Clinical trial NCT04113642: The Effect Thoracolumbar Fascia on the Abdominal Muscle
Official title: The Effect of Activation of Thoracolumbar Fascia on the Thickness of Abdominal Muscles; an Ultrasonographic Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Abdominal Muscle
Posture
Muscle Strength
Keywords: abdominal muscles
ultrasonography
exercise
lumbar fascia
Lead sponsor: Koç University
Sponsor class: OTHER
First posted: 2019-10-03
Enrollment: 30
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: OTHER
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: healthy hospital staff

Brief summary: The aim of this study was to evaluate the changes in the thickness of abdominal muscles during activation of thoracolumbar fascia through contracting the gluteus maximus and latissimus dorsi muscles. The hypothesis was that the thickness of transversus abdominis and internal oblique would show greater increase when abdominal contraction was performed with simultaneous contraction of gluteus maximus and latissimus dorsi (bridge with arm extension) than that of abdominal contraction alone (abdominal hollowing) or abdominal contraction with simultaneous activation of only gluteus maximus (bridge). Thirty healthy subjects (15 women, 15 men) were enrolled in this cross-sectional study. Thickness of transversus abdominis, internal oblique and external oblique muscles were evaluated using ultrasound at rest and during three exercise positions: abdominal hollowing in neutral spine, bridge, and bridge with isometric arm extension using ultrasound device equipped with 55 mm convex array transducer

Detailed description: Spinal stabilization is crucial in maintaining healthy posture. Core muscle activation could be enhanced using thoracolumbar fascia for this stability.

Core, also called 'power house', is a muscular box built from abdominal muscles in the front, paraspinal, and gluteal muscles at the back, diaphragm at the top, and pelvic floor muscles at the bottom. Deep core muscles control intersegmental motion and respond to postural and extrinsic load changes and consist of transversus abdominis, internal oblique, multifidi and pelvic floor muscles.

Myofascial system links latissimus dorsi and gluteus maximus through thoracolumbar fascia causing tensegrity-like network in the whole body.

The aim of this study was to evaluate the changes in the thickness of abdominal muscles during activation of thoracolumbar fascia through contracting the gluteus maximus and latissimus dorsi muscles. The hypothesis was that the thickness of transversus abdominis and internal oblique would show greater increase when abdominal contraction was performed with simultaneous contraction of gluteus maximus and latissimus dorsi (bridge with arm extension) than that of abdominal contraction alone (abdominal hollowing) or abdominal contraction with simultaneous activation of only gluteus maximus (bridge).

Thirty healthy subjects (15 women, 15 men) were enrolled in this cross-sectional study. Thickness of transversus abdominis, internal oblique and external oblique muscles were evaluated using ultrasound at rest and during three exercise positions: abdominal hollowing in neutral spine, bridge, and bridge with isometric arm extension using ultrasound device equipped with 55 mm convex array transducer.

Eligibility criteria: age of \>18 years absence of back or abdominal problems.

