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Strohm H, Rothluebbers S, Perotti L, Stamm O, Fournelle M, Jenne J, Guenther M. Contraction assessment of abdominal muscles using automated segmentation designed for wearable ultrasound applications. Int J Comput Assist Radiol Surg 2024; 19:1607-1614. [PMID: 38865060 DOI: 10.1007/s11548-024-03204-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/27/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE Wearable ultrasound devices can be used to continuously monitor muscle activity. One possible application is to provide real-time feedback during physiotherapy, to show a patient whether an exercise is performed correctly. Algorithms which automatically analyze the data can be of importance to overcome the need for manual assessment and annotations and speed up evaluations especially when considering real-time video sequences. They even could be used to present feedback in an understandable manner to patients in a home-use scenario. The following work investigates three deep learning based segmentation approaches for abdominal muscles in ultrasound videos during a segmental stabilizing exercise. The segmentations are used to automatically classify the contraction state of the muscles. METHODS The first approach employs a simple 2D network, while the remaining two integrate the time information from the videos either via additional tracking or directly into the network architecture. The contraction state is determined by comparing measures such as muscle thickness and center of mass between rest and exercise. A retrospective analysis is conducted but also a real-time scenario is simulated, where classification is performed during exercise. RESULTS Using the proposed segmentation algorithms, 71% of the muscle states are classified correctly in the retrospective analysis in comparison to 90% accuracy with manual reference segmentation. For the real-time approach the majority of given feedback during exercise is correct when the retrospective analysis had come to the correct result, too. CONCLUSION Both retrospective and real-time analysis prove to be feasible. While no substantial differences between the algorithms were observed regarding classification, the networks incorporating the time information showed temporally more consistent segmentations. Limitations of the approaches as well as reasons for failing cases in segmentation, classification and real-time assessment are discussed and requirements regarding image quality and hardware design are derived.
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Affiliation(s)
- Hannah Strohm
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany.
- mediri GmbH, Heidelberg, Germany.
| | | | - Luis Perotti
- Geriatrics and Medical Gerontology, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Oskar Stamm
- Geriatrics and Medical Gerontology, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Marc Fournelle
- Fraunhofer Institute for Biomedical Engineering IBMT, Sulzbach, Germany
| | - Juergen Jenne
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
- mediri GmbH, Heidelberg, Germany
| | - Matthias Guenther
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
- mediri GmbH, Heidelberg, Germany
- University of Bremen, Bremen, Germany
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Farley JR, Pokhrel S, Koppenhaver SL, Fritz JM. Comparison of erector spinae and gluteus medius muscle thickness and activation in individuals with and without low back pain. J Bodyw Mov Ther 2024; 39:67-72. [PMID: 38876701 DOI: 10.1016/j.jbmt.2024.02.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 12/10/2023] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Dysfunctional patterns of the erector spinae (ES) and gluteus medius (GM) muscles often accompany episodes of low back pain (LBP). Rehabilitative ultrasound imaging (RUSI) has been used to measure ES and GM muscle thickness, however such measurements have not been compared in individuals with and without LBP. OBJECTIVES To compare ES and GM muscle thickness and change in thickness utilizing RUSI in individuals with and without LBP. DESIGN Cross-sectional comparison. METHODS A volunteer sample of 60 adults with (n = 30) and without (n = 30) LBP was examined. Thickness measurements of the ES and GM at rest and during contraction were obtained by using RUSI during a single session. Statistical comparison was performed using ANCOVA. The demographic variable age was used as a covariate in the primary comparative analysis. RESULTS Mean difference for age between groups was 5.4 years (95% CI: 1.85, 8.94, p = 0.004). Average ODI score was 32.33±6.58 and pain level of 5.39±0.73 over the last 24 h in the symptomatic group. There was a statistically significant difference in the percent thickness change in both the ES, mean difference = -3.46 (95% CI: -6.71, -0.21, p = 0.039) and GM, mean difference = -1.93 (95% CI: -3.85, -0.01, p = 0.049) muscles between groups. CONCLUSIONS Individuals with LBP may have reduced percent thickness change of the ES and GM muscles when compared to asymptomatic individuals.
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Affiliation(s)
- Jedidiah R Farley
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake City, UT, USA.
| | - Swikriti Pokhrel
- Baylor University Robbins College of Health & Human Sciences, Waco, TX, USA.
| | | | - Julie M Fritz
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake City, UT, USA.
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Papic C, Andersen J, Naemi R, Hodierne R, Sanders RH. Augmented feedback can change body shape to improve glide efficiency in swimming. Sports Biomech 2024; 23:898-917. [PMID: 33821747 DOI: 10.1080/14763141.2021.1900355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
Curvatures of the body can disrupt fluid flow and affect hydrodynamic resistance. The purpose of this study was to evaluate the effect of a feedback intervention on glide performance and torso morphology. Eleven male and female national swimmers performed glides before and after augmented feedback. Feedback consisted of self-modelling visual feedback and verbal cuing, to manipulate body curvatures that affect hydrodynamic resistance. Two-dimensional landmark position data (knee, hip and shoulder) were used to enable computation of glide factor and glide coefficient as indicators of glide efficiency; posture (trunk incline and hip angle); and performance (horizontal velocity). Underwater images of the swimmers were manually traced to derive transverse and sagittal diameters, cross-sectional areas, and continuous form outlines (anterior and posterior) of the torso. Maximum rate of change in cross-sectional area and form gradient progressing caudally, were calculated for torso segments: shoulder-chest, chest-waist, waist-hip. Mean velocity, glide factor and glide coefficient values significantly (p< 0.001) improved due to the intervention, with large effect size (d) changes 0.880 (p= 0.015), 2.297 and 1.605, respectively. Significant changes to form gradients were related to reductions in lumbar lordosis and chest convexity. The study provides practical cuing phrases for coaches and swimmers to improve glide efficiency and performance.
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Affiliation(s)
- Christopher Papic
- Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jordan Andersen
- Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Roozbeh Naemi
- Centre for Biomechanics and Rehabilitation Technologies, School of Life Science and Education, Staffordshire University, Stoke-on-Trent, UK
| | - Ryan Hodierne
- New South Wales Institute of Sport, Sydney, New South Wales, Australia
| | - Ross H Sanders
- Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Cai S, Lin Y, Chen H, Huang Z, Zhou Y, Zheng Y. Automated analysis of pectoralis major thickness in pec-fly exercises: evolving from manual measurement to deep learning techniques. Vis Comput Ind Biomed Art 2024; 7:8. [PMID: 38625580 PMCID: PMC11021386 DOI: 10.1186/s42492-024-00159-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
This study addresses a limitation of prior research on pectoralis major (PMaj) thickness changes during the pectoralis fly exercise using a wearable ultrasound imaging setup. Although previous studies used manual measurement and subjective evaluation, it is important to acknowledge the subsequent limitations of automating widespread applications. We then employed a deep learning model for image segmentation and automated measurement to solve the problem and study the additional quantitative supplementary information that could be provided. Our results revealed increased PMaj thickness changes in the coronal plane within the probe detection region when real-time ultrasound imaging (RUSI) visual biofeedback was incorporated, regardless of load intensity (50% or 80% of one-repetition maximum). Additionally, participants showed uniform thickness changes in the PMaj in response to enhanced RUSI biofeedback. Notably, the differences in PMaj thickness changes between load intensities were reduced by RUSI biofeedback, suggesting altered muscle activation strategies. We identified the optimal measurement location for the maximal PMaj thickness close to the rib end and emphasized the lightweight applicability of our model for fitness training and muscle assessment. Further studies can refine load intensities, investigate diverse parameters, and employ different network models to enhance accuracy. This study contributes to our understanding of the effects of muscle physiology and exercise training.
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Affiliation(s)
- Shangyu Cai
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Yongsheng Lin
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Haoxin Chen
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Zihao Huang
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong, 999077, China
| | - Yongjin Zhou
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China.
| | - Yongping Zheng
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong, 999077, China.
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Biały M, Szewczyk W, Kłaptocz P, Gnat R. Assessment of Lateral Abdominal Muscle Activation Asymmetry via M-mode Ultrasonography. Cureus 2024; 16:e57563. [PMID: 38707132 PMCID: PMC11068978 DOI: 10.7759/cureus.57563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
INTRODUCTION This study aimed to evaluate the asymmetry in the lateral abdominal muscles (LAMs) expressed as tissue deformation index asymmetry (aTDI) with the use of M-mode ultrasonography. The muscles of interest were the transversus abdominis, internal oblique, and external oblique. METHODS This is a cohort of 126 healthy subjects who participated in the study. Measurements were taken by two raters, blinded to the aim of the study. M-mode ultrasounds with a measurement frequency of 5 MHz were utilized to record the postural response of LAMs to external perturbation in the form of rapid arm abduction with load, and individual aTDI values for each muscle were calculated. RESULTS The aTDI values from deep to superficial LAMs were 78.28% for transversus abdominis, 55.68% for internal oblique, and 44.80% for external oblique. Only the aTDI for transversus abdominis results differed significantly from those of the other LAMs (P<0.05). CONCLUSION LAM asymmetry values exhibit the following gradient: transversus abdominis >internal oblique >external oblique. Specifically, only transversus abdominis demonstrates noteworthy asymmetry in postural activity. This observation contributes to the literature by indicating that transversus abdominis asymmetry may serve as a marker for assessing the variability in motor control of the deep abdominal musculature. The dominance of transversus abdominis (TrA) asymmetric activity underlines the importance of personalized approaches for patients with lumbopelvic disorders or for athletes seeking to enhance performance.
