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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 -
Hernia : the Journal of Hernias and... Aug 2014Although ventral incisional hernia (VIH) repair in patients is often evaluated in terms of hernia recurrence rate and health-related quality of life, there is no clear... (Review)
Review
PURPOSE
Although ventral incisional hernia (VIH) repair in patients is often evaluated in terms of hernia recurrence rate and health-related quality of life, there is no clear consensus regarding optimal operative treatment based on these parameters. It was proposed that health-related quality of life depends largely on abdominal muscle function (AMF), and the present review thus evaluates to what extent AMF is influenced by VIH and surgical repair.
METHODS
The PubMed and EMBASE databases were searched for articles following a systematic strategy for inclusion.
RESULTS
A total of seven studies described AMF in relation to VIH. Five studies examined AMF using objective isokinetic dynamometers to determine muscle strength, and two studies examined AMF by clinical examination-based muscle tests.
CONCLUSION
Both equipment-related and functional muscle tests exist for use in patients with VIH, but very few studies have evaluated AMF in VIH. There are no randomized controlled studies to describe the impact of VIH repair on AMF, and no optimal surgical treatment in relation to AMF after VIH repair can be advocated for at this time.
Topics: Abdominal Muscles; Abdominal Wall; Hernia, Ventral; Herniorrhaphy; Humans; Muscle Strength; Muscle Strength Dynamometer; Quality of Life; Recovery of Function
PubMed: 24728836
DOI: 10.1007/s10029-014-1242-8 -
Chest Oct 2021
Topics: Abdominal Muscles; Cough; Humans; Respiration, Artificial; Ultrasonography; Ventilator Weaning
PubMed: 34625161
DOI: 10.1016/j.chest.2021.07.006 -
Journal of Strength and Conditioning... Feb 2021Crommert, ME, Bjerkefors, A, Tarassova, O, and Ekblom, MM. Abdominal muscle activation during common modifications of the trunk curl-up exercise. J Strength Cond Res...
Crommert, ME, Bjerkefors, A, Tarassova, O, and Ekblom, MM. Abdominal muscle activation during common modifications of the trunk curl-up exercise. J Strength Cond Res 35(2): 428-435, 2021-The purpose of this study was to investigate effects of common modifications of trunk curl-up exercise on the involvement of the abdominal muscles, particularly the deepest muscle layer, transversus abdominis (TrA). Ten healthy females performed 5 different variations of the trunk curl-up at a standardized speed, varying the exercise by assuming 3 different arm positions and applying left and right twist. Indwelling fine-wire electromyography (EMG) electrodes were used to record from TrA, obliquus internus (OI), obliquus externus (OE), and rectus abdominis (RA) unilaterally on the right side. Increasing the load by changing the arm position during a straight trunk curl-up increased the EMG of all abdominal muscles. Obliquus internus and TrA showed higher activation during right twist compared with left twist, whereas OE displayed the opposite pattern. Rectus abdominis did not show any change in activation level between twisting directions. The apparent load dependency on the activation level of all muscles, and the twisting direction dependency of all muscles except RA, are in keeping with the fiber orientation of the muscles. Notably, also TrA, with a less obvious mechanical role with regards to fiber orientation, increased activation with load during the straight trunk curl-up. However, the highest activation level of TrA during the trunk curl-up was only 40% of a maximum contraction; thus, it might not be the most suitable strength training exercise for this muscle.
Topics: Abdominal Muscles; Electromyography; Exercise Therapy; Female; Humans; Muscle Contraction; Rectus Abdominis; Torso
PubMed: 29319600
DOI: 10.1519/JSC.0000000000002439 -
Chest Oct 2021Ultrasound may be useful to assess the structure, activity, and function of the abdominal muscles in patients who are mechanically ventilated. (Observational Study)
Observational Study
BACKGROUND
Ultrasound may be useful to assess the structure, activity, and function of the abdominal muscles in patients who are mechanically ventilated.
RESEARCH QUESTION
Does measurement of abdominal muscle thickening on ultrasound in patients who are mechanically ventilated provide clinically relevant information about abdominal muscle function and weaning outcomes?
STUDY DESIGN AND METHODS
This study consisted of two parts, a physiological study conducted in healthy subjects and a prospective observational study in patients who were mechanically ventilated. Abdominal muscle thickness and thickening fraction were measured during cough and expiratory efforts in 20 healthy subjects, and prior to and during a spontaneous breathing trial in 57 patients being ventilated.
RESULTS
In healthy subjects, internal oblique and rectus abdominis thickening fraction correlated with pressure generated during expiratory efforts (P < .001). In patients being ventilated, abdominal muscle thickness and thickening fraction were feasible to measure in all patients, and reproducibility was moderately acceptable. During a failed spontaneous breathing trial, thickening fraction of transversus abdominis and internal oblique increased substantially from baseline (13.2% [95% CI, 0.9-24.8] and 7.2% [95% CI, 2.2-13.2], respectively). The combined thickening fraction of transversus abdominis, internal oblique, and rectus abdominis measured during cough was associated with an increased risk of reintubation or reconnection to the ventilator following attempted liberation (OR, 2.1; 95% CI, 1.1-4.4 per 10% decrease in thickening fraction).
