Most of the movements under this heading take place also in the hip joints and give work to the flexors of the hip. They are also, as regards both effects and uses, similar to the "Movements for flexors of the hip," but they arc classified and described here because the trunk is the part of the body which is moved. Their common effects are : -

(a) Exercise for flexors of hip joint and trunk.

(b) Increased supply of blood to the pelvic and abdominal organs (Brandt).

(c) Increased peristalsis, by associated action between the external abdominal muscles and the non-striated muscle fibres in the alimentary canal.

(d) Fixing the lower margin of the chest and thus impeding respiration.

According to the manner of working of the muscles we can divide these movements into three chief groups : -

(A) Movements in which the abdominal muscles work statically.

(B) Movements in which the abdominal muscles work eccentrically and concentrically in lengthening.

(C) Movements in which the abdominal muscles work eccentrically and concentrically in shortening.

A. Exercises with chiefly Static Work for Abdominal Muscles.

Hips-firm (or Wing)-high-ride-sitting Neck-firm (or Neck-rest)-high-ride-sitting Stretch-high-ride-sitting

Trunk -backward-drawing (and -raising).

Wing-High-Ride-Sitting Trunk-Backw

Drawing (Fig. 92).

The patient's knees must be fixed by a strap or by an assistant. The gymnast stands behind the patient supporting the back against his chest, or grasping the shoulders from below. The movement is performed by the gymnast drawing the patient back against his resistance, alter which the patient raises himself up again to the starting position against the resistance of the gymnast. Repeated three to five times. (N.B. - The patient must hold the back straight the whole time so that the movement takes place only in the hip joints; the gymnast should draw the shoulders up slightly in the long direction of the trunk, and not in any way support himself against or press down the patient.)

The importance of this form of the movement is due to the fact that it can be modified to any extent, and so can be given to old or delicate patients.

Neck-Firm-And Str. H. -R. -S. Trunk-backw.-drawing . - Like the preceding, but the resistance is applied at the elbows or at the wrists. It is seldom used, and only for strong patients. (N.B. - Because the centre of gravity is further from the axis of movement, and because the gymnast's lever is considerably lengthened, the stretching of the trunk in the long direction must be stronger and the resistance weaker.)

Wing-H.r -sitting Neck-rest-h -r -sitting Str.-h.-r.-sitting

Trunk -back-ward-falling and-raising.

(Fig. 93).

The patient's knees may be fixed by a strap or in some other way. The movement is performed by the patient, carefully maintaining the position of head and trunk, falling backward in the hip joints, and then returning to the starting position. At first only a small amount of falling is made, and weak patients are supported in the back by the gymnast. Later the support is diminished and the falling made deeper as strength increases.

The movement can of course be done in sitting position if the knees are fixed by an assistant.

Fig. 02.

Fig. 93.

Fig. 94.

Effects And Uses

Similar to the preceding movement, but the strength cannot be so well regulated.

Wing-Toe-Support-Sitting Trunk-Backward-Falling And

Raising

Like the preceding, but the feet are fixed by a wall-bar, or in some other way. The flexors of the ankle and the extensors of the knee work statically to maintain the position. The exercise is rather more severe, because the origin and insertion of Rectus Femoris are nearer each other, so that the strength of the muscle is diminished.

Wing-sit-lying

Neck-rest-sit-lying

Stretch-sit-lying

Trunk-raising (and -backward-falling) (Fig. 94).

The gymnast stands in front of the patient and fixes his knees and feet. The patient raises himself to sitting position, breathes, and returns to the starting position. Trunk quite erect. Head and shoulders must not be carried forward during the exercise.

Working muscles, effects and uses as in the preceding exercises.

(N.B. - Raising is harder than backward falling.)

13. Exercises where the Abdominal Muscles work eccentrically And Concentrically And In The Outer Part Of The Range Of Movement (i.e., "In Lengthening ").

Wing-loin-lean-standing

Neck-rest-loin-lean-standing

Stretch-loin-lean-standing

Trunk-backward-drawing (and -raising). (Fig. 05).

The patient stands with the sacrum supported by a boom, the gymnast behind him. Grasp and performance of the movement as in H.-r.-s. backw.-drawing, but the patient's back not supported by the gymnast.

Movement takes place chiefly in the joints of the lumbar spine.

The working muscles are: -

Abdominal muscles (eccentrically and concentrically). Flexors of the hips do not take part in the movement, but only work statically to diminish the stretching of the ligaments in front of the joint.

Effects And Uses

Principally like the movements of the preceding group, but because the movement is limited to the abdominal muscles, these are more exercised and the effect on peristalsis is greater. Also has repleting effect on pelvis, but this is caused by the strong arch position taken in backward-drawing.

Fig. 95.

Lastly it also increases mobility in the joints of the lumbar spine.

Wing-knee-stride-standing

Neck-rest-knee-stride-standing

Stretch-knee-stride-standing

Backward-drawing {and raising).

Grasp and performance as in the preceding exercise, except that the gymnast supports the patient with one knee in the back while drawing him backward. The movement takes place first at the waist (lumbar region), then in the knee joints; in raising the knees are stretched first and then the lumbar spine is straightened out.

Working muscles, effects and uses chiefly as in the preceding exercise, except that the movement also takes place in the knee joints, the extensors of which work eccentrically and concentrically, so that the repleting effect on the pelvis is increased. Less often used.

C. Exercises where the Flexors of the Trunk (Abdominal Muscles) work eccentrically and concentrically in shortening, i.e., in the inner part of the range of Movement,

Wing-Lax -Stp

h.-r.-sitting Trunk-backw.-drawing to vertical plane (and forward-bending). - Grasp and performance of the exercise as in H.-r.-s. backw.-drawing. Patient tries to keep the lumbar region rounded backward throughout.

Used by Major Brandt, especially in treatment of movable kidney, to strengthen and shorten the abdominal muscles.

Leg-lying Trunk-raising is usually given combined with "Abdominal and Lumbar pressure."

The patient lies on his back on a plinth, trunk over one end, an over-sitter on the legs; one gymnast on each side of the patient, who places his arms over their shoulders. As the patient raises himself, with the help of the arms if necessary, the gymnasts give "Abdominal and Lumbar pressure," as already described (see Reach-grasp-st. Heel-raising and Knee-bending). Repeated three to five times.

Effects And Uses

Specially aids peristalsis by the abdominal and lumbar pressure. Is now seldom used,

To this group also belong : -

2 (double) Knee-updrawing and -downpressing.

2 „ Leg-updrawing and -downpressing.

2 ,, Leg-lifting and -downpressing. These are described in connection with exercises for the flexors of the hip.