-
International Journal of Environmental... Sep 2019Most of the studies evaluating core muscle activity during exercises have been conducted with healthy participants. The objective of this study was to compare core...
Most of the studies evaluating core muscle activity during exercises have been conducted with healthy participants. The objective of this study was to compare core muscle activity and tolerability of a variety of dynamic and isometric exercises in patients with non-specific low back pain (NSLBP). 13 outpatients (average age 52 years; all with standing or walking work in their current or latest job) performed 3 consecutive repetitions at 15-repetition maximum during different exercises in random order. Surface electromyography was recorded for the rectus abdominis; external oblique and lumbar erector spinae. Patients rated tolerability of each exercise on a 5-point scale. The front plank with brace; front plank and modified curl-up can be considered the most effective exercises in activating the rectus abdominis; with a median normalized EMG (nEMG) value of 48% (34-61%), 46% (26-61%) and 50% (28-65%), respectively. The front plank with brace can be considered the most effective exercise in activating the external oblique; with a nEMG of 77% (60-97%). The squat and bird-dog exercises are especially effective in activing the lumbar erector spinae; with nEMG of 40% (24-87%) and 29% (27-46%), respectively. All the exercises were well tolerated; except for the lateral plank that was mostly non-tolerated. In conclusion; the present study provides a variety of dynamic and isometric exercises; where muscle activity values and tolerability can be used as guide to design evidence-based exercise programs for outpatients with NSCLBP.
Topics: Adult; Back Muscles; Chronic Pain; Cross-Sectional Studies; Electromyography; Exercise Therapy; Female; Humans; Low Back Pain; Male; Middle Aged; Rectus Abdominis; Spain
PubMed: 31547140
DOI: 10.3390/ijerph16193509 -
Ugeskrift For Laeger Jan 2023Rectus diastasis is defined by thinning and widening of linea alba and is a part of pregnancy. In some patients, the diastasis persists giving symptoms such as core... (Review)
Review
Rectus diastasis is defined by thinning and widening of linea alba and is a part of pregnancy. In some patients, the diastasis persists giving symptoms such as core instability, and cosmetic complaints. Treatment consists of exercise and surgery by either a plastic surgeon or a general surgeon. Lately, rectus diastasis has gained both national and international attention but it is not clear which patients will benefit from surgery or which operative technique has the best outcome. This review describes postgestational rectus diastasis and summarizes treatment possibilities based on the latest literature.
Topics: Pregnancy; Female; Humans; Rectus Abdominis; Abdominal Wall; Surgeons; Exercise
PubMed: 36760187
DOI: No ID Found -
Physical Therapy Apr 2018Diastasis recti abdominis affects a significant number of women during the prenatal and postnatal period. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Diastasis recti abdominis affects a significant number of women during the prenatal and postnatal period.
OBJECTIVE
The objective was to evaluate the effect of a postpartum training program on the prevalence of diastasis recti abdominis.
DESIGN
The design was a secondary analysis of an assessor-masked randomized controlled trial.
METHODS
One hundred seventy-five primiparous women (mean age = 29.8 ± 4.1 years) were randomized to an exercise or control group. The interrectus distance was palpated using finger widths, with a cutoff point for diastasis as ≥2 finger widths. Measures were taken 4.5 cm above, at, and 4.5 cm below the umbilicus. The 4-month intervention started 6 weeks postpartum and consisted of a weekly, supervised exercise class focusing on strength training of the pelvic floor muscles. In addition, the women were asked to perform daily pelvic floor muscle training at home. The control group received no intervention. Analyses were based on intention to treat. The Mantel-Haenszel test (relative risk [RR] ratio) and the chi-square test for independence were used to evaluate between-group differences on categorical data.
RESULTS
At 6 weeks postpartum, 55.2% and 54.5% of the participants were diagnosed with diastasis in the intervention and control groups, respectively. No significant differences between groups in prevalence were found at baseline (RR: 1.01 [0.77-1.32]), at 6 months postpartum (RR: 0.99 [0.71-1.38]), or at 12 months postpartum (RR: 1.04 [0.73-1.49]).
LIMITATIONS
The interrecti distance was palpated using finger widths, and the sample included women with and without diastasis.
CONCLUSIONS
A weekly, postpartum, supervised exercise program, including strength training of the pelvic floor and abdominal muscles, in addition to daily home training of the pelvic floor muscles, did not reduce the prevalence of diastasis.
Topics: Adult; Diastasis, Muscle; Exercise Therapy; Female; Humans; Parity; Pelvic Floor; Postnatal Care; Pregnancy; Pregnancy Complications; Rectus Abdominis; Risk Factors; Treatment Outcome
PubMed: 29351646
DOI: 10.1093/ptj/pzy008 -
British Journal of Sports Medicine Sep 2016Diastasis recti abdominis (DRA) is defined as a separation of the 2 muscle bellies of rectus abdominis. To date there is scant knowledge on prevalence, risk factors, and...
