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Mark A. Sutherlin, L. Colby Mangum, Jay Hertel, Susan A. Saliba and Joseph M. Hart

Key Points ▸ Correlations exist between anthropometric measures and transversus abdominis and lumbar multifidus muscle thickness, but are influenced by positions and history of low back pain status. ▸ Mass and body mass index were the most consistent normalization variables for the transversus

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Shandi L. Partner, Mark Alan Sutherlin, Shellie Acocello, Susan A. Saliba, Eric M. Magrum and Joe M. Hart

Context:

Individuals with low back pain (LBP) have reduced function of the transversus abdominis (TrA) and lumbar multifidus (LM) muscles. Biofeedback during exercise may increase the ability to contract the TrA and LM muscles compared with exercise alone.

Objective:

To compare TrA preferential activation ratio (PAR) and the percent change in LM-muscle thickness in patients with LBP history before and after exercise with or without biofeedback.

Design:

Controlled laboratory study.

Setting:

University research laboratory.

Patients:

20 LBP individuals, 10 exercise alone and 10 exercise with biofeedback.

Interventions:

Patients were allotted to tabletop exercises in isolation or tabletop exercises with visual, auditory, and tactile biofeedback.

Main Outcome Measures:

TrA PAR and percent change in LM-muscle thickness.

Results:

There were no differences between groups at baseline (all P > .05). Nonparametric statistics showed decreased resting muscle thickness for total lateral abdominal-wall muscles (P = .007) but not TrA (P = .410) or LM (P = .173). Percent TrA thickness increased from table to standing positions before (P = .006) and after exercise (P = .009). TrA PAR increased after exercise (pre 0.01 ± 0.02, post 0.03 ± 0.04, P = .033) for all patients and for exercise with biofeedback (pre 0.02 ± 0.01, post 0.03 ± 0.01, P = .037) but not for exercise alone (pre 0.01 ± 0.02, post 0.02 ± 0.05, P = .241). No group differences were observed for TrA PAR before (exercise 0.01 ± 0.02, exercise with biofeedback 0.02 ± 0.01, P = .290) or after exercise (exercise 0.02 ± 0.05, exercise with biofeedback 0.03 ± 0.01, P = .174). There were no group differences in LM percent change before exercise (P = .999) or after exercise (P = .597). In addition, no changes were observed in LM percent change as a result of exercise among all participants (P = .391) or for each group (exercise P = .508, exercise with biofeedback P = .575).

Conclusion:

TrA PAR increased after a single session of exercises, whereas no thickness changes occurred in LM.

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Brian Catania, Travis Ross, Bradley Sandella, Bradley Bley and Andrea DiTrani Lobacz

15. Hodges PW , Richardson CA . Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb . Clin Spine Surg . 1998 ; 11 ( 1 ): 46 – 56 . 16. Djordjevic O , Djordjevic A , Konstantinovic L . Interrater and intrarater reliability

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Timothy J. Gibbons and Marie-Louise Bird

device on abdominal muscle activation during graded exercise have not been investigated. In determining abdominal muscle activation, the use of ultrasound technology has been employed in practice and research as a noninvasive method of investigating the activity of the transversus abdominis (TrA

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Billy Chun-Lung So, Calvin Hong-Nin Yuen, Ken Long-Hin Tung, Sheena Lam, Sammy Lan Cheng, Zina Wing-Lam Hung, Rainy Wai-Kwan Leung and Grace Pui-Yuk Szeto

collected from their right transversus abdominis (TrA), rectus abdominis (RA), lumbar multifidus (LM), and ES muscles, and videos were taken for motion analysis in synchronization to EMG signals. The DWR trials were conducted in a public swimming pool of 2 m deep with a water temperature of 27°C. The

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Jeffrey M. Willardson, Fabio E. Fontana and Eadric Bressel

Purpose:

To compare core muscle activity during resistance exercises performed on stable ground vs. the BOSU Balance Trainer.

Methods:

Twelve trained men performed the back squat, dead lift, overhead press, and curl lifts. The activity of the rectus abdominis, external oblique abdominis, transversus abdominis/internal oblique abdominis, and erector spinae muscles was assessed. Subjects performed each lift under three separate conditions including standing on stable ground with 50% of a 1-RM, standing on a BOSU Balance Trainer with 50% of a 1-RM, and standing on stable ground with 75% of a 1-RM.

Results:

Significant differences were noted between the stable 75% of 1-RM and BOSU 50% of 1-RM conditions for the rectus abdominis during the overhead press and transversus abdominis/internal oblique abdominis during the overhead press and curl (P < .05). Conversely, there were no significant differences between the stable 75% of 1-RM and BOSU 50% of 1-RM conditions for the external obliques and erector spinae across all lifts examined. Furthermore, there were no significant differences between the BOSU 50% of 1-RM and stable 50% of 1-RM conditions across all muscles and lifts examined.

