A total of 20 healthy male adults participated in the study. The subjects performed three conditions in side-lying in random order: SHA with ADIM (SHA-ADIM), SHA with AB (SHA-AB), and SHA with PCB (SHA-PCB). To compare the differences among the three conditions, the EMG activities of the GM, QL, EO and IO, and GM/QL EMG activity ratio were analyzed using one-way repeated ANOVA. Results: The EMG activity of the QL was significantly higher in SHA-AB than in SHA-ADIM and SHA-PCB. The GM/QL activity ratio was significantly higher in SHA-PCB than in SHA-ADIM and SHA-AB. In addition, the figure for SHA-ADIM was significantly higher than that for SHA-AB. In the case of the EO, the figure for SHA-AB was significantly higher than corresponding values for the other two conditions. The figure for SHA-ADIM was significantly higher than that for SHA-PCB. The EMG activity of the IO was significantly higher in SHA-AH than in SHA-PCB. Conclusion: It can be suggested that wearing the PCB can more selectively strengthen the GM than to perform ADIM and AB during SHA. In addition, the ADIM can be recommended when there is a need to strengthen abdominal muscles during SHA.