Department of Human Services, University of Virginia, Charlottesville, Virginia, USA.
J Strength Cond Res. 2012 Nov;26(11):3106-12. doi: 10.1519/JSC.0b013e318247300f.
Low back pain (LBP) affects 70-80% of the population. The transversus abdominis (TrA) has been implicated as part of the cause of LBP. Prevention and rehabilitation of LBP often target the TrA using exercises such as the side bridge accompanied with the abdominal drawing-in maneuver (ADIM). However, it is unknown whether individuals with recurrent LBP, when they are in a period of no pain, are able to activate the TrA and healthy individuals during this exercise. The purpose of our study was to compare the activation ratio of the TrA during a 5-level side-bridge exercise progression. Twenty-three subjects with a history of recurrent, nonspecific LBP, but not experiencing an exacerbation of symptoms and 24 healthy controls volunteered. All the subjects performed the ADIM and side-bridge exercises with clinician feedback (verbal cueing). Each participant performed the side-bridge exercise progression while ultrasound images were taken. The subjects were only progressed if they successfully completed the previous level. The thickness of the TrA was measured in rested and contracted states at each exercise level to find the activation ratio (TrA contracted/TrA rest). Separate analyses of covariance did not reveal a difference in activation ratios between groups (p > 0.40) when the ratio at the lowest level was used as the covariate. The results from this study indicate that both groups were able to contract the TrA with verbal cueing during a side-bridge exercise progression. Because the TrA contracted similarly during exercise in both groups, the association of LBP with the TrA may be because of another mechanism, such as delayed activation in the feed-forward mechanism during activity or a lack of endurance of the TrA.
下背痛 (LBP) 影响了 70-80%的人群。腹横肌 (TrA) 被认为是 LBP 的部分原因。LBP 的预防和康复通常使用侧桥等运动来针对 TrA，并结合腹部内收运动 (ADIM)。然而，目前还不清楚反复发作性 LBP 的个体在没有疼痛的时期是否能够在这种运动中激活 TrA 和健康个体。我们的研究目的是比较 5 级侧桥运动进展过程中 TrA 的激活比率。23 名有反复发作、非特异性 LBP 病史但没有症状加重的受试者和 24 名健康对照者自愿参加了研究。所有受试者在临床医生的反馈（口头提示）下进行 ADIM 和侧桥运动。每位参与者在进行侧桥运动进展的同时拍摄超声图像。如果前一级成功完成，参与者才能进入下一级。在每个运动水平上，测量 TrA 在休息和收缩状态下的厚度，以找到激活比（收缩/休息）。当使用最低级别作为协变量时，协方差的单独分析并未显示组间激活比存在差异（p > 0.40）。本研究的结果表明，两组都能够在侧桥运动进展过程中通过口头提示收缩 TrA。由于两组在运动过程中 TrA 的收缩方式相似，LBP 与 TrA 之间的关联可能是由于另一种机制，例如活动中前馈机制的延迟激活或 TrA 的耐力不足。