Conclusions:

The current study did not demonstrate any advantage in utilizing the BOSU Balance Trainer. Therefore, fitness trainers should be advised that each of the aforementioned lifts can be performed while standing on stable ground without losing the potential core muscle training benefits.

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Rebecca J. Guthrie, Terry L. Grindstaff, Theodore Croy, Christopher D. Ingersoll and Susan A. Saliba

Context:

Individuals with low back pain (LBP) are thought to benefit from interventions that improve motor control of the lumbopelvic region. It is unknown if therapeutic exercise can acutely facilitate activation of lateral abdominal musculature.

Objective:

To investigate the ability of 2 types of bridging-exercise progressions to facilitate lateral abdominal muscles during an abdominal drawing-in maneuver (ADIM) in individuals with LBP.

Design:

Randomized control trial.

Setting:

University research laboratory.

Participants:

51 adults (mean ± SD age 23.1 ± 6.0 y, height 173.6 ± 10.5 cm, mass 74.7 ± 14.5 kg, and 64.7% female) with LBP. All participants met 3 of 4 criteria for stabilization-classification LBP or at least 6 best-fit criteria for stabilization classification.

Interventions:

Participants were randomly assigned to either traditional-bridge progression or suspension-exercise-bridge progression, each with 4 levels of progressive difficulty. They performed 5 repetitions at each level and were progressed based on specific criteria.

Main Outcome Measures:

Muscle thickness of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) was measured during an ADIM using ultrasound imaging preintervention and postintervention. A contraction ratio (contracted thickness:resting thickness) of the EO, IO, and TrA was used to quantify changes in muscle thickness.

Results:

There was not a significant increase in EO (F 1,47 = 0.44, P = .51) or IO (F 1,47 = .30, P = .59) contraction ratios after the exercise progression. There was a significant (F 1,47 = 4.05, P = .05) group-by-time interaction wherein the traditional-bridge progression (pre = 1.55 ± 0.22; post = 1.65 ± 0.21) resulted in greater (P = .03) TrA contraction ratio after exercise than the suspension-exercise-bridge progression (pre = 1.61 ± 0.31; post = 1.58 ± 0.28).

Conclusion:

A single exercise progression did not acutely improve muscle thickness of the EO and IO. The magnitude of change in TrA muscle thickness after the traditional-bridging progression was less than the minimal detectable change, thus not clinically significant.

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Samuel J. Howarth, Tyson A.C. Beach and Jack P. Callaghan

The goal of this study was to quantify the relative contributions of each muscle group surrounding the spine to vertebral joint rotational stiffness (VJRS) during the push-up exercise. Upper-body kinematics, three-dimensional hand forces and lumbar spine postures, and 14 channels (bilaterally from rectus abdominis, external oblique, internal oblique, latissimus dorsi, thoracic erector spinae, lumbar erector spinae, and multifidus) of trunk electromyographic (EMG) activity were collected from 11 males and used as inputs to a biomechanical model that determined the individual contributions of 10 muscle groups surrounding the lumbar spine to VJRS at five lumbar vertebral joints (L1-L2 to L5-S1). On average, the abdominal muscles contributed 64.32 ± 8.50%, 86.55 ± 1.13%, and 83.84 ± 1.95% to VJRS about the flexion/extension, lateral bend, and axial twist axes, respectively. Rectus abdominis contributed 43.16 ± 3.44% to VJRS about the flexion/extension axis at each lumbar joint, and external oblique and internal oblique, respectively contributed 52.61 ± 7.73% and 62.13 ± 8.71% to VJRS about the lateral bend and axial twist axes, respectively, at all lumbar joints with the exception of L5-S1. Owing to changes in moment arm length, the external oblique and internal oblique, respectively contributed 55.89% and 50.01% to VJRS about the axial twist and lateral bend axes at L5-S1. Transversus abdominis, multifidus, and the spine extensors contributed minimally to VJRS during the push-up exercise. The push-up challenges the abdominal musculature to maintain VJRS. The orientation of the abdominal muscles suggests that each muscle primarily controls the rotational stiffness about a single axis.

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most consistent normalization variables for the transversus abdominis muscle? a. body mass index and height times mass b. body mass index and hip circumference c. mass and body mass index d. mass and waist circumference 13. What was the most consistent normalization variable for the lumbar multifidus

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Rafael Gnat, Agata Dziewońska, Maciej Biały and Martyna Wieczorek

by studying corticospinal projections to the abdominal muscles. They found that transcranial magnetic stimulation of the ipsilateral motor cortex elicited responses from both ipsi- and contralateral transversus abdominis muscles, suggesting simultaneous engagement of the crossed and uncrossed