Objective
The purpose of the study was to examine the effectiveness of a novel supported dynamic lumbar extension with the abdominal drawing-in maneuver (ADIM) technique on stature change, deep ...abdominal muscle activity, trunk muscle fatigue, and pain intensity during prolonged sitting in chronic low back pain (CLBP) participants.
Background
Prolonged sitting can cause trunk muscle fatigue from continuous contraction of deep trunk muscles in seated postures. Deficiency of activity of deep muscles can reduce muscular support of the spine, causing stress on spinal structures, which could result in pain.
Method
Thirty participants with CLBP were randomly allocated: (a) control—sitting without exercise, and (b) intervention—supported dynamic lumbar extension with the ADIM technique.
Results
Compared to the intervention condition, the control condition demonstrated significantly greater deterioration in stature change, increased levels of deep trunk muscle fatigue, and an increase in pain during prolonged sitting.
Conclusion
The supported dynamic lumbar extension with the ADIM technique appears to provide a protective effect on detrimental stature change and deep trunk muscle fatigue. In addition, it prevented an increase in pain intensity during prolonged sitting in people with CLBP.
Application
Sedentary behavior harms health, particularly affecting the lower back. Clinicians can use the intervention to induce dynamic lumbar movement, and this exercise can maintain deep trunk muscle activity during prolonged sitting, thereby helping to prevent low back pain (LBP) problems.
Purpose To determine the short-term effects of thoracic manipulation, used alone or in conjunction with the Rungthip massage technique, on pain and neural extensibility in patients with chronic ...mechanical neck pain. Participants and Methods Thirty participants were randomly allocated to the aforementioned two groups. Outcome measures were neck pain at rest assessed using the Visual Analog Scale, and elbow extension range of motion evaluated using Upper Limb Neurodynamic Test 1 prior to treatment and three weeks after it. Results A statistically significant reduction in resting neck pain, and an improvement in elbow extension range of motion was reported by both groups shortly after the moment when the pain was first felt (threshold level). However, an improvement in elbow extension range of motion was not observed in either group at the maximum level of pain (tolerance level). A significant reduction in resting neck pain was seen in the thoracic manipulation plus Rungthip massage group, compared to that achieved using thoracic manipulation alone. Conclusion The use of thoracic manipulation and Rungthip massage is recommended to reduce resting neck pain and increase pain-free neural tissue extensibility.
Purpose This study aimed to examine the effect of core stabilization exercise (CSE) on joint position sense, pain intensity, and functional disability in patients with subacute non-specific low back ...pain (NSLBP). Participants and Methods Thirty-eight participants with subacute nonspecific low back pain of 6–12 weeks duration, aged 18–60 years, were included in this study. Participants were randomly divided into two groups: a core stabilization exercise group (n=19) or a control group (n=19). Outcomes measures included lumbar joint repositioning error (LJRE), numeric pain rating scale (11-NRS), and the Roland-Morris disability questionnaires (RMDQ). Measures were taken at baseline, 4 weeks, 7 weeks of intervention, and at 4 weeks after the last intervention. Results All outcomes measures were significantly improved in the core stabilization exercise group, compared with the control group. Conclusion Core stabilization exercise can improve acuity of joint position sense, reduce pain, and functional disability compared with thermal therapy. The finding demonstrated that core stabilization exercises are more suitable for patients with subacute NSLBP than thermal therapy and this should be useful to clinicians.
To enhance stature recovery, lumbar spine stabilization by stimulating the deep trunk muscle activation for compensation forces originating from the upper body was introduced. The abdominal ...drawing-in maneuver (ADIM) technique has been found mainly to activate deep trunk muscles. The purpose of the current study was to determine whether 5 weeks of training of deep trunk muscles using the ADIM technique could improve stature recovery, delay trunk muscle fatigue, and decrease pain intensity during prolonged sitting. Thirty participants with chronic low back pain (CLBP) conducted a core stabilization exercise (CSE) with the ADIM technique for 5 weeks. Participants were required to sit for 41 min before and after the exercise intervention. Stature change was measured using a seated stadiometer with a resolution of ±0.006 mm. During sitting, the stature change, pain intensity, and trunk muscle fatigue were recorded. A comparison between measurements at baseline and after 5 weeks of training demonstrated: (i) stature recovery and pain intensity significantly improved throughout the 41 min sitting condition; (ii) the bilaterally trunk muscle showed significantly decreased fatigue. The CSE with the ADIM technique was shown to provide a protective effect on detrimental reductions in stature change and trunk muscle fatigue during prolonged sitting in young participants under controlled conditions in a laboratory. This information may help to prevent the risk of LBP from prolonged sitting activities in real life situations.
