Effects of Blood Flow Restriction Training Combined With Abdominal draw-in Maneuver on Transverse Abdominis Strengthening
Phase: NA
Conditions: Blood Flow Restriction, draw-in Maneuver, Transverse Abdominis
Sponsor: China Medical University Hospital

 
 
 
 
 
Effects of Blood Flow Restriction Training Combined with 
Abdominal draw-in Maneuver on Transverse Abdominis 
Strengthening 
 
CRREC-109-007 
 
Date : 2021/09/14 
 
 

I. 
Study Protocol: 
Healthy adults (age ranged 18-34 years and BMI between 18.5~24.99) were 
randomly recruited in the study. For the intervention group, an inflatable cuff (14 
cm in width * 84 cm in length) is warped around abdominal muscles below ribs 
which may cause to at least 60% restriction of blood flow detected by Power Doppler 
ultrasonography. All participants are instructed to perform ADIM both condition of 
BFR and BFR-free twice a week, for four weeks. Core muscle thickness will be 
measured at rest and at draw-in by 2D ultrasound. Abdominal core stability, strength 
and endurance test by double leg lowering test, dynamometer and abdominal static 
endurance test. 
 
II. 
Statistical Analysis Plan 
Two-way mixed design ANOVA test is used to measure the group difference, 
time difference and interaction. Using Bonferroni post hoc test to analyze the 
difference among timepoints within group and Independent t test for the difference 
between two groups. 
 
III. Results  
1. 
Muscle thickness measured by ultrasound 
1.1 Transverse abdominis 
Measured by two-way mixed design ANOVA, there is no main time effect, 
group effect and interaction of time and group of mean bilateral thickness of 
transverse abdominis (TrA) at rest. At draw-in, there is no main time effect but 
group effect and interaction of time and group of mean bilateral thickness of TrA. 
Of muscle thickness change between draw-in and resting, there are main time effect, 
group effect and interaction of time and group of mean bilateral thickness of TrA. 
    Before training, there is no significant difference between ADIM+BFR group 
and ADIM group of TrA thickness at rest, draw-in and thickness change(p>0.05). 
After 3 weeks of training, there is no significant difference between ADIM+BFR 
group and ADIM group of TrA thickness at rest. ADIM+BFR group shows 
significant thicker muscle at draw-in and thickness change. After 4 weeks of training, 
there is no significant difference between ADIM+BFR group and ADIM group of 
TrA thickness at rest. ADIM+BFR group shows significant thicker muscle at draw-
in and thickness change. One week after the end of training, there is no significant 
difference between ADIM+BFR group and ADIM group of TrA thickness at rest. 
ADIM+BFR group shows significant thicker muscle at draw-in and thickness change. 
    ADIM+BFR group shows no significant difference of TrA thickness among 
timepoints at rest. There is significant increase at week 4 and one week after the 

end of training compared with baseline and at week 4 compared with week 3 at 
draw-in. There is significant thickness change at week 3, 4 and one week after the 
end of training compared with baseline. There is no significant difference at rest, at 
draw-in and thickness change among timepoints in ADIM group. 
 
2. 
Abdominal functional test 
2.1 Abdominal core stability 
    Measured by two-way mixed design ANOVA, there are main time effect, group 
effect and interaction of time and group. 
    Before training, there is no significant difference between ADIM+BFR group 
and ADIM group of double leg lowering test, so as after 3 weeks of training. However, 
ADIM+BFR group shows significant decrease in angle of double leg lowering test 
after 4 weeks of training and one week after the end of training, which shows better 
core stability. 
    ADIM+BFR group shows significant different among timepoints. Compared 
with baseline, it shows significant decrease after 3,4 weeks of training and one week 
after the end of training. Furthermore, after 4 weeks of training and one week after 
the end of training, it shows significant different compared with week 3 and week 
4. 
 
2.2 Abdominal strength test 
    Measured by two-way mixed design ANOVA, there is main time effect but no 
group effect and interaction of time and group. 
    Before training, there is no significant difference between ADIM+BFR group 
and ADIM group of abdominal strength test measured by dynamometer, so as after 
3 weeks of training. However, ADIM+BFR group shows significant increase after 4 
weeks of training and one week after the end of training, which shows better core 
strength. 
    ADIM+BFR group shows significant different among timepoints. Compared 
with baseline, it shows significant increase after 4 weeks of training and one week 
after the end of training. Furthermore, after 4 weeks of training and one week after 
the end training, it shows significant different compared with week 3. ADIM group 
shows significant different after 4 weeks of training compared with baseline. 
 
2.3 Abdominal endurance test 
    Measured by two-way mixed design ANOVA, there are main time effect, group 
effect and interaction of time and group. 
    Before training, there is no significant difference between ADIM+BFR group 

and ADIM group of abdominal endurance test, so as after 3 weeks of training. 
However, ADIM+BFR group shows significant increase after 4 weeks of training 
and one week after the end of training, which shows better core endurance. 
    ADIM+BFR group shows significant different among timepoints. Compared 
with baseline and 3 weeks of training, it shows significant increase after 4 weeks of 
training and one week after the end of training. Furthermore, one week after the end 
of training, it shows significant different compared with week 3. ADIM group shows 
significant different after 3,4 weeks of training and one week after the end of training 
compared with baseline.