BACKGROUND/AIM
Diastasis recti abdominis (DRA) is defined as a separation of the 2 muscle bellies of rectus abdominis. To date there is scant knowledge on prevalence, risk factors, and consequences of the condition. The present study aimed to investigate the prevalence of DRA during pregnancy and post partum, presence of possible risk factors, and the occurrence of lumbopelvic pain among women with and without DRA.
METHODS
This prospective cohort study followed 300 first-time pregnant women from pregnancy till 12 months post partum. Data were collected by electronic questionnaire and clinical examinations. DRA was defined as a palpated separation of ≥2 fingerbreadths either 4.5 cm above, at or 4.5 cm below the umbilicus. Women with and without DRA were compared with independent samples Student's t-test and χ(2)/Fisher exact test, and OR with significance level >0.05.
RESULTS
Prevalence of DRA was 33.1%, 60.0%, 45.4%, and 32.6% at gestation week 21, 6 weeks, 6 months and 12 months post partum, respectively. No difference in risk factors was found when comparing women with and without DRA. OR showed a greater likelihood for DRA among women reporting heavy lifting ≥20 times weekly (OR 2.18 95% CI 1.05 to 4.52). There was no difference in reported lumbopelvic pain (p=0.10) in women with and without DRA.
CONCLUSIONS
Prevalence of mild DRA was high both during pregnancy and after childbirth. Women with and without DRA reported the same amount of lumbopelvic pain 12 months post partum.
Topics: Adult; Female; Humans; Low Back Pain; Muscular Diseases; Norway; Pelvic Pain; Pregnancy; Pregnancy Complications; Prevalence; Prospective Studies; Rectus Abdominis; Risk Factors; Young Adult
PubMed: 27324871
DOI: 10.1136/bjsports-2016-096065 -
Sports Health Jul 2016Prone, supine, and side position exercises are employed to enhance core stability.
BACKGROUND
Prone, supine, and side position exercises are employed to enhance core stability.
HYPOTHESIS
Overall core muscle activity would be greater in prone position exercises compared with supine and side position exercises.
STUDY DESIGN
Controlled laboratory study.
METHODS
Eighteen men and women between 23 and 45 years of age served as subjects. Surface electrodes were positioned over the upper and lower rectus abdominis, external and internal obliques, rectus femoris, latissimus dorsi, and lumbar paraspinals. Electromyography data were collected during 5 repetitions of 10 exercises, then normalized by maximum voluntary isometric contractions (MVIC). Differences in muscle activity were assessed using 1-way repeated-measures analysis of variance, while t tests with a Bonferroni correction were employed to assess pairwise comparisons.
RESULTS
Upper and lower rectus abdominis activity was generally significantly greater in the crunch, bent-knee sit-up, and prone position exercises compared with side position exercises. External oblique activity was significantly greater in the prone on ball with right hip extension, side crunch on ball, and side bridge (plank) on toes compared with the prone and side bridge (plank) on knees, the crunch, or the bent-knee sit-up positions. Internal oblique activity was significantly greater in the prone bridge (plank) on ball and prone on ball with left and right hip extension compared with the side crunch on ball and prone and side bridge (plank) on knees positions. Lumbar paraspinal activity was significantly greater in the 3 side position exercises compared with all remaining exercises. Latissimus dorsi activity was significantly greater in the prone on ball with left and right hip extension and prone bridge (plank) on ball and on toes compared with the crunch, bent-knee sit-up, and prone and side bridge (plank) on knees positions. Rectus femoris activity was significantly greater in the prone on ball with left hip extension, bent-knee sit-up, or prone bridge (plank) on toes compared with the remaining exercises.
CONCLUSION
Prone position exercises are good alternatives to supine position exercises for recruiting core musculature. Side position exercises are better for oblique and lumbar paraspinal recruitment.
CLINICAL RELEVANCE
Because high core muscle activity is associated with high spinal compressive loading, muscle activation patterns should be considered when prescribing trunk exercises to those in which high spinal compressive loading may be deleterious.
Topics: Abdominal Muscles; Adult; Back Muscles; Electromyography; Exercise; Female; Humans; Male; Middle Aged; Posture; Prone Position; Sports Equipment; Supine Position; Young Adult
PubMed: 27302152
DOI: 10.1177/1941738116653931 -
Knee Surgery, Sports Traumatology,... Dec 2017Adductor longus injuries are complex. The conflict between views in the recent literature and various nineteenth-century anatomy books regarding symphyseal and...
PURPOSE
Adductor longus injuries are complex. The conflict between views in the recent literature and various nineteenth-century anatomy books regarding symphyseal and perisymphyseal anatomy can lead to difficulties in MRI interpretation and treatment decisions. The aim of the study is to systematically investigate the pyramidalis muscle and its anatomical connections with adductor longus and rectus abdominis, to elucidate injury patterns occurring with adductor avulsions.
METHODS
A layered dissection of the soft tissues of the anterior symphyseal area was performed on seven fresh-frozen male cadavers. The dimensions of the pyramidalis muscle were measured and anatomical connections with adductor longus, rectus abdominis and aponeuroses examined.
