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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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2017, Vol. 0, No. 0 9
Posture Control and Deep Muscle
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... This study provides important novel insight into the relationships among RMS, UDI-6, IIQ-7, PF, AMS, WC, and BMI of patients with SUI. These findings are confirmed by the functional connection between the diaphragm, abdominal muscles, and PFM [9], which participate in postural control and breathing [7,44]. ...
... Thus, it is recommended to integrate RMS measurements in patients with SUI to prevent some comorbidities [54] (i.e., urinary tract infections, constipation, chronic obstructive pulmonary disease, depression), stop SUI's negative effect on lifestyle, and reduce the impairment of quality of life. In this vein, some researchers have found that PFM exercise improves pulmonary function and posture [44,55,56], especially when paired with abdominal muscle training [57]. The ability to perform activities of daily living without assistance is commonly used to assess functional capacity. ...
... In addition, as determined by TUG performance, functional mobility impairment was statistically associated with weaker AMS, abdominal obesity, and poorer expiratory muscle strength but not with the inspiratory muscles. These findings, however, could also be attributed to expiratory muscle strength directly interfering with the trunk stabilizing system [44] given that the trunk stabilizing system is associated with balance and walking ability [59]. In support, functional capacity is negatively affected by weakness in the abdominal muscles [59] and a lower balance capacity [60] compared to continent women. ...
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Patients with stress urinary incontinence (SUI) may be afraid to increase intra-abdominal pressure to avoid incontinence. This could lead to weak expiratory muscles. The aim of this study was to investigate the association between respiratory muscle strength, physical function, and SUI in patients with SUI. A cross-sectional study was conducted in the Physical Medicine and Functional Rehabilitation Department. Thirty-one incontinent women (IG) and twenty-nine women in a control group (CG) were enrolled in this study. Anthropometric data, respiratory muscle strength (maximal inspiratory pressure; maximal expiratory pressure), SUI (Urogenital Distress Inventory-6; Incontinence Impact Questionnaire-7; Pad test), and physical function (waist circumference; timed-up-and-go test; abdominal muscle strength) were assessed. Body fat, body mass index, body weight, and waist circumference were higher in IG than CG (p < 0.01), while postural gait and abdominal muscles were lower (p < 0.001). Respiratory muscle strength displayed moderate correlations with SUI severity, especially for maximal expiratory pressure (p < 0.01). Maximal expiratory pressure was moderately associated with physical function. Deterioration in respiratory muscle strength is a characteristic of women with SUI. In this population, pelvic floor muscle training may be prescribed to improve continence. By feeling more confident about increasing intra-abdominal pressure, women with SUI would strengthen their expiratory muscles and eventually improve their physical function.
... The test lasted two minutes, and the two belts were used simultaneously. Previous studies used various methods to choose the number of respiratory cycles for analysisfrom three satisfactory readings to six minutes of breathing cycles [22][23][24]. We noticed that the respiration waves generally reached a stable state after 30 s from the start of the test. ...
... The test lasted two minutes, and the two belts were used simultaneously. Previous studies used various methods to choose the number of respiratory cycles for analysis-from three satisfactory readings to six minutes of breathing cycles [22][23][24]. We noticed that the respiration waves generally reached a stable state after 30 s from the start of the test. ...
