-
Journal of Physiotherapy Jul 2023What is the effect of a 12-week, home-based, abdominal exercise program containing head lifts and abdominal curl-ups on inter-recti distance (IRD) in women with... (Randomized Controlled Trial)
Randomized Controlled Trial
Curl-up exercises improve abdominal muscle strength without worsening inter-recti distance in women with diastasis recti abdominis postpartum: a randomised controlled trial.
QUESTION
What is the effect of a 12-week, home-based, abdominal exercise program containing head lifts and abdominal curl-ups on inter-recti distance (IRD) in women with diastasis recti abdominis (DRA) 6 to 12 months postpartum? What is the effect of the program on: observed abdominal movement during a curl-up; global perceived change; rectus abdominis thickness; abdominal muscle strength and endurance; pelvic floor disorders; and low back, pelvic girdle and abdominal pain?
DESIGN
This was a two-arm, parallel-group, randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis.
PARTICIPANTS
Seventy primiparous or multiparous women 6 to 12 months postpartum, having a single or multiple pregnancy following any mode of delivery, with a diagnosis of DRA (IRD > 28 mm at rest or > 25 mm during a curl-up).
INTERVENTION
The experimental group was prescribed a 12-week standardised exercise program including head lifts, abdominal curl-ups and twisted abdominal curl-ups 5 days a week. The control group received no intervention.
OUTCOME MEASURES
The primary outcome measure was change in IRD measured with ultrasonography. Secondary outcomes were: observed abdominal movement during a curl-up; global perceived change; rectus abdominis thickness; abdominal muscle strength and endurance; pelvic floor disorders; and low back, pelvic girdle and abdominal pain.
RESULTS
The exercise program did not improve or worsen IRD (eg, MD 1 mm at rest 2 cm above the umbilicus, 95% CI -1 to 4). The program improved rectus abdominis thickness (MD 0.7 mm, 95% CI 0.1 to 1.3) and strength (MD 9 Nm, 95% CI 3 to 16) at 10 deg; its effects on other secondary outcomes were trivial or unclear.
CONCLUSION
An exercise program containing curl-ups for women with DRA did not worsen IRD or change the severity of pelvic floor disorders or low back, pelvic girdle or abdominal pain, but it did increase abdominal muscle strength and thickness.
REGISTRATION
NCT04122924.
Topics: Pregnancy; Female; Humans; Rectus Abdominis; Pelvic Floor Disorders; Abdominal Muscles; Postpartum Period; Exercise Therapy; Diastasis, Muscle; Abdominal Pain
PubMed: 37286390
DOI: 10.1016/j.jphys.2023.05.017 -
Physiological Reports Nov 2023The existence of spot reduction, exercise-induced local body fat reduction, has been debated for half a century. Although the evidence is equivocal, no study has applied... (Randomized Controlled Trial)
Randomized Controlled Trial
The existence of spot reduction, exercise-induced local body fat reduction, has been debated for half a century. Although the evidence is equivocal, no study has applied aerobic endurance training closely matching interventions for energy expenditure. Sixteen overweight (BMI: 29.8 ± 3.3(SD) kg m ) males (43 ± 9 years) were randomized to: (1) abdominal endurance exercise (AG), combining treadmill running at 70% HR (27 min) with 4 × 4 min (30%-40% maximal strength, 1RM) of torso rotation and abdominal crunches (57 min), 4 days⋅week for 10 weeks; or (2) control group (CG) performing only treadmill running (45 min) at 70% HR . Local fat mass was measured by dual-energy x-ray absorptiometry (DEXA), along with 1RM, and pulmonary oxygen uptake (to control energy expenditure during training). Trunk fat mass decreased more (697 g, 3%, p < 0.05) in AG (1170 ± 1093 g, 7%; p < 0.05) than in CG (no change). Total fat mass (AG: 1705 ± 1179 g, 6%; CG: 1134 ± 731 g, 5%; both p < 0.01) and body weight (AG: 1.2 ± 1.2 kg, 1%, p < 0.05; CG: 2.3 ± 0.9 kg, 3%, p < 0.01) decreased similarly in AG/CG. Torso rotation (AG: 32 ± 16 kg, 39%, p < 0.01; CG: no change) and abdominal crunch 1RM (AG: 35 ± 16 kg, 36%, p < 0.01; CG: 13 ± 12 kg, 17%, p < 0.05) increased more (p < 0.05/0.01) in AG than CG. Abdominal endurance exercise utilized more local fat than treadmill running, indicating that spot reduction exists in adult males.
