Effects of Abdominal Draw-In Maneuver in Combination With Ankle Dorsiflexion in Strengthening

115 Pages·2011·1.71 MB·English

Effects of Abdominal Draw-In Maneuver in
Combination With Ankle Dorsiflexion in
Strengthening the Transverse Abdominal
Muscle in Healthy Young Adults and
Patients With Low Back Pain

Seungchul Chon

The Graduate School
Yonsei University
Department of Rehabilitation Therapy
Effects of Abdominal Draw-In Maneuver in
Combination With Ankle Dorsiflexion in
Strengthening the Transverse Abdominal
Muscle in Healthy Young Adults and
Patients With Low Back Pain

Seungchul Chon

The Graduate School
Yonsei University
Department of Rehabilitation Therapy
Effects of Abdominal Draw-In Maneuver in
Combination With Ankle Dorsiflexion in
Strengthening the Transverse Abdominal
Muscle in Healthy Young Adults and
Patients With Low Back Pain

A Dissertation
Submitted to the Department of Rehabilitation Therapy
and the Graduate School of Yonsei University
in partial fulfillment of the
requirements for the degree of
Doctor of Philosophy

Seungchul Chon

June 2011
This certifies that the doctoral dissertation of
Seungchul Chon is approved.

Thesis Supervisor: Sunghyun (Joshua) You

Suhnyeop Kim

Minye Jung

Hyeson Jeon

Duckwon Oh

The Graduate School
Yonsei University
June 2011
Acknowledgements

First of all, I thank and praise God for preparing and guidance this thesis. This
thesis would not have been possible without individuals who offered their valuable
assistance and strong support to prepare and complete this study. It is great pleasure
to express my sincere gratitude to them in my humble acknowledgement.
First and foremost I would like to convey my gratitude to my advisor, Dr.
Sunghyun (Joshua) You for his excellent guidance, advice and supervision
throughout this research work. He has supported me with his expertise and patiently
encouraged me to bring out my best, allowing me to grow as a researcher and a
scholar. The tireless passion and enthusiasm for his research was an important key
which motivated me to pursue my degree. I would never have productive experience
without his crucial contributions of time and ideas.
I gratefully acknowledge Professor Suhnyeop Kim, Professor Minye Jung,
Professor Hyeson Jeon, and Professor Duckwon Oh for their faith in me to be a good
scholar. Their endless passion and commitment in physical therapy has been driving
force for me to keep moving forward when frustrated. I would like to thank for their
valuable advice and critical comments on my paper. I would also like to thank
Professor Chunghwi Yi, Professor Ohyun Kwon, Professor Sanghyun Cho, and
Professor Heonseock Cynn for being a great mentor with best suggestion and their
willingness to share their valuable insight with me. I believe my intellectual maturity
has been nourished through their sincere advice.
I am indebted to professors at Woosong University for their strong support and
encouragement with their best wishes. My special thanks go to students at Woosong
who help to implement and complete my experiment.
Last but not the least, I would like to show my deepest gratitude to my family. This
dissertation would be impossible without them. I would like to thank my father for
his thoughtful support with love and care. I would also like to thank my mother for
sincerely raising me and standing by me in joy and sorrow. No words can describe
my mother‟s everlasting love to me. Many thanks go to my brother for always
cheering me up.
I owe my loving thanks to my wife. My wife has lost me a lot due to my research
even during her pregnancy. She has been unselfish and dedicated herself to support
my study. Without her understanding and persistent confidence in me, I would never
finish this work. My special thanks to my newborn son for being healthy and showing
me the best smile in the world.
Table of Contents

List of Figures ···························································································· iv
List of Tables ····························································································· vi
Abstract ···································································································· viii
Chapter Ⅰ. Introduction ············································································ 1
Chapter Ⅱ. Effects of the Abdominal Draw-In Maneuver in Combination
With Ankle Dorsiflexion in Strengthening the Transverse
Abdominal Muscle in Healthy Young Adults
Introduction ··················································································· 4
Method ·························································································· 8
1. Participants ············································································ 8
2. Intervention ········································································· 10
3. Ultrasound Imaging Measurement ······································ 11
4. Electromyographic Measurement ······································· 13
5. Statistical Analysis ······························································ 16
Results ························································································· 17
1. Ultrasound Imaging Data ···················································· 17
2. Test-Retest Reliability ························································ 19
3. Electromyographic Data ····················································· 23
Discussion ··················································································· 24
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Chapter Ⅲ. Use of Co-contraction of Ankle Dorsiflexors to Increase
Transverse Abdominis Function in Low Back Pain
Introduction ················································································· 28
Method ························································································ 32
1. Participants ·········································································· 32
2. Intervention ········································································· 36
3. Pain and Function Assessment ··········································· 39
4. Ultrasound Imaging Measurement ······································ 41
5. Electromyographic Measurement ······································· 44
6. Statistical Analysis ······························································ 48
Results ························································································· 50
1. Clinical Data ······································································· 50
2. Ultrasound Imaging Data ···················································· 51
3. Test-Retest Reliability ························································ 54
4. Electromyographic Data ····················································· 55
Discussion ··················································································· 58
Chapter IV. Conclusion ············································································ 64
References ································································································· 65
Appendices ································································································ 79
Appendix A. Pain Disability Index ······················································· 80
Appendix B. Pain Rating Scale ····························································· 83
Appendix C. Multivariate tests of ANOVA in SPSS ···························· 88
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Appendix D. Independent t-test in SPSS ·············································· 89
Appendix E. Review Form Clinical Trial Research Plan ····················· 94
Appendix F. Declaration of Ethical Conduct in Research ···················· 97
Abstract in Korean ···················································································· 98

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List of Figures

Figure 1. Electromyographic measurement of muscle activity ················ 15
Figure 2. Thickness of the transverse abdominal muscle, internal oblique
muscle and external oblique muscle in the experimental and
control groups ··········································································· 18
Figure 3. Bland and Altman plot showing the reliability of ultrasound
image measurement for the thickness of the transverse
abdominal muscle imaged in two abdominal draw-in
maneuver interventions ····························································· 20
Figure 4. Bland and Altman plot showing the reliability of ultrasound
image measurement for the thickness of the internal oblique
muscle imaged in two abdominal draw-in maneuver
interventions ·············································································· 21
Figure 5. Bland and Altman plot showing the reliability of ultrasound
image measurement for the thickness of the external oblique
muscle imaged in two abdominal draw-in maneuver
interventions ·············································································· 22
Figure 6. Flow diagram for this study ······················································ 35
Figure 7. EMG biofeedback during the resisted dorsiflexion training to
augment transverse abdominis muscle contraction ·················· 37
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