Effectiveness of Transverse Abdominis Activation on Lumbar Stiffness, Flexibility and Functional Stability in Patients with Low Back Pain

Abstract

BACKGROUND: Low back pain (LBP) is one of the main causes of disability worldwide, significantly impairs physical function and quality of life. The delayed and inadequate activation of deep abdominal muscles, particularly the Transverse Abdominis (TrA), is one of the main causes of persistent low back pain.

OBJECTIVE: To evaluate the combined effect of Abdominal Drawing-In Maneuver (ADIM) for Transverse Abdominis activation and stretching on lumbar stiffness, flexibility, and functional stability in individuals with low back pain.

METHODOLOGY: A quasi-experimental trial was conducted with 60 participants aged 20-30 years who experienced lumbar stiffness and low back pain.After meeting the inclusion and exclusion criteria, data were collected from female students living in the Government College University Faisalabad females' hostels. The experimental group received intervention twice a day for two weeks, followed by sessions on alternate days for the next two weeks. Then, one session per week for follow-up.The study was conducted for six months in total. Outcome measures included Modified Oswestry Disability Index (MODI), Numeric Pain Rating Scale (NPRS), and Goniometric assessment. Statistical analysis was performed using SPSS version 27.

RESULTS: Lumbar spine range of motion, lumbar stiffness, lumbar flexibility, and pain were all significantly improved. NPRS scores reduced (p<0.001), MODI scores improved (P<0.001), and ROM in all directions increased significantly.

CONCLUSIONS: The combined application of Transverse Abdominis activation exercises and stretching is effective in improving lumbar flexibility, reducing stiffness, and enhancing functional stability in patients with low back pain.