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Background and Objectives: The current study aimed to better understand the changes in respiration that occur with aging in men and women to provide accurate recommendations for breathing exercises to improve health. Materials and Methods: A total of 610 healthy subjects, aged 20 to 59, participated in the study. They performed quiet breathing while wearing two respiration belts (Vernier, Beaverton, OR, USA) at the height of the navel and at the xiphoid process to record abdominal motion (AM) and thoracic motion (TM), respectively. Vital capacity, representing maximal inhalation movement, was measured using a spirometer (Xindonghuateng, Beijing, China). After exclusion, 565 subjects (164 men, aged 41 ± 11; 401 women, aged 42 ± 9) were included for statistical analysis using the Kruskal-Wallis U test and stepwise multiple linear regression. Results: Abdominal motion and its contribution to spontaneous breathing were significantly larger for older men, while the contribution of thoracic motion was smaller for older men. There was no significant difference in thoracic motion between the younger and older men. The differences in women's respiratory movements among various ages were mild and negligible. The contribution of thoracic motion to spontaneous breathing in women was larger than in men for those of older ages (40-59 years), but not for those of younger ages (20-39 years). Additionally, men's and women's vital capacities were less in those of older ages, and the men's were larger than the women's. Conclusions: The findings indicate that men's abdominal contribution to spontaneous breathing increased from 20 to 59 years of age due to increased abdominal motion. Women's respiratory movements did not change much with aging. The maximal inhalation movement became smaller with aging for men and women. Healthcare professionals should focus on improving thoracic mobility when addressing health concerns about aging.
... The muscles of the shoulder girdle, flexors and rotators of the trunk, muscles that allow the arm to be raised above the horizontal axis of the shoulder, muscles that are used when moving the arms backward, and the muscles of the forearm and hand for gripping the ball together with the deep stabilizing muscles form the so-called muscle chain consisting of local and global stabilizers (Ammer et al., 2022, Bernacíková, 2010, Kostadinović et al., 2020, Srhoj et al., 2012. The mentioned muscles are one of the prerequisites for a movement pattern based on a kinetic chain, the components of which must work together to achieve proper movement, preventing muscle imbalance or injury (Lin et al., 2022, Manchado et al., 2017, Thurgood and Paternoster, 2014, Szczygieł et al. 2018. One factor that influences the functioning of this kinetic chain during shooting is the muscles of the DSS of the spine. ...
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The muscles of the deep stabilization system (DSS) affect spinal stabilization and correct muscular coordination as a prerequisite for a centered position of the joints with optimal biomechanics of movement. Its stimulation by special exercises might lead to better performance in sports. The study verifies the effect of an 8-week intervention to activate DSS on the shot speed in a group of 15 adult elite female handball players. 30 participants were distributed to either the Control group (CG) or the Experimental group (EG). The EG involved special blocks with exercises activating DSS included in regular handball training. The CG involved only casual training. Input and output measurements included shot velocity assessment from various positions with a Stalker Sports Radar Gun. Mann-Whitney U-test was utilized for the statistical analysis with a 0.05 level of significance. The experiment showed a significant speed increase for all three tested throws. Speed increased by 3.82% for a one-handed overhead shot from the ground from a distance of 7m (free throw), 2.23% for a one-handed overhead shot from the ground after a run-up from a distance of 9m, and 2.23% for a one-handed overhead shot from a jump from a distance of 9 m by 2.38%. Specific activation exercises of DSS of the spine led to increased shot speed in handball.
... They observed weakness of the deep exors of the cervical spine and shortening or contraction of the stylohyoid and sternocleidomastoid muscles and instability of the trunk in subjects with voice disorders. Given the reciprocal correlations of posture and breathing [23] as well as posture and voice [3], a link between posture, breathing and voice seems highly likely. ...
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Introduction There is a noticeable lack of studies relating to voice, breathing and how they relate to each other in patients with voice or respiratory diseases. Therefore, the aim of our study was to assess and compare the breathing pattern and voice variables in people with voice and respiratory disorders. Material and Methods The research was conducted on a group of 61 persons, including 16 patients with chronic obstructive pulmonary disease (COPD), 15 patients with dysphonia and 30 healthy persons. Breathing pattern and voice variables were assessed in relaxed sitting position. The breathing parameters was evaluated separately for upper and lower chest using the respiratory inductive plethysmography. The recording of acoustic speech signal was performed using a dynamic stage microphone with a preamplifier and a digital signal recorder. The acoustic signal was further analysed by evaluating four parameters: Jitter, Shimmer, HNR and MFCC. Results In the sitting position, people with dysphonia and COPD had longer and deeper exhalations and deeper breaths than healthy subjects, regardless of the assessed track, however in the subjects with COPD higher for the abdominal track and for dysphonia subjects in thoracic track were observed. Subjects suffering from dysphonia were characterized by lower voice power and pitch and more distortions in the speech signal compared to healthy subjects, whereas both dysphonia and COPD patients had statistically significantly lower voice frequency compared to the control group. Conclusion Subjects with COPD made greater use of the diaphragmatic track in sitting position, whereas subjects with dysphonia used the thoracic track to a greater extent. Stronger correlations between voice and respiratory parameters for the abdominal track exist in people with voice or respiratory dysfunctions than in healthy subjects.
