The Effect Thoracolumbar Fascia on the Abdominal Muscle

Muscle Strength Clinical Trial

Official title:

The Effect of Activation of Thoracolumbar Fascia on the Thickness of Abdominal Muscles; an Ultrasonographic Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04113642
• Other study ID #: 2019.100.IRB1.012
• Status: Completed
• Start date: March 1, 2019
• Est. completion date: March 29, 2019

Study information

• Verified date: October 2019
• Source: Koç University
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 30
• Est. completion date: March 29, 2019
• Est. primary completion date: March 29, 2019
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• age more than18 years

• volunteering for the study

• absence of back or abdominal problems

Exclusion Criteria:

• recent history of lower back pain

• previous history of trauma or surgery including back, abdominal, or pelvic region

• pregnancy

• congenital or acquired spinal disorders

Related Conditions & MeSH terms

• Abdominal Muscle
• Muscle Strength
• Posture

Intervention

Other:
• ultrasonographic measurement of abdominal muscle thickness at four positions
Thickness of transversus abdominis, internal oblique and external oblique muscles were evaluated using ultrasound at rest and during abdominal hollowing, bridge, and bridge with isometric arm extension.

Locations

Country	Name	City	State
Turkey	Koc University School of Medicine	Istanbul

Sponsors (1)

Lead Sponsor	Collaborator
Koç University

Country where clinical trial is conducted

Turkey, 

References & Publications (32)

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. Review. — View 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. — View 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. — View Citation

Bogduk N, Johnson G, Spalding D. The morphology and biomechanics of latissimus dorsi. Clin Biomech (Bristol, Avon). 1998 Sep;13(6):377-385. — View Citation

Bogduk N, Macintosh JE. The applied anatomy of the thoracolumbar fascia. Spine (Phila Pa 1976). 1984 Mar;9(2):164-70. — View Citation

Carvalhais VO, Ocarino Jde M, Araújo 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.2012.11.04 — View 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. — View 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. Review. — View Citation

Crisco JJ, Panjabi MM, Yamamoto I, Oxland TR. Euler stability of the human ligamentous lumbar spine. Part II: Experiment. Clin Biomech (Bristol, Avon). 1992 Feb;7(1):27-32. doi: 10.1016/0268-0033(92)90004-N. — View 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. — View 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. — View 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. — View 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. — View 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. — View 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. Erratum in: Eur Spine J. — View Citation

Hodges PW, Pengel LH, Herbert RD, Gandevia SC. Measurement of muscle contraction with ultrasound imaging. Muscle Nerve. 2003 Jun;27(6):682-92. — View Citation

Hodges PW. Ultrasound imaging in rehabilitation: just a fad? J Orthop Sports Phys Ther. 2005 Jun;35(6):333-7. — View 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. Review. — View 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 — View 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 — View 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. — View 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. — View Citation

O'Sullivan PB. Lumbar segmental 'instability': clinical presentation and specific stabilizing exercise management. Man Ther. 2000 Feb;5(1):2-12. Review. — View 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. — View Citation

Panjabi MM. Clinical spinal instability and low back pain. J Electromyogr Kinesiol. 2003 Aug;13(4):371-9. — View 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. — View 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. — View Citation

Schleip R, Müller 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. Review. — View 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. Erratum in: J Bodyw Mov Ther. 20 — View 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. — View 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. — View 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. Review. — View Citation

* Note: There are 32 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in ultrasonographic thickness of abdominal muscles	The ultrasound transducer was placed over an intersection point of two imaginary lines: one line passing horizontally from the level of navel and the second line running vertically through the anterior superior iliac spine. Subsequent images were obtained at rest, during abdominal hollowing, bridge and bridge with arm extension. Thicknesses of the muscles were measured using onscreen caliper. Results were recorded in millimeters.	1 day (Change of muscle thickness from rest to exercise positions)