Document Type : Research articles


1 Sports and Exercise Medicine Specialist, Helal - Iran Institute, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran

2 2 Community Medicine Specialists, Research Center for Addiction and Risky Behaviors, Iran University of Medical Sciences, Tehran, Iran.


Introduction: The abdominal draw-in maneuver (ADIM) has been suggested to enhance core stability through the improvement of lumbopelvic stability. Although the effect of ADIM and core muscle activation on some biomechanical parameters has been studied, the effect of exercising a few minutes of this maneuver on balance test results has not been established yet.
Objectives: This study aimed to study the effect of exercising a few minutes of ADIM on balance test results.
Materials and Methods: This study included 18 apparently healthy participants in the age range of 18-60 years. The participants performed a fall risk test using the Biodex balance system. Afterward, the participants were instructed to perform the abdominal drawing-in maneuver. The fall risk test was repeated while the participants were performing this maneuver. The results were compared with the data obtained from participants at the beginning of the study using paired t-test. Data were analyzed according to the participants BMI (more or less than 25 kg/m2) or abdominal circumference (more or less than 100 cm) to reveal the effect of doing ADIM on balance scores in these subgroups.
Results. Based on the obtained results, a significant improvement was observed in the means of balance scores after the participants performed the ADIM. Further analysis revealed a significant improvement in the means of balance scores of individuals with abdominal circumference more than 100 cm or BMI more than 25kg/m2 (P?0.05).
Conclusion: The short-term impairment of postural control can be dangerous, especially for elderly individuals with abdominal obesity in risky situations, such as mass gatherings. Therefore, it is recommended that individuals with a high risk of falling should be instructed to practice ADIM correctly.


