Interventions
Richardson
CONTRACTION
The intervention was carried out at the Faculty of Nursing and Physiotherapy of the University of Lleida, Spain. Based on several previous studies, the duration of the intervention was four weeks [The patients assigned to the control group followed the conventional treatment prescribed by their family physician during the primary care consultation, following the guidelines of the Catalan Health Institute [Patients assigned to the experimental group followed a program of re-education exercises for preactivation of the transverse abdominal muscle for approximately 30 min each session. The sessions were conducted individually to ensure adequate attention and individualization of the exercises. Each intervention session was divided into warm-up and TrA muscle training (Individualized parameters were established for each patient to obtain optimal results in motor control. This individualized training method has been described in several articles where a PBU has been used as an element of assessment and feedback [By transferring this procedure to the lumbar muscles combined with the optimal resistance training parameters described by Borde et al. [To facilitate the contraction of the deep trunk muscles, the PBU was used to give feedback information, and they were ordered to perform the drawing-in maneuver (bring the abdomen in and up). According to Richardson et al. [By abdominal palpation and observation, the physiotherapist verified whether the patients performed this action correctly, without compensation by pelvic retroversion, trunk rotations, or the contraction of any nearby muscles, if no verbal feedback was given to improve the movement. Furthermore, to facilitate the action of this abdominal musculature, the patient was asked to contract the pelvic floor musculature. In this case, the order given was ‘squeeze your ass’, ‘put your ass in’, and ‘hold your urine’.Verbal and tactile reinforcement was given to the patient to hold the contraction for 6 s. If the patient did not achieve that, we worked with the time that the patient was able to hold it. After the contraction, the patient rested for four seconds, and then the contraction was repeated to see how many repetitions the patient could perform. Then, the patient rested for 60 s before performing another series until a maximum of three and a minimum of two series for each exercise. Following these parameters, four different exercises were performed in each session, progressively increasing the weekly training load and difficulty.The exercises are available in a 