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Postural control and breathing are mechanically and neuromuscularly interdependent. Both systems- of spinal stability and respiration- involve the diaphragm, transversus abdominis, intercostal muscles, internal oblique muscles and pelvic floor muscles. The aim of the study was to evaluate the effect of exercises activating deep stabilizer muscles on postural control and quality of breathing movements. Eighteen volunteers (25,7 ± 3,5) were recruited from the general population. All the subjects implemented an exercise program activating deep muscles. Head, pelvic and trunk positions in the sagittal and frontal planes were assessed with the photogrammetric method. Breathing movements were estimated with the respiratory inductive plethysmography. The results indicate that the use of deep muscle training contributed to a significant change in the position of the body in the sagittal plane (p = 0.008) and the increase in the amplitude of breathing (p = 0.001).
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Journal of Motor Behavior
ISSN: 0022-2895 (Print) 1940-1027 (Online) Journal homepage:
The Impact of Deep Muscle Training on the Quality
of Posture and Breathing
Elżbieta Szczygieł, Jędrzej Blaut, Katarzyna Zielonka-Pycka, Krzysztof
Tomaszewski, Joanna Golec, Dorota Czechowska, Agata Masłoń & Edward
To cite this article: Elżbieta Szczygieł, Jędrzej Blaut, Katarzyna Zielonka-Pycka, Krzysztof
Tomaszewski, Joanna Golec, Dorota Czechowska, Agata Masłoń & Edward Golec (2017):
The Impact of Deep Muscle Training on the Quality of Posture and Breathing, Journal of Motor
Behavior, DOI: 10.1080/00222895.2017.1327413
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The Impact of Deep Muscle Training on the Quality of Posture
and Breathing
zbieta Szczygiel
,J˛edrzej Blaut
, Katarzyna Zielonka-Pycka
, Krzysztof Tomaszewski
, Joanna Golec
Dorota Czechowska
, Agata Maslo
, Edward Golec
Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech
Physical Academy Education, Krakow, Poland.
AGH University of Science and Technology, Faculty of Mechanical
Engineering and Robotics, Krakow, Poland.
Faculty of Physiotherapy, Andrzej Frycz Modrzewski Krakow University, Poland.
Department of Anatomy, Jagiellonian University, Krakow, Poland.
ABSTRACT. Postural control and breathing are mechanically and
neuromuscularly interdependent. Both systems– of spinal stability
and respiration– involve the diaphragm, transversus abdominis,
intercostal muscles, internal oblique muscles and pelvic floor
muscles. The aim of the study was to evaluate the effect of exer-
cises activating deep stabilizer muscles on postural control and
quality of breathing movements. Eighteen volunteers (25,7 §3,5)
were recruited from the general population. All the subjects imple-
mented an exercise program activating deep muscles. Head, pelvic
and trunk positions in the sagittal and frontal planes were assessed
with the photogrammetric method. Breathing movements were
estimated with the respiratory inductive plethysmography. The
results indicate that the use of deep muscle training contributed to
a significant change in the position of the body in the sagittal plane
(pD0.008) and the increase in the amplitude of breathing
Keywords: motor control, movement, multisegment movement,
The entire motor system comprises many body seg-
ments. Their proper alignment with the line of gravity
ensures proper posture. Any irregularities in this alignment
can result in changes in both closer and further segments or
even in the working of particular systems and organs.
A number of studies confirm that body posture is condi-
tioned by deep muscle activity (Kibler, Press, & Sciascia,
2006; Panjabi, Abumi, Duranceau, & Oxland, 1989; Tsao
& Hodges, 2008). Among others, Hides, Richardson, and
Jull (1996) reported that the transversus abdominis, internus
obliquus abdominis, and externus obliquus abdominis
muscles stabilize the trunk and also play an important role
in postural adjustment. In particular, the transversus
abdominis, together with the multifidus, plays a major role
in stabilizing the lumbar region. The work of Lee, Kim,
Kim, Shim, and Lim (2015) and Ainscough-Potts, Morris-
sey, and Critchley (2006) also confirms the effect of activat-
ing deep muscles, including the transversus abdominis, in
adjusting and improving body posture.
Many authors believe that correct posture is an important
condition for proper respiratory function (Crosibie &
Myles, 1985; Pawlicka-Lisowska, Motylewski, Lisowski,
Michalak, & Poziomska-Piatkowska, 2013). The tests pre-
viously conducted by our team (Szczygiel, Rojek, Golec,
Klimek, & Golec, 2010) on healthy participants have
shown that even momentary and to a slight extent postural
defects have a significant impact on spirometry variables
characterizing breathing. Normal breathing, also known as
diaphragmatic breathing, involves the synchronized motion
of the upper ribcage, lower ribcage, and abdomen. Addi-
tionally, it requires adequate use and functionality of the
diaphragm muscles. Hodges, Heijnen, and Gandevia (2001)
acknowledged that abnormal posture prevents the proper
functioning of the diaphragm, resulting in increased activity
of the thoracic excursion. Under normal physiological con-
ditions, the diaphragm lowers when air is inhaled and rises
during exhalation. Among others, Hodges, Sapsford, and
Pengel (2007) and Vostatek, Novak, Rychnovsky, and
Rychnovska (2013) believed that the diaphragm has both a
postural and a respiratory function. Many reports indicate
that both the diaphragm and abdominal muscles, working
together, create a hydraulic effect in the abdominal cavity
that assists spinal stabilization by stiffening the lumbar
spine through increased intra-abdominal pressure (Kolar
et al., 2009; Miyamoto, Shimizu & Masuda, 2002).
Because of this, deep muscle training is recommended
mainly for the prevention and treatment of back pain
(Anoop, Suraj, & Dharmendar, 2010; Sumit & Selkar,
2013). Bliss confirms that deep muscle training improves
core stability, which is the ability to strengthen the lumbo-
pelvic complex and transfer forces from the upper to the
lower limbs of the body while maintaining the spine in a
neutral position (Bliss & Teeple, 2005). This muscle group
is characterized by early activation independent of the per-
formed movement (i.e., the so-called feedforward or early
timing). These muscles work mostly isometrically, with no
change in their length (Hadala & Gryckiewicz, 2014).
McGill (2010) noted that muscles should generate about
25% of maximum voluntary contraction during the training
and closed kinetic chain exercises should be performed to
produce an isolated muscle contraction.
Postural control deficits are a common phenomenon,
often unnoticed in the clinical evaluation (Ferreira, Duarte,
Maldonado, Bersanetti, & Marques, 2011). Among others
Correspondence address: El _zbieta Szczygiel, Rehabilitation in
Orthopaedics, Faculty of Rehabilitation, Department of Clinical Reha-
bilitation, Bronislaw Czech Physical Academy Education, al. Jana
Pawla II 78, 31-571 Cracow, Poland. e-mail:
Color versions of one or more of the figures in the article can
be found online at
Journal of Motor Behavior, Vol. 0, No. 0, 2017
Copyright ©Taylor & Francis Group, LLC
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Butowicz, Ebaugh, Noehren, and Silfies (2016) believed
that their occurrence is related to the weakening of deep
We hypothesized that deep muscle exercises have a
positive impact on the body posture and, thereby, they can
positively influence the breathing movements of the chest.
