Guthrie Rebecca J, Grindstaff Terry L, Croy Theodore, Ingersoll Christopher D, Saliba Susan A
Orthopaedics Dept, Emory Sports Medicine Center, Atlanta, GA, USA.
J Sport Rehabil. 2012 May;21(2):151-60. doi: 10.1123/jsr.21.2.151. Epub 2011 Nov 15.
Individuals with low back pain (LBP) are thought to benefit from interventions that improve motor control of the lumbopelvic region. It is unknown if therapeutic exercise can acutely facilitate activation of lateral abdominal musculature.
To investigate the ability of 2 types of bridging-exercise progressions to facilitate lateral abdominal muscles during an abdominal drawing-in maneuver (ADIM) in individuals with LBP.
Randomized control trial.
University research laboratory.
51 adults (mean ± SD age 23.1 ± 6.0 y, height 173.6 ± 10.5 cm, mass 74.7 ± 14.5 kg, and 64.7% female) with LBP. All participants met 3 of 4 criteria for stabilization-classification LBP or at least 6 best-fit criteria for stabilization classification.
Participants were randomly assigned to either traditional-bridge progression or suspension-exercise-bridge progression, each with 4 levels of progressive difficulty. They performed 5 repetitions at each level and were progressed based on specific criteria.
Muscle thickness of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) was measured during an ADIM using ultrasound imaging preintervention and postintervention. A contraction ratio (contracted thickness:resting thickness) of the EO, IO, and TrA was used to quantify changes in muscle thickness.
There was not a significant increase in EO (F1,47 = 0.44, P = .51) or IO (F1,47 = .30, P = .59) contraction ratios after the exercise progression. There was a significant (F1,47 = 4.05, P = .05) group-by-time interaction wherein the traditional-bridge progression (pre = 1.55 ± 0.22; post = 1.65 ± 0.21) resulted in greater (P = .03) TrA contraction ratio after exercise than the suspension-exercise-bridge progression (pre = 1.61 ± 0.31; post = 1.58 ± 0.28).
A single exercise progression did not acutely improve muscle thickness of the EO and IO. The magnitude of change in TrA muscle thickness after the traditional-bridging progression was less than the minimal detectable change, thus not clinically significant.
下腰痛（LBP）患者被认为可从改善腰骨盆区域运动控制的干预措施中获益。尚不清楚治疗性锻炼是否能急性促进腹外侧肌肉的激活。
研究两种桥式锻炼进阶方式在LBP患者进行收腹动作（ADIM）时促进腹外侧肌肉的能力。
随机对照试验。
大学研究实验室。
51名患有LBP的成年人（平均±标准差年龄23.1±6.0岁，身高173.6±10.5厘米，体重74.7±14.5千克，64.7%为女性）。所有参与者符合稳定分类LBP的4项标准中的3项或至少6项稳定分类的最佳拟合标准。
参与者被随机分配到传统桥式进阶组或悬吊锻炼桥式进阶组，每组有4个难度递增级别。他们在每个级别进行5次重复，并根据特定标准进阶。
在ADIM过程中，使用超声成像在干预前和干预后测量腹外斜肌（EO）、腹内斜肌（IO）和腹横肌（TrA）的肌肉厚度。使用EO、IO和TrA的收缩率（收缩厚度：静息厚度）来量化肌肉厚度的变化。
锻炼进阶后，EO（F1,47 = 0.44，P = ０.51）或IO（F1,47 = 0.30，P = 0.59）的收缩率没有显著增加。存在显著的（F1,47 = 4.05，P = 0.05）组间时间交互作用，其中传统桥式进阶（干预前 = 1.55±0.22；干预后 = 1.65±0.21）在锻炼后导致TrA收缩率比悬吊锻炼桥式进阶（干预前 = 1.61±0.31；干预后 = 1.58±0.28）更大（P = 0.03）。
单次锻炼进阶并未急性改善EO和IO的肌肉厚度。传统桥式进阶后TrA肌肉厚度的变化幅度小于最小可检测变化，因此在临床上不显著。