RESULTS
The pyramidalis is the only abdominal muscle anterior to the pubic bone and was found bilaterally in all specimens. It arises from the pubic crest and anterior pubic ligament and attaches to the linea alba on the medial border. The proximal adductor longus attaches to the pubic crest and anterior pubic ligament. The anterior pubic ligament is also a fascial anchor point connecting the lower anterior abdominal aponeurosis and fascia lata. The rectus abdominis, however, is not attached to the adductor longus; its lateral tendon attaches to the cranial border of the pubis; and its slender internal tendon attaches inferiorly to the symphysis with fascia lata and gracilis.
CONCLUSION
The study demonstrates a strong direct connection between the pyramidalis muscle and adductor longus tendon via the anterior pubic ligament, and it introduces the new anatomical concept of the pyramidalis-anterior pubic ligament-adductor longus complex (PLAC). Knowledge of these anatomical relationships should be employed to aid in image interpretation and treatment planning with proximal adductor avulsions. In particular, MRI imaging should be employed for all proximal adductor longus avulsions to assess the integrity of the PLAC.
Topics: Aged; Cadaver; Groin; Humans; Ligaments, Articular; Male; Middle Aged; Pubic Symphysis; Rectus Abdominis
PubMed: 28866812
DOI: 10.1007/s00167-017-4688-2 -
International Journal of Environmental... Jun 2022To investigate the efficacy of exercise intervention using a real-time video conferencing platform (ZOOM) on inter-recti distance, abdominal muscle thickness, static... (Randomized Controlled Trial)
Randomized Controlled Trial
To investigate the efficacy of exercise intervention using a real-time video conferencing platform (ZOOM) on inter-recti distance, abdominal muscle thickness, static trunk endurance, and maternal quality of life, 37 women with diastasis recti between six months and one year postpartum were randomly divided into the online (n = 19) and offline (n = 18) groups. The online group underwent 40-min trunk stabilization exercise sessions twice a week for six weeks, through a real-time video conference platform, while the offline group attended the same program in person. The inter-recti distance and muscle thickness between the abdominal muscles were measured by rehabilitation ultrasound imaging, the Torso endurance test was used to compare the static trunk endurance, and the maternal quality of life questionnaire (MAPP-QOL, score) was applied. Significant improvements were observed in the inter-recti distance between the rectus abdominis, abdominal muscle thickness, static trunk endurance, and maternal quality of life in both groups (p < 0.001); a more significant improvement was observed in the offline group. No significant differences were observed between groups except for the left rectus abdominis thickness and Psychological/Baby and Relational/Spouse-Partner subscale in the maternal quality of life index (p > 0.05). Exercise interventions delivered in a real-time videoconferencing platform are effective at improving the inter-recti distance, trunk stability, and quality of life in postpartum women and may be an alternate to face-to-face intervention.
Topics: Exercise; Female; Humans; Postpartum Period; Quality of Life; Rectus Abdominis; Videoconferencing
PubMed: 35742279
DOI: 10.3390/ijerph19127031 -
BMJ Open Feb 2022Diastasis recti abdominis (DRA) is a common condition in pregnant and postpartum women.Evidence for the treatment of DRA is both sparse and weak. As thiscondition occurs...
INTRODUCTION
Diastasis recti abdominis (DRA) is a common condition in pregnant and postpartum women.Evidence for the treatment of DRA is both sparse and weak. As thiscondition occurs during the last two trimesters of pregnancy and there is a paucity of high-quality studies on a pregnant population, we will conduct a randomised trial on the effect ofa specific exercise programme during pregnancy on DRA.
METHODS AND ANALYSIS
This is an exploratory, assessor-blinded, randomised parallel group trial carried out in aprimary healthcare setting in a Norwegian city. 100 pregnant women, both primigravida andmultigravida, in gestation week 24 presenting with DRA of ≥28 mm willbe included. Participants will be allocated to either an intervention group or a control groupby block randomisation. The intervention group will participate in a 12-week specific exerciseprogramme. The control group will not participate in any exercise intervention. Data collectionwill take place prior to intervention, postintervention at gestation week 37, and 6 weeks, 6and 12 months postpartum. The primary outcome measure will be change in the inter-rectidistance, measured by two-dimensional ultrasonography. Data will be analysed and presentedin accordance with international Consolidated Standards of Reporting Trials guidelines and analysed according to the intention-to-treat principle.
ETHICS AND DISSEMINATION
Ethical approval has been obtained by the regional ethical committee (76296), and allprocedures will be performed in adherence to the Helsinki declaration. The study has beenregistered with ClinicalTrials.gov. Results from this study will be presented atscientific conferences and in peer-reviewed scientific journals.
TRIAL REGISTRATION NUMBER
NCT04960800; Pre-results.
Topics: Exercise; Exercise Therapy; Female; Humans; Postpartum Period; Pregnancy; Pregnant Women; Randomized Controlled Trials as Topic; Rectus Abdominis
PubMed: 35121606
DOI: 10.1136/bmjopen-2021-056558