ArticleBMJ open2015
The abdominal drawing-in manoeuvre for detecting activity in the deep abdominal muscles: is this clinical tool reliable and valid?
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Article
- Transversus Abdominis Ultrasound Thickness during Popular Trunk-Pilates Exercises in Young and Middle-Aged Women.Journal of functional morphology and kinesiology · 2023Article
- Comparison of Abdominal Muscle Thickness between the Abdominal Draw-in Maneuver and Maximum Abdominal Contraction Maneuver.Healthcare (Basel, Switzerland) · 2022Article
- The Role of Rehabilitative Ultrasound Imaging Technique in the Lumbopelvic Region as a Diagnosis and Treatment Tool in Physiotherapy: Systematic Review, Meta-Analysis and Meta-Regression.Journal of clinical medicine · 2021Review
- Reproducibility and Concurrent Validity of Manual Palpation with Rehabilitative Ultrasound Imaging for Assessing Deep Abdominal Muscle Activity: Analysis with Preferential Ratios.Diagnostics (Basel, Switzerland) · 2021Article
- Gliding performance is affected by cranial movement of abdominal organs.Scientific reports · 2020Article
- Prefabricated foot orthoses compared to a placebo intervention for the treatment of chronic nonspecific low back pain: a study protocol for a randomised controlled trial.Journal of foot and ankle research · 2018Article
- Article
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3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveThe abdominal drawing-in manoeuvre (ADIM) is a common clinical tool for manually assessing whether a preferential activation of the deep abdominal muscles in patients with low back pain (LBP) is 'correct' or not. The validity and reliability of manual assessment of the ADIM are, however, as yet unknown. This study evaluated the concurrent and discriminative validity and reliability of the manually assessed ADIM.
designSingle-blinded cross-sectional study. SETTINGS: General population in Stockholm County, Sweden.
participantsThe study sample comprised 38 participants seeking care for LBP, and 15 healthy subjects. MEASURES: The manual ADIM was assessed as correct or not following a standard procedure. Ultrasound imaging (USI) was used as the concurrent reference (gold standard) for the manually assessed ADIM by calculating a ratio of the change in muscle thickness between the resting and the contracted states: the correlation between manual test and USI was calculated. Discriminative validity was analysed by calculating sensitivity and specificity. A sample of 24 participants was analysed with κ coefficients for interobserver reliability between two raters.
resultsThe concurrent validity between the manual ADIM and the ADIM-USI ratios showed poor correlations (r=0.13-0.40). The discriminative validity of the manually assessed ADIM to predict LBP showed a sensitivity/specificity of 0.30/0.73, while the ADIM-USI ratio to predict LBP showed 0.19/0.87. The interobserver reliability for the manually assessed ADIM revealed substantial agreement: K=0.71, CI (95%) 0.41 to 1.00.
conclusionsAlthough the interobserver reliability of the manually assessed ADIM was high, the concurrent and discriminative validity were both low for examining the preferential activity of the deep abdominal muscles. Neither the manually assessed ADIM nor the ultrasound testing discriminated between participants with LBP and healthy subjects regarding preferential activity of the transversus muscle as this ability/inability was also present in healthy subjects.
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