Primary outcomes:
measure: Change in ultrasonographic thickness of abdominal muscles
timeFrame: 1 day (Change of muscle thickness from rest to exercise positions)
Secondary outcomes:
Other outcomes:
Locations:
city: Istanbul
country: Turkey
facility: Koc University School of Medicine
Study officials:
affiliation: Koc University School of Medicine
name: Ozden Ozyemisci Taskiran, Prof
role: PRINCIPAL_INVESTIGATOR
References:
citation: Panjabi MM. Clinical spinal instability and low back pain. J Electromyogr Kinesiol. 2003 Aug;13(4):371-9. doi: 10.1016/s1050-6411(03)00044-0.
citation: Crisco JJ, Panjabi MM, Yamamoto I, Oxland TR. Euler stability of the human ligamentous lumbar spine. Part II: Experiment. Clin Biomech (Bristol). 1992 Feb;7(1):27-32. doi: 10.1016/0268-0033(92)90004-N.
citation: Key J. 'The core': understanding it, and retraining its dysfunction. J Bodyw Mov Ther. 2013 Oct;17(4):541-59. doi: 10.1016/j.jbmt.2013.03.012. Epub 2013 Jun 28.
citation: Akuthota V, Ferreiro A, Moore T, Fredericson M. Core stability exercise principles. Curr Sports Med Rep. 2008 Feb;7(1):39-44. doi: 10.1097/01.CSMR.0000308663.13278.69.
citation: Czaprowski D, Afeltowicz A, Gebicka A, Pawlowska P, Kedra A, Barrios C, Hadala M. Abdominal muscle EMG-activity during bridge exercises on stable and unstable surfaces. Phys Ther Sport. 2014 Aug;15(3):162-8. doi: 10.1016/j.ptsp.2013.09.003. Epub 2013 Sep 27.
citation: Panjabi MM. The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disord. 1992 Dec;5(4):390-6; discussion 397. doi: 10.1097/00002517-199212000-00002.
citation: Panjabi M, Abumi K, Duranceau J, Oxland T. Spinal stability and intersegmental muscle forces. A biomechanical model. Spine (Phila Pa 1976). 1989 Feb;14(2):194-200. doi: 10.1097/00007632-198902000-00008.
citation: Schleip R, Muller DG. Training principles for fascial connective tissues: scientific foundation and suggested practical applications. J Bodyw Mov Ther. 2013 Jan;17(1):103-15. doi: 10.1016/j.jbmt.2012.06.007. Epub 2012 Jul 21.
citation: Dischiavi SL, Wright AA, Hegedus EJ, Bleakley CM. Biotensegrity and myofascial chains: A global approach to an integrated kinetic chain. Med Hypotheses. 2018 Jan;110:90-96. doi: 10.1016/j.mehy.2017.11.008. Epub 2017 Nov 20.
citation: Bogduk N, Macintosh JE. The applied anatomy of the thoracolumbar fascia. Spine (Phila Pa 1976). 1984 Mar;9(2):164-70. doi: 10.1097/00007632-198403000-00006.
citation: Wilke J, Krause F, Vogt L, Banzer W. What Is Evidence-Based About Myofascial Chains: A Systematic Review. Arch Phys Med Rehabil. 2016 Mar;97(3):454-61. doi: 10.1016/j.apmr.2015.07.023. Epub 2015 Aug 14.
citation: Escamilla RF, Lewis C, Bell D, Bramblet G, Daffron J, Lambert S, Pecson A, Imamura R, Paulos L, Andrews JR. Core muscle activation during Swiss ball and traditional abdominal exercises. J Orthop Sports Phys Ther. 2010 May;40(5):265-76. doi: 10.2519/jospt.2010.3073.
citation: Hodges PW, Pengel LH, Herbert RD, Gandevia SC. Measurement of muscle contraction with ultrasound imaging. Muscle Nerve. 2003 Jun;27(6):682-92. doi: 10.1002/mus.10375.
citation: Ferreira PH, Ferreira ML, Nascimento DP, Pinto RZ, Franco MR, Hodges PW. Discriminative and reliability analyses of ultrasound measurement of abdominal muscles recruitment. Man Ther. 2011 Oct;16(5):463-9. doi: 10.1016/j.math.2011.02.010. Epub 2011 Mar 12.
citation: Chanthapetch P, Kanlayanaphotporn R, Gaogasigam C, Chiradejnant A. Abdominal muscle activity during abdominal hollowing in four starting positions. Man Ther. 2009 Dec;14(6):642-6. doi: 10.1016/j.math.2008.12.009. Epub 2009 Feb 28.
citation: Hodges PW. Ultrasound imaging in rehabilitation: just a fad? J Orthop Sports Phys Ther. 2005 Jun;35(6):333-7. doi: 10.2519/jospt.2005.0106. No abstract available.
