Blood Flow Restriction, draw-in Maneuver, Transverse Abdominis
Conditions
Brief summary
This study expects to provide a new alternative way to improve the muscle activation, strength and activation of transverse abdominis in abdominal draw-in maneuver combined with blood flow restriction.
Detailed description
The transverse abdominis (TrA) is the deepest muscle layer of lateral and anterior abdominal wall and also known as a significant component of core stability. Abdominal draw-in maneuver (ADIM) is the main for the strengthening of the deep muscle, however, sufficient activation of TrA by ADIM is limited. Blood flow restriction (BFR) training is a technique combined with low intensity exercise that produces similar results to high intensity training. However, there is few evidences for BFR training on core muscles. Healthy adults (age ranged 18-34 years and BMI between 18.5\ 24.99) were randomly recruited in the study. For the intervention group, an inflatable cuff (14 cm in width \* 84 cm in length) is warped around abdominal muscles below ribs which may cause to at least 60% restriction of blood flow detected by Power Doppler ultrasonography. All participants are instructed to perform ADIM both condition of BFR and BFR-free twice a week, for six weeks. Outcome measurements include Double leg lowering test (DLLT) for muscle strength, brightness mode ultrasound (USD) for muscle hypertrophy and electromyography (EMG) muscle activation. The same physical therapist will do the measurement at first week, third week and the sixth week.
Interventions
BEHAVIORALblood flow restriction
an inflatable cuff (14 cm in width \* 84 cm in length) is warped around abdominal muscles below ribs which may cause to at least 60% restriction of blood flow detected by Power Doppler ultrasonography. All participants are instructed to perform abdominal draw-in maneuver.
BEHAVIORALsham blood flow restriction
an inflatable cuff (14 cm in width \* 84 cm in length) is warped around abdominal muscles below ribs without inflation. All participants are instructed to perform abdominal draw-in maneuver.
Sponsors
China Medical University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
20 Years to 35 Years
Healthy volunteers
Yes
Inclusion criteria
* Healthy subjects * 20\ 35 years old * BMI 18.5\ 24.99
Exclusion criteria
* Hypertension * Have cardio-vascular disease * Used to have abdominal operation or wound * Have spinal surgeries or deformities * Known neuromuscular or joint disease * Pregnant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Muscle Thickness Change of Transverse Abdominis | 3,4,5 weeks | muscle thickness change on week3, 4 and 5 compared with baseline |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Internal Oblique Thickness Change | baseline,3,4,5 weeks | Data represents the muscle thickness change on week 3, 4 and 5 compared with baseline. The thickness of the muscle was calculated by the differences between the muscle thickness during contraction and the muscle thickness during resting position. If the muscle thickness during contraction was smaller than the muscle thickness during the resting position, therefore, the values would be negative. The values in baseline presented as negative may be because the internal oblique muscle thickness during contraction was smaller before receiving any training. Previous studies stated that after receiving ADIM and BFR training, the internal oblique muscle thickness will be thicker. Therefore, it was reasonable that the results in baseline presented negative values while the values became positive after receiving training. |
| External Oblique Thickness Change | baseline,3,4,5weeks | Data represents the muscle thickness change on week 3, 4 and 5 compared with baseline. The thickness of the muscle was calculated by the differences between the muscle thickness during contraction and the muscle thickness during resting position. If the muscle thickness during contraction was smaller than the muscle thickness during the resting position, therefore, the values would be negative. The values in baseline presented as negative may be because the external oblique muscle thickness during contraction was smaller before receiving any training. After receiving ADIM and BFR training, the tranverse abdominis and internal oblique muscle thickness will be thicker while the external oblique will be thinner due to the compression from the TrA and IO muscles. |
Countries
Taiwan
Participant flow
Recruitment details
participants were recruited from college aged between 20\ 35
Pre-assignment details
of 37 participants, 36 met the inclusion criteria while 1 participant was excluded because of overweighted.
Participants by arm
| Arm | Count |
|---|---|
| Blood Flow Restriction An inflatable cuff (14 cm in width \* 84 cm in length) is warped around abdominal muscles below ribs which may cause to at least 60% restriction of blood flow detected by Power Doppler ultrasonography. All participants are instructed to perform abdominal draw-in maneuver both condition of BFR and BFR-free twice a week, for six weeks.
blood flow restriction: an inflatable cuff (14 cm in width \* 84 cm in length) is warped around abdominal muscles below ribs which may cause to at least 60% restriction of blood flow detected by Power Doppler ultrasonography. All participants are instructed to perform abdominal draw-in maneuver. | 17 |
| Sham Blood Flow Restriction an inflatable cuff (14 cm in width \* 84 cm in length) is warped around abdominal muscles below ribs without inflation. All participants are instructed to perform abdominal draw-in maneuver.
