Soylu Caglar, Atalay Emre Serdar, Turker Duygu, Sahan Tezel Yildirim, Un Yildirim Necmiye
Gulhane Faculty of Physical Therapy and Rehabilitation, University of Health Sciences, 06010 Ankara, Turkey.
Int J Environ Res Public Health. 2024 Dec 16;21(12):1675. doi: 10.3390/ijerph21121675.
Non-specific low back pain (NSLBP) is a common musculoskeletal issue that can limit function and reduce the patient's quality of life. Enhancing spinal stabilizer muscle activity through targeted exercises may help improve spinal alignment and alleviate NSLBP symptoms. This study aimed to investigate whether incorporating the abdominal drawing-in maneuver (ADIM) into selected low back exercises influences the electromyographic (EMG) activity of key spinal extensor muscles. Forty participants with NSLBP (n = 29 female and n = 11 male; mean age = 21.42 ± 1.07 years; BMI = 20.65 ± 2.08 kg/m; 80% right-side dominant) performed three exercises, prone trunk extension, superman, and unstable superman, with and without the ADIM. The EMG amplitudes of the iliocostalis lumborum pars lumborum (ICL), iliocostalis lumborum pars thoracis (ICT), and longissimus thoracis (LT) were measured. A cross-sectional observational study design was employed. Significant main effects were observed for both exercise types and the ADIM on the EMG amplitudes of the ICL, ICT, and LT (ICL: F1,14 = 82.69-114.23, < 0.001, η ≥ 0.88; ICT: F1,14 = 100.69-117.13, < 0.001, η ≥ 0.90; LT: F1,14 = 62.69-74.88, < 0.001, η ≥ 0.81). Under ADIM conditions, the ICL activity decreased significantly (right ICL mean difference: 14.06-20.02; left ICL: 13.06-21.32; < 0.001), while the ICT and LT activity increased (ICT mean difference: 6.45-8.89; LT: 9.37-12.13; < 0.001). These changes were most pronounced during the unstable superman exercise ( < 0.01). Integrating the ADIM into specific low back exercises can differentially modulate spinal extensor muscle activity. In particular, the unstable superman exercise demonstrated the greatest changes in the EMG amplitudes. These findings support the inclusion of the ADIM in exercise programs aimed at improving spinal stability and may have implications for NSLBP management. Future research should examine the effects of the ADIM in populations with varying experience levels to enhance its generalizability and refine the clinical recommendations.
非特异性下腰痛（NSLBP）是一种常见的肌肉骨骼问题，会限制功能并降低患者的生活质量。通过有针对性的锻炼增强脊柱稳定肌的活动可能有助于改善脊柱排列并减轻NSLBP症状。本研究旨在调查将收腹动作（ADIM）纳入选定的下背部锻炼是否会影响关键脊柱伸肌的肌电图（EMG）活动。40名NSLBP患者（n = 29名女性，n = 11名男性；平均年龄 = 21.42 ± 1.07岁；BMI = 20.65 ± 2.08 kg/m²；80%为右侧优势）进行了三项锻炼，即俯卧位躯干伸展、超人动作和不稳定超人动作，分别在有和没有ADIM的情况下进行。测量了腰髂肋肌腰段（ICL）、腰髂肋肌胸段（ICT）和胸最长肌（LT）的EMG振幅。采用横断面观察性研究设计。观察到锻炼类型和ADIM对ICL、ICT和LT的EMG振幅均有显著的主效应（ICL：F1,14 = 82.69 - 114.23，P < 0.001，η² ≥ 0.88；ICT：F1,14 = 100.69 - 117.13，P < 0.001，η² ≥ 0.90；LT：F1,14 = 62.69 - 74.88，P < 0.001，η² ≥ 0.81）。在ADIM条件下，ICL活动显著降低（右侧ICL平均差异：14.06 - 20.02；左侧ICL：13.06 - 21.32；P < 0.001），而ICT和LT活动增加（ICT平均差异：6.45 - 8.89；LT：9.37 - 12.13；P < 0.001）。这些变化在不稳定超人动作期间最为明显（P < 0.01）。将ADIM纳入特定的下背部锻炼可以不同程度地调节脊柱伸肌的活动。特别是，不稳定超人动作在EMG振幅方面表现出最大的变化。这些发现支持将ADIM纳入旨在改善脊柱稳定性的锻炼计划中，并且可能对NSLBP的管理有影响。未来的研究应该检查ADIM在不同经验水平人群中的效果，以提高其普遍性并完善临床建议。