Our review of the literature, however, indicates a notice-
able lack of reports evaluating the impact of deep muscle
training on both the posture and the mobility of the chest.
Bearing in mind the previously described relations, the
purpose of our study was to evaluate the effect of whole
program exercises for activating deep stabilizer muscles on
the posture and quality of respiratory movements.
Twenty-one volunteers between 20 and 30 years old par-
ticipated in this study. During the implementation of this
program, three individuals resigned and, therefore, 18 peo-
ple completed the program (Mage 25.7 §3.5 years; M
height 1.69 §0.20 cm; Mweight 64.2 §7.3 kg). The par-
ticipants were recruited from the general nonsmoking popu-
lation and without any respiratory disorders, chest
deformations, pain complaints, or visible postural defects
(scoliosis, kyphoscoliosis, barrel, or pectus excavatum). No
obesity was observed among the participants (body mass
index was below 30 kg/m
Measurements of posture and breathing were made
twice: before and after the exercise program.
Posture Evaluation
The posture was assessed with photogrammetrical body
positioning using the optoelectronic body explorer (OBE
[Department of Photogrammetry and Remote Sensing
Informatics]). The OBE is a system positioning selected
human body points, which allows for the determination of
spatial coordinates of these body points. It belongs to the
systems of photogrammetric body evaluation. Such systems
provide reliable and reproducible data characterizing the
posture (Furlanetto, Sedrez, Candotti, & Loss, 2016; Mikrut
& Tokarczyk, 2000).
The measurement was entirely remote. Reflective
markers were taped on the points that describe the position
of the head, pelvic, and trunk in two dimensions (Table 1)
and their positions were captured with an optoelectronic
system. Sections created by connection of the indicated
points, including the y, x created angles used for further
analysis. The y-axis was represented by the vertical align-
ment line running across the spinous process of the seventh
cervical vertebrae (Tokarczyk & Mazur, 2006). In the OBE
system, points determined by the photogrammetric mea-
surement represent the transfer of skeleton elements to the
body surface and they are signaled by the self-adhesive
polystyrene balls of 4–5 mm diameter. The precision of
determining the spatial coordinates of the signaled body
points is high and amounts to §2–4 mm. To limit the mea-
surement errors, the balls were fixed by one person. It was a
physiotherapeutist, who had been taking measurements
with the use of such system for four years.
The task of the participants was to keep a casual, habitual
standing position with their weight evenly distributed on
both feet and looking straight ahead. To evaluate the head
posture, the following standards were applied: sagittal
plane: 60 §1(values over 60indicated head in the
protraction whereas values below 60indicated head in the
protraction), frontal plane: 90 §1(values over 90
indicated head bend to the right whereas values below 90
indicated head bend to the right).
To evaluate the pelvic the standards were: sagittal plane:
80 §1(values over 80indicated pelvic in the anterior
pelvic tilt whereas values below 80indicated pelvic in the
anterior pelvic tilt), frontal plane: 90 §1(values over 90
indicated pelvic bend to the right whereas values below 90
indicated pelvic bend to the right).
Additionally, the research considered trunk position, also
in the sagittal and frontal planes (Table 1). To evaluate the
body posture, we applied a standard involving the sagittal
and frontal plane: 180 §1(values over 180indicated
body leaning to the right whereas values below 180
indicated body leaning to the left and forward).
Breathing Movement Measurement
Respiratory chest movements were assessed using respira-
tory inductive plethysmography (Embletta Gold, Mediserv
International, Warsaw, Poland). Respiratory inductive plethys-
mography (RIP) measurements are based on changes to the
TABLE 1. Chosen Photogrammetric Points (in the
Sagittal and Frontal Planes)
Sagittal plane
Head posture The angle between the central part of
upper lip, occipital tuberosity, and
Pelvic posture The angle between the line between iliac
spines and y-axis
Trunk posture The angle between the line connecting the
spinous process of the seventh cervical
vertebra and the sacrum and y-axis
Frontal plane
Head posture The angle between the left and right eyes
and y-axis
Pelvic posture The angle between the line connecting the
superior anterior iliac spines and y-axis
Trunk posture The angle between the line connecting the
spinous process of the seventh cervical
vertebra and the sacrum and y-axis
E. Szczygiel et al.
2 Journal of Motor Behavior
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cross-sectional area detected by two inductance belts. Among
others Fiamma, Samara, Baconnier, Similowski, and Straus
(2007) proved, that the measurement results obtained by this
method are accurate. To best utilize the RIP technology, all
chest (thoracic excursion) and abdomen (abdominal excur-
sion) respiratory movement measurements were acquired
using the XactTrace inductive method. The XactTrace sensors
were located on two belts fixed in accordance with the manual;
below the arms and level with the navel. The belts were given
a slight stretch to fit tightly around the participant and mini-
mize signal distortion, but without limiting chest movement or
causing discomfort. After the calibration, the plethysmo-
graphic data were recorded for around 3 min. A fragment of
the last 1-min record reproduced in RemLogic was selected to
assess respiratory movements (
cfm?page=products_vascular_obstetric&crid=983). The test
enabled us to obtain separate charts reflecting the respira-
tory movements of both the upper and lower chest. The
analysis was conducted using individually developed
software for analyzing the records of the Embletta Gold
system and was possible after prior exporting of the data to
an EDF (European Data Format) data recording system.
The specially developed software enables finding the
amplitude and location of local minima and maxima (peaks
and valleys) in the signal, on the basis of which it is
possible to conduct further statistical analysis. Statistical
analysis allows for determining of the average interpeak
Avp value (the amplitude of breath). The amplitude is the
value of tension, proportional to the elongation of the belt
covering the chest. The measurements were performed in a
relaxed standing position.
Exercise Program
All test participants implemented an exercise program acti-
vating deep muscles in isolated positions with particular
emphasis on transverse abdominal, multifidus, and internal
oblique muscles (Figure. 1, 2, 3, 4, 5). Exercises were
performed when the participant was lying on their back, bridg-
ing, in four-point kneeling positions, and on an unstable sur-
face (Feldwieser, Sheeran, Meana-Esteban, & Sparkes, 2012;
Imai et al., 2010; Okubo et al., 2010; Vera-Garcia, Barbado,
& Moya, 2014). Each exercise session consisted of three sets
of holding a specific posture for 10 s with the trunk straight
then resting for 5 s, repeated 10 times. Exercises were per-
formed three times a week for four weeks. The participants
declared their consent not to attend other classes or sport
Statistical Analysis
Statistical analysis was performed using Statistica 6.0
software (
Polska/). The normality of distribution of test parameters in
the groups was presented by the Shapiro-Wilk test whereas
the homogeneity in the groups was shown using Levene’s
To study the relationship between the parameters of pho-
togrammetry and respiratory parameters before the exer-
cises and the difference in parameters before and after the
exercises, Pearson’s correlation coefficient or Spearman’s
rank correlation coefficient were used, depending on the
normality of the parameter distribution.
