Effects of posture on the thickness of transversus abdominis in pain-free subjects.

The role of transversus abdominis (TrA) on spinal stability may be important in low back pain (LBP). To date, there have not been any investigations into the influence of lumbo-pelvic neutral posture on TrA activity. The present study therefore examines whether posture influences TrA thickness. A normative within-subjects single-group study was carried out. Twenty healthy adults were recruited and taught five postures: (1) supine lying; (2) erect sitting (lumbo-pelvic neutral); (3) slouched sitting; (4) erect standing (lumbo-pelvic neutral); (5) sway-back standing. In each position, TrA thickness was measured (as an indirect measure of muscle activity) using ultrasound. In erect standing, TrA (mean TrA thickness: 4.63+/-1.35 mm) was significantly thicker than in sway-back standing (mean TrA thickness: 3.32+/-0.95 mm) (p=00001). Similarly, in erect sitting TrA (mean thickness=4.30 mm+/-1.58 mm) was found to be significantly thicker than in slouched sitting (mean thickness=3.46 mm+/-1.13 mm) (p=0002). In conclusion, lumbo-pelvic neutral postures may have a positive influence on spinal stability compared to equivalent poor postures (slouched sitting and sway-back standing) through the recruitment of TrA. Therefore, posture may be important for rehabilitation in patients with LBP.

[1]  Askar Om.  Surgical Anatomy of the Aponeurotic Expansions of the Anterior Abdominal Wall , 1977 .

[2]  C. Richardson,et al.  Long-Term Effects of Specific Stabilizing Exercises for First-Episode Low Back Pain , 2001, Spine.

[3]  P. Hodges,et al.  Relationship between limb movement speed and associated contraction of the trunk muscles. , 1997, Ergonomics.

[4]  C. Yip,et al.  The relationship between head posture and severity and disability of patients with neck pain. , 2008, Manual therapy.

[5]  Jacek Cholewicki,et al.  Coordination of muscle activity to assure stability of the lumbar spine. , 2003, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[6]  A. Thorstensson,et al.  Intervertebral Stiffness of the Spine Is Increased by Evoked Contraction of Transversus Abdominis and the Diaphragm: In Vivo Porcine Studies , 2003, Spine.

[7]  Wim Dankaerts,et al.  Effect of Different Upright Sitting Postures on Spinal-Pelvic Curvature and Trunk Muscle Activation in a Pain-Free Population , 2006, Spine.

[8]  P. Hodges,et al.  Pain and motor control of the lumbopelvic region: effect and possible mechanisms. , 2003, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[9]  D. Critchley,et al.  The response of the transverse abdominis and internal oblique muscles to different postures. , 2006, Manual therapy.

[10]  P. Maurer,et al.  Trunk muscle recruitment patterns in specific chronic low back pain populations. , 2005, Clinical biomechanics.

[11]  P. Hodges,et al.  Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. , 1998, Journal of spinal disorders.

[12]  K. Strohl,et al.  Regional differences in abdominal muscle activity during various maneuvers in humans. , 1981, Journal of applied physiology: respiratory, environmental and exercise physiology.

[13]  Y. Duval.  Limitations of This Study , 2019, Because of You: Understanding Second-Person Storytelling.

[14]  N. Foster,et al.  Re: Goldby LJ, Moore AP, Doust J, Trew ME. A randomised controlled trial investigating the efficiency of musculoskeletal physiotherapy on chronic low back disorder. Spine 2006;31:1083-93. , 2006, Spine.

[15]  L. Selen,et al.  Trunk muscle activation in low-back pain patients, an analysis of the literature. , 2003, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[16]  A. Moore,et al.  A Randomized Controlled Trial Investigating the Efficiency of Musculoskeletal Physiotherapy on Chronic Low Back Disorder , 2006, Spine.

[17]  C. Richardson,et al.  Sitting posture affects pelvic floor muscle activity in parous women: an observational study. , 2006, The Australian journal of physiotherapy.

[18]  C. Richardson,et al.  Muscle control-pain control. What exercises would you prescribe? , 1995, Manual therapy.

[19]  J. L. Whittaker,et al.  Rehabilitative ultrasound imaging of the abdominal muscles. , 2007, The Journal of orthopaedic and sports physical therapy.

[20]  A Thorstensson,et al.  Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man. , 1992, Acta physiologica Scandinavica.

[21]  Paul W Hodges,et al.  Core stability exercise in chronic low back pain. , 2003, The Orthopedic clinics of North America.

[22]  Julie A. Hides,et al.  The Relation Between the Transversus Abdominis Muscles, Sacroiliac Joint Mechanics, and Low Back Pain , 2002, Spine.

[23]  I Iandelli,et al.  In vivo ultrasound assessment of respiratory function of abdominal muscles in normal subjects. , 1997, The European respiratory journal.

[24]  Karen V Richards,et al.  The Effect of Different Standing and Sitting Postures on Trunk Muscle Activity in a Pain-Free Population , 2002, Spine.

[25]  Q A Louw,et al.  A systematic review of posture and psychosocial factors as contributors to upper quadrant musculoskeletal pain in children and adolescents , 2008, Physiotherapy theory and practice.

[26]  S. Gandevia,et al.  Measurement of muscle contraction with ultrasound imaging , 2003, Muscle & nerve.

[27]  P. O'Sullivan,et al.  Lumbar segmental 'instability': clinical presentation and specific stabilizing exercise management. , 2000, Manual therapy.

[28]  P. Hodges,et al.  Co‐activation of the abdominal and pelvic floor muscles during voluntary exercises , 2001, Neurourology and urodynamics.

[29]  Lawrence F. Borges,et al.  SPINE: State of the Art Reviews , 1993 .

[30]  P. Hodges,et al.  Inefficient Muscular Stabilization of the Lumbar Spine Associated With Low Back Pain: A Motor Control Evaluation of Transversus Abdominis , 1996, Spine.

[31]  Thomas Stretch Dowse,et al.  MUSCLE AND NERVE , 1903 .

[32]  B. Murphy,et al.  The validity and reliability of surface EMG to assess the neuromuscular response of the abdominal muscles to rapid limb movement. , 2003, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[33]  Garry T. Allison,et al.  Evaluation of Specific Stabilizing Exercise in the Treatment of Chronic Low Back Pain With Radiologic Diagnosis of Spondylolysis or Spondylolisthesis , 1997, Spine.

[34]  N. Vøllestad,et al.  The Efficacy of a Treatment Program Focusing on Specific Stabilizing Exercises for Pelvic Girdle Pain After Pregnancy: A Two-Year Follow-up of a Randomized Clinical Trial , 2004, Spine.

[35]  Rizk Nn.  A new description of the anterior abdominal wall in man and mammals. , 1980 .

[36]  H. Stam,et al.  Why Leg Crossing?: The Influence of Common Postures on Abdominal Muscle Activity , 1995, Spine.

[37]  P. Hodges,et al.  Regional morphology of the transversus abdominis and obliquus internus and externus abdominis muscles. , 2005, Clinical biomechanics.

[38]  J. Mcmeeken,et al.  The relationship between EMG and change in thickness of transversus abdominis. , 2004, Clinical biomechanics.

[39]  P. O'Sullivan,et al.  The relationship beween posture and back muscle endurance in industrial workers with flexion-related low back pain. , 2006, Manual therapy.

[40]  M. Ferreira,et al.  Changes in Recruitment of the Abdominal Muscles in People With Low Back Pain: Ultrasound Measurement of Muscle Activity , 2004, Spine.