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Affiliation(s)
- Maciej Biały
- Physiotherapy, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, POL
- Physiotherapy, Functional Diagnostics Laboratory, Sport-Klinika, Scanmed Sport, Żory, POL
- Physiotherapy, Shoulder and Knee Clinic, Katowice, POL
| | | | | | - Rafał Gnat
- Physiotherapy, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, POL
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Muramoto Y, Iwamoto W, Iida S, Sasagawa K, Kobayashi H, Ishibuchi S, Murakami J, Maehara Y, Tanaka N, Wagatsuma K, Kuruma H. Effectiveness of warm-up and dynamic balance training in preventing anterior cruciate ligament injuries in college gymnasts: a 3-year prospective study for one team. J Sports Med Phys Fitness 2024; 64:167-174. [PMID: 38093642 DOI: 10.23736/s0022-4707.23.15539-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND The effect of trunk stability and dynamic balance warm-up exercises on physical functional improvement remains unelucidated. This study examined whether exercises could prevent anterior cruciate ligament (ACL) injury and improve trunk muscle activation and dynamic balance in gymnasts. METHODS This comparison study, involving gymnastics practice sessions, included 31 university gymnasts and was conducted in two periods: 1 year of observation followed by 2 years of intervention. Participants performed a trunk and dynamic balance warm-up exercise program during the intervention. The effect of exercise on the incidence of ACL injury was evaluated. In addition, the paired t-test was used to compare the Y-balance distance and the changes in muscle thickness associated with trunk muscle activation at rest and during plank. RESULTS ACL injury risk during the intervention was significantly lower, with a relative risk of 0.23 (P=0.02, 95% CI: 0.06-0.88). Changes in muscle thickness with activation of the transversus abdominis (P<0.01, mean difference 4.1, 95% CI: 9.97-28.07, Cohen's d=0.52), internal oblique (P<0.01, mean difference 5.2, 95% CI: 9.72-21.55, Cohen's d=0.65), and external oblique (P<0.01, mean difference 5.5, 95% CI: 20.44-39.09, Cohen's d=0.71) muscles were significantly higher during the intervention. The Y-balance distance was also significantly greater in the posterior medial reach (P<0.01, mean difference 3.3, 95% CI: 1.56-6.26, Cohen's d=0.46) during the intervention. CONCLUSIONS Exercise-based warm-up programs may decrease ACL injuries. It can improve physical functions, such as the rate of change in trunk muscle thickness and the posterior medial distance during Y balance.
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Affiliation(s)
- Yuki Muramoto
- Institute for Integrated Sports Medicine, School of Medicine, Keio University, Tokyo, Japan -
- Department of Sports Medicine, Edogawa Hospital, Tokyo, Japan -
| | - Wtataru Iwamoto
- Department of Sports Medicine, Edogawa Hospital, Tokyo, Japan
| | - Syota Iida
- Department of Sports Medicine, Edogawa Hospital, Tokyo, Japan
| | - Kaoru Sasagawa
- Department of Sports Medicine, Edogawa Hospital, Tokyo, Japan
| | | | | | | | - Yuko Maehara
- Department of Sports Medicine, Edogawa Hospital, Tokyo, Japan
| | - Naoki Tanaka
- Faculty of Health Care and Medical Sports, Teikyo Heisei University, Chiba, Japan
| | - Koji Wagatsuma
- Department of Sports Medicine, Edogawa Hospital, Tokyo, Japan
| | - Hironobu Kuruma
- Department of Physical Therapy Science, Tokyo Metropolitan University Graduate School of Human Health Sciences, Tokyo, Japan
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Jiroumaru T, Hyodo Y, Wachi M, Shichiri N, Ochi J, Fujikawa T. Relationship between walking speed, respiratory muscle strength, and dynamic balance in community-dwelling older people who required long-term care or support and used a daycare center. PeerJ 2023; 11:e16630. [PMID: 38144200 PMCID: PMC10749086 DOI: 10.7717/peerj.16630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/16/2023] [Indexed: 12/26/2023] Open
Abstract
Background Focusing on the relationship between frail older people and gait speed is vital to minimize the need for long-term care or increased support. The relationship between gait speed, respiratory muscle strength, and dynamic balance, is not well understood in older people requiring long-term care or support. Therefore, this study aimed to provide new insights into the relationship between gait speed, respiratory muscle strength, and dynamic balance in community-dwelling older people who required long-term care or support and used a daycare center. Methods This was a cross-sectional study of 49 community-dwelling older people (21 men, 28 women) aged ≥65 years who were certified as requiring long-term care or support under the Japanese system. The participants' maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), walking speed (maximal and normal walking speed), and maximal double-step length test (MDST) results were recorded. The measurement data were evaluated using Pearson's correlation coefficient and multiple regression analysis. Results Pearson's correlation coefficient revealed correlations between PImax and the following: maximal walking speed (r = 0.606, p < 0.001), normal walking speed (r = 0.487, p < 0.001), and MDST (r = 0.435, p = 0.002). Correlations were also observed between PEmax and the following: maximal walking speed (r = 0.522, p < 0.001), normal walking speed (r = 0.467, p < 0.001), and MDST (r = 0.314, p = 0.028). Moreover, a correlation was found between MDST and both maximal walking speed and (r = 0.684, p < 0.001) and normal walking speed (r = 0.649, p < 0.001). The effect size was 0.379. Multiple regression analysis using a forced entry method with maximal walking speed as the dependent variable showed that maximal walking speed was significantly associated with MDST (p < 0.001) and PEmax (p = 0.036), with an effect size of 0.272. The model's adjusted coefficient of determination was 0.593 (p < 0.001). Multiple regression analysis using a forced entry method with normal walking speed as the dependent variable showed that normal walking speed was significantly associated with MDST (p < 0.001) and PEmax (p = 0.021), with an effect size of 0.272. The model's adjusted coefficient of determination was 0.497 (p < 0.001). Multiple regression analysis using a forced entry method with MDST as the dependent variable showed that MDST was significantly associated with PImax (p < 0.025), with an effect size of 0.243. The model's adjusted coefficient of determination was 0.148 (p = 0.017). Conclusions Respiratory muscle strength and dynamic balance were related to walking speed in older people requiring long-term care or support.
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Affiliation(s)
- Takumi Jiroumaru
- Department of Physical Therapy, School of Health Sciences, Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
| | - Yutaro Hyodo
- Department of Rehabilitation, Kanazawa Orthopaedic and Sports Medicine Clinic, Ritto, Shiga, Japan
| | - Michio Wachi
- Department of Physical Therapy, School of Health Sciences, Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
| | - Nobuko Shichiri
- Department of Occupational Therapy, School of Health Sciences, Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
| | - Junko Ochi
- Department of Physical Therapy, School of Health Sciences, Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
| | - Takamitsu Fujikawa
- Department of Physical Therapy, School of Health Sciences, Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
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Rubí-Carnacea F, Masbernat-Almenara M, Climent-Sanz C, Soler-González J, García-Escudero M, Martínez-Navarro O, Valenzuela-Pascual F. Effectiveness of an exercise intervention based on preactivation of the abdominal transverse muscle in patients with chronic nonspecific low back pain in primary care: a randomized control trial. BMC PRIMARY CARE 2023; 24:180. [PMID: 37674205 PMCID: PMC10483714 DOI: 10.1186/s12875-023-02140-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Low back pain is one of the most common disabling pathologies in humanity worldwide. Physical exercises have been used in recent decades to reduce the pain, improve the functionality of the lumbar spine and avoid relapses. The purpose of the study is to analyze the effect of a program based on re-education exercises involving preactivation of the abdominal transverse muscle compared to conventional treatment in adults with chronic nonspecific low back pain. METHODS A two-arm, single-blind randomized control trial with 35 primary care patients with chronic nonspecific low back pain. Both groups received a 4-week intervention. Data were collected at baseline and at the end of the intervention. Sixteen patients participated in the intervention group, and 19 patients in the control group. RESULTS For the experimental group, the outcomes of disability and activation of the abdominal transverse muscle decreased significantly (MD -2.9; CI 95% -5.6 to -0.35; η2 = 0.14; p = 0.028) and (MD 2.3; CI 95% 0.91 to 3.67; η2 = 0.25; p = 0.002) respectively, with a large effect size, compared to the control group. There were no differences between the groups in pain intensity, thickness, and resistance of the transverse abdominal muscle. CONCLUSION A 4-week specific program based on re-education exercises of the preactivation of the abdominal transverse muscle is more effective than conventional treatment for reducing disability and increasing the activation of the abdominal transverse muscle measured by VAS scale and PBU. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT03097497. Date of registration: 31/03/2017.
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Affiliation(s)
- Francesc Rubí-Carnacea
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
| | - Maria Masbernat-Almenara
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España.
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España.
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España.
| | - Carolina Climent-Sanz
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
| | - Jorge Soler-González
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
- Catalan Institute of Health, Rambla de Ferran 44, 25007, Lleida, España
| | - María García-Escudero
- Faculty of Medicine and Health Sciences, Universidad Católica de Valencia San Vicente Mártir, Valencia, España
| | - Oriol Martínez-Navarro
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
| | - Fran Valenzuela-Pascual
- Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España
- Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España
- Research Group of Health Care (GReCS), Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRB Lleida), Avda Alcalde Rovira Roure 80, 25198, Lleida, España
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Alavi SF, Tahan N, Mikaili S, Baghban AA. The Effects of Curl-Up and Straight Leg Raising Exercises in Different Hip Joint Positions on Abdominal Muscle Thickness. J Chiropr Med 2023; 22:173-179. [PMID: 37645001 PMCID: PMC10461201 DOI: 10.1016/j.jcm.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 04/29/2023] [Accepted: 04/30/2023] [Indexed: 08/31/2023] Open
Abstract
Objective The purpose of this study was to investigate the effect of combining 2 exercises at different angles of the hip joint on the thickness of the transverse abdominis and internal oblique muscles. Methods Twenty-eight healthy adults (22.7 ± 2.5 years of age; 64.93 ± 8.8 kg; body mass index: 22.2 ± 2 kg/m2) performed the curl-up exercise and straight leg raise with external rotation of the hip and dorsiflexion of the ankle simultaneously. The thicknesses of transverse abdominis and internal oblique muscles were measured from right and left sides while resting, in curl up, curl up with 10º flexion of hip, curl up with 15º flexion of hip, and curl up with 10º flexion and 15º abduction of the hip. The means of muscle thicknesses were compared using repeated-measures analysis of variance and post hoc Bonferroni tests in the 5 positions. Results The thicknesses of transverse abdominis (P < .001) and internal oblique (P < .001) muscles were significantly greater in curl up with 10º flexion and 15º abduction of hip compared with the other positions. There was no significant difference between abdominal muscle thicknesses in measuring from either side. Conclusion Doing the curl-up exercise with 10º flexion and 15º abduction of the hip may be beneficial in strengthening deep abdominal muscles.
