I began to work with my patient based on the article that I found. I used the same outcome measures: VAS, ODQ and MMT to assess the muscle strength instead of using MedX ( lumbar extension machine). All 16 stabilization exercises which mentioned onin the research were performed once, consecutively, and in the same order. Before each exercise, I gave detailed verbal explanation and visual instructions (pictures), regarding the start and end positions.
At the first session, the patient found the hollowing very difficult to do it while keep breathing, then. Then, I started to find easy way to educate her the maneuver. And while I am reading the article, one of the aims of stabilization exercises which is mentioned on it is to improve the neuromus¬cularneuromuscular control, which made me to think about how I can connect the hollowing education with this aim through working with her brain, imagination, verbal instruction and tactile feedback. I said to her ( you, "You cannot strengthen a muscle if your brain cannot activate)activate," and to 1- Imagine a line that connects the inside of two pelvic bones (front of hips) , 2- Think about connecting, or drawing the muscle, along this line as if closing two book covers , 3- Contract pelvic floor by drawing the muscles from behind your pubic bone to your tail bone and the left and right sides of pelvic floor together and then like a draw string bag, gently draw the entire pelvic floor up . At the end of the session, she mastered the hollowing with breathing while doing the exercise. The number of times I saw the patient was not enough to note the same results as the research, but after she is masteringmastered the hollowing, she started feelingto feel better than previouspreviously and the VAS decreasesdecreased.