  1. Hrysomallis C. Relationship between balance ability, training and sports injury risk. Sports Med. 2007;37(6):547-56. doi: 10.2165/00007256-200737060-00007. [PubMed: 17503879].
  2. Esteghamati A, Khalilzadeh O, Rashidi A, Kamgar M, Meysamie A, Abbasi M. Physical activity in Iran: results of the third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007). J Phys Act Health. 2011;8(1):27-35. doi: 10.1123/jpah.8.1.27. [PubMed: 21297182].
  3. Verhagen E, van der Beek A, Twisk J, Bouter L, Bahr R, van Mechelen W. The effect of a proprioceptive balance board training program for the prevention of ankle sprains: a prospective controlled trial. Am J Sports Med. 2004;32(6):1385-93. doi: 10.1177/0363546503262177. [PubMed: 15310562].
  4. Soderman K, Werner S, Pietila T, Engstrom B, Alfredson H. Balance board training: prevention of traumatic injuries of the lower extremities in female soccer players? A prospective randomized intervention study. Knee Surg Sports Traumatol Arthrosc. 2000;8(6):356-63. doi: 10.1007/s001670000147. [PubMed: 11147154].
  5. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine. 1996;21(22):2640-50. doi: 10.1097/00007632-199611150-00014. [PubMed: 8961451].
  6. Hodges PW, Richardson CA. Contraction of the abdominal muscles associated with movement of the lower limb. Phys Ther. 1997;77(2):132-42. doi: 10.1093/ptj/77.2.132. [PubMed: 9037214].
  7. Teyhen DS, Miltenberger CE, Deiters HM, Del Toro YM, Pulliam JN, Childs JD, et al. The use of ultrasound imaging of the abdominal drawing-in maneuver in subjects with low back pain. J Orthop Sports Phys Ther. 2005;35(6):346-55. doi: 10.2519/jospt.2005.35.6.346. [PubMed: 16001906].
  8. Hodges PW. Changes in motor planning of feedforward postural responses of the trunk muscles in low back pain. Exper Brain Res. 2001;141(2):261-6. doi: 10.1007/s002210100873. [PubMed: 11713638].
  9. Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil. 2004;85(3 Suppl 1):S86-92. doi: 10.1053/j.apmr.2003.12.005. [PubMed: 15034861].
  10. Standaert CJ, Herring SA. Expert opinion and controversies in sports and musculoskeletal medicine: the diagnosis and treatment of spondylolysis in adolescent athletes. Arch Phys Med Rehabil. 2007;88(4):537-40. doi: 10.1016/j.apmr.2007.01.007. [PubMed: 17398258].
  11. Linde[S1]  LD, Archibald J, Lampert EC, Srbely JZ. The effect of abdominal muscle activation techniques on trunk and lower limb mechanics during the single-leg squat task in females. J Sport Rehabil. 2018;27(5):438-44. doi: 10.1123/jsr.2016-0038. [PubMed: 28714764].
  12. Ivanenko Y, Gurfinkel VS. Human postural control. Front Neurosci. 2018;12:171. doi: 10.3389/fnins.2018.00171. [PubMed: 29615859].
  13. Urquhart DM, Hodges PW, Allen TJ, Story IH. Abdominal muscle recruitment during a range of voluntary exercises. Man Ther. 2005;10(2):144-53. doi: 10.1016/j.math.2004.08.011. [PubMed: 15922235].
  14. Richardson CA, Snijders CJ, Hides JA, Damen L, Pas MS, Storm J. The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine. 2002;27(4):399-405. doi: 10.1097/00007632-200202150-00015. [PubMed: 11840107].
  15. Mole JL, Bird M-L, Fell JW. The effect of transversus abdominis activation on exercise-related transient abdominal pain. J Sci Med Sport. 2014;17(3):261-5. doi: 10.1016/j.jsams.2013.05.018. [PubMed: 23849908].
  16. Jin Z, Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. J Beijing Sports Univ. 2008;12:039.
  17. Hides J, Wilson S, Stanton W, McMahon S, Keto H, McMahon K, et al. An MRI investigation into the function of the transversus abdominis muscle during “drawing-in” of the abdominal wall. Spine. 2006;31(6):E175-8. doi: 10.1097/01.brs.0000202740.86338.df. [PubMed: 16540858].
  18. Linde LD, Archibald J, Lampert EC, Srbely JZ. The effect of abdominal muscle activation techniques on trunk and lower limb mechanics during the single-leg squat task in females. J Sport Rehabil. 2018;27(5):438-44. doi: 10.1123/jsr.2016-0038. [PubMed: 28714764].
  19. Jamison ST, McNally MP, Schmitt LC, Chaudhari AM. The effects of core muscle activation on dynamic trunk position and knee abduction moments: implications for ACL injury. J Biomech. 2013;46(13):2236-41. doi: 10.1016/j.jbiomech.2013.06.021. [PubMed: 23891313].
  20. Kisner C, Colby L. Resistance exercise. Therapeutic exercise foundations and techniques. 4th ed. Philadelphia: FA Davis; 2002. P. 68-9.
  21. Lee JY, Lee DY. The effect of therapeutic abdominal drawing-in maneuver using ultrasonography on lateral abdominal muscle thickness and balance. J Back Musculoskelet Rehabil. 2018;31(6):1139-43. doi: 10.3233/BMR-171080. [PubMed: 30010104].
  22. Larson DJ, Brown SH. The effects of trunk extensor and abdominal muscle fatigue on postural control and trunk proprioception in young, healthy individuals. Hum Mov Sci. 2018;57:13-20. doi: 10.1016/j.humov.2017.10.019. [PubMed: 29121507].
  23. Park SD, Yu SH. The effects of abdominal draw-in maneuver and core exercise on abdominal muscle thickness and Oswestry disability index in subjects with chronic low back pain. J Exerc Rehabil. 2013;9(2):286-91. doi: 10.12965/jer.130012. [PubMed: 24278873].
  24. Son SM. Influence of obesity on postural stability in young adults. Osong Public Health Res Perspect. 2016;7(6):378-81. doi: 10.1016/j.phrp.2016.10.001. [PubMed: 28053843].
  25. Cieślińska-Świder J, Furmanek MP, Błaszczyk JW. The influence of adipose tissue location on postural control. J Biomech. 2017;60:162-9. doi: 10.1016/j.jbiomech.2017.06.027. [PubMed: 28705486].
  26. Corbeil P, Simoneau M, Rancourt D, Tremblay A, Teasdale N. Increased risk for falling associated with obesity: mathematical modeling of postural control. IEEE Trans Neural Syst Rehabil Eng. 2001;9(2):126-36. doi: 10.1109/7333.928572. [PubMed: 11474965].