J Orthop Sports Phys Ther. 2019 Apr;49(4):262-271. doi: 10.2519/jospt.2019.8565. Epub 2019 Jan 18.
Two potential interventions for enhancing lumbar stability are to actively increase abdominal muscle activity, either through the abdominal drawing-in maneuver (ADIM) or bracing, and passively increase lumbar stiffness using a lumbosacral orthosis (LSO).
To compare the increase in lumbar stiffness after 2 active interventions (ADIM versus bracing) and 1 passive intervention (LSO), and to evaluate the combined effect of active (abdominal bracing) and passive interventions.
In this experimental and comparative study, lumbar stiffness, a surrogate measure of lumbar stability, was estimated in 25 healthy individuals during 7 trunk perturbation conditions: (1) control, (2) ADIM, (3) bracing at 5% of right external oblique maximal voluntary activation (5% bracing), (4) bracing at 10% of right external oblique maximal voluntary activation (10% bracing), (5) LSO, (6) LSO plus 5% bracing, and (7) LSO plus 10% bracing. Electromyographic biofeedback of the external oblique was provided on a monitor, while ultrasound was used for the ADIM to ensure a sustained contraction of the transversus abdominis.
The ADIM, 5% bracing, and 10% bracing active interventions generated comparable lumbar stiffness. However, considering that bracing can range from 10% to 20%, it may be superior to hollowing, as further estimated with a mixed-effect statistical model. Combining bracing and an LSO resulted in an additive effect on lumbar stiffness.
Bracing and ADIM produced comparable lumbar stiffness, as they were performed at the same overall abdominal activation levels (5% and 10% maximal voluntary activation). The independent effects of bracing and LSO raises the possibility of combining these interventions in some circumstances. J Orthop Sports Phys Ther 2019;49(4):262-271. Epub 18 Jan 2019. doi:10.2519/jospt.2019.8565.
增强腰椎稳定性的两种潜在干预措施是主动增加腹部肌肉活动，无论是通过腹部收缩（ADIM）还是支撑，还是使用腰骶矫形器（LSO）被动增加腰椎刚度。
比较 2 种主动干预（ADIM 与支撑）和 1 种被动干预（LSO）后腰椎刚度的增加，并评估主动（腹部支撑）和被动干预的联合效应。
在这项实验性和比较性研究中，25 名健康个体在 7 种躯干扰动条件下估计了腰椎刚度，这是腰椎稳定性的替代测量指标：（1）对照，（2）ADIM，（3）右侧外斜肌最大随意激活的 5%（5%支撑）支撑，（4）右侧外斜肌最大随意激活的 10%（10%支撑）支撑，（5）LSO，（6）LSO 加 5%支撑，和（7）LSO 加 10%支撑。外部斜肌的肌电图生物反馈在监视器上提供，而超声用于 ADIM 以确保腹横肌持续收缩。
ADIM、5%支撑和 10%支撑主动干预产生了相当的腰椎刚度。然而，考虑到支撑范围可能在 10%到 20%之间，根据混合效应统计模型进一步估计，它可能优于空心化。将支撑和 LSO 结合使用可对腰椎刚度产生附加效应。
支撑和 ADIM 产生了相当的腰椎刚度，因为它们在相同的总体腹部激活水平（5%和 10%最大随意激活）下进行。支撑和 LSO 的独立作用增加了在某些情况下结合这些干预措施的可能性。