... Several studies have also proved that the core muscles aid in stabilizing the lumbar spine and postural maintenance (Hides et al., 1996;Hodges et al., 2007;Kibler et al., 2006). Szczygieł et al. demonstrated that four weeks of core deep muscle training helps to improve posture, particularly trunk postural control in the sagittal plane (Szczygieł et al., 2018). ...
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The current study intended to determine recreational runners' knowledge, attitude, and practices toward CSE to prevent LBP. Materials and Methods: A cross-sectional study design was adopted. Two hundred fifty-seven recreational runners were chosen using a simple random sampling approach and administered with a semi-structured questionnaire to evaluate their KAP toward CSE. Data analysis was carried out using SPSS 28.0. Results: The correct response to the knowledge-related items in the questionnaire was from 65% to 91%. Precisely, 91.4% of study participants understood CSE. Furthermore, most participants showed a positive attitude toward CSE, considering that it is essential for running (79%), improving fitness (76%), reducing the risk of injuries (71%), and boosting their appearance (54%). Most participants (>85%) performed CSE for recommended frequency and duration to strengthen their core muscles and prevent LBP. The recreational runners had good practice toward CSE. Conclusion: Recreational runners possess adequate knowledge, a positive attitude, and good practice toward CSE. This study suggested that motivational strategies and awareness programs can be conducted to improve recreational runners' KAP toward CSE preventing LBP.
... Indeed, the position of the pelvis is directly related to spine positioning and is responsible for modulating trunk muscle activity (23). In this sense, a study on healthy adults revealed sagittal plane postural changes and breathing amplitude after an exercise program targeting the deep stabilizing muscles (39). ...
Hypopressive exercises (HE) are part of the Low Pressure Fitness training program which is widely used by physical therapists in the rehabilitation of the pelvic floor, abdominal and spinal musculature. The aim of this study was to compare the effects of HE on the sagittal lumbo-pelvic posture in athletic and non-athletic females. It was hypothesized that a 5-week training program of HE could influence lumbo-pelvic position while reducing abdominal circumference and low back pain in athletic and non-athletic females. Twenty normoweight females (mean age= 24.8 (SD3.5) years; body mass index= 22.4(SD1.6) kg/m2) participated in this study. Ten athletic females were rugby players (RG), and 10 females were non-athletic (SG). Participants completed twenty minutes of HE twice weekly for 5 weeks. Before and after the intervention, two-dimension photogrammetry was used to assess lumbar lordosis and pelvic horizontal alignment. A Visual Analog Scale was used to assess low back pain and cirtometry was used to assess abdominal circumferences at umbilical, supra and infra-umbilical levels. An analysis of variance between moments revealed no significant differences in lumbar lordosis and pelvic positioning but showed significant differences for abdominal circumferences between groups. No significant differences between groups were found for other variables. Significant correlations were found between the three different abdominal circumference measurements (p>0.05) but not between lumbar lordosis and abdominal circumferences. These preliminary findings indicate that a 5-week HE intervention displayed non-significant changes in lumbar lordosis, pelvic horizontal alignment, and low back pain but a significant reduction in abdominal circumferences in non-athletic and athletic females.
... However, posture control, spinal stabilization and breathing are mechanically and neuromuscularly interdependent, and they all involve abdominal wall muscle and PFM [47]. Breathing exercises also stimulate PFM activation, especially during forced exhalation, PFM contraction and maintaining the position of the pelvis [48]. ...