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Affiliation(s)
- Seyyedeh Fatemeh Alavi
- Student Research Committee, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nahid Tahan
- Department of Physiotherapy, School of Rehabilitation. Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Mikaili
- Department of Physiotherapy, School of Rehabilitation. Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzade Baghban
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Taxiarchopoulos N, Drakonaki E, Gianniotis M, Matzaroglou C, Tsepis E, Billis E. Investigation of Real-Time Diagnostic Ultrasound as a Means of Biofeedback Training in Transversus Abdominus Re-Education of Patients with Non-Specific Low Back Pain: A Prospective Randomized Controlled Pilot Study. Healthcare (Basel) 2023; 11:healthcare11101396. [PMID: 37239681 DOI: 10.3390/healthcare11101396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/27/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Background: It is believed that ultrasound-guided imaging of activation/contraction of the deep abdominal muscles (such as transervsus abdominis) is useful for assisting deep muscle re-education, which is often dysfunctional in non-specific low back pain (NSLBP). Thus, this pilot study aimed to evaluate the use of real-time ultrasound (US) as a feedback device for transverse abdominis (TrA) activation/contraction during an exercise program in chronic NSLBP patients. Methods: Twenty-three chronic NSLBP patients were recruited and randomly assigned to a US-guided (n = 12, 8 women, 47.6 ± 2.55 years) or control group (n = 11, 9 women, 46.9 ± 4.29 years). The same motor control-based exercise program was applied to both groups. All patients received physiotherapy twice per week for seven weeks. Outcome measures, tested at baseline and post-intervention, included Numeric Pain Rating Scale, TrA activation level (measured through a pressure biofeedback unit-based developed protocol), seven established motor control tests, Roland-Morris Disability Questionnaire and Hospital Anxiety and Depression Scale. Results: For each group, all outcome variables yielded statistical differences post-intervention (p < 0.05), indicating significant improvements. However, there were no significant group x time interactions for any of the outcomes (p > 0.05), thus, indicating no superiority of the US-guided group over the control. Conclusions: The addition of US as a visual feedback device for TrA re-education during a motor control exercise program was not proven superior to traditional physiotherapy.
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Affiliation(s)
| | - Elena Drakonaki
- Medical School, University of Crete, 71003 Heraklion, Greece
| | - Maria Gianniotis
- Department of Physiotherapy, University of Patras, 26504 Rion, Greece
| | | | - Elias Tsepis
- Department of Physiotherapy, University of Patras, 26504 Rion, Greece
| | - Evdokia Billis
- Department of Physiotherapy, University of Patras, 26504 Rion, Greece
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11
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Marchand F, Laudner K, Delank KS, Schwesig R, Steinmetz A. Effects of Sensorimotor Training on Transversus Abdominis Activation in Chronic Low Back Pain Patients. J Pers Med 2023; 13:jpm13050817. [PMID: 37240987 DOI: 10.3390/jpm13050817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: The aim of this study was to investigate and compare the effect of sensorimotor training on transversus abdominis activation. (2) Methods: Seventy-five patients with chronic low back pain were randomly assigned to one of three groups (whole body vibration training using Galileo®, coordination training using Posturomed®, or physiotherapy (control)). Transversus abdominis activation was measured by using sonography pre- and post-intervention. Second, changes in clinical function tests and their correlation with the sonographic measurements were determined. (3) Results: All three groups showed an improvement in activation of the transversus abdominis post-intervention, with the Galileo® demonstrating the largest improvement. There were no relevant (r > 0.5) correlations between activation of the transversus abdominis muscle and any clinical tests. (4) Conclusions: The present study provides evidence that sensorimotor training on the Galileo® significantly improves the activation of the transversus abdominis muscle.
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Affiliation(s)
- Felix Marchand
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, 06120 Halle, Germany
- Department of Orthopedic and Trauma Surgery, Josephs-Hospital Warendorf, 48231 Warendorf, Germany
| | - Kevin Laudner
- Department of Health Sciences, Hybl Sports Medicine and Performance Center, University of Colorado, Colorado Springs, CO 80918, USA
| | - Karl-Stefan Delank
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, 06120 Halle, Germany
| | - René Schwesig
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, 06120 Halle, Germany
| | - Anke Steinmetz
- Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, Physical and Rehabilitation Medicine, 17475 Greifswald, Germany
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12
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Trevino M, Perez S, Sontag S, Olmos A, Jeon S, Richardson L. Influence of Pennation Angle and Muscle Thickness on Mechanomyographic Amplitude-Torque Relationships and Sex-Related Differences in the Vastus Lateralis. J Funct Morphol Kinesiol 2023; 8:jfmk8020053. [PMID: 37218849 DOI: 10.3390/jfmk8020053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/17/2023] [Accepted: 04/27/2023] [Indexed: 05/24/2023] Open
Abstract
This study examined potential sex-related differences and correlations among the pennation angle (PA), muscle thickness (MT), and mechanomyographic amplitude (MMGRMS)-torque relationships of the vastus lateralis (VL) in 11 healthy males and 12 healthy females. The PA and MT of the VL were quantified with ultrasound. Participants performed an isometric muscle action of the knee extensors that linearly increased to 70% of maximal strength followed by a 12 s plateau. MMG was recorded from the VL. Linear regression models were fit to the log-transformed MMGRMS-torque relationships to calculate b terms (slopes) for the linearly increasing segment. MMGRMS was averaged during the plateau. Males exhibited greater PA (p < 0.001), MT (p = 0.027), b terms (p = 0.005), and MMGRMS (p = 0.016). The b terms were strongly (p < 0.001, r = 0.772) and moderately correlated (p = 0.004, r = 0.571) with PA and MT, respectively, while MMGRMS was moderately correlated with PA (p = 0.018, r = 0.500) and MT (p = 0.014, r = 0.515). The greater mechanical behavior of individuals possessing a larger PA and MT of the VL may reflect increased cross-bridge activity within the muscle fibers. Additionally, PA may help explain sex-related differences in MMGRMS between sexes.
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Affiliation(s)
- Michael Trevino
- Applied Neuromuscular Physiology Laboratory, Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, OK 74078, USA
| | - Sergio Perez
- Applied Neuromuscular Physiology Laboratory, Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, OK 74078, USA
| | - Stephanie Sontag
- Applied Neuromuscular Physiology Laboratory, Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, OK 74078, USA
| | - Alex Olmos
- Applied Neuromuscular Physiology Laboratory, Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, OK 74078, USA
| | - Sunggun Jeon
- Applied Neuromuscular Physiology Laboratory, Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, OK 74078, USA
| | - Lyric Richardson
- Applied Neuromuscular Physiology Laboratory, Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, OK 74078, USA
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13
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Fuckner Leonel FJ, Paula LD, Raab Ferreira GC, Dos Reis do Nascimento DM, Gnoato Zotz TG, de Melo JM, Brandt de Macedo AC. Effect of two suspension training programs on pain and musculoskeletal function in chronic low back pain: study protocol. Pain Manag 2023; 13:271-282. [PMID: 37458193 DOI: 10.2217/pmt-2022-0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
The aim of this study is to compare the effects of two suspension training (ST) protocols on pain and musculoskeletal function in women with chronic low back pain (CLBP). The study will be randomized, controlled, blinded clinical trial. Women aged 18-60 years who present CLBP will be selected. They will be randomized into three groups: STG1, which will carry out the program with difficulty progression in the exercises; STG2, in which the progression will be made by increasing the number of sets; and control group. STG1 and STG2 will perform the training two-times a week for 60 min for 12 weeks. It is expected that ST will effectively reduce pain and improve functionality in CLBP and that the best protocol will be verified. Clinical Trial Registration: RBR-10rv3fqt.
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Affiliation(s)
| | - Lauana de Paula
- Master's Student of the Graduate Program in Physical Education at the Federal Technological University of Paraná, Curitiba, Paraná, Brazil
| | - Gustavo Cezar Raab Ferreira
- Undergraduate student of Physical Therapy at the Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | | | - Talita Gianello Gnoato Zotz
- Prevention and Rehabilitation in Physiotherapy Department, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Julia Milena de Melo
- Undergraduate student of Physical Therapy at the Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
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14
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Liu X, Yang Y, Jia J. Respiratory muscle ultrasonography evaluation and its clinical application in stroke patients: A review. Front Neurosci 2023; 17:1132335. [PMID: 37090789 PMCID: PMC10115993 DOI: 10.3389/fnins.2023.1132335] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
Background Respiratory muscle ultrasound is a widely available, highly feasible technique that can be used to study the contribution of the individual respiratory muscles related to respiratory dysfunction. Stroke disrupts multiple functions, and the respiratory function is often significantly decreased in stroke patients. Method A search of the MEDLINE, Web of Science, and PubMed databases was conducted. We identified studies measuring respiratory muscles in healthy and patients by ultrasonography. Two reviewers independently extracted and documented data regarding to the criteria. Data were extracted including participant demographics, ultrasonography evaluation protocol, subject population, reference values, etc. Result A total of 1954 participants from 39 studies were included. Among them, there were 1,135 participants from 19 studies on diaphragm, 259 participants from 6 studies on extra-diaphragmatic inspiratory muscles, and 560 participants from 14 studies on abdominal expiratory muscles. The ultrasonic evaluation of diaphragm and abdominal expiratory muscle thickness had a relatively typically approach, while, extra-diaphragmatic inspiratory muscles were mainly used in ICU that lack of a consistent paradigm. Conclusion Diaphragm and expiratory muscle ultrasound has been widely used in the assessment of respiratory muscle function. On the contrary, there is not enough evidence to assess extra-diaphragmatic inspiratory muscles by ultrasound. In addition, the thickness of the diaphragm on the hemiplegic side was lower than that on the non-hemiplegic side in stroke patients. For internal oblique muscle (IO), rectus abdominis muscle (RA), transversus abdominis muscle (TrA), and external oblique muscle (EO), most studies showed that the thickness on the hemiplegic side was lower than that on the non-hemiplegic side.Clinical Trial Registration: The protocol of this review was registered in the PROSPERO database (CRD42022352901).