To evaluate the statistical significance of differences in the
spatial setting of the parameters before and after exercises,
Student’s ttest was used where the assumption of normal
distribution of the parameters was fulfilled. However, if the
previous assumption was not fulfilled, the Wilcoxon test for
dependent samples was used. The level of significance less
than or equal to .05 was assumed in the analysis.
The descriptive statistics of head, trunk, and pelvic posi-
tion in sagittal and frontal planes are shown in Table 2. The
chest excursion changing is visible on Figures 6 and 7.
FIGURE 1. Image of the participant performing activating transverse abdominal muscle.
Posture Control and Deep Muscle
2017, Vol. 0, No. 0 3
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The results obtained from these studies, describing the
head, pelvic, and trunk position in the frontal plane,
showed distribution compliant with the standard distri-
bution. For that reason, they were participant to further
statistical analysis by means of firstly, Student’s ttest
for a single sample, in which the results obtained were
compared with the generally applicable standard (90§
1 for the head, 90§1 for the pelvis, and 180§1for
the trunk), and secondly, Student’s ttest for two inde-
pendent variables, where, due to the compliance of the
results obtained with the standard distribution, variances
of the averages were compared, describing the head,
pelvic, and trunk leaning. Due to the fact that the results
obtained indicated no differences between the right and
left-hand side (p>a,whereaD.05), no division into
right and left-hand side was taken into account in
further analysis.
As the assumptions of normality of variable distribution
were fulfilled, Student’s ttest was used for dependent sam-
ples, which allowed for verification of the null hypothesis
(H 0), assuming no differences in the spatial position of the
head, torso, and pelvis before and after exercise, against the
alternative hypothesis (H 1) in which these differences
were supposed to occur. If the parameter assumptions in
the group after or before exercise were not fulfilled, the
Wilcoxon test was used.
FIGURE 2. Image of the participant performing the back-bridge exercise with elevated leg.
FIGURE 3. Image of the participant performing in the four-point kneeling positions exercise with elevated upper limb.
4 Journal of Motor Behavior
E. Szczygiel et al.
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The results of the statistical analysis indicate that a sig-
nificant statistical relationship (pD.0089) between trunk
setting in the sagittal plane and the amplitude of the respira-
tion in the thoracic excursion (Avp) occurs (Table 3).
The aim of this study was to assess the impact of exercise
activating deep stabilizing muscles on posture and quality
of respiratory movements. Deep muscles play an important
role in postural control. The activity of these muscles con-
tributes directly to joint stiffness—the greater the stiffness
is, the more stable the structure is (O’Sullivan, 2000;
Sangwan, Green, & Taylor, 2014). Reduced deep muscle
activity of the lower trunk triggers compensatory posture
and movement patterns. The specific pattern of compensa-
tion resulting from lack of tension in the deep stabilizers of
the lower trunk is associated with the overuse of superficial
(global) muscles and changes in the position of the body
segments (Gogola, Saulicz, Kuszewski, Matyja, &
sliwiec, 2014). For this reason, many authors see the
need to strengthen deep muscles in the re-education of pos-
tural control. However, searching the literature for informa-
change has not yielded satisfactory results. The majority of
works focus on evaluating the activity of these muscles in
people with pain in the lumbar spine. As far as we know,
this study is, therefore, the first to show the effect of exercis-
ing deep muscles on both posture and respiration. Kim and
Lee (2013) tried to determine the effects of enhanced dia-
phragmatic function, achieved through deep abdominal mus-
cle strengthening exercises, on respiratory function and
lumbar stability. Assessed variables were forced vital capac-
ity and forced expiratory volume for 1 s. Lumbar stability
was measured based on the contractility of the transversus
abdominis by using a pressure biofeedback unit. Participants
in their study realized a program of exercises of the transver-
sus abdominis and assessed the strength of this muscle in the
hook-lying position. In our program, we used exercises in
different positions and the assessment of posture and move-
ment of the chest was made in the freestanding position,
bearing in mind this is a more functional position.
The exercises we used mainly activated transverse
abdominal muscles as well as multifidus and internal obli-
que muscles. The results confirmed the effect of deep mus-
cle training on improved postural control. Although our
observations were related to the position of the head, torso,
and pelvis, the applied exercises only positively affected
control of the trunk in the sagittal plane. In our opinion,
FIGURE 5. Image of the participant performing exercise
on the ball with elevated leg.
FIGURE 4. Image of the participant performing front-bridge exercise.
2017, Vol. 0, No. 0 5
Posture Control and Deep Muscle
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such a relationship may be explained by the kind of exer-
cises applied, which activated only the stabilizing muscles
of the lower trunk. Any future program should include exer-
cises to improve control of the head and upper body
(e.g. activation of serratus anterior).
Postural control and breathing are mechanically and neu-
romuscularly interdependent (Hudson, Butler, Gandevia, &
De Troyer, 2010). Both systems—of spinal stability and
respiration—involve the same muscles, being the dia-
phragm, transversus abdominis, intercostal muscles, inter-
nal oblique muscle, and pelvic floor muscles (Hodges et al.,
2001). Among others, Kolar et al. (2012) claimed that a
normal breathing pattern requires a stable lower trunk. The
structure connecting a stable trunk with breathing is the
diaphragm, but the diaphragm does not participate homo-
geneously as a functional unit in stabilization. Smith,
Russel, and Hodges (2006) found a significant correlation
between the diaphragm and transversus abdominis that
simultaneously control both respiration and posture. Kim
and Lee (2013) indicated that deep abdominal muscle
strengthening exercise was effective at increasing vital
capacity. The study by Park, Kweon, and Hong (2015) is
also noteworthy in this respect. Its results showed improved
lumbar stability with increased transversus abdominis con-
tractility after four weeks of deep breathing exercises . In
light of our findings, we can say that the previously indi-
cated relationship works both ways. Our results confirmed
the effect of exercising the muscles stabilizing the lower
TABLE 2. Descriptive Statistics of the Examined Parameters of Posture and Breathing Before and After Exercis-
ing Deep Muscles as well as Differences in Spatial Position of Selected Segments of the Posture and Breathing
Amplitude Before and After Exercising Deep Muscles
Before Mean §SD After Mean §SD Student’s ttest pWilcoxon test p
Sagittal ()
Head posture 85.32 §6.50 84.73 §7.17 ¡0.302 .7660
Pelvic posture 83.20 §8.71 82.17 §4.18 ¡0.711 .4267
Trunk posture 176.51 §3.95 179.16 §3.20 3.015 .0078
Frontal ()
Head posture 91.09 §2.81 90.04 §2.15 ¡1.972 .0651
Pelvis posture 90.06 §1.85 90.27 §1.79 0.784 .4331
Trunk posture 179.73 §1.61 179.97 §2.67 0.065 .9479
TE Avp (mV) 565.41 §221.99 673.80 §314.83 1.590 .1119
AE Avp (mV) 399.02 §191.60 553.78 §214.01 3.593 .0003
Note.AEDabdominal excursion; Avp Damplitude of breath; TE Dthoracic excursion.
p<.05; df D17.