Natural rubber is considered an economic plant in Thailand and is used to manufacture many products. Foam back pillows have proven to have various benefits for the lower back. However, no study has ...compared the effects of foam and rubber pillows. Therefore, the current study aimed to compare the efficacy of foam and rubber pillows on transversus abdominis and internal oblique muscle fatigue, patient satisfaction, and discomfort scores during 60 min of prolonged sitting. Thirty healthy participants were invited to the study and randomized into three sitting conditions over three consecutive days. The three groups were as follows: control, foam pillow, and rubber pillow. Our results revealed that the discomfort score increased with the sitting time in all three groups (
< 0.05). The control group had the highest discomfort when compared to the rubber pillow group at 30 min (T4;
= 0.007) and 60 min (T7;
= 0.0001), as well as the foam pillow group at 60 min (T7;
= 0.0001). Participants were more satisfied sitting with the two types of back pillows at the initial time (T1;
= 0.0001) and at 60 min (T7;
= 0.0001) when compared with the control group. Furthermore, the participants were more satisfied with using rubber pillows rather than foam pillows throughout the sitting period (
= 0.0001). The control group experienced more transversus abdominis and internal oblique muscle fatigue at 60 min (T7) of sitting compared to the initial time (T1) (
= 0.038). Thus, sitting with pillow support can decrease deep trunk muscle fatigue, and using a pillow made from natural rubber may ensure greater satisfaction and less discomfort for the user.
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 (
-value = 0.001). Our finding demonstrated that ADIM technique improved stature recovery.
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.
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.
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.
Trunk stability exercises that focus on either deep or superficial muscles might produce different effects on lumbar segmental motion. This study compared outcomes in 34 lumbar instability patients ...in two exercises at 10 weeks and 12 months follow up. Participants were divided into either Core stabilization (deep) exercise, incorporating abdominal drawing-in maneuver technique (CSE with ADIM), or General strengthening (superficial) exercise (STE). Outcome measures were pain, muscle activation, and lumbar segmental motion. Participants in CSE with ADIM had significantly less pain than those in STE at 10 weeks. They showed significantly more improvement of abdominal muscle activity ratio than participants in STE at 10 weeks and 12 months follow-up. Participants in CSE with ADIM had significantly reduced sagittal translation at L4-L5 and L5-S1 compared with STE at 10 weeks. Participants in CSE with ADIM had significantly reduced sagittal translations at L4-L5 and L5-S1 compared with participants in STE at 10 weeks, whereas STE demonstrated significantly increased sagittal rotation at L4-L5. However, at 12 months follow-up, levels of lumbar sagittal translation were increased in both groups. CSE with ADIM which focuses on increasing deep trunk muscle activity can reduce lumbar segmental translation and should be recommended for lumbar instability.
University students have the highest smartphone-use addiction, which coincides with a rising number in instances of neck pain. As the time in smartphone use increases, neck flexion tends to increase. ...These positions can affect the spinal cord by the direct and indirect mechanisms which lead to cervical myelopathy. Thus, the current study aimed to determine the prevalence and associated factors of clinical myelopathic signs in smartphone-using university students with neck pain. A total of 237 smartphone-using university students with neck pain participated in the study. They were 20 to 25 years old. Their clinical myelopathic signs were evaluated using standardized test procedures. The prevalence of the clinical myelopathic sign was the Trömner sign at 41.35%, the finger escape sign at 28.27%, Hoffmann's sign at 25.74%, and the inverted supinator sign at 18.14%. Smartphone usage ≥9.15 h per day was associated with ≥1 of a positive clinical myelopathic sign (adjusted OR = 1.85, 95% CI = 1.05 to 3.26,
= 0.05). The current study highlighted that prolonged smartphone usage may affect the spinal cord. Long duration (≥9 h per day) was associated with at least one positive clinical myelopathic sign. Therefore, smartphone-using university students need to keep their duration of smartphone use to less than 9 h per day. More attention should be given to increasing awareness about the importance of having healthy positions when using smartphones and using them for restricted durations in order to control the increasing prevalence of cervical myelopathy among smartphone-using university student in our societies.
Ergonomists measure height loss in relation to loads imposed on the spine. It is difficult to interpret whether height loss responses recorded on different days are accurate due to natural daily ...fluctuations in height loss and measurement variability. The objective of this research was to investigate whether the variability of height loss in the sitting position is affected by time of day and to analyse day-to-day variability in asymptomatic participants. Fifty asymptomatic participants attended two sessions (morning and afternoon) of stadiometry testing on four separate days. The results showed that a variability of height loss response changes in excess of 0.886 mm in morning and 1.128 mm in afternoon between days indicates that an intervention itself has influenced height loss. Future investigations on height loss in sitting should take these results into consideration to confidently state that an intervention has influenced height loss response at each time of day.
Practitioner summary: Daily fluctuation creates difficulties when interpreting whether height losses recorded on different days and times are intervention related. Seated stadiometry measures on different days and times of day demonstrated specific levels of natural variation. Changes above 0.886 mm (morning) and 1.128 mm (afternoon) can be attributed to intervention effects.
Abbreviations: LBP: low back pain; SEM: standard error of measurement; MeanSDs: means of standard deviations
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