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Affiliation(s)
- Xiaoman Liu
- Department of Rehabilitation Medicine, The People’s Hospital of Suzhou New District, Suzhou, China
| | - Ying Yang
- Department of Rehabilitation Medicine, The People’s Hospital of Suzhou New District, Suzhou, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Fudan University Huashan Hospital, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Fudan University Huashan Hospital, Shanghai, China
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15
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Vishwas P, Amara V, Maddani SS, Chaudhuri S, Podder S. Risk Factors of Decreased Abdominal Expiratory Muscle Thickness in Mechanically Ventilated Critically Ill Patients-The mNUTRIC Score is an Independent Predictor. Indian J Crit Care Med 2023; 27:8-15. [PMID: 36756480 PMCID: PMC9886045 DOI: 10.5005/jp-journals-10071-24375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/26/2022] [Indexed: 01/02/2023] Open
Abstract
Background The expiratory abdominal skeletal muscles are an important component of the respiratory muscle pump, and their reduced thickness has been associated with difficult weaning. There is no objective score that may help clinicians to predict expiratory abdominal muscle thinning. Patients and methods This was a single-center retrospective study on 81 patients undergoing weaning from mechanical ventilation. The thickness of the four abdominal expiratory muscles-rectus abdominis (RA), internal oblique (IO), external oblique (EO), and transversus abdominis (TA) on the day of the first spontaneous breathing trial (SBT), was obtained. The various parameters of the patients with thinner RA, IO, EO, and TA below the determined thickness cut-off values, predicting difficult weaning was analyzed. Results Modified nutritional risk in critically ill (mNUTRIC) score was found to be an independent predictor of thinner IO muscle after logistic regression analysis [p = 0.001, adjusted OR 2.33, 95% CI (1.394-3.892)]. The mNUTRIC score was also an independent predictor of thinner EO (p = 0.014, adjusted OR 1.57) and RA muscle (p = 0.002, adjusted OR 1.69). The mNUTRIC cutoff score ≥4 predicted thinner IO (AUC 0.813, p < 0.001 sensitivity 71%, specificity 77%) and thinner EO (AUC 0.738, p < 0.001, 71% sensitivity, 67% specificity). The mNUTRIC score ≥3 predicted that at least one out of the four abdominal expiratory muscles will be thin (AUC 0.849, p < 0.001, 95% CI [0.763-0.935], sensitivity 87.5%, specificity 59%). Conclusion The mNUTRIC score is an independent predictor of thinner abdominal expiratory muscles in mechanically ventilated critically ill patients. How to cite this article Vishwas P, Amara V, Maddani SS, Chaudhuri S, Podder S. Risk Factors of Decreased Abdominal Expiratory Muscle Thickness in Mechanically Ventilated Critically Ill Patients-The mNUTRIC Score is an Independent Predictor. Indian J Crit Care Med 2023;27(1):8-15.
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Affiliation(s)
- P Vishwas
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vedaghosh Amara
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sagar Shanmukhappa Maddani
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Souvik Chaudhuri
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India,Souvik Chaudhuri, Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India, Phone: +91 9937178620, e-mail:
| | - Suvajit Podder
- Department of Anaesthesiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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16
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PUELLES Á, GONZÁLEZ J, PIZARRO A, GALLEGUILLOS F, TORRES C, FABREGA A. Ultrasound analysis of morphological changes in the abdominal wall in postpartum women with diastasis recti: a cross-sectional study. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.21.04664-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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17
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Immediate Effects of the Reverse Plank Exercise on Muscle Thickness and Postural Angle in Individuals with the Forward Shoulder Posture. J Funct Morphol Kinesiol 2022; 7:jfmk7040082. [PMID: 36278743 PMCID: PMC9624361 DOI: 10.3390/jfmk7040082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/27/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
The forward shoulder posture (FSP) results from shoulders being pulled forward by shortened anterior shoulder girdle muscles. The objective of this study was to investigate the short-term effectiveness of the reverse plank exercise on parascapular muscle thickness and forward shoulder angle (FSA) in patients with FSP. Participants were divided into the FSP and non-FSP (NFSP) groups based on the observed angle between the horizontal line of the C7 spinous process and the acromion process. All participants performed a total of five sets of reverse plank exercises at 30 s per set. FSA and muscle thickness of the pectoralis major (PM), serratus anterior (SA), upper trapezius (UT), and lower trapezius (LT) were measured before and after the reverse plank exercise. The muscle thicknesses of the SA and LT, and the FSA, were significantly increased after exercise in the FSP group (p < 0.05). Muscle thickness of the PM and UT significantly decreased after the exercise. In the NFSP group, muscle thickness of the LT was significantly increased, and muscle thickness of the PM and UT were significantly reduced after exercise (p < 0.05). Upon using between-group analysis, there were significant differences between the FSA, SA, UT, and LT groups (p < 0.05). The reverse plank exercise has the short-term benefit of correcting and preventing FSP by increasing SA and LT thickness while decreasing PM and UT thickness. We believe that the reverse plank exercise significantly improved the ability to prevent FSP in FSP-related muscles and was beneficial in achieving optimal postural alignment.
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Kim HJ, Choi W, Jung J, Park S, Joo Y, Lee S, Lee S. Efficacy of radial extracorporeal shockwave therapy in rehabilitation following arthroscopic rotator cuff repair: A STROBE compliant study. Medicine (Baltimore) 2022; 101:e30053. [PMID: 36107497 PMCID: PMC9439771 DOI: 10.1097/md.0000000000030053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Rotator cuff tear is a common cause of shoulder pain and disability. Arthroscopic rotator cuff repair (ARCR) is performed to treat a torn tendon. Postoperative joint immobilization is essential, but it is a problem that needs to be addressed in the rehabilitation process. This study aimed to evaluate the effects of radial extracorporeal shock wave therapy (rESWT) in patients who underwent ARCR and required active movement after the immobilization period. This study was an open-label, prospective, single-arm trial of 30 inpatients aged >18 years who underwent ARCR. A total of 6 rESWT sessions, along with the conventional rehabilitation program for ARCR patients, were provided at the hospital's sports rehabilitation center for 2 weeks. The application sites of rESWT are periscapular muscles (supraspinatus, infraspinatus, teres minor, and rhomboid). Evaluations were conducted 3 time points-baseline, immediately after the first session of rESWT, and after 2 weeks of intervention. The outcome measures were the numeric pain rating scale for pain, and shoulder flexion, scaption flexion, abduction, horizontal adduction, external rotation, and internal rotation for shoulder range of motion. For shoulder function, disabilities of the arm, shoulder and hand, shoulder pain and disability index, and simple shoulder test were used, and muscle strength was expressed by grip strength. supraspinatus and infraspinatus evaluated thickness, tone, and stiffness. The muscle strength (95% CI, -3.554 to -0.073) and supraspinatus tone (P = .017) showed significant changes immediately after the first session of rESWT. Further, there was significant improvement in ROM (P < .01); shoulder function (P < .01); and muscle strength (95% CI, -3.561 to -0.625), supraspinatus stiffness (95% CI, -67.455 to -26.345), and infraspinatus stiffness (P = .045) after 2 weeks of intervention. However, muscle thickness and tone were significantly improved only in supraspinatus (P = .044, P = .040). Rehabilitation with radial extracorporeal shock wave therapy additionally applied to the periscapular muscles in patients who started active movement in rehabilitation after arthroscopic rotator cuff repair is effective for shoulder function and muscle properties (muscle strength, thickness, tone, and stiffness). However, a randomized controlled trial is needed to further assess the effects of radial extracorporeal shock wave therapy alone.
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Affiliation(s)
- Hyun-Joong Kim
- Sports Rehabilitation Center, The Better Hospital, Gwangju, Republic of Korea
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Wonjae Choi
- Department of Physical Therapy, Joongbu University, Chungcheongnam-do, Republic of Korea
| | - JiHye Jung
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
- Institute of SMART Rehabilitation Sahmyook University, Seoul, Republic of Korea
| | - SunGeon Park
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - YoungLan Joo
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Sangbong Lee
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Seungwon Lee
- Department of Physical Therapy, Sahmyook University, Seoul, Republic of Korea
- *Correspondence: Seungwon Lee, Department of Physical Therapy, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul 01795, Republic of Korea (e-mail: )
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19
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Amara V, Chaudhuri S. Author\'s Response to Diaphragm Evaluation and Lung Ultrasound Score during Weaning. Indian J Crit Care Med 2022; 26:1056-1057. [PMID: 36213705 PMCID: PMC9492737 DOI: 10.5005/jp-journals-10071-24313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
How to cite this article: Amara V, Chaudhuri S. Author's Response to Diaphragm Evaluation and Lung Ultrasound Score during Weaning. Indian J Crit Care Med 2022;26(9):1056–1057.