INTERPRETATION
Abdominal muscle thickening on ultrasound was correlated to the airway pressure generated by expiratory efforts. In patients who were mechanically ventilated, abdominal muscle ultrasound measurements are feasible and moderately reproducible. Among patients who passed a spontaneous breathing trial, reduced abdominal muscle thickening during cough was associated with a high risk of liberation failure.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov; No.: NCT03567564; URL: www.clinicaltrials.gov.
Topics: Abdominal Muscles; Abdominal Oblique Muscles; Adult; Aged; Cough; Exhalation; Female; Healthy Volunteers; Humans; Male; Maximal Respiratory Pressures; Middle Aged; Pneumonia; Postoperative Care; Prospective Studies; Rectus Abdominis; Reproducibility of Results; Respiration; Respiration, Artificial; Respiratory Insufficiency; Respiratory Mechanics; Thoracic Surgical Procedures; Ultrasonography; Ventilator Weaning
PubMed: 34090872
DOI: 10.1016/j.chest.2021.05.053 -
International Journal of Environmental... Feb 2021Abdominal muscles may be both morphologically and functionally affected by pregnancy. Dysfunction of the muscles can lead to persistent postpartum low back pain. The...
Abdominal muscles may be both morphologically and functionally affected by pregnancy. Dysfunction of the muscles can lead to persistent postpartum low back pain. The recovery process of the abdominal muscles following childbirth is not well understood. This study aimed to demonstrate the changes in the thickness and contractile function of abdominal muscles during the first six months postpartum. Nine perinatal and 15 nulliparous females participated. The thicknesses and contraction/relaxation thickness ratios of the rectus abdominis (RA), external abdominal oblique (EO), internal abdominal oblique (IO), and transverse abdominis (TrA) were measured using ultrasound images from 36-39 weeks' gestation until six months postpartum. The RA, IO, and TrA muscles were thinner in perinatal females than controls at 36-39 weeks of gestation (4.8 vs. 9.47 mm (RA), 5.45 vs. 7.73 mm (IO), 2.56 vs. 3.38 mm (TrA), respectively). The thinner IO muscle persisted for six months after delivery. The decreased TrA thickness ratio persisted until four months post-delivery. Abdominal muscle thickness and contractile function decreased in the postpartum period. Therefore, abdominal muscle exercises might help prevent postpartum symptoms; however, because deterioration of muscle function is significant in the first four months, careful attention should be paid to exercise intensity. The study limitation was a relatively small sample size, thus future studies should involve more participants.
Topics: Abdominal Muscles; Exercise; Female; Humans; Low Back Pain; Muscle Contraction; Pregnancy; Ultrasonography
PubMed: 33671663
DOI: 10.3390/ijerph18042130 -
Journal of Musculoskeletal & Neuronal... Sep 2022The study aims to investigate the relationship between abdominal muscle activity and the cross-sectional area (CSA) of the lumbar muscles and assess their role in the...
Association between abdominal muscle activity and lumbar muscle morphology, and their role in the functional assessment of patients with low back pain: A cross-sectional study.
OBJECTIVES
The study aims to investigate the relationship between abdominal muscle activity and the cross-sectional area (CSA) of the lumbar muscles and assess their role in the functional assessment of patients with chronic non-specific low back pain (CNSLBP).
METHODS
142 patients with CNSLBP were included in this study. Disability levels were evaluated with the Roland-Morris Low Back Pain and Disability Questionnaire. The functional assessments of the participants were evaluated with a 6-minute walk test. Abdominal muscle activity was measured using a pressure biofeedback unit. The CSA of the bilateral multifidus, erector spinae, and psoas muscles were measured T2-weighted MRI images at the L2-L5 levels.
RESULTS
Significant correlations were found between the abdominal muscle activity during the posterior pelvic tilt movement and the CSA of the erector spinae muscle at the L4 and L5 levels, and the psoas muscle at the L2-L5 levels (correlation coefficient range from 0.32 to 0.48). Abdominal muscle activity yielded a significant additional contribution to the variance on the functional assessment (R change=0.101).
CONCLUSIONS
The relationship of abdominal muscle activity with lumbar muscles and the contribution of muscle activities to functional assessment should be considered in the management of patients with CNSLBP.
Topics: Abdominal Muscles; Cross-Sectional Studies; Humans; Low Back Pain; Lumbar Vertebrae; Magnetic Resonance Imaging; Paraspinal Muscles
PubMed: 36046994
DOI: No ID Found -
Journal of Ultrasound in Medicine :... Sep 2023Lumbopelvic pain (LPP) is a very common cause of discomfort during pregnancy, but its etiology remains unclear. The association between abdominal muscle thickness and...
OBJECTIVES
Lumbopelvic pain (LPP) is a very common cause of discomfort during pregnancy, but its etiology remains unclear. The association between abdominal muscle thickness and LPP in pregnant women has not been studied extensively, despite the significant abdominal changes that occur during pregnancy. This study aimed to examine the relationship between abdominal muscle thickness and LPP in pregnant women.