Topics: Adult; Male; Humans; Exercise Therapy; Exercise; Abdominal Muscles; Body Weight; Adipose Tissue; Body Composition
PubMed: 38010201
DOI: 10.14814/phy2.15853 -
Anatomical Science International Jul 2023The purpose of this review is to present our researches on the pelvic outlet muscles, including the pelvic floor and perineal muscles, which are responsible for urinary... (Review)
Review
The purpose of this review is to present our researches on the pelvic outlet muscles, including the pelvic floor and perineal muscles, which are responsible for urinary function, defecation, sexual function, and core stability, and to discuss the insights into the mechanism of pelvic floor stabilization based on the findings. Our studies are conducted using a combination of macroscopic examination, immunohistological analysis, 3D reconstruction, and imaging. Unlike most previous reports, this article describes not only on skeletal muscle but also on smooth muscle structures in the pelvic floor and perineum to encourage new understanding. The skeletal muscles of the pelvic outlet are continuous, which means that they share muscle bundles. They form three muscle slings that pass anterior and posterior to the anal canal, thus serving as the foundation of pelvic floor support. The smooth muscle of the pelvic outlet, in addition to forming the walls of the viscera, also extends in three dimensions. This continuous smooth muscle occupies the central region of the pelvic floor and perineum, thus revising the conventional understanding of the perineal body. At the interface between the levator ani and pelvic viscera, smooth muscle forms characteristic structures that transfer the lifting power of the levator ani to the pelvic viscera. The findings suggest new concepts of pelvic floor stabilization mechanisms, such as dynamic coordination between skeletal and smooth muscles. These two types of muscles possibly coordinate the direction and force of muscle contraction with each other.
Topics: Pelvic Floor; Perineum; Muscle, Skeletal; Muscle, Smooth; Anal Canal
PubMed: 36961619
DOI: 10.1007/s12565-023-00717-7 -
Journal of Bodywork and Movement... Oct 2023Core stabilization is a vital concept in clinical rehabilitation (including low back pain rehabilitation) and competitive athletic training. The core comprises of a... (Review)
Review
INTRODUCTION
Core stabilization is a vital concept in clinical rehabilitation (including low back pain rehabilitation) and competitive athletic training. The core comprises of a complex network of hip, trunk and neck muscles including the diaphragm.
AIMS
The paper aims to discuss the role of the diaphragm in core stability, summarize current evidence and put forth ideal core training strategies involving the diaphragm.
METHOD
Narrative review RESULTS: The diaphragm has a dual role of respiration and postural control. Evidence suggests that current core stability exercises for low back pain are superior than minimal or no treatment, however, no more beneficial than general exercises and/or manual therapy. There appears to be a higher focus on the transversus abdominis and multifidi muscles and minimal attention to the diaphragm. We propose that any form of core stabilization exercises for low back pain rehabilitation should consider the diaphragm. Core stabilization program could commence with facilitation of normal breathing patterns and progressive systematic restoration of the postural control role of the diaphragm muscle.
CONCLUSION
The role of the diaphragm is often overlooked in both research and practice. Attention to the diaphragm may improve the effectiveness of core stability exercise in low back pain rehabilitation.