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Affiliation(s)
- Vedaghosh Amara
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Souvik Chaudhuri
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
- Souvik Chaudhuri, Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India, Phone: +91 9937178620, e-mail:
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20
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Zhang Q, Fragnito N, Franz JR, Sharma N. Fused ultrasound and electromyography-driven neuromuscular model to improve plantarflexion moment prediction across walking speeds. J Neuroeng Rehabil 2022; 19:86. [PMID: 35945600 PMCID: PMC9361708 DOI: 10.1186/s12984-022-01061-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 07/21/2022] [Indexed: 11/28/2022] Open
Abstract
Background Improving the prediction ability of a human-machine interface (HMI) is critical to accomplish a bio-inspired or model-based control strategy for rehabilitation interventions, which are of increased interest to assist limb function post neurological injuries. A fundamental role of the HMI is to accurately predict human intent by mapping signals from a mechanical sensor or surface electromyography (sEMG) sensor. These sensors are limited to measuring the resulting limb force or movement or the neural signal evoking the force. As the intermediate mapping in the HMI also depends on muscle contractility, a motivation exists to include architectural features of the muscle as surrogates of dynamic muscle movement, thus further improving the HMI’s prediction accuracy. Objective The purpose of this study is to investigate a non-invasive sEMG and ultrasound (US) imaging-driven Hill-type neuromuscular model (HNM) for net ankle joint plantarflexion moment prediction. We hypothesize that the fusion of signals from sEMG and US imaging results in a more accurate net plantarflexion moment prediction than sole sEMG or US imaging. Methods Ten young non-disabled participants walked on a treadmill at speeds of 0.50, 0.75, 1.00, 1.25, and 1.50 m/s. The proposed HNM consists of two muscle-tendon units. The muscle activation for each unit was calculated as a weighted summation of the normalized sEMG signal and normalized muscle thickness signal from US imaging. The HNM calibration was performed under both single-speed mode and inter-speed mode, and then the calibrated HNM was validated across all walking speeds. Results On average, the normalized moment prediction root mean square error was reduced by 14.58 % (\documentclass[12pt]{minimal}
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\begin{document}$$p<0.001$$\end{document}p<0.001) with the proposed HNM when compared to sEMG-driven and US imaging-driven HNMs, respectively. Also, the calibrated models with data from the inter-speed mode were more robust than those from single-speed modes for the moment prediction. Conclusions The proposed sEMG-US imaging-driven HNM can significantly improve the net plantarflexion moment prediction accuracy across multiple walking speeds. The findings imply that the proposed HNM can be potentially used in bio-inspired control strategies for rehabilitative devices due to its superior prediction. Supplementary Information The online version contains supplementary material available at 10.1186/s12984-022-01061-z.
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Affiliation(s)
- Qiang Zhang
- Joint Department of Biomedical Engineering at the University of North Carolina-Chapel Hill and North Carolina State University, 1840 Entrepreneur Dr., 27695, Raleigh, NC, USA.,Joint Department of Biomedical Engineering at the University of North Carolina-Chapel Hill and North Carolina State University, 333 S Columbia St., 27514, Chapel Hill, NC, USA
| | - Natalie Fragnito
- Joint Department of Biomedical Engineering at the University of North Carolina-Chapel Hill and North Carolina State University, 1840 Entrepreneur Dr., 27695, Raleigh, NC, USA.,Joint Department of Biomedical Engineering at the University of North Carolina-Chapel Hill and North Carolina State University, 333 S Columbia St., 27514, Chapel Hill, NC, USA
| | - Jason R Franz
- Joint Department of Biomedical Engineering at the University of North Carolina-Chapel Hill and North Carolina State University, 1840 Entrepreneur Dr., 27695, Raleigh, NC, USA.,Joint Department of Biomedical Engineering at the University of North Carolina-Chapel Hill and North Carolina State University, 333 S Columbia St., 27514, Chapel Hill, NC, USA
| | - Nitin Sharma
- Joint Department of Biomedical Engineering at the University of North Carolina-Chapel Hill and North Carolina State University, 1840 Entrepreneur Dr., 27695, Raleigh, NC, USA. .,Joint Department of Biomedical Engineering at the University of North Carolina-Chapel Hill and North Carolina State University, 333 S Columbia St., 27514, Chapel Hill, NC, USA.
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The Application of Image Texture Analysis Techniques on the Effects of Dry Needling versus Placebo in Low-Back Pain Patients: A Pilot-Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Low back pain is the leading cause of disability in the world, with a significant socio-economic impact. Deep dry needling is effective in the treatment of this pain, and it is one of the techniques preferred by physiotherapists. In this field, the use of ultrasound provides information of interest such as length, thickness, diameter, cross-sectional area, or muscle volume, among others. Objective: To find out whether the tissue changes (thickness, histogram, and contraction rate) that occur in the lumbar multifidus after application of the deep dry needle are related to changes in the pain and the disability of the patient. Design: Randomized, double-blind, parallel-group clinical trial. Setting: University of Alcalá, Department of Physiotherapy. Subjects: 21 voluntary patients (women and men) with non-specific low-back pain aged 18–65 years. Intervention: Patients were randomly divided into two groups. One group received dry needling and the other group a dry needling placebo. Initial post-needling and one week post-needling assessments were performed by a therapist blinded to the intervention. Variables: Lumbar multifidus thickness measured by RUSI, contraction time measured by M-mode, histograms measured by image analysis, muscle area, pain measured by VAS, pressure pain threshold measured by pressure algometer, and disability measured by Roland–Morris questionnaire. Conclusions: The contraction speed, resting thickness, and pain demonstrated significant differences within each group, but not between groups. There were significant differences in contraction ratio and in PPT between groups. There was excellent intra-examiner reliability in image collection for histogram analysis. Histogram analysis showed no significant differences between groups and measurements, neither for the parameters nor for the parameters combined with the outcome variables. A robust method for the image texture analyses in future histogram muscle analyses has been performed.
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22
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Pan L, Liu K, Li J. Effect of Subcutaneous Muscle Displacement of Flexor Carpi Radialis on Surface Electromyography. IEEE Trans Neural Syst Rehabil Eng 2022; 30:1244-1251. [PMID: 35533166 DOI: 10.1109/tnsre.2022.3173406] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Changes in joint angle can change the position and orientation of muscle fibers relative to the surface EMG electrode. Our previous study has shown that EMG patterns can identify hand/wrist movements with a greater degree of classification accuracy (CA) when muscle contractions involve a change in the joint angle. The results of this study suggest that changes in the position of the muscle relative to the recording electrode can influence the properties of the recorded EMG signals, however, this was not directly quantified. The present study aims to further investigate the effect of subcutaneous muscle displacement caused by the changes in joint angle on surface EMG signals. Nine able-bodied subjects were tested. The subjects were instructed to perform wrist flexion at five different joint angles (0, 20, 40, 60, and 80) with the same level of muscle contraction. EMG signals and ultrasound images were acquired from the flexor carpi radialis (FCR) simultaneously. Time and frequency domain analysis was adopted to extract features from the EMG signals. The subcutaneous muscle displacement of the FCR relative to the skin surface was measured from the ultrasound images. Spearmans rank correlation coefficient was employed to analyze the correlation between the subcutaneous muscle displacement and the EMG signals. The results showed the subcutaneous muscle displacement of the FCR measured by the ultrasound images was 1 cm when the wrist joint angle changed from 0 to 80. There was a positive relationship between the subcutaneous muscle displacement and the mean absolute value (MAV) (rs = 0.896) and median frequency (MF) (rs = 0.849) extracted from the EMG signals. The results demonstrated that subcutaneous muscle displacement associated with wrist angle change had a significant effect on FCR EMG signals. This property might have a positive effect on the CA of dynamic tasks.
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Huang ZH, Ma CZH, Wang LK, Wang XY, Fu SN, Zheng YP. Real-Time Visual Biofeedback via Wearable Ultrasound Imaging Can Enhance the Muscle Contraction Training Outcome of Young Adults. J Strength Cond Res 2022; 36:941-947. [PMID: 35319000 PMCID: PMC8936156 DOI: 10.1519/jsc.0000000000004230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Huang, Z-H, Ma, CZ-H, Wang, L-K, Wang, X-Y, Fu, S-N, and Zheng, Y-P. Real-time visual biofeedback via wearable ultrasound imaging can enhance the muscle contraction training outcome of young adults. J Strength Cond Res 36(4): 941-947, 2022-Real-time ultrasound imaging (RUSI) can serve as visual biofeedback to train deep muscle contraction in clinical rehabilitative settings. However, its effectiveness in resistance training in sports/fitness fields remains unexplored. This article introduced a newly developed wearable RUSI system that provided visual biofeedback of muscle thickening and movement and reported its effectiveness in improving the training outcomes of muscle thickness change (%) during dynamic contraction. Twenty-five healthy young men participated and performed pec fly exercise both with and without RUSI biofeedback. Statistical analysis was conducted to examine the reliability of the measurements and the immediate effects of (a) RUSI biofeedback of muscle contraction and (b) training intensity (50 vs. 80% of 1-repetition maximum [1RM]) on the pectoralis major (PMaj) thickness change measured by ultrasound images. In addition to significantly high inter-contraction reliability (ICC3,1 > 0.97), we observed significantly increased PMaj thickness change for both training intensities upon receiving biofeedback in subjects, compared with without biofeedback (p < 0.001). We also observed significantly larger PMaj thickness change at 80% of 1RM compared with 50% of 1RM (p = 0.023). The provision of visual biofeedback using RUSI significantly enlarged the magnitude of PMaj thickness change during pec fly exercises, potentially indicating that RUSI biofeedback could improve the ability of targeted muscle contraction of PMaj in healthy young adults. To our knowledge, this study has pioneered in applying RUSI as a form of biofeedback during weight training and observed positive effectiveness. Future iterations of the technique will benefit more subject groups, such as athletes and patients with neuromuscular disorders.
