The immediate effect of the abdominal drawing-in maneuver technique on stature change in seated sedentary workers with chronic low back pain.

Many studies have measured stature change arising from loads imposed on the spine during sitting. To improve stature recovery, it is important to stabilise the lumbar spine and compensate forces from the upper body. The abdominal drawing-in maneuver (ADIM) technique has been found to mainly activate deep trunk muscles. The purpose of this study was to determine whether activation of deep trunk muscles by the ADIM technique could immediately improve stature recovery during prolonged sitting. Twenty-four patients with chronic low back pain (CLBP) were randomly allocated into different orders of experimental conditions: control (sitting without ADIM technique) and intervention conditions (sitting with ADIM technique). The latter condition required participants to complete ADIM technique for 1 min and repeat it three times throughout 41 min prolonged sitting time. Stature recovery was improved by 3.292 mm in the intervention condition compared with control condition (p-value = 0.001). Our finding demonstrated that ADIM technique improved stature recovery. Practitioner Summary: Prolonged sitting seemingly harms sedentary workers' health, particularly affecting the lower back. Activation of deep trunk muscles using abdominal drawing-in maneuver technique can promote spinal recovery. Clinicians can teach abdominal drawing-in maneuver technique to activate deep trunk muscles in chronic low back pain, thereby promoting self-management of seated stature recovery. Abbrevations: ADIM: abdominal drawing-in maneuver; RA: rectus abdominis; ICLT: iliocostalis lumborum pars thoracis; LM: lumbar multifidus; TrA: transversus abdominis; IO: internal oblique; CLBP: chronic low back pain; LBP: low back pain; RMDQ: Roland Morris disability questionnaire; NRS: numerical rating scale.

Overflow using proprioceptive neuromuscular facilitation in post-stroke hemiplegics: A preliminary study.

Hemiplegia is the classic condition resulting from a stroke. To assist in recovery, the overflow method can be employed to stimulate the affected limb, using the healthy contralateral lower limb (LL) to activate the plegic upper limb (UL) musculature. The aim of this study was to evaluate the immediate effect of overflow using the PNF method on the plegic upper limb muscles of post-stroke individuals in the acute and chronic stages, as well as on the muscles of healthy individuals. A total of 22 individuals participated in the work, comprising 8 healthy individuals (control group), 6 post-stroke acute stage individuals (acute group), and 8 post-stroke chronic stage individuals (chronic group). The participants were assessed using a questionnaire with sections for personal and disease data and application of the ICF scale and the Fugl-Meyer index. The three groups were submitted to electromyographic evaluation, using the posterior deltoid (PD), anterior deltoid (AD), pectoralis major (PM), and external oblique (EO) muscles in four different positions: P1 (resting the UL, with the LL contralateral to the affected limb positioned in diagonal); P2 (resting the UL, with manual resistance in the contralateral LL); P3 (affected UL positioned in diagonal, with manual resistance in the contralateral LL) e P4 (affected UL positioned in diagonal, with fixed point and manual resistance in the contralateral LL). The electromyography results revealed no significant differences between most of the positions for the four muscles evaluated (p > 0.05). However, high clinical relevance (d > 0.8) was found for muscle activation in positions 2 and 4. It could be concluded that for post-stroke individuals in the acute and chronic stages, overflow using PNF effectively increased activation of the PD, AD, PM, and EO muscles in the P2, as well as position 4.

Dry needling in chronic abdominal wall pain of uncertain origin.

BACKGROUND: Abdominal wall pain is considered as pain that arises from the abdominal muscles rather than the underlying viscera or the spine. It is frequently overlooked and is often misdiagnosed, as these patients continue to suffer with pain. Many such patients would have even been subjected to a psychiatric evaluation in view of the absence of any ostensible clinical cause for the pain. In this study, we describe the role of myofascial trigger points in the abdominal wall pain that could be a cause of chronic pain and present our findings of pain relief by dry needling technique. OBJECTIVES: To report the effect of dry needling treatment for patients who suffer from chronic abdominal wall pain of uncertain etiology and in whom specific myofascial trigger points were identified. METHODS: Twelve patients diagnosed with chronic abdominal wall pain were included in the study. All patients were clinically evaluated and subjected to a combination of imaging techniques. Once categorized as patients suffering from chronic abdominal wall pain, they were subjected to a thorough palpation of the abdominal wall to identify the presence of myofascial trigger points (MTrPs) over the abdominal muscles. All had MTrPs over one or more abdominal muscles either unilaterally or bilaterally. Dry Needling using a standard technique was done based on the side and localization of the myofascial trigger points. Numerical pain rating scale (NPRS) was used to measure pain before and after treatment and at the end of four months. All patients were then seen by the primary clinician and re-evaluated. RESULTS: Eleven out of twelve patients had significant reduction with a mean difference 5.95 in NPRS in their pain levels at four months follow up. Seven patients had complete resolution of the pain. Some patients had improvement in complaints such as Dysmenorrhea, Urinary Frequency and constipation. CONCLUSION: Dry Needling can be a useful adjunct in treating chronic abdominal wall pain especially in those patients in whom Myofascial Trigger Points in the muscles of abdomen are identified by palpation. LEVEL OF EVIDENCE: Level 4.

Abdominal muscle activity during breathing in different postural sets in healthy subjects.

OBJECTIVE: This study aims to evaluate the effect of different postural sets on abdominal muscle activity during breathing in healthy subjects. METHODS: Twenty-nine higher education students (20.86 ± 1.48 years; 9 males) breathed at the same rhythm (inspiration: 2 s; expiration: 4 s) in supine, standing, tripod and 4-point-kneeling positions. Surface electromyography was performed to assess the activation intensity of rectus abdominis, external oblique and transversus abdominis/internal oblique muscles during inspiration and expiration. RESULTS: During both breathing phases, the activation intensity of external oblique and transversus abdominis/internal oblique was significantly higher in standing when compared to supine (p ≤ 0.001). No significant differences were found between tripod position and 4-point-kneeling positions. Transversus abdominis/internal oblique activation intensity in these positions was higher than in supine and lower than in standing. CONCLUSIONS: Postural load and gravitational stretch are factors that should be considered in relation to the specific recruitment of abdominal muscles for breathing mechanics.

Effects of Weight-shifting Exercise Combined with Transcutaneous Electrical Nerve Stimulation on Muscle Activity and Trunk Control in Patients with Stroke.

This study investigated the effects of weight-shifting exercise (WSE) combined with transcutaneous electrical nerve stimulation (TENS), applied to the erector spinae and external oblique (EO) muscles, on muscle activity and trunk control in patients with hemiparetic stroke. Sixty patients with stroke were recruited to this study and randomly distributed into three treatment groups: (1) WSE + TENS, (2) WSE + placebo TENS, and (3) control. All participants underwent 30 sessions of training (30 minutes five times per week for 6 weeks) and received 1 hour of conventional physical therapy five times per week for 6 weeks. Muscle activity, maximum reaching distance and trunk impairment scale scores were assessed in all patients before and after the training. After training, the WSE + TENS group showed significant increase in the EO activity, maximum reaching distance and trunk impairment scale scores compared with the WSE + placebo TENS and control groups. These findings suggest that WSE with TENS applied to the erector spinae and EO muscles increased the trunk muscle activity and improved trunk control. Therefore, WSE with TENS could be a beneficial intervention in clinical settings for individuals with hemiparetic stroke. Copyright © 2016 John Wiley & Sons, Ltd.