Topics: Humans; Diaphragm; Low Back Pain; Exercise Therapy; Exercise; Abdominal Muscles
PubMed: 37949564
DOI: 10.1016/j.jbmt.2023.07.008 -
Archives of Physical Medicine and... Nov 2023To compare the effects of Swiss ball stabilization training (SBST) and stable surface stabilization training (SSST) on the trunk control, abdominal muscle thickness,... (Randomized Controlled Trial)
Randomized Controlled Trial
Effect of Swiss Ball Stabilization Training on Trunk Control, Abdominal Muscle Thickness, Balance, and Motor Skills of Children With Spastic Cerebral Palsy: A Randomized, Superiority Trial.
OBJECTIVES
To compare the effects of Swiss ball stabilization training (SBST) and stable surface stabilization training (SSST) on the trunk control, abdominal muscle thickness, balance, and motor skills of children with spastic cerebral palsy (CWSCP).
DESIGN
Single-blind, randomized superiority trial.
SETTING
General Community and Referral Center.
PARTICIPANTS
Thirty CWSCP, aged 6-12 years, with Gross Motor Function Classification System levels I-III were randomly assigned to the SBST and SSST groups (N=30).
INTERVENTIONS
The participants were randomized to receive either SBST or SSST for 5 weeks, 3 days a week.
OUTCOME MEASURES
The Trunk Control Measurement Scale (TCMS), abdominal muscle thickness, Pediatric Balance Scale (PBS), standing and walking sections of Gross Motor Function Measure (GMFM-88), and mobility section of the Pediatric Evaluation of Disability Inventory (PEDI) were assessed.
RESULTS
After 5 weeks of the intervention and 9 weeks of follow-up, the SBST group showed statistically significant improvements in the TCMS, GMFM-88, PEDI, thickness of the internal oblique muscle at rest and contraction, and thickness of the transverse abdominis muscle at rest and contraction compared with the SSST group (P<.0001). Contrarily, the thickness of the external oblique muscle increased statistically significantly in the SSST group compared with the SBST group after 5 weeks of the intervention and 9 weeks of follow-up both at rest (P<.0001 and P=.0001, respectively) and contraction (P=.015 and P=.017, respectively). No statistically significant difference was found between the groups regarding the PBS score after 5 weeks of intervention.
CONCLUSION
The SBST could improve the trunk control, balance, and motor skills of CWSCP and increase the thickness of local abdominal muscles. Also, SBST was more effective than SSST for CWSCP.
Topics: Child; Humans; Cerebral Palsy; Motor Skills; Single-Blind Method; Switzerland; Abdominal Muscles
PubMed: 37442218
DOI: 10.1016/j.apmr.2023.05.011 -
BMJ Case Reports Sep 2023The vermiform appendix (VA) is known to exhibit a wide range of anatomic variability, with clinical presentation correlating with certain known anatomic positioning. To...
The vermiform appendix (VA) is known to exhibit a wide range of anatomic variability, with clinical presentation correlating with certain known anatomic positioning. To the best of our knowledge, we describe the second known case of a retro-psoas muscle VA variant and the first known case of appendicitis in such a location. Retroperitoneal access was obtained, and the appendix was freed from the intermuscular recess between the psoas and iliacus. The peritoneal defect was primarily repaired, and the patient was discharged on postoperative day 1 in good condition.
Topics: Humans; Appendicitis; Appendix; Abdominal Muscles; Patient Discharge; Peritoneum
PubMed: 37730427
DOI: 10.1136/bcr-2022-253128 -
Archives of Gynecology and Obstetrics Jul 2023Our objective was to evaluate the effectiveness of pelvic floor physiotherapy interventions for stress urinary incontinence (SUI) in postmenopausal women. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION AND HYPOTHESIS
Our objective was to evaluate the effectiveness of pelvic floor physiotherapy interventions for stress urinary incontinence (SUI) in postmenopausal women.