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Affiliation(s)
- Zi-Hao Huang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Christina Z.-H. Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Li-Ke Wang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Xiao-Yun Wang
- Guangdong Work Injury Rehabilitation Center, Guangzhou, China; and
| | - Siu-Ngor Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Haruyama K, Furiya S, Tsuzura T, Hirano S, Yamaha Y, Kameda Y, Takino Y, Masubuchi K. Effects of mouthpiece shape and expiratory threshold loading on contraction of the lateral abdominal muscles: A cross-sectional study. J Bodyw Mov Ther 2022; 29:16-22. [DOI: 10.1016/j.jbmt.2021.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 07/01/2021] [Accepted: 09/24/2021] [Indexed: 11/26/2022]
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Hallock LA, Sud B, Mitchell C, Hu E, Ahamed F, Velu A, Schwartz A, Bajcsy R. Toward Real-Time Muscle Force Inference and Device Control via Optical-Flow-Tracked Muscle Deformation. IEEE Trans Neural Syst Rehabil Eng 2021; 29:2625-2634. [PMID: 34874866 DOI: 10.1109/tnsre.2021.3133813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Despite the utility of musculoskeletal dynamics modeling, there exists no safe, noninvasive method of measuring in vivo muscle output force in real time - limiting both biomechanical insight into dexterous motion and intuitive control of assistive devices. In this paper, we demonstrate that muscle deformation constitutes a promising, yet unexplored signal from which to 1) infer such forces and 2) build novel device control schemes. Through a case study of the elbow joint on a preliminary cohort of 10 subjects, we show that muscle deformation (specifically, thickness change of the brachioradialis, as measured via ultrasound and tracked via optical flow) correlates well with elbow output force to an extent comparable with standard surface electromyography (sEMG) activation during varied isometric elbow contraction. We then show that, given real-time visual feedback, subjects can readily perform a trajectory tracking task using this deformation signal, and that they largely prefer this method to a comparable sEMG-based control scheme and perform the tracking task with similar accuracy. Together, these contributions illustrate muscle deformation's potential utility for both biomechanical study of individual muscle dynamics and device control, in a manner that - thanks to, unlike sEMG, the localized nature of the signal and its tight mechanistic coupling to output force - is readily extensible to multiple muscles and device degrees of freedom. To enable such future extensions, all modeling, tracking, and visualization software described in this paper, as well as all raw and processed data, have been made available on SimTK as part of the Open-Arm project (https://simtk.org/projects/openarm) for general research use.
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Fernández-Carnero S, Martin-Saborido C, Achalandabaso Ochoa-Ruiz de Mendoza A, Ferragut-Garcias A, Cuenca-Zaldivar JN, Leal-Quiñones A, Calvo-Lobo C, Gallego-Izquierdo T. The Role of Rehabilitative Ultrasound Imaging Technique in the Lumbopelvic Region as a Diagnosis and Treatment Tool in Physiotherapy: Systematic Review, Meta-Analysis and Meta-Regression. J Clin Med 2021; 10:5699. [PMID: 34884401 PMCID: PMC8658262 DOI: 10.3390/jcm10235699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/22/2021] [Accepted: 12/01/2021] [Indexed: 01/25/2023] Open
Abstract
Rehabilitative ultrasound imaging (RUSI) technique seems to be a valid and reliable tool for diagnosis and treatment in physiotherapy and has been widely studied in the lumbopelvic region the last three decades. The aims for this utility in clinical settings must be review through a systematic review, meta-analysis and meta-regression. A systematic review was designed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with PROSPERO registration and per review in all phases of the process using COVIDENCE, analysis of risk of bias and meta-analysis using REVMAN, and meta-regression calculation using STATA. Database screening provided 6544 references, out of which 321 reported narrative synthesis, and 21 reported quantitative synthesis, while only 7 of them provided comparable data to meta-analyze the variables pain and muscle thickness. In most cases, the forest plots showed considerable I2 heterogeneity indexes for multifidus muscle thickness (I2 = 95%), low back pain (I2 = 92%) and abdominal pain (I2 = 95%), not important for transversus abdominis muscle thickness (I2 = 22%), significant heterogenity (I2 = 69%) depending on the subgroup and not important internal oblique muscle thickness (I2 = 0%) and external oblique muscle thickness (I2 = 0%). Meta-regression did not provide significant data for the correlations between the variables analyzed and the intervention, age, and BMI (Body Mass Index). This review reveals that RUSI could contribute to a high reliability of the measurements in the lumbopelvic region with validity and reliability for the assessments, as well as showing promising results for diagnosis and intervention assessment in physiotherapy compared to the traditional model, allowing for future lines of research in this area.
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Affiliation(s)
- Samuel Fernández-Carnero
- Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, 28801 Alcalá de Henares, Spain; (S.F.-C.); (A.A.O.-R.d.M.); (A.F.-G.); (T.G.-I.)
| | | | - Alexander Achalandabaso Ochoa-Ruiz de Mendoza
- Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, 28801 Alcalá de Henares, Spain; (S.F.-C.); (A.A.O.-R.d.M.); (A.F.-G.); (T.G.-I.)
- Área de Fisioterapia, Departamento de Ciencias de la Salud, Universidad de Jaén, Jaén, 23071 Andalucía, Spain
| | - Alejandro Ferragut-Garcias
- Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, 28801 Alcalá de Henares, Spain; (S.F.-C.); (A.A.O.-R.d.M.); (A.F.-G.); (T.G.-I.)
- Departamento de Enfermería y Fisioterapia, Islas Baleares University, 07122 Ciudad de Palma, Spain
| | | | | | - Cesar Calvo-Lobo
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Tomas Gallego-Izquierdo
- Physiotherapy and Pain Group, Department of Physiotherapy and Nursing, Alcalá University, 28801 Alcalá de Henares, Spain; (S.F.-C.); (A.A.O.-R.d.M.); (A.F.-G.); (T.G.-I.)
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Miyashita S, Isoda S, Hirose N, Hashiguchi T. Identification of the Core Activate Position for a Seated Subject: Proposal of a new Exercise Method for Maintenance Rehabilitation. Prog Rehabil Med 2021; 6:20210036. [PMID: 34557606 PMCID: PMC8419633 DOI: 10.2490/prm.20210036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 08/25/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives: This study aimed to identify a position for core muscle activation (core activate
position) for a seated subject and to design an exercise method using this position for
rehabilitation during the daily maintenance or maintenance stages. Methods: Thirteen young men participated as subjects in this study. We manufactured a chair in
which the seat had an adjustable forward tilt angle. The subjects underwent
ultrasonographic measurements of the thickness of the transversus abdominis, internal
oblique, and external oblique muscles while sitting in the chair with the seat angle
adjusted to 0°, 6°, or 12°. Further, we conducted image analysis to determine the
positional relationships of these muscles using the following four points as landmarks:
the anterior superior iliac spine, the posterior superior iliac spine, the fourth lumbar
vertebra, and the seventh thoracic vertebra. Results: Significant increases in the thickness of the transversus abdominis and external
oblique muscles were observed when the seat forward tilt angle was adjusted to 12° (P
<0.05). In the core activate position (which demonstrated effective activation of the
transversus abdominis), the posterior superior iliac spine, the fourth lumbar vertebra,
and the seventh thoracic vertebra were aligned in a straight line that was nearly
perpendicular to the line connecting the anterior superior iliac spine and the posterior
superior iliac spine. Conclusions: This postural guidance can be applied to core exercise methods during maintenance
rehabilitation.
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Affiliation(s)
- Satoshi Miyashita
- Graduate School of Medical Science, Teikyo University of Science, Graduate School, Tokyo, Japan
| | - Shuma Isoda
- Department of Lifestyle Rehabilitation, Long-Term Care Health Facility, Yamayuri, Nagano, Japan
| | - Noboru Hirose
- Graduate School of Medical Science, Teikyo University of Science, Graduate School, Tokyo, Japan
| | - Takeo Hashiguchi
- Center for Teacher Development, Teikyo University of Science, Tokyo, Japan
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Prolonged sitting-induced back pain influences abdominal muscle thickness in a sitting but not a supine position. Sci Rep 2021; 11:16369. [PMID: 34385531 PMCID: PMC8360962 DOI: 10.1038/s41598-021-95795-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/29/2021] [Indexed: 11/08/2022] Open
Abstract
The current study explored whether (i) abdominal muscle thickness differed between non-painful supine and painful sitting positions and (ii) the sitting position was more reliable and useful than the supine position to discriminate between people with and without prolonged sitting-induced lower back pain (LBP). Participants with and without prolonged sitting-induced LBP participated. The thickness of the transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles was measured using ultrasonography in supine, usual sitting, and upright sitting positions. Analysis of variance was used to compare muscle thickness among the positions. Intraclass correlation coefficients and receiver operating characteristic curves were used to determine which position reliably identified between group. The group with LBP showed significantly greater EO muscle thickness than that without LBP only in the upright sitting position. In the group without LBP, the TrA thickness was significantly greater in the usual and upright sitting positions than in the supine position, but there was no significant difference in TrA thickness among three positions in LBP group. Only EO thickness in the upright sitting position significantly predicted prolonged sitting-induced LBP. The current study suggests that clinicians should assess abdominal activation patterns in the upright sitting rather than supine position before applying abdominal muscle motor control training for patients with prolonged sitting-induced LBP, and to distinguish between those with and without prolonged sitting-induced LBP.
