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Background: The straight leg raise (SLR) maneuver, often performed during esophageal manometry, requires patients to lift their leg(s) to augment intraabdominal pressure (IAP). Diverse techniques have been applied for SLR. This study aimed to evaluate and compare the effects of SLR between single and double leg raises. Methods: During esophageal manometry, patients were asked to raise one leg, followed by elevating both legs. The efficacy of SLR for (1) detecting hiatal hernia, (2) increasing IAP, and (3) predicting gastroesophageal reflux disease (GERD) with intraesophageal pressure (IEP) was assessed. The value of change in impedance to indicate reflux during SLR in predicting esophageal acid exposure was investigated. Key Results: The leg raise procedures were performed in 86 patients undergoing high‐resolution esophageal manometry. Both the single and double leg raises exhibited a higher hiatal hernia detection rate compared to the landmark (p = 0.008 and 0.005, respectively). Double leg raise was more effective in raising IAP by >50% compared to single leg raise (100% vs. 65.1%, p < 0.001), increasing yield by 53.6%. The change in IAP showed a positive correlation with the change in IEP during double leg raise (r = 0.31; p = 0.004), higher than that for single leg raise (r = 0.23; p = 0.03). Lower intraesophageal impedance during SLR was associated with AET > 6% with double leg raise (1.5 kΩ vs. 2.5 kΩ, p = 0.04). Conclusions & Inferences: Our study demonstrates the efficacy of both single and double leg raise maneuvers during HREMI in increasing hiatal hernia detection and possible value in predicting GERD. The double leg raise resulted in a higher rate of effective increase in IAP, potentially enabling more patients to undergo effective SLR during HREMI. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to compare the EMG activity of upper and lower rectus abdominis in normal subjects and chronic low back pain patients. Method: A convenience sample of 30 male subjects were participated in the study. In group A 15 healthy male subjects of mean age (24±1.7) year, height (162.6±3.5cm.) and weight (65.9±5.6) kg participated and they were not having any history of low back pain and abdominal surgery. In group B 15 patients having chronic low back pain from at least past 3 months were participated who scored more than 50% disability according to the Oswestry disability index with mean age (24.3±2.6year), height (163.6±4.8) cm and weight (67.2±6.3) kg. All the subjects were selected according to the inclusion and exclusion criteria and were divided into two groups. The subject in both the groups were performed two exercises i.e. curl-ups and leg raise. The EMG activity was recorded from URA and LRA muscles sites during curl-ups and leg raise exercise after proper placement of electrode. Results: Analysis of activity of URA & LRA between group A & B was showing no significant difference of URA & LRA activity during curl-ups & leg raise (P>0.05). Analysis of EMG activity within exercises for group A during Curlups and Leg-raises showed no significant difference (P>0.05). Analysis of the EMG activity of URL & LRA within exercises for group B showed no significant difference (P>0.05). Analysis of the amplitude of EMG activity of URA during leg raise and curl ups showed significant difference. The activity of URA during curls-up was more than during leg raise (P<0.05).Analysis of the activity of LRA also shows significant difference between the exercises i.e. curl- up & leg raise. The activity of LRA was also less during leg raise & more during curlups (P<0.05). Analysis of EMG activity of URA and LRA between exercises in group B also showed significant difference. The URA and LRA activity more in curl-ups than in leg raise exercise (P<0.05). Conclusion: The result of this study showed that there was no significant difference in EMG activity of URA & LRA between healthy subjects and chronic low back pain patients. The URA & LRA showed equal activity within the exercise in both groups, but EMG activity of URA & LRA showed significant difference between the exercises i.e. during curl-ups the URA & LRA showed more EMG activity/amplitude than during leg raise exercise. Clinical Relevance In this present study we have seen that there was no significant difference in EMG activity of URA & LRA between healthy individuals and low back pain patient, but URA & LRA showed more EMG amplitude during curl ups than in the leg raise. So curl-up exercise was more strenuous on rectus abdominis than leg raise. So curl-ups exercise can be used to strength the Rectus abdominis. [ABSTRACT FROM AUTHOR]