TABLE 3. Dependency Test Results between the Parameters of Photogrammetry and Breathing as a Difference
between the Value of the Parameter Measured Before Exercise and After Exercising Deep Muscles
Spearman’s rank correlation coefficient pPearson line correlation coefficient p
Head posture TE Avp ¡0.027 .9166
AE Avp ¡0.032 .8997
Pelvic posture TE Avp ¡0.271 .2218
AE Avp ¡0.207 .2185
Trunk posture TE Avp 0.597 .0089
AE Avp 0.063 .8040
Head posture TE Avp ¡0.055 .8276
AE Avp 0.017 .9481
Pelvic posture TE Avp 0.032 .8992
AE Avp ¡0.176 .4836
Trunk posture TE Avp 0.091 .7198
AE Avp 0.189 .4529
Note.AEDabdominal excursion; Avp Damplitude of breath; TE Dthoracic excursion.
p<.05; df D16.
6 Journal of Motor Behavior
E. Szczygiel et al.
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trunk on both posture quality and the amplitude of respira-
tory movements. Applied deep trunk muscle training con-
tributed significantly to an increase in the amplitude of the
abdominal excursion and modified the spatial position of
the torso. Abnormal breathing stereotype, known as tho-
racic breathing, involves breathing from the upper chest,
evidenced by greater upper rib cage motion, compared with
the lower rib cage. Thoracic breathing is produced by the
accessory muscles of respiration (including sternocleido-
mastoid, upper trapezius, and scalene muscles), dominating
over lower rib cage and abdominal motion (Chaitow, Brad-
ley, & Gilbert, 2002). Vickery (2008) suggested that
decreased abdominal motion, relative to upper thoracic
motion, confirms poor diaphragm action. In our study, the
observed changes in chest excursion can be a confirmation
of improvement of breathing pattern. However, we cannot
give a straight answer to the question if the increase in the
amplitude of the abdominal excursion was related to the
increase in the activity of the diaphragm during the training,
or rather to the change in the torso position. Strongoli,
Christopher, Gomez, and Coast (2010) reported increased
diaphragm activation, evidenced by increased transdiaph-
ragmatic pressure during core exercises in six healthy par-
ticipants. They were instructed to inhale during the exertion
phase to elicit a higher and more consistent transdiaphrag-
matic pressure. In other reports, similarly, authors added
instructions regarding breathing or introduced special
breathing exercises (Kim & Lee, 2013).
Cavaggioni, Ongaro, Zannin, Iaia, and Alberti (2015)
demonstrated that, compared with traditional exercises, a
program including core exercises performed with a focus
on muscular chain stretching and breathing techniques can
lead to greater improvement in respiratory function (mea-
sured by forced vital capacity, forced expiratory volume in
1 s, and peak expiratory flow). A group of 32 healthy par-
ticipants participated in the program. Applied exercises
FIGURE 6. Examples of records of the abdominal excursion of one participant before exercises (Mamplitude D240 mV).
FIGURE 7. Examples of records of the abdominal excursion of the same participant after exercises (Mamplitude D390 mV).
2017, Vol. 0, No. 0 7
Posture Control and Deep Muscle
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were focused on achieving and maintaining a proper dia-
phragmatic breathing pattern for 2–3 s during inspiration
and 8–10 s during expiration, with a vocal sound emitted to
induce active recruitment of the pelvic floor muscles and
deep internal abdominals. Their results suggested that a
series of core exercises performed with a vocal sound emis-
sion can be a valid strategy to enhance proper diaphrag-
matic breathing patterns and deep internal abdominal
activation much more than in traditional abdominal routines
in which people tend to hold their breath or use chest wall
respiration. In our group, we did not educate the partici-
pants of the training about how they were supposed to
breathe. Also, we did not introduce any special breathing
exercises, thus allowing the participants to breathe in their
natural way.
On the other hand, we should underline that, after the
exercises, the values of the angle describing the position of
the torso in the sagittal plane were close to 180, which
indicates a better control of the torso (Table 2). We also
noticed that the higher the difference between after-exercise
and pre-exercise values in the measurement of the body
position parameter in the sagittal plane, the higher the dif-
ference between after-exercise and pre-exercise values in
the measurement of the amplitude in the abdominal
Among the tested posture parameters, a significant corre-
lation occurred between the amplitude of breathing and
trunk position. Undoubtedly, the position of the trunk is
related to both rib tilting and muscle activity involved in
stabilization and breathing. Kolar and colleagues (Kolar &
Kobesova, 2010; Kolar, Kobesova, Valouchova, & Bitnar,
2014) have said that, in the normal pattern of breathing, the
thorax should be positioned so that the anteroposterior axis
between the insertion of the diaphragm’s pars sternalis and
the posterior costophrenic angle is almost horizontal. The
forward drawn position of the chest or apex of the T kypho-
sis situated behind the L/S junction present other abnormal-
ities preventing ideal muscle balance and proper
stabilization (Kolar & Kobesova, 2010; Kolar et al., 2014).
We believe that changing the setting of the trunk in the sag-
ittal plane corresponds with the course of this axis, which
may explain the correlation that we have observed. There-
fore, the change in the spatial position of the torso that we
observed could also have influenced the increase in the
amplitude of breathing movements. We expected that our
studies would confirm the effect of head setting on the
mobility of the chest. We observed relationship previously
(Szczygiel et al., 2015) during tests using 65 participants.
Unfortunately, we have found no such relationship. Perhaps
this was due to the small sample size of the study group and
the fact that the exercises mainly activated the muscles sta-
bilizing the lower trunk. We have not used exercise to
improve head control.
Limitations of the present study can be the fact that
we focused on the biomechanical aspect of breathing
and did not measure the pulmonary function. In the
future, it would be reasonable to consider the evaluation
of the influence of deep muscle training not only on
breath amplitude, but also on the change in the tidal
volume parameter.
Deep muscle training improves control of trunk and
respiratory control. Posture and breathing stereotype forms
a functional unit and is strongly influenced by the thorax
The authors would like to thank Dr. Tadeusz Mazur for
his helpful suggestions and comments on an earlier version
of the manuscript. The protocol for this study was approved
by the local bioethics committee (No.104/KBL/OIL/2014).
All the participants gave their written informed consent
prior to participation.