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29
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Cuña-Carrera ID, Alonso-Calvete A, González-González Y, Soto-González M. Changes in abdominal muscles architecture induced by different types of breathing. ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-210159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The underlying morphology and behavior of abdominal muscles during breathing are still lacking in knowledge in healthy population. OBJECTIVE: To analyze the effects of three different types of breathing on the architectural characteristics of abdominal muscles. METHODS: Ninety-eight healthy subjects were measured to assess the effects of breathing on the abdominal muscles, subjects performed three different types of breathing and the muscular thickness was measured with ultrasound imaging, analyzing also the differences between sexes. RESULTS: During the three different types of breathing and in comparison with the resting state, an increase of the thickness has been reported in the transversus abdominis (p< 0.001; effect size = 2.44, very large) and internal oblique (p< 0.001; effect size = 1.04, moderate) in both sexes, but with a higher increase in men. External oblique and rectus abdominis increased their thickness through breathing only while the lips were with pursed (p< 0.05) with trivial effect sizes and only differences between sexes were found in rectus abdominis. CONCLUSIONS: All breathings activated the deepest abdominal muscles, but the most superficial were only activated with lips pursed. Moreover, men appeared to activate more the deepest abdominal muscles but also the rectus abdominis. Findings in this study support the use of different types of breathing depending on the muscle to be activated or the sex, helping health care professionals to address their interventions on the abdominal muscles with a more focused approach.
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Affiliation(s)
- Iria Da Cuña-Carrera
- Departamento de Bioloxía Funcional e Ciencias da Saúde, Facultade de Fisioterapia, Universidade Vigo, Campus A Xunqueira, Pontevedra, Spain
| | - Alejandra Alonso-Calvete
- Departamento de Bioloxía Funcional e Ciencias da Saúde, Facultade de Fisioterapia, Universidade Vigo, Campus A Xunqueira, Pontevedra, Spain
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, Campus A Xunqueira, Pontevedra, Spain
| | - Yoana González-González
- Departamento de Bioloxía Funcional e Ciencias da Saúde, Facultade de Fisioterapia, Universidade Vigo, Campus A Xunqueira, Pontevedra, Spain
| | - Mercedes Soto-González
- Departamento de Bioloxía Funcional e Ciencias da Saúde, Facultade de Fisioterapia, Universidade Vigo, Campus A Xunqueira, Pontevedra, Spain
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Doran M, Öneş K, Terzibaşioğlu AM, Ҫinar Ҫ, Ata İ. Ultrasonographic evaluation of abdominal muscle thickness symmetry in adolescent idiopathic scoliosis: a case controlled study. Eur J Phys Rehabil Med 2021; 57:968-976. [PMID: 34196160 DOI: 10.23736/s1973-9087.21.06833-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To date, there are limited studies evaluating abdominal muscle symmetry in adolescent idiopathic scoliosis (AIS) patients and these studies in the literature do not evaluate the rectus abdominis (RA) muscle in AIS patients. AIM To evaluate the symmetry of the thickness of the abdominal muscles while standing and supine position in AIS patients. DESİGN: A case control study. METHODS AND POPULATION Radiographic examination data of patients with AIS (n=40) were collected. An ultrasound assessment was performed of the side-to-side differences of the RA, external oblique (EO), internal oblique (IO), and transversus abdominalis (TrA) muscles in the standing and supine positions in AIS and control groups (n=40). Three repeat measurements of the thickness of each muscle were performed and relative thicknesses were compared. RESULTS The mean percentage (%) difference between the right and left sides muscle measurement of the control group was between on standing position 1.54% and 3.00%, in supine 0.8% and 5.87% for different muscles; however, the meanpercentage (%) of this difference in the ASI group ranged from 6.28% to 15.13% (standing ) and 7.21% to 17.24% (supine). Muscle asymmetry in the ASI group was significantly higher than in the control group for all muscles in measurements in the standing and supine position (p <0.001). CONCLUSIONS All abdominal relative muscle thicknesses in the AİS patients were more asymmetric than healthy adolacents.
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Affiliation(s)
- Muhsin Doran
- Department of Physical Medicine and Rehabilitation, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Health Sciences University, Istanbul, Turkey -
| | - Kadriye Öneş
- Department of Physical Medicine and Rehabilitation, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Aynur M Terzibaşioğlu
- Department of Physical Medicine and Rehabilitation, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Ҫiğdem Ҫinar
- Department of Physical Medicine and Rehabilitation, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - İlhami Ata
- Department of Physical Medicine and Rehabilitation, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Health Sciences University, Istanbul, Turkey
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Kuo YL, Kao CY, Tsai YJ. Abdominal Expansion versus Abdominal Drawing-In Strategy on Thickness and Electromyography of Lumbar Stabilizers in People with Nonspecific Low Back Pain: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094487. [PMID: 33922598 PMCID: PMC8122920 DOI: 10.3390/ijerph18094487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 11/30/2022]
Abstract
The abdominal expansion (AE) strategy, involving eccentric contraction of the abdominal muscles, has been increasingly used in clinical practices; however, its effects have not been rigorously investigated. This study aimed to investigate the immediate effects of the AE versus abdominal drawing-in (AD) strategy on lumbar stabilization muscles in people with nonspecific low back pain (LBP). Thirty adults with nonspecific LBP performed the AE, AD, and natural breathing (NB) strategies in three different body positions. Ultrasonography and surface electromyography (EMG) were, respectively, used to measure the thickness and activity of the lumbar multifidus and lateral abdominal wall muscles. The AE and AD strategies showed similar effects, producing higher EMG activity in the lumbar multifidus and lateral abdominal wall muscles when compared with the NB strategy. All muscles showed higher EMG activity in the quiet and single leg standing positions than in the lying position. Although the AE and AD strategies had similar effects on the thickness change of the lumbar multifidus muscle, the results of thickness changes of the lateral abdominal muscles were relatively inconsistent. The AE strategy may be used as an alternative method to facilitate co-contraction of lumbar stabilization muscles and improve spinal stability in people with nonspecific LBP.
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Affiliation(s)
- Yi-Liang Kuo
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan;
| | - Chieh-Yu Kao
- Department of Rehabilitation, Sengkang Community Hospital 1 Anchorvale Street, Singapore 544835, Singapore;
| | - Yi-Ju Tsai
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan;
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Correspondence: ; Tel.: +886-6-235-3535 (ext. 5021)
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Exercising on Different Unstable Surfaces Increases Core Abdominal Muscle Thickness: An Observational Study Using Real-Time Ultrasound. J Sport Rehabil 2021; 28:803-808. [PMID: 30526226 DOI: 10.1123/jsr.2017-0385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 10/14/2018] [Accepted: 10/28/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND The training of abdominal muscles has a positive impact on the functional capacity of healthy adults, being applied practically in fields of athletics and fitness through rehabilitation for lower back pain. OBJECTIVE The study compares abdominal muscle activity while performing graded isometric exercises on stable and unstable surfaces. The authors also examined perceived stability and comfort for the different surfaces. METHODS A total of 30 young, healthy adults performed 3 graded isometric exercises on a Pilates table, foam roller, and Oov (a newly developed tool). Ultrasound investigation measured transversus abdominis, internal oblique abdominis, and external oblique abdominis thickness during each task, comparing muscle thickness between conditions using general linear modeling. RESULTS Core abdominal activation was greater on the foam roller than the Oov and Pilates table during crook lying (bilateral leg support). Both Oov and foam roller elicited greater contralateral transversus abdominis and internal oblique abdominis thickness than the Pilates table during tabletop and straight leg raises (unilateral leg exercises). For transversus abdominis only, the foam roller elicited more muscle thickness than the Oov during straight leg raises. The Oov was rated more comfortable than the foam roller. DISCUSSION Exercises performed on the Oov and foam roller elicit core greater abdominal muscle thickness than those performed on a Pilates table. Unilateral leg exercises in a supine position elicit more contralateral muscle thickness than those with bilateral leg support. CONCLUSIONS These results provide information to support choices in exercise progression from flat stable to more unstable surfaces and from those with bilateral foot support to unilateral foot support. The Oov was more comfortable that the foam roller, and this may help with exercise adherence.
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Fukano M, Tsukahara Y, Takei S, Nose-Ogura S, Fujii T, Torii S. Recovery of Abdominal Muscle Thickness and Contractile Function in Women after Childbirth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042130. [PMID: 33671663 PMCID: PMC7926552 DOI: 10.3390/ijerph18042130] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 11/26/2022]
Abstract
Abdominal muscles may be both morphologically and functionally affected by pregnancy. Dysfunction of the muscles can lead to persistent postpartum low back pain. The recovery process of the abdominal muscles following childbirth is not well understood. This study aimed to demonstrate the changes in the thickness and contractile function of abdominal muscles during the first six months postpartum. Nine perinatal and 15 nulliparous females participated. The thicknesses and contraction/relaxation thickness ratios of the rectus abdominis (RA), external abdominal oblique (EO), internal abdominal oblique (IO), and transverse abdominis (TrA) were measured using ultrasound images from 36–39 weeks’ gestation until six months postpartum. The RA, IO, and TrA muscles were thinner in perinatal females than controls at 36–39 weeks of gestation (4.8 vs. 9.47 mm (RA), 5.45 vs. 7.73 mm (IO), 2.56 vs. 3.38 mm (TrA), respectively). The thinner IO muscle persisted for six months after delivery. The decreased TrA thickness ratio persisted until four months post-delivery. Abdominal muscle thickness and contractile function decreased in the postpartum period. Therefore, abdominal muscle exercises might help prevent postpartum symptoms; however, because deterioration of muscle function is significant in the first four months, careful attention should be paid to exercise intensity. The study limitation was a relatively small sample size, thus future studies should involve more participants.