METHODS
Searches were performed in MEDLINE/PubMed, PEDro, Cochrane Library Registry and LILACS databases until October 2021. Only randomized controlled trials (RCTs) which had physiotherapy interventions as primary outcome were included. There were no restrictions on the year of publication or language. Qualitative methodology was evaluated using the PEDro scale.
RESULTS
After applying inclusion/exclusion criteria and quality control, 6 randomized controlled trials were included in this systematic review. Methodological quality of trials varied from 5 to 8 (out of 10 possible points in PEDro scale score). Sample consisted of 715 subjects; mean age was between 51.6 and 66.3 years; SUI severity scale ranged from small to severe. Interventions were pelvic floor muscle training (PFMT); vaginal cone (VC); biofeedback (BF); electrical muscle stimulation (EMS); radiofrequency (RF) and electroacupuncture (EA). Pelvic floor physiotherapy was effective in all studies, however, meta-analysis was considered irrelevant due to the heterogeneity of the reported interventions.
CONCLUSION
There is not a literature consensus about the most effective pelvic floor physiotherapy intervention applied to stress urinary incontinence in postmenopausal women. It seems appropriate to state that further randomized controlled clinical trials should be done, due to the limited number of studies and heterogeneity of physiotherapeutic interventions applied to date.
TRIAL REGISTRATION
This systematic review is registered in PROSPERO in the trial registration CRD42021255062.
Topics: Female; Humans; Middle Aged; Aged; Urinary Incontinence, Stress; Pelvic Floor; Exercise Therapy; Postmenopause; Physical Therapy Modalities; Treatment Outcome
PubMed: 35831758
DOI: 10.1007/s00404-022-06693-z -
Chirurgie (Heidelberg, Germany) Oct 2023
Topics: Humans; Abdomen; Abdominal Muscles; Abdominal Neoplasms
PubMed: 37752356
DOI: 10.1007/s00104-023-01947-1 -
BMC Primary Care Sep 2023Low back pain is one of the most common disabling pathologies in humanity worldwide. Physical exercises have been used in recent decades to reduce the pain, improve the... (Randomized Controlled Trial)
Randomized Controlled Trial
Effectiveness of an exercise intervention based on preactivation of the abdominal transverse muscle in patients with chronic nonspecific low back pain in primary care: a randomized control trial.
BACKGROUND
Low back pain is one of the most common disabling pathologies in humanity worldwide. Physical exercises have been used in recent decades to reduce the pain, improve the functionality of the lumbar spine and avoid relapses. The purpose of the study is to analyze the effect of a program based on re-education exercises involving preactivation of the abdominal transverse muscle compared to conventional treatment in adults with chronic nonspecific low back pain.
METHODS
A two-arm, single-blind randomized control trial with 35 primary care patients with chronic nonspecific low back pain. Both groups received a 4-week intervention. Data were collected at baseline and at the end of the intervention. Sixteen patients participated in the intervention group, and 19 patients in the control group.
RESULTS
For the experimental group, the outcomes of disability and activation of the abdominal transverse muscle decreased significantly (MD -2.9; CI 95% -5.6 to -0.35; η2 = 0.14; p = 0.028) and (MD 2.3; CI 95% 0.91 to 3.67; η2 = 0.25; p = 0.002) respectively, with a large effect size, compared to the control group. There were no differences between the groups in pain intensity, thickness, and resistance of the transverse abdominal muscle.
CONCLUSION
A 4-week specific program based on re-education exercises of the preactivation of the abdominal transverse muscle is more effective than conventional treatment for reducing disability and increasing the activation of the abdominal transverse muscle measured by VAS scale and PBU.
TRIAL REGISTRATION
Clinicaltrials.gov identifier: NCT03097497. Date of registration: 31/03/2017.
Topics: Adult; Humans; Low Back Pain; Single-Blind Method; Abdominal Muscles; Exercise Therapy; Primary Health Care
PubMed: 37674205
DOI: 10.1186/s12875-023-02140-3