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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: http://www.tandfonline.com/loi/vjmb20
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
Golec
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
To link to this article: http://dx.doi.org/10.1080/00222895.2017.1327413
Published online: 18 Aug 2017.
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RESEARCH ARTICLE
The Impact of Deep Muscle Training on the Quality of Posture
and Breathing
El_
zbieta Szczygiel
1
,J˛edrzej Blaut
2
, Katarzyna Zielonka-Pycka
3
, Krzysztof Tomaszewski
4
, Joanna Golec
1
,
Dorota Czechowska
1
, Agata Maslo
n
1
, Edward Golec
1
1
Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech
Physical Academy Education, Krakow, Poland.
2
AGH University of Science and Technology, Faculty of Mechanical
Engineering and Robotics, Krakow, Poland.
3
Faculty of Physiotherapy, Andrzej Frycz Modrzewski Krakow University, Poland.
4
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
(pD0.001).
Keywords: motor control, movement, multisegment movement,
muscle
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: elzbietasz@gmail.com
Color versions of one or more of the figures in the article can
be found online at www.tandfonline.com/vjmb.
1
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
muscles.
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.
Methods
Participants
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
2
).
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
y-axis
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 (http://www.natus.com/index.
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
activities.
Statistical Analysis
Statistical analysis was performed using Statistica 6.0
software (https://www.statsoft.pl/O-Firmie/O-nas/StatSoft-
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
test.
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.
Results
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).
Discussion
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, &
My
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-
tionontheeffectsofdeepmuscletrainingonpostural
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
Sagittal
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
Frontal
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
excursion.
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.
Conclusion
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
position.
ACKNOWLEDGEMENTS
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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... 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. ...
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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.
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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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[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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