sham blood flow restriction: an inflatable cuff (14 cm in width \* 84 cm in length) is warped around abdominal muscles below ribs without inflation. All participants are instructed to perform abdominal draw-in maneuver. | 17 |
| Total | 34 |
Baseline characteristics
| Characteristic | Blood Flow Restriction | Sham Blood Flow Restriction | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 17 Participants | 17 Participants | 34 Participants |
| Age, Continuous | 21.47 years STANDARD_DEVIATION 1.33 | 21.53 years STANDARD_DEVIATION 1.69 | 21.5 years STANDARD_DEVIATION 1.52 |
| BMI | 21.41 kg/m^2 STANDARD_DEVIATION 0.93 | 21.53 kg/m^2 STANDARD_DEVIATION 1.69 | 21.5 kg/m^2 STANDARD_DEVIATION 1.7 |
| Race and Ethnicity Not Collected | — | — | 0 Participants |
| Region of Enrollment Taiwan | 17 participants | 17 participants | 34 participants |
| Sex: Female, Male Female | 10 Participants | 8 Participants | 18 Participants |
| Sex: Female, Male Male | 7 Participants | 9 Participants | 16 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Muscle Thickness Change of Transverse Abdominis
muscle thickness change on week3, 4 and 5 compared with baseline
Time frame: 3,4,5 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Blood Flow Restriction | Muscle Thickness Change of Transverse Abdominis | baseline | 0.93 mm | Standard Deviation 0.97 |
| Blood Flow Restriction | Muscle Thickness Change of Transverse Abdominis | week 3 | 1.98 mm | Standard Deviation 1.4 |
| Blood Flow Restriction | Muscle Thickness Change of Transverse Abdominis | week 4 | 2.65 mm | Standard Deviation 1.08 |
| Blood Flow Restriction | Muscle Thickness Change of Transverse Abdominis | week 5 | 2.7 mm | Standard Deviation 1.62 |
| Sham Blood Flow Restriction | Muscle Thickness Change of Transverse Abdominis | week 5 | 0.83 mm | Standard Deviation 0.75 |
| Sham Blood Flow Restriction | Muscle Thickness Change of Transverse Abdominis | baseline | 0.77 mm | Standard Deviation 1.45 |
| Sham Blood Flow Restriction | Muscle Thickness Change of Transverse Abdominis | week 4 | 0.78 mm | Standard Deviation 0.79 |
| Sham Blood Flow Restriction | Muscle Thickness Change of Transverse Abdominis | week 3 | 0.99 mm | Standard Deviation 0.79 |
Secondary
External Oblique Thickness Change
Data represents the muscle thickness change on week 3, 4 and 5 compared with baseline. The thickness of the muscle was calculated by the differences between the muscle thickness during contraction and the muscle thickness during resting position. If the muscle thickness during contraction was smaller than the muscle thickness during the resting position, therefore, the values would be negative. The values in baseline presented as negative may be because the external oblique muscle thickness during contraction was smaller before receiving any training. After receiving ADIM and BFR training, the tranverse abdominis and internal oblique muscle thickness will be thicker while the external oblique will be thinner due to the compression from the TrA and IO muscles.
Time frame: baseline,3,4,5weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Blood Flow Restriction | External Oblique Thickness Change | week 4 | -0.94 mm | Standard Deviation 1.09 |
| Blood Flow Restriction | External Oblique Thickness Change | baseline | -0.77 mm | Standard Deviation 1.08 |
| Blood Flow Restriction | External Oblique Thickness Change | week 5 | -0.95 mm | Standard Deviation 1.02 |
| Blood Flow Restriction | External Oblique Thickness Change | week 3 | -0.97 mm | Standard Deviation 1.11 |
| Sham Blood Flow Restriction | External Oblique Thickness Change | week 5 | -0.68 mm | Standard Deviation 1.13 |
| Sham Blood Flow Restriction | External Oblique Thickness Change | baseline | -0.47 mm | Standard Deviation 1.04 |
| Sham Blood Flow Restriction | External Oblique Thickness Change | week 4 | -0.16 mm | Standard Deviation 0.8 |
| Sham Blood Flow Restriction | External Oblique Thickness Change | week 3 | -0.41 mm | Standard Deviation 0.76 |
Secondary
Internal Oblique Thickness Change
Data represents the muscle thickness change on week 3, 4 and 5 compared with baseline. The thickness of the muscle was calculated by the differences between the muscle thickness during contraction and the muscle thickness during resting position. If the muscle thickness during contraction was smaller than the muscle thickness during the resting position, therefore, the values would be negative. The values in baseline presented as negative may be because the internal oblique muscle thickness during contraction was smaller before receiving any training. Previous studies stated that after receiving ADIM and BFR training, the internal oblique muscle thickness will be thicker. Therefore, it was reasonable that the results in baseline presented negative values while the values became positive after receiving training.
Time frame: baseline,3,4,5 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Blood Flow Restriction | Internal Oblique Thickness Change | week 5 | 1.21 mm | Standard Deviation 1.53 |
| Blood Flow Restriction | Internal Oblique Thickness Change | baseline | -0.01 mm | Standard Deviation 1.06 |
| Blood Flow Restriction | Internal Oblique Thickness Change | week 3 | 0.75 mm | Standard Deviation 1.72 |
| Blood Flow Restriction | Internal Oblique Thickness Change | week 4 | 0.96 mm | Standard Deviation 2.66 |
| Sham Blood Flow Restriction | Internal Oblique Thickness Change | week 4 | 0.14 mm | Standard Deviation 0.94 |
| Sham Blood Flow Restriction | Internal Oblique Thickness Change | baseline | -0.2 mm | Standard Deviation 1.09 |
| Sham Blood Flow Restriction | Internal Oblique Thickness Change | week 3 | 0.02 mm | Standard Deviation 1.04 |
| Sham Blood Flow Restriction | Internal Oblique Thickness Change | week 5 | 0.4 mm | Standard Deviation 1.78 |