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Received September 30, 2016
Revised February 24, 2017
Accepted February 25, 2017
2017, Vol. 0, No. 0 9
Posture Control and Deep Muscle
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... To further support this, work by Butowicz and colleagues (2016) points towards the value of intrinsic core strength (i.e. diaphragm, ribcage coordination, abdominal muscles, etc) in COMPREHENSIVE PROJECT 4 facilitating spinal stabilization and respiratory function (Szczygieł et al., 2017). As exercise is our avenue through which we work our muscles, completing specific exercises, as intrinsic core stabilization ones, to optimize breathing physiology and function holds great potential to decrease our dysfunctional breathing and enhance our overall well-being. ...
... Intervention methods implicate: nasal inhalation and slow mouth exhalation (Kiesel et al., 2020), a biweekly progression from laying postures to quadruped, kneeling, and standing (Kiesel et al., 2020), usage of the 90/90 bridge with ball and balloon exercise daily (Rose & Dhakal, 2017), isometrics (Szczygieł et al., 2017), unstable surface usage (Szczygieł et al., 2017), and dynamic neuromuscular stabilization (DNS) exercises (Nasser et al., 2019), to be effective. They found normalized dysfunctional breathing (biomechanically and biochemically) (Kiesel et al., 2020), significant improvement in "forced expiratory volume in 1 second (FEV1) and FEV1/FVC ratio" (Rose & Dhakal, 2017;Nasser et al., 2019) The implications for future research are far-reaching as we have the potential to explore further healthcare oriented interventions as well as performance enhancing measures (Rana et al., 2011) for DB and non-DB individuals. ...
... Intervention methods implicate: nasal inhalation and slow mouth exhalation (Kiesel et al., 2020), a biweekly progression from laying postures to quadruped, kneeling, and standing (Kiesel et al., 2020), usage of the 90/90 bridge with ball and balloon exercise daily (Rose & Dhakal, 2017), isometrics (Szczygieł et al., 2017), unstable surface usage (Szczygieł et al., 2017), and dynamic neuromuscular stabilization (DNS) exercises (Nasser et al., 2019), to be effective. They found normalized dysfunctional breathing (biomechanically and biochemically) (Kiesel et al., 2020), significant improvement in "forced expiratory volume in 1 second (FEV1) and FEV1/FVC ratio" (Rose & Dhakal, 2017;Nasser et al., 2019) The implications for future research are far-reaching as we have the potential to explore further healthcare oriented interventions as well as performance enhancing measures (Rana et al., 2011) for DB and non-DB individuals. ...
... Of the six eligible papers, one used variations of an acute, single-bout stretching session following ischemic compression [54], one implemented a denneroll traction device combined with neuromuscular inhibition techniques [51], and the remaining four articles focused on stabilization and strengthening of involved musculature using neuromuscular integration techniques [50,52,53,55]. ...
... In the selected papers, four articles reported on FHP [50][51][52][53] and used varying methods to do so, and all articles implemented their own unique form of neuromuscular integration for the rehabilitation of FHP. Kim et al. [50] used the McKenzie exercise program to investigate changes in FHP and respiratory function. ...
... Szczygieł et al. [52] recruited 18 volunteers aged 20-30 from a healthy, nonsmoking population without respiratory issues to complete a 4-week training intervention aimed at activating the deep stabilizers. The researchers evaluated how deep stabilizer muscle training would impact postural control and quality of breathing movements. ...
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Objective: The aim of this study was to review the scientific literature on the efficacy of neuromuscular integration techniques for the rehabilitation of forward head posture (FHP) and rounded shoulder posture (RSP). Data Sources: Online databases CINAHL, PubMed, and SportDiscus were searched for the Boolean terms: “neuromusc* AND shoulder AND posture”, “neuromusc* AND neck AND posture”, “neuromusc* AND head AND posture”. Study Selection: Reviewed studies were limited to human studies with an exercise intervention. Studies that contained participants with severe chronic conditions or acute musculoskeletal injuries were excluded. Data Extraction: One reviewer extracted data on study and patient characteristics and selected articles were evaluated by 2 raters for methodological quality. Data Synthesis: A total of 281 subjects participated in the six chosen studies that met the inclusion criteria. Exercise intervention protocols were then reviewed and recommendations were made accordingly for the FHP and RSP respectively. Conclusions: Evidence showed efficacy of neuromuscular techniques for FHP, but not for RSP. This review also highlighted the lack of research in this field and the ambiguity in practice for what constitutes a neuromuscular integration method.
... [14,16,18,20,21] The core muscle training included PFM contraction affects breathing movements measured by the respiratory inductive plethysmography. [22] Because of the association between the PFM and breathing, as an alternative treatment for urinary incontinence, not only PFM training but also corrective training for breathing patterns and diaphragmatic breathing training have been suggested [7] and applied. [23] However, although previous studies suggested association PFM and breathing, [16][17][18][19] causality is still unclear for relationship between PFM and breathing and there are lack of study for effect of PFM training on breathing pattern. ...
... In addition, retraining diaphragmatic, deep abdominal, and PFM-coordinated function involving diaphragm breathing and functional expiratory pattern Table 3 PFM strength, diaphragm excursion and upper rib cage kinematics values pre-and post-training for both groups (means ± SD). training improves symptoms of urinary incontinence as an alternative intervention. [22,23] Otherwise, specific motor learning intervention involving PFM contraction for subjects with sacroiliac joint pain can positively change diaphragm kinematics and patterns of respiration. [9] The cause and effect relationship between improved PFM contraction and improved diaphragm excursion has been controversial. ...
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Background: The pelvic floor muscle (PFM) is associated with respiratory function. We investigated the effects of PFM training by pelvic floor electrical stimulation (PFES) on PFM strength, diaphragm excursion, and upper rib cage movement during tidal and forceful breathing and coughing in women with stress urinary incontinence (SUI). Methods: In total, 33 participants with SUI were divided into PFES and control groups. The two groups were measured pre- and post-8 weeks of training. Diaphragm excursion and upper rib cage movement during tidal and forceful breathing and coughing and PFM strength were measured using sonography, electromagnetic sensors, and perineometry. Results: There were significant difference of main effect between pre- and post-training and between groups in PFM strength (between groups: P = .001, between time: P<.001) and diaphragm excursion during forceful breathing (between groups: P=.015, between time: P=.026) and coughing (between groups: P=.035, between time: P=.006). There were significant differences in diaphragm excursion during tidal (P=.002) and forceful breathing (P=.005) and coughing (P<.001) between pre- and post-training in the PFES group. Elevation of the upper rib cage during tidal (P<.001) and forceful breathing (P=.001) was significantly decreased after 8 weeks of training in the PFES group. Widening in the horizontal plane in the upper rib cage during forceful breathing (P<.001) was significantly increased after 8 weeks of training in the PFES group. PFM strength (P<.001) was significantly increased after 8 weeks of training in the PFES group. Conclusions: Pelvic floor muscles training by electrical stimulation can improve diaphragm excursion and breathing patterns in women with SUI.
... Focused breath training can improve strength and endurance respiratory muscles, thereby improving breathing phenotype [5][6][7][8][9]. Respiratory muscles use up to 11% of total energy output during maximal exercise [5]. ...