METHODS
In this study, 49 pregnant women in their second trimester participated. The intensity of LPP was assessed using a numerical rating scale. Ultrasound imaging was used to measure the thickness of abdominal muscles, including the rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles. Participants were classified into two groups, the LPP group and non-LPP group, and the abdominal muscle thickness was compared between the two groups. The statistical significance level was set at P < .05.
RESULTS
There were 24 and 25 participants in the LPP and non-LPP groups, respectively. Internal oblique (IO) thickness was significantly thinner in the LPP group than in the non-LPP group (5.4 ± 0.2 mm versus 6.1 ± 0.2 mm; P = .042). Multivariate logistic regression analysis showed that IO thickness was significantly associated with LPP (odds ratio, 0.516; 95% confidence interval, 0.284-0.935; P = .019).
CONCLUSIONS
This study suggested that LPP in second trimester pregnancy might be related to IO thickness. Further longitudinal studies are needed to understand the role of this muscle as an LPP risk factor for pregnant women.
Topics: Female; Humans; Pregnancy; Pregnant Women; Low Back Pain; Abdominal Muscles; Ultrasonography; Rectus Abdominis
PubMed: 37079609
DOI: 10.1002/jum.16232 -
Journal of Physical Activity & Health Apr 2022Using data from a multiethnic cohort, the authors tested associations of multiple types and intensities of physical activity (PA) with abdominal muscle area and density.
BACKGROUND
Using data from a multiethnic cohort, the authors tested associations of multiple types and intensities of physical activity (PA) with abdominal muscle area and density.
METHODS
1895 Multiethnic Study of Atherosclerosis participants (mean age 64.6 [9.6] y) completed health history and PA questionnaires and computed tomography to quantify body composition and measurements of cardiovascular and inflammatory biomarkers. Analyses included multivariable regression.
RESULTS
Compared with those not meeting PA guidelines for Americans, those meeting the guidelines had higher total abdominal muscle area (odds ratio, 95% confidence interval 1.60, 1.20 to 2.15), stability muscle area (1.68, 1.28 to 2.20), and stability muscle density (1.35, 1.03 to 1.76). After adjustment for relevant covariates, each SD increase in total moderate to vigorous PA was associated with a higher total abdominal (β, 95% confidence interval = 0.068, 0.036 to 0.173), stability (0.063, 0.027 to 0.099), and locomotor (0.069, 0.039 to 0.099) muscle area and higher locomotor muscle density (0.065, 0.022 to 0.108, P < .01). Only intentional and conditioning exercise were associated with total abdominal and stability muscle density (P < .05). Light PA and walking were not associated with muscle area or density.
CONCLUSIONS
Most types of PA are positively associated with abdominal muscle area and density across functional categories, independent of relevant covariates. These results provide additional evidence for promoting PA for healthy muscle aging.
Topics: Abdominal Muscles; Atherosclerosis; Body Composition; Cardiovascular System; Exercise; Humans; Middle Aged
PubMed: 35276663
DOI: 10.1123/jpah.2021-0409 -
Physical Therapy Aug 2009Rehabilitative ultrasound imaging (RUSI) measures of abdominal wall muscles are used to indirectly measure muscle activity. These measures are used to identify suitable... (Review)
Review
BACKGROUND
Rehabilitative ultrasound imaging (RUSI) measures of abdominal wall muscles are used to indirectly measure muscle activity. These measures are used to identify suitable patients and to monitor progress of motor control exercise treatment of people with low back pain.
PURPOSE
The purpose of this study was to systematically review reproducibility studies of RUSI for measuring thickness of abdominal wall muscles.
DATA SOURCES
Eligible studies were identified via searches of MEDLINE, EMBASE, and CINAHL. The authors also searched personal files and tracked references of the retrieved studies via the Web of Science Index.
STUDY SELECTION
Studies involving any type of reliability and or agreement of any type of ultrasound measurements (B or M mode) for any of the abdominal wall muscles were selected.
DATA EXTRACTION
Two independent reviewers extracted data and assessed methodological quality.
DATA SYNTHESIS
Due to heterogeneity of the studies' designs, pooling the data for a meta-analysis was not possible. Twenty-one studies were included, and these studies were typically of low quality and studied subjects who were healthy rather than people seeking care for low back pain. The studies reported good to excellent reliability for single measures of thickness and poor to good reliability for measures of thickness change (reflecting the muscle activity). Interestingly, no studies checked reliability of measures of the difference in thickness changes over time (representing improvement or deterioration in muscle activity).
CONCLUSIONS
The current evidence of the reproducibility of RUSI for measuring abdominal muscle activity is based mainly on studies with suboptimal designs and the study of people who were healthy. The critical question of whether RUSI provides reliable measures of improvement in abdominal muscle activity remains to be evaluated.
Topics: Abdominal Muscles; Abdominal Wall; Humans; Muscle Contraction; Reproducibility of Results; Ultrasonography
PubMed: 19520732
DOI: 10.2522/ptj.20080331