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Purpose: Stress urinary incontinence (SUI) refers to involuntary leakage from the urethra, synchronous with exertion/effort, sneezing or coughing, which has a negative effect on quality of life. Studies have shown that mild-to-moderate physical activities reduce the risk of SUI by multiple mechanisms. The objective of this study was to determine whether the Rumba dance combined with breathing training (RDBT) can reduce the severity of incontinence and improve the quality of life of patients with SUI. Methods: A randomized clinical trial was conducted with women who were sedentary, were postmenopausal, reported mild-to-moderate SUI on a 1-h pad test, were not already engaged in Rumba dance and did not receive estrogen replacement therapy. The patients were randomly assigned to the RDBT group (n = 13) or the control group (n = 11). The intervention included 90 min of RDBT three times per week for 16 weeks, and the vaginal resting pressure (VRP), pelvic floor muscle (PFM) strength and endurance, 1-h pad test, International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and the Incontinence Quality of Life Questionnaire (I-QOL) were measured or completed at baseline and 16 weeks. None of the participants reported adverse events. Results: The mean (±SD) age of the participants was 55.75 ± 5.58 years. After 16 weeks, in the RDBT group, the urine leakage on the 1-h pad test was significantly decreased -2.91 ± 0.49 from the baseline (p = 0.000). The VRP increased from 76.00 ± 16.23 cmH2O to 95.09 ± 18.90 cmH2O (p = 0.000), the PFM endurance of class I (-3.15 ± 1.99% vs. -0.46 ± 0.97%, p = 0.000) and class II (-0.69 ± 0.95% vs. -0.23 ± 0.44%, p = 0.065) increased, and the grades of PFM strength of class I and class II were significantly enhanced (p < 0.01). Finally, the severity of self-reported incontinence (ICIQ-UI SF) significantly decreased from 6.12 ± 2.15 to 3.81 ± 1.68 (p = 0.000), and quality of life (I-QOL) improved from 75.73 ± 11.93 to 83.48 ± 7.88 (p = 0.005). Conclusion: A 16-week RDBT program can increase PFM strength and endurance to reduce the severity of incontinence symptoms and improve the quality of life in patients with SUI, demonstrating the feasibility of recruiting and retaining postmenopausal women with SUI into a RDBT therapeutic program.
... An increasing number of studies suggested that the functional incoordination of the "core" trunk muscles and the postural control disorder were the important causes of low back pain [7,8]. Te diaphragm muscle, as one of the important components of the "core" deep trunk muscles as well as the main respiratory muscle, plays a key role in both respiratory and postural control [9][10][11]. However, whether there is a potential relationship between diaphragm dysfunction and low back pain is rarely reported, and the pathogenic mechanisms involved in it remain poorly understood. ...
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Background: It is reported that impaired postural control in patients with non-specific chronic low back pain (NCLBP) was associated with "core" trunk muscle incoordination. However, as the diaphragm is an important component of the "core" deep trunk muscle group, we still know little about the potential relationship between diaphragm dysfunction and NCLBP. Objectives: This case-control study is intended to investigate the changes of diaphragm morphological structure and function in young and middle-aged subjects with and without NCLBP by ultrasound evaluation and its possible validity in predicating the occurrence of NCLBP. Methods: 31 subjects with NCLBP (NCLBP group) and 32 matched healthy controls (HC group) were enrolled in this study. The diaphragm thickness at the end of inspiration (T ins) or expiration (T exp) during deep breathing was measured through B-mode ultrasound, and the diaphragm excursion (T exc) was estimated at deep breathing through M-mode ultrasound. The diaphragm thickness change rate (T rate) was calculated by the formula: T rate=(T ins - T exp)/T exp × 100%. Results: Compared with the HC group, the NCLBP group had a significant smaller degree of Tins (t = -3.90, P < 0.001), T exp (Z = -2.79, P=0.005), and T rate (t = -2.03, P=0.047). However, there was no statistical difference in T exc between the two groups (t = -1.42, P=0.161). The binary logistic regression analysis indicated that T rate (OR = 16.038, P=0.014) and T exp (OR = 7.714, P=0.004) were potential risk factors for the occurrence of NCLBP. Conclusions: The diaphragm morphological structure and function were changed in young and middle-aged subjects with NCLBP, while the diaphragm thickness change rate (T rate) and diaphragm thickness at the end of expiration (T exp) may be conductive to the occurrence of NCLBP. Furthermore, these findings may suggest that abnormal diaphragm reeducation is necessary for the rehabilitation of patients with NCLBP.