citation: Costa LO, Maher CG, Latimer J, Smeets RJ. Reproducibility of rehabilitative ultrasound imaging for the measurement of abdominal muscle activity: a systematic review. Phys Ther. 2009 Aug;89(8):756-69. doi: 10.2522/ptj.20080331. Epub 2009 Jun 11.
citation: Linek P, Saulicz E, Wolny T, Mysliwiec A. Intra-rater reliability of B-mode ultrasound imaging of the abdominal muscles in healthy adolescents during the active straight leg raise test. PM R. 2015 Jan;7(1):53-9. doi: 10.1016/j.pmrj.2014.07.007. Epub 2014 Aug 1.
citation: Linek P, Saulicz E, Wolny T, Mysliwiec A. Reliability of B-mode sonography of the abdominal muscles in healthy adolescents in different body positions. J Ultrasound Med. 2014 Jun;33(6):1049-56. doi: 10.7863/ultra.33.6.1049.
citation: Gibbon KC, Debuse D, Hibbs A, Caplan N. Reliability and Precision of Sonography of the Lumbar Multifidus and Transversus Abdominis During Dynamic Activities. J Ultrasound Med. 2017 Mar;36(3):571-581. doi: 10.7863/ultra.16.03059. Epub 2017 Feb 2.
citation: Mangum LC, Sutherlin MA, Saliba SA, Hart JM. Reliability of Ultrasound Imaging Measures of Transverse Abdominis and Lumbar Multifidus in Various Positions. PM R. 2016 Apr;8(4):340-347. doi: 10.1016/j.pmrj.2015.09.015. Epub 2015 Sep 30.
citation: Kim JS, Seok CH, Jeon HS. Abdominal draw-in maneuver combined with simulated weight bearing increases transversus abdominis and internal oblique thickness. Physiother Theory Pract. 2017 Dec;33(12):954-958. doi: 10.1080/09593985.2017.1359866. Epub 2017 Sep 6.
citation: Gnat R, Saulicz E, Miadowicz B. Reliability of real-time ultrasound measurement of transversus abdominis thickness in healthy trained subjects. Eur Spine J. 2012 Aug;21(8):1508-15. doi: 10.1007/s00586-012-2184-4. Epub 2012 Feb 12.
citation: O'Sullivan PB. Lumbar segmental 'instability': clinical presentation and specific stabilizing exercise management. Man Ther. 2000 Feb;5(1):2-12. doi: 10.1054/math.1999.0213.
citation: Teyhen DS, Miltenberger CE, Deiters HM, Del Toro YM, Pulliam JN, Childs JD, Boyles RE, Flynn TW. The use of ultrasound imaging of the abdominal drawing-in maneuver in subjects with low back pain. J Orthop Sports Phys Ther. 2005 Jun;35(6):346-55. doi: 10.2519/jospt.2005.35.6.346.
citation: Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992 Dec;5(4):383-9; discussion 397. doi: 10.1097/00002517-199212000-00001.
citation: Barker PJ, Briggs CA, Bogeski G. Tensile transmission across the lumbar fasciae in unembalmed cadavers: effects of tension to various muscular attachments. Spine (Phila Pa 1976). 2004 Jan 15;29(2):129-38. doi: 10.1097/01.BRS.0000107005.62513.32.
citation: Vleeming A, Pool-Goudzwaard AL, Stoeckart R, van Wingerden JP, Snijders CJ. The posterior layer of the thoracolumbar fascia. Its function in load transfer from spine to legs. Spine (Phila Pa 1976). 1995 Apr 1;20(7):753-8.
citation: Barker PJ, Hapuarachchi KS, Ross JA, Sambaiew E, Ranger TA, Briggs CA. Anatomy and biomechanics of gluteus maximus and the thoracolumbar fascia at the sacroiliac joint. Clin Anat. 2014 Mar;27(2):234-40. doi: 10.1002/ca.22233. Epub 2013 Aug 20.
citation: Stecco A, Gilliar W, Hill R, Fullerton B, Stecco C. The anatomical and functional relation between gluteus maximus and fascia lata. J Bodyw Mov Ther. 2013 Oct;17(4):512-7. doi: 10.1016/j.jbmt.2013.04.004. Epub 2013 May 11.
citation: Bogduk N, Johnson G, Spalding D. The morphology and biomechanics of latissimus dorsi. Clin Biomech (Bristol). 1998 Sep;13(6):377-385. doi: 10.1016/s0268-0033(98)00102-8.
citation: Carvalhais VO, Ocarino Jde M, Araujo VL, Souza TR, Silva PL, Fonseca ST. Myofascial force transmission between the latissimus dorsi and gluteus maximus muscles: an in vivo experiment. J Biomech. 2013 Mar 15;46(5):1003-7. doi: 10.1016/j.jbiomech.2012.11.044. Epub 2013 Feb 8.