Lateral Abdominal Muscles Thickness in Sitting and Standing Positions During Abdominal Drawing-In Maneuver and Abdominal Bracing Among Chronic Low Back Pain Individuals

Low back pain (LBP) is a general problem that influences most working populations throughout their lifetime. Spinal stabilization exercises, such as abdominal drawing maneuver (ADIM) and abdominal bracing (AB) are potential for the management of low back pain, especially in functional positions such as sitting and standing. This study aimed to determine the effects of testing positions (sitting, standing) and types of exercises (ADIM, AB) on muscle thickness of the lateral abdominal muscles among chronic LBP individuals. Twenty-four adults (12 males, 12 females) with chronic non-specific low back pain were assessed in sitting and standing positions while performing ADIM and AB exercises. Ultrasound imaging was used to quantify the thickness of the lateral abdominal muscles during the exercises. The Wilcoxon signed-rank test was used to compare the muscle thickness of Transversus Abdominis (TrA), Internal Oblique (IO), and External Oblique (EO) at rest, ADIM, and AB. The results showed that during ADIM, the thickness of the TrA and IO muscles increased compared to rest (P <0.05). Furthermore, TrA was thicker during ADIM than during AB exercise at both positions (P <0.05). The thickness of IO increased during AB compared to rest in both positions, but the EO muscle thickness significantly greater during ADIM compared to rest and AB in the standing position (P <0.05). In conclusion, ADIM stimulates the TrA and IO muscles, whereas AB stimulates IO in individuals with LBP. Therefore, ADIM can initially be included in exercise regimes to improve spinal stability in individuals with chronic non-specific LBP.