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(1) Background: Breathing economy during endurance sports plays a major role in performance. Poor breathing economy is mainly characterized by excessive breathing frequency (BF) and low tidal volume (VT) due to shallow breathing. The purpose of this study was to evaluate whether a 4 week intervention based on the Wim Hof breathing method (WHBM) would improve breathing economy during exercise in adolescent runners. (2) Methods: 19 adolescent (16.6 ± 1.53 years) middle- and long-distance runners (11 boys and 8 girls) participated in the study. Participants were randomly divided into experimental (n = 11) and control groups (n = 8). The study was set in the transition period between competitive race seasons and both groups had a similar training program in terms of running volume and intensity over the course of the study. The experimental group performed breathing exercises every day (~20 min/day) for 4 weeks. The control group did not perform any kind of breathing exercise. The breathing exercises consisted of three sets of controlled hyperventilation and consecutive maximum breath holds. Before and after the intervention, participants performed incremental cycle ergometer testing sessions consisting of two minute stages at 1, 2, 3, and 4 W·kg−1 with breath-by-breath metabolic analysis. During the testing sessions, BF, VT, and minute ventilation (VE) were assessed and compared. (3) Results: There were no statistically significant differences (p > 0.05) in BF, VT, or VE between experimental and control groups before or after the intervention. A nonsignificant small-to-large effect for an increase in VE and BF in both groups following the 4 week intervention period was observed, possibly due to a reduction in training volume and intensity owing to the down period between competitive seasons. (4) Conclusions: The 4 week intervention of WHBM did not appear to alter parameters of breathing economy during a maximal graded exercise test in adolescent runners.
... It was emphasized that a trained core area is important for efficient performance and the prevention of injuries, and core training practices significantly improve balance performance, dynamic postural control and athletic performance (Kachanathu, Tyagi, Anand, 2014;Freeman et al., 2010;Sadeghi, Shariat, Asadmanesh, Mosavat, 2013). In the researches, after the core stability training applied, a significant increase was found in breathing and flexibility in healthy individuals (Hodges, Gandevia, 2000;Szczygieł et al., 2018, Sato & Mokha, 2009Sekendiz, Cuğ, Korkusuz, 2010), and in strength, speed and vertical jump performance in 5000 m runners sporcularda kuvvet, sürat ve dikey sıçrama (Afyon & Boyacı, 2016;Saeterbakken & Fimland, 2011;Sharma et al., 2012;Butcher et al., 2007). ...
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... The impaired diaphragmatic function may be caused by the dysfunction of pelvic floor muscles in PD. The pelvic floor muscles operate with other synergistic muscles, such as the diaphragm and deep erectors, to maintain intraabdominal pressure (Szczygiel et al., 2018;Hwang et al., 2021). It is reasonable to suggest that paradoxical movement of the pelvic floor muscles might impact the diaphragm. ...
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Background: In normal subjects, the diaphragm plays a key functional role in postural stability, articulation, respiration, defecation, and urination. Objectives: The aim of this study was to investigate the role of the diaphragm in postural stability and visceral function in patients with Parkinson’s disease (PD) and to compare the diaphragm function by gender, Hoehn and Yahr (H&Y) staging, and motor subtypes. Methods: In total, 79 patients were enrolled in this cross-sectional study. The severity of the disease was assessed by the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale III and by H&Y staging. Postural stability was quantitatively recorded, and respiratory function was evaluated by spirometry. Several scales were used to evaluate visceral function in patients with PD. In addition, diaphragm ultrasound was used to measure the excursion, contraction velocity, and thickness of the diaphragm during quiet breathing, deep breathing, and the sniff test. Significant features were selected by the least absolute shrinkage and selection operator (LASSO) regression and fitted in the multivariate linear regression and Pearson’s correlation analysis. Results: Diaphragm thickness and excursion during quiet breathing were significantly different between men and women and between H&Y stage 1–2 and stage 2.5–3, whereas the diaphragm function was not influenced by motor subtypes. It was shown that the diaphragmatic function was significantly correlated with postural stability, voice function, respiratory function, constipation, and urological function to varying degrees in patients with PD. Conclusion: The diaphragmatic function is associated with dysfunction in PD although it remains unclear as to whether the observed changes in the diaphragm are primary or secondary.
Objectives To verify the possible function of Liuzijue Qigong (LQG), a kind of traditional Chinese health exercise, in improving phonation. Methods A total of 30 healthy volunteers (10 males, 20 females) without voice disorders were included. The subjects were asked to have phonation tasks at the sitting and LQG postures. Aerodynamic, electroglottographic, and acoustic parameters were measured. Expiratory Volume (FVC); Subglottic Pressure at comfortable phonation (SGP), Glottal Resistance (GR), Glottal Efficiency (GE); Contact Quotient (CQ), Mean Flow (MF), Fundamental frequency (F0), Mean Sound Pressure Level (SPL); Phonation Threshold Pressure (PTP); and Maximum Phonation Time (MPT) were measured and analyzed. Results In total subjects, the analysis showed a significant increase in FVC (P = 0.020), SGP (P = 0.043), F0 (P = 0.021), and PTP (P = 0.000) at the LQG posture when compared with the sitting posture, and there is no difference in CQ, MF, SPL, GR, GE, and MPT. Conclusions The results showed LQG posture increased the respiratory support and glottal closure, while induced the respiratory system and vocal system in coordination to improve phonation. It is logical to postulate that LQG has potential in the management of voice disorders with glottal closure insufficiency.
Background: Previous reviews relating to the effects of respiratory muscle training (RMT) after stroke tend to focus on only one type of training (inspiratory or expiratory muscles) and most based the results on poor-quality studies (PEDro score ≤4). Objectives: With this systematic review and meta-analysis, we aimed to determine the effects of RMT (inspiratory or expiratory muscle training, or mixed) on exercise tolerance, respiratory muscle function and pulmonary function and also the effects depending on the type of training performed at short- and medium-term in post-stroke. Methods: Databases searched were MEDLINE, PEDro, CINAHL, EMBASE and Web of Science up to the end of April 2020. The quality and risk of bias for each included study was examined by the PEDro scale (including only high-quality studies) and Cochrane Risk of Bias tool. Results: Nine studies (463 patients) were included. The meta-analysis showed a significant increase in exercise tolerance [4 studies; n = 111; standardized mean difference [SMD] = 0.65 (95% confidence interval 0.27-1.04)]; inspiratory muscle strength [9 studies; n = 344; SMD = 0.65 (0.17-1.13)]; inspiratory muscle endurance [3 studies; n = 81; SMD = 1.19 (0.71-1.66)]; diaphragm thickness [3 studies; n = 79; SMD = 0.9 (0.43-1.37)]; and peak expiratory flow [3 studies; n = 84; SMD = 0.55 (0.03-1.08)] in the short-term. There were no benefits on expiratory muscle strength and pulmonary function variables (forced expiratory volume in 1 sec) in the short-term. Conclusions: The meta-analysis provided moderate-quality evidence that RMT improves exercise tolerance, diaphragm thickness and pulmonary function (i.e., peak expiratory flow) and low-quality evidence for the effects on inspiratory muscle strength and endurance in stroke survivors in the short-term. None of these effects are retained in the medium-term. Combined inspiratory and expiratory muscle training seems to promote greater respiratory changes than inspiratory muscle training alone.
