Novel augmented ADIM training using ultrasound imaging and electromyography in adults with core instability

To determine the effect of novel augmented abdominal drawing-in maneuver (ADIM) training using rehabilitative ultrasound imaging (RUSI) and electromyography (EMG) in adults with core instability.

A convenience sample of 20 young adults with core instability (female =4; mean age ± standard deviation=24.4 ± 2.9 years) was recruited. Core instability was determined by the formal test. All subjects underwent an intensive ADIM that was augmented by comprehensive visual feedback via a pressure biofeedback unit, RUSI, and EMG. The intervention was provided for 20 minutes a day, 7 days a week, over a two-week period.

The paired t-test showed that both transverse abdominal (TrA) and internal oblique (IO) muscle thickness during ADIM were significantly greater than at rest (p= 0.000). However, external oblique (EO) muscle thickness remained relatively unchanged. The mean EMG amplitudes of the EO and erector spinae (ES) muscles were significantly decreased after the intervention (p=0.001, p=0.008). The intra-class correlation coefficient (ICC(1,2)) showed the excellent test-retest reliability for muscle thickness (ranging from 0.90 to 0.98 in the prone position).

This is the first evidence to demonstrate that the novel augmented ADIM training can effectively improve the lumbo-pelvic stabilization in adults with core instability.