The Effects of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique versus General Strengthening Exercise on Lumbar Segmental Motion in Patients with Clinical Lumbar Instability: A Randomized Controlled Trial with 12-Month Follow-Up

Rungthip Puntumetakul, Pongsatorn Saiklang, Weerasak Tapanya, Thiwaphon Chatprem, Jaturat Kanpittaya, Preeda Arayawichanon, Rose Boucaut, Rungthip Puntumetakul, Pongsatorn Saiklang, Weerasak Tapanya, Thiwaphon Chatprem, Jaturat Kanpittaya, Preeda Arayawichanon, Rose Boucaut

Abstract

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.

Keywords: electromyography; low back pain; lumbar rotation; lumbar translation; radiography; stability exercises.

Conflict of interest statement

The author reports no conflict of interest in this work.

Figures

Figure 1
Figure 1
Flow chart of participants through the study.
Figure 2
Figure 2
Measurement technique and positions of sagittal angulation and translation.
Figure 3
Figure 3
Trunk muscle activity at each time of measurement between the two exercises. Note: a = p-value < 0.05, difference between baseline; b = p-value < 0.05, difference between 10 weeks; ** = p-value < 0.05, difference between CSE with ADIM and STE group.

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Source: PubMed

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