Introduction Sport participation is an important for deaf children as participants experience physical, psychological and social benefits; however, the beneficial effect of core stability training on core muscle endurance is unclear. The present study aimed to examine the effects of an 8-week core stability exercise training program on endurance of trunk muscles in deaf children. Methods Twenty male deaf students (age, 16.5 ± 0.65 y; body mass, 62.08 ± 5.39 kg; BMI, 22.33 ± 2.24 kg/m2) volunteered to participate in this study and were randomly assigned to experimental (EXP, n = 10) and control (CON, n = 10) groups. The subjects in the EXP group performed 3 times a week for 8 weeks period of core stability training program and tested trunk muscle endurance including prone bridge, supine bridge and flexor endurance tests at pre and post 8 weeks intervention. Results The CON group did not show any significant change after training period (p > 0.05). The EXP group showed significantly changes in core stability muscle endurance tests following the 8-week core stability training program (p < 0.05). In addition, the EXP group indicated statistically significant changes than the CON group in truck muscle endurance (p < 0.05). Conclusions The results indicated that core stability training program improved trunk muscle endurance. Therefore, this training approach can be recommended in deaf rehabilitation programs to improve trunk muscle endurance.
Objectives The purpose of the study was to check if the trunk muscle activation done in accordance with rules of the Bobath concept affects the occlusion pressure and respiratory muscle efficacy in forced breathing manoeuvres in healthy participants. Design Randomized controlled trial. Between-subjects design. Participants Seventy-four healthy volunteers, aged 20-26 years, were recruited from medical students, randomly assigned to the experimental or control groups. Intervention The intervention in the experimental group was individual physiotherapy based on the Bobath concept. It was provided by qualified physiotherapist and lasted about 60 minutes. The Bobath concept is an inclusive, individualized therapeutic approach to optimize movement recovery, informed by contemporary movement and neuro-sciences. The control group participated in a 45-minute lecture on the importance of the stability of trunk muscle and the diaphragm position that is adequate for its respiratory work. The described interventions, in both groups, were performed once, between the initial and final measurement of the respiratory drive. Outcome measures The subjects underwent two assessments of the following variables: occlusion pressure (P0.1) and the respiratory muscle strength: maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), maximal occlusion pressure (P0.1max) with the use of MasterScope Spirometer. In experimental group, the physiotherapy assessment was carried out before intervention. Results As a result of the applied intervention, P0.1 in the experimental group increased (p = 0.001; 82.45 vs 103.73), which was not observed in the control group (p = 0.629; 88.95 vs 85.83). The intervention did not change the results of all other outcomes including P0.1 max; PImax and PEmax. Conclusion The activation of trunk muscles such as transversus abdominis, multifidius and muscles of the pelvic floor was found to improve the effectiveness of diaphragmatic work during tidal breathing as measured with P0.1 values. Established abdominal pressure, which stabilizes the trunk and prevents chest mobility, might be the reason why forced measurements (PImax, PEmax, P.01 max) remain unchanged.
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Background: Emerging evidence suggests poor core stability is a risk factor for low back and lower extremity injuries in athletes. Recently the trunk stability test (TST) and unilateral hip bridge endurance test (UHBE) were developed to clinically assess core stability. Although these and other clinical tests of core stability exist, how well they assess core stability when compared to biomechanical measures of isolated core stability has not been thoroughly evaluated. Purpose/hypothesis: The purposes of this study were to 1) determine concurrent validity of two novel clinical core stability assessments (TST and UHBE), and 2) assess relationships between these assessments and the trunk endurance and Y-Balance tests. The authors' hypothesized that the TST and UHBE would be highly correlated to the lab-based biomechanical measure of isolated core stability. Also, the TST and UHBE would be moderately correlated with each other, but not with the trunk extensor endurance and Y-Balance. Study design: Cross-Sectional design. Methods: Twenty healthy active individuals completed the TST (recorded number of errors), UHBE (s), trunk extensor endurance (s), Y-Balance (% leg length) test (YBT), and biomechanical test of core stability. Results: Correlational analyses revealed a small, non-significant association between TST and biomechanical measures (rs = 0.2 - 0.22), while a moderate, significant relationship existed between UHBE and biomechanical measures (rs = -0.49 to -0.56, p < 0.05). There was little to no relationship between TST and UHBE (r = -0.07 to - 0.21), or TST and extensor endurance (r = -0.18 to -0.24). A moderate, significant association existed between TST and two reach directions of the YBT (r = -0.41 to -0.43, p < 0.05). Conclusions: Study data support the utility of UHBE as a clinical measure of core stability. The poor relationship between the TST and biomechanical measures, combined with observation of most control faults occurring in the lower extremity (LE) suggest the TST may not be an appropriate clinical test of core stability. Levels of evidence: Level 3.
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DOI: The aim of this study was to analyze the trunk muscular response during different variations of some of the most popular stabilization exercises: front-bridge, back-bridge, side-bridge, and bird-dog. Surface electromyography was bilaterally re-corded from rectus abdominis, external and internal oblique and erector spinae during 25 variations of the aforementioned exercises. Compared to the conventional form of the front- and side-bridge, performing these exercises kneeling on a bench or with elbows extended reduced the muscular challenge. Conversely, performing the back-bridge with elbows extended elicited higher muscular activation than the conventional exercise. While bridge exercises with double leg support produced the highest activation levels in those muscles that counteracted gravity, single leg support while bridging increased the activation of the trunk rotators, especially internal oblique. The highest activation levels were found in three exercises: sagittal walkout in a front-bridge position, rolling from right side-bridge into front-bridge position, and side-bridge with single leg support on a BOSUTMbalance trainer. Although the exercises performed on unstable surfaces usu-ally enhanced the muscle activation, performing the exercises on the BOSUTMbalance trainer did not always increase the trunk muscle activity. Overall, this information may be useful to guide fitness instructors and clinicians when establishing stabilization exercise progressions for the trunk musculature.
