Affiliations: [a] Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey | [b] Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey | [c] Department of Biophysics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
Correspondence:
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Corresponding author: Esra Dülger, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey. Tel.: +90 312 3052565; E-mail: esradulger@hacettepe.edu.tr.
Note: [1] The first two authors contributed equally to the study.
Abstract: BACKGROUND: The transversus abdominis (TrA) is an important muscle for spinal stabilization. The abdominal draw-in maneuver (ADIM) is a method that selectively activates the TrA without overactivation of the external oblique (EO) and internal oblique (IO). Individuals with low back pain may have trouble in understanding proper contraction of the TrA. OBJECTIVE: The aim of this study was to investigate the differences between two feedback techniques to re-educate the TrA. METHODS: One hundred eighty healthy volunteers (123 female, 57 male) were randomized into two groups. The ADIM was performed with different feedback methods: conventional (verbal and tactile) feedback and visual feedback from real-time ultrasound images. RESULTS: A within-group comparison revealed a significant increase in the thickness of the TrA, IO, and EO during the ADIM (p< 0.001) in both groups. The mean change (SD) in the thickness of the TrA and IO between rest and the ADIM was an increase of 2.541.25 and 1.882.14 in group 1 and 1.821.27 and 1.241.87 in group 2, respectively (p< 0.001). No significant differences were observed in EO thickness between the two groups. CONCLUSIONS: Although visual biofeedback shows a greater effect on ADIM training, both approaches are applicable, and clinicians may decide on which to use based on their clinical environment and experience.
Keywords: Ultrasound imaging, transversus abdominis, visual feedback, low back pain
