The subject then performed three maximal inspiratory pressure (MIP) maneuvers and three maximal sniff efforts, and proceeded with the exercises. Proper catheter placement was confirmed by pressure swings during normal breathing. Two esophageal balloon catheters (Cooper Surgical Company, Trumbul, CT) were inserted through the nose into the stomach and the esophagus by the investigators, who had performed this technique for more than one year. Data was collected on day two, which was separated by 24-48 hours from the practice session. On day one subjects practiced the exercises and the MIP maneuvers. We hypothesized that core exercises would yield a variety of Pdi, some of which may be sufficient to elicit an inspiratory muscle training stimulus.ĭata collection took place over two days. Given the relative lack of research relating core exercises to Pdi, and the possibility that this type of exercise may be useful for training the inspiratory muscles, we evaluated Pdi during thirteen core exercises. Such exercises, while increasing transdiaphragmatic pressure do not involve respiratory activity as the primary goal of the exercise. Core exercises may represent a viable addition to a standard rehabilitation program. While respiratory maneuvers may elicit training responses, they may not be comfortable or practical for some groups. One traditional method of inspiratory muscle training is loaded inspiration, which improves inspiratory muscle strength (Clanton et al., 1985) and endurance (Wylegala et al., 2006) when the inspiratory resistance was sufficient. While only one study has addressed this possibility (De Palo et al., 2004), there is a large body of research on inspiratory muscle training through respiratory maneuvers (e.g. The fact that the diaphragm is activated during core exercises indicates a potential for these exercises to be used for diaphragmatic training. In addition to abdominal exercises, other non-respiratory movements such as repetitive arm movements increase diaphragmatic activity (Hodges and Gandevia, 1999). They also measured increased Pdi during sit-ups and found values of over 40% of Pdi max. Al-Bilbeisi and McCool, 2000 reported increased diaphragm activation, evidenced by increased transdiaphragmatic pressure (Pdi), during several weight lifting activities that ranged from 20% of maximal Pdi (Pdi max) for bench press to over 40% of Pdi max for power lifts. Its anatomical position, separating the thorax from the abdomen means that it is exposed to pressures exerted by muscles surrounding both body cavities.ĭuring movements involving the core (thoracic and abdominal) musculature, diaphragm activity is increased both to overcome pressures opposing inspiration and for postural support (Hodges et al., 1997). As such, it is a chronically active muscle with as much as 65% Type I muscle fibers (Keens, et al., 1978). The diaphragm is the primary muscle of inspiration. The Pdi measurements also provide insight into diaphragm recruitment during different core exercises, and may aid in the design of exercises to improve diaphragm strength and endurance. Seven of the exercises yielded Pdi ≥ 50% of the Pdi during the MIP maneuver, which may provide a training stimulus to the diaphragm if used as a regular exercise. The exercises stratified into three Pdi levels. ![]() There was a significant difference between the exercises and the MIP Pdi, as well as between the exercises and resting Pdi (p < 0.001). The exercises were performed from least to most difficult, with five repetitions each. Prior to initiating the exercises, each subject performed a maximal inspiratory pressure (MIP) maneuver. Each subject was instrumented with two balloon-tipped catheters to obtain gastric and esophageal pressures, from which Pdi was calculated. Six healthy subjects, aged 22 to 53, participated. We evaluated the effect of 13 different abdominal exercises, ranging in difficulty, on transdiaphragmatic pressure (Pdi), an index of diaphragmatic activity. We also sought to determine if some of the easy exercises would produce pressures sufficient for a training stimulus to the diaphragm. We hypothesized that core exercises would produce a variety of transdiaphragmatic pressures. An overlooked aspect of abdominal exercises is the compression the abdomen, leading to increased diaphragmatic work. Abdominal exercises, such as sit ups and leg lifts, are used to enhance strength of the core muscles.
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