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[Purpose] This study determined the effects a new modality of core stabilization exercises based on diaphragmatic breathing on pulmonary function, abdominal fitness, and movement efficiency. [Subjects] Thirtytwo physically active, healthy males were randomly assigned to an experimental group (n = 16) and a control group (n = 16). [Methods] The experimental group combined diaphragmatic breathing exercises with global stretching postures, and the control group performed common abdominal exercises (e.g., crunch, plank, sit-up), both for 15 minutes twice weekly for 6 weeks. Pulmonary function (measured by forced vital capacity, forced expiratory volume in 1 second, and peak expiratory flow) and abdominal fitness (measured with the American College of Sports Medicine curl-up [cadence] test and the Functional Movement Screen™) were evaluated before and after the intervention. [Results] Significant changes in curl-up (cadence) test scores, Functional Movement Screen scores, and all pulmonary parameters were recorded in the experimental group at the posttraining assessment, whereas in the control group, no significant differences over baseline were observed in any parameters. [Conclusion] Compared with traditional abdominal exercises, core stabilization exercises based on breathing and global stretching postures are more effective in improving pulmonary function and abdominal fitness.
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Purpose: The head represents 6% of total body weight, therefore it can significantly affect the biomechanics of human posture control, movements and activities. When set out of vertical body axis, head position interferes with the work of the other links in the kinematic chain. The aim of our study was to evaluate the effect of head posture on the breathing activities of the chest. Material and methods: The research was conducted on a group of 65 patients (51 years ± 9.8 years), including 48 women and 17 men. Head posture and chest movements were assessed using a photogrammetric method. Results: The results confirmed the existence of a negative correlation between head position in the sagittal plane and movements of lower ribs. Forward head posture resulted in lower amplitude of costal arch motion: for the transverse plane Spearman's R = -0.296, for the frontal plane; -0.273, -0.289. Tilting the head in the frontal plane also influenced the change in the biomechanics of breathing and contributed to a reduction of respiratory movements of the lower ribs Spearman's R = -0.260. Conclusions: Changing the position of the head causes disturbances in the three-dimensional shape of the chest and its respiratory movements.
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[Purpose] The purpose of this study was to examine the effects of selective exercise for the deep abdominal muscles (SEDA) and lumbar stabilization exercise (LSE) on the thickness of the transversus abdominis and postural maintenance on an unstable base of support. [Subjects and Methods] The subjects of this study were 20 male and 10 female adults in their 20s without lumbar pain. They were equally and randomly assigned to a SEDA group and a LSE group. The thickness of the transversus abdominis was measured using ultrasound imaging during rest and drawing-in. The thickness of the transversus abdominis was measured when subjects raised their right and left legs while lying on a Swiss ball. [Results] Initially, there were no differences between the two groups. After the intervention, significant differences were observed in all parameters. A significant interaction between group and period was not found for any parameters. [Conclusion] In conclusion, both SEDA and LSE thickened the transversus abdominis, which is a deep abdominal muscle, thereby adjusting posture, and stabilizing the trunk. These exercises increased the thickness of the deep abdominal muscles. They are important exercises for improving the stability of athletes or patients who need postural adjustment.
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[Purpose] The purposes of this study were to investigate the influences of position on %MVIC of spinal stability muscles to establish for the most effective breathing pattern for activation of spinal stability muscles in order to provide an additional treatment method for use in spinal stability exercise programs. [Subjects and Methods] Thirty-three healthy subjects performed quiet breathing and four different forced respiratory maneuvers (FRM); [pursed lip breathing (PLB), diaphragmatic breathing (DB), combination breathing (CB) and respiration muscle endurance training (RMET)] in both standing and sitting positions. %MVIC of them (the multifidus (MF), erector spinae (ES), internal oblique/transversus abdominis (IO/TrA), external oblique (EO), rectus abdominis (RA) measured. [Results] IO/TrA, MF and EO showed greater activation in standing than in sitting, while RA and ES showed greater activation in sitting than in standing. RMET induced significantly greater activation of spinal stability muscles then other breathing patterns. %MVIC changes of muscle activities induced by FRM were independent of position with a few exceptions. [Conclusion] The increased respiratory demands of FRM induced greater activation of spinal stability muscles than QB. RMET was found to be the most effective breathing pattern for increasing the activation of the spinal stability muscles.
Aim: To evaluate the use of photogrammetry and identify the mathematical procedures applied when evaluating spinal posture. Methods: A systematic search using keywords was conducted in the PubMed, EMBASE, Scopus, Science and Medicine(®) databases. The following inclusion criteria adopted were: (1) the use of photogrammetry as a method to evaluate spinal posture; (2) evaluations of spinal curvature in the sagittal and/or frontal plane; (3) studies published within the last three decades; and (4) written entirely in English. The exclusion criteria were: (1) studies which objective involved the verification of some aspect of validation of instruments; (2) studies published as abstracts and those published in scientific events; and (3) studies using evaluation of the anteriorization of the head to determine the angular positioning of the cervical spine. The articles in this review were included and evaluated for their methodological quality, based on the Downs and Black scale, by two independent reviewers. Results: Initially, 1758 articles were found, 76 of which were included upon reading the full texts and 29 were included in accordance with the predetermined criteria. In addition, after analyzing the references in those articles, a further six articles were selected, so that 35 articles were included in this review. This systematic review revealed that the photogrammetry has been using in observational studies. Furthermore, it was also found that, although the data collection methodologies are similar across the studies, in relation to aspects of data analysis, the methodologies are very different, especially regarding the mathematical routines employed to support different postural evaluation software. Conclusion: With photogrammetry, the aim of the assessment, whether it is for clinical, research or collective health purposes, must be considered when choosing which protocol to use to evaluate spinal posture.
The values of vital capacity and forced expiratory volume in one second were obtained for 20 young adults, recordings being taken in four different body positions: sitting, supine lying, prone lying and in a slumped half-lying position. The values derived were analysed using simple statistical methods and there were found to be significant reductions in some pulmonary capacities in the slumped position compared with the values obtained with the subjects in the other positions. These findings tend to support the suggestion that the posture frequently adopted by hospitalised patients in bed creates a set of circumstances which may place the patients at risk due to reduced respiratory function.
Photogrammetry is a method of measurement of a physical object by means of images. The term comprises registration of electromagnetic radiation in a wide range of wave lengths. Determination of location of a point in a three-dimensional space is the common principle for all methods. Photographs of the same point taken simultaneously from at least two locations constitute the basis of calculations. Photogrametric methods used in medicine fall into two basic groups: evaluation of movement and assessment of changes on a surface. The presented principle of classification is very simplified. The real complexity of the idea is reflected by a great variety of measurement systems. So far, Moire's system assessing the shape of the back has gained greatest popularity in rehabilitation. Methods assessing movement are much less popular due to the prices of the equipment, necessity to use large rooms and being time-consuming. Fortunately, there has lately been an improvement in this respect. Depending on the capturing method, information about structure or movement can be obtained. None of the devices using most modern measurement technologies is able to examine both kinds of data simultaneously. The advantage of all photogrametric systems is a large amount of information obtained; their disadvantage is a difficulty of its interpretation. Usefulness of measurement equipment requires presence of a system of data interpretation as an integral part of this equipment. Progress in rehabilitation depends on one hand on technical features of measurement equipment and, on the other hand, on rehabilitation specialists who will be able to formulate their expectations towards systems of movement measurement being newly developed.