Background and Purpose The test-retest reliability and minimal detectable changes (MDCs) for respiratory muscle strength measures have not been determined in individuals with multiple sclerosis (MS). This study determined the test-retest reliability and MDCs for specific respiratory muscle strength measures, as well as their associations with health-related quality of life (HRQoL), disability, dyspnea, and physical activity level measures in this population. In addition, the study examined differences in respiratory muscle strength between different degrees of disability. Methods Sixty-one individuals with MS attended 2 appointments separated by 7 to 10 days. Respiratory muscle strength was evaluated by maximal inspiratory and expiratory pressures (MIP/MEP), HRQoL by EuroQol-5D-5L (index and visual analog scale [EQ-VAS]), disability by the Expanded Disability Status Scale, dyspnea by the Medical Research Council scale, and physical activity levels by the International Physical Activity Questionnaire. Results Respiratory muscle strength measures had excellent test-retest reliability (ICC ≥ 0.92). The MDC for MIP is 15.42 cmH 2 O and for MEP is 17.84 cmH 2 O. Participants with higher respiratory muscle strength (MIP/MEP cmH 2 O and percentage of predicted values) had higher HRQoL ( r = 0.54-0.62, P < 0.01, EQ-5D-5L index; r = 0.30-0.42, P < 0.05, EQ-VAS); those with higher expiratory muscle strength (cmH 2 O and percentage of predicted values) had lower levels of disability ( r ≤ −0.66) and dyspnea ( r ≤ −0.61). There were differences in respiratory muscle strength between different degrees of disability ( P < 0.01; d ≥ 0.73). Discussion and Conclusion Respiratory muscle strength measures provide excellent test-retest reliability in individuals with MS. MDCs can be interpreted and applied in the clinical setting. Low respiratory muscle strength can contribute to a poor HRQoL; specifically, expiratory muscle strength appears to have the strongest influence on disability status and dyspnea. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at:
The present study aimed to evaluate forced expiration based on transverse abdominis (TrA) stiffness by identifying the relationship between TrA stiffness and peak expiratory flow (PEF) in both younger and older adults. We also assessed the relationship between diaphragm thickness and PEF. A total of 31 younger (21.24 ± 2.73 years) and 34 older (71.35 ± 5.26 years) adults were included in the present study. TrA muscle stiffness was measured at rest and during abdominal bracing using shear wave elastography (SWE). Diaphragm thickness was measured during deep inspiration and expiration using B-mode ultrasound, and respiratory function was assessed by measuring PEF using a spirometer. We found that TrA stiffness during bracing was significantly lower in older than younger adults (P < 0.05). Similarly, the difference in absolute stiffness of the TrA when bracing vs. at rest was significantly lower in older than younger adults (P < 0.05). Additionally, TrA stiffness during bracing was positively associated with PEF in the younger group (r = 0.483), while a very weak correlation was found in the older group (r = 0.172). Similarly, PEF was moderately correlated with diaphragm thickness during expiration as well as during changes between inspiration and expiration in the younger group (r = 0.405 and r = 0.403); however, no significant correlation was found in the older group. These findings of the present study indicate that the variations in PEF between younger and older adults may be due to age-associated changes in the musculoskeletal structure and muscle fiber type. This article is protected by copyright. All rights reserved.
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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.