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Affiliation(s)
- Mako Fukano
- College of Engineering, Shibaura Institute of Technology, Saitama 135-8548, Japan
- Faculty of Sport Sciences, Waseda University, Saitama 169-8050, Japan;
- Correspondence: ; Tel.: +81-48-720-6442
| | - Yuka Tsukahara
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo 108-8345, Japan;
- Waseda Institute for Sport Sciences, Waseda University, Saitama 169-8050, Japan
| | - Seira Takei
- Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 158-8557, Japan;
- Waseda Institute of Human Growth and Development, Waseda University, Saitama 169-8050, Japan
| | - Sayaka Nose-Ogura
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo 158-8557, Japan; (S.N.-O.); (T.F.)
| | - Tomoyuki Fujii
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo 158-8557, Japan; (S.N.-O.); (T.F.)
| | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, Saitama 169-8050, Japan;
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Valentín-Mazarracin I, Nogaledo-Martín M, López-de-Uralde-Villanueva I, Fernández-de-las-Peñas C, Stokes M, Arias-Buría JL, Díaz-Arribas MJ, Plaza-Manzano G. Reproducibility and Concurrent Validity of Manual Palpation with Rehabilitative Ultrasound Imaging for Assessing Deep Abdominal Muscle Activity: Analysis with Preferential Ratios. Diagnostics (Basel) 2021; 11:diagnostics11020298. [PMID: 33668663 PMCID: PMC7918832 DOI: 10.3390/diagnostics11020298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 11/16/2022] Open
Abstract
The abdominal drawing-in maneuver (ADIM) is a clinical tool used for identifying preferential activity of deep abdominal muscles. However, concurrent validity and reproducibility of palpation during the ADIM has not been formally investigated. The aims of this study were (1) to assess intra- and interrater reliability of manual palpation during the ADIM, and (2) to determine the concurrent validity of manual palpation during the ADIM by calculating preferential activation ratio cut-off as assessed with ultrasound imaging (RUSI). Thirty-two subjects (n = 16 patients with nonspecific low back pain and 16 comparable healthy individuals) performed the ADIM in a supine hook-lying position. Two experienced assessors evaluated the presence or absence of preferential contraction of the deep abdominal muscles by palpation during the ADIM on 2 different days. Intrarater (test-retest) and interrater reliability of palpation were calculated using Cohen's kappa coefficients. Muscle thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles at rest and during the ADIM were also measured. TrA-Contraction Ratio (TrA-CR), TrA-Preferential Activation Ratio (TrA-PAR), and Modified-TrA-PR (M-TrA-PAR) were calculated. The concurrent validity of manual palpation was determined using the correlation between manual palpation and imaging and by calculating ROC curve (operating characteristics curve), Youden index, and sensitivity and specificity. Intra- and interrater reliability of manual palpation during the ADIM was excellent (k: 0.82-1.00) and good to excellent (k: 0.71-1.00), respectively. Interrater reliability for muscle thickness ranged from good to excellent (ICC3,1 0.79-0.91). Manual palpation and TrA ratio showed low to moderate correlations (r: 0.36-0.60). When evaluating the diagnostic accuracy of manual palpation, the best predictive model (ROC value: 0.89; p < 0.001) for correct a preferential contraction of TrA was obtained when the M-TrA-PAR was ≥0.08 (sensitivity: 0.95-1.00; specificity: 0.62). Good to excellent intra- and interrater reliability of manual palpation was found during the ADIM in both patients and healthy groups. Manual palpation showed concurrent validity for identifying the preferential activity of the TrA muscle supporting its use in clinical practice.
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Affiliation(s)
| | | | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (I.L.-d.-U.-V.); (M.J.D.-A.); (G.P.-M.)
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Madrid, Spain
- Correspondence: ; Tel.: +34-91-488-88-84
| | - María Stokes
- School of Health Sciences, University of Southampton, Southampton S017 1BJ, UK;
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Southampton NG7 2UH, UK
| | - José L. Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Madrid, Spain
| | - María J. Díaz-Arribas
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (I.L.-d.-U.-V.); (M.J.D.-A.); (G.P.-M.)
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (I.L.-d.-U.-V.); (M.J.D.-A.); (G.P.-M.)
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Petraş A, Drăgoi RG, Pupazan V, Drăgoi M, Popa D, Neagu A. Using Portable Ultrasound to Monitor the Neuromuscular Reactivity to Low-Frequency Electrical Stimulation. Diagnostics (Basel) 2021; 11:diagnostics11010065. [PMID: 33401607 PMCID: PMC7824493 DOI: 10.3390/diagnostics11010065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/26/2020] [Accepted: 12/28/2020] [Indexed: 01/19/2023] Open
Abstract
Neuromuscular electrical stimulation (NMES) is useful for muscle strengthening and for motor restoration of stroke patients. Using a portable ultrasound instrument, we developed an M-mode imaging protocol to visualize contractions elicited by NMES in the quadriceps muscle group. To quantify muscle activation, we performed digital image processing based on the Teager–Kaiser energy operator. The proposed method was applied for 35 voluntary patients (18 women and 17 men), of 63.8 ± 14.1 years and body mass index (BMI) 30.2 ± 6.70 kg/m2 (mean ± standard deviation). Biphasic, rectangular electric pulses of 350 µs duration were applied at two frequencies (60 Hz and 120 Hz), and ultrasound was used to assess the sensory threshold (ST) and motor threshold (MT) amplitude of the NMES signal. The MT was 23.4 ± 4.94 mA, whereas the MT to ST ratio was 2.69 ± 0.57. Linear regression analysis revealed that MT correlates poorly with body mass index (R2 = 0.004) or with the thickness of the subcutaneous adipose tissue layer that covers the treated muscle (R2 = 0.013). Our work suggests that ultrasound is suitable to visualize neuromuscular reactivity during electrotherapy. The proposed method can be used in the clinic, enabling the physiotherapist to establish personalized treatment parameters.
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Affiliation(s)
- Alin Petraş
- Department of Medical Rehabilitation, Balneology and Rheumatology, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania; (A.P.); (M.D.); (D.P.)
| | - Răzvan Gabriel Drăgoi
- Department of Medical Rehabilitation, Balneology and Rheumatology, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania; (A.P.); (M.D.); (D.P.)
- Correspondence:
| | - Vasile Pupazan
- Department of Functional Sciences, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041Timişoara, Romania; (V.P.); (A.N.)
| | - Mihai Drăgoi
- Department of Medical Rehabilitation, Balneology and Rheumatology, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania; (A.P.); (M.D.); (D.P.)
| | - Daniel Popa
- Department of Medical Rehabilitation, Balneology and Rheumatology, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania; (A.P.); (M.D.); (D.P.)
| | - Adrian Neagu
- Department of Functional Sciences, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041Timişoara, Romania; (V.P.); (A.N.)
- Department of Physics and Astronomy, University of Missouri, Columbia, MO 65211, USA
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Sadler S, Spink M, Chuter V. Gluteus medius muscle activity during gait in people with and without chronic nonspecific low back pain: A case control study. Gait Posture 2021; 83:15-19. [PMID: 33065524 DOI: 10.1016/j.gaitpost.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/08/2020] [Accepted: 10/06/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Research investigating differences in gluteus medius muscle activity in those with and without chronic nonspecific low back pain is both limited and conflicting. Additionally, in these populations the relationship between gluteus medius muscle activity, foot type, and transversus abdominis muscle thickness is unclear. RESEARCH QUESTION We aimed to investigate gluteus medius muscle activity during gait in those with and without chronic nonspecific low back pain. Secondarily, we aimed to explore the association between gluteus medius muscle activity, foot type, and transversus abdominis muscle thickness within groups. METHODS This case control study recruited 30 people with and 30 people without chronic nonspecific low back pain and matched participants by age (±5 years), sex, and body mass index (±2 BMI units). Gluteus medius muscle activity was measured with surface electromyography during walking gait, with foot type and transversus abdominis muscle thickness measured with the Foot Posture Index and ultrasound respectively. The Mann-Whitney U test was used to investigate differences in gluteus medius muscle activity between groups. Spearman rank order correlation was performed to explore the association between gluteus medius muscle activity, foot type, and transversus abdominis thickness within each group. A linear regression was used to analyse significant correlations (P < 0.05). RESULTS We found no significant differences in gluteus medius muscle activity between groups. However, there was a moderate correlation between the Foot Posture Index score and gluteus medius peak amplitude (P = 0.04) for those with mild to moderate chronic nonspecific low back pain. SIGNIFICANCE Clinicians should be aware that patients with mild to moderate chronic nonspecific low back pain may not demonstrate significant differences in gluteus medius muscle activity compared to those without back pain. Additionally, higher peak gluteus medius muscle activity is likely to occur in people with mild to moderate chronic nonspecific low back pain and planus feet.
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Affiliation(s)
- Sean Sadler
- Discipline of Podiatry, University of Newcastle, Ourimbah, NSW, 2258, Australia.
| | - Martin Spink
- Discipline of Podiatry, University of Newcastle, Ourimbah, NSW, 2258, Australia
| | - Vivienne Chuter
- Discipline of Podiatry, University of Newcastle, Ourimbah, NSW, 2258, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, 2308, Australia
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Ha SY, Shin D. The effects of curl-up exercise in terms of posture and muscle contraction direction on muscle activity and thickness of trunk muscles. J Back Musculoskelet Rehabil 2021; 33:857-863. [PMID: 32144977 DOI: 10.3233/bmr-191558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The curl-up exercise is widely used in clinical practice for strengthening abdominal muscles, but has been applied without a systematic method. OBJECTIVE The purpose of this study was to determine the most effective method considering the angle and muscle contraction direction during the curl-up exercise. METHODS Fourteen healthy males performed the curl-up exercise according to contraction direction (concentric and eccentric) and angle (30∘, 60∘, and 90∘). The muscle activity of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and iliopsoas (IP) was measured using electromyography (EMG), and the muscle thickness of transversus abdominis (TrA) was measured using ultrasonography. RESULTS The activities of the abdominal muscles (RA, EO, and IO) decreased with increasing angles (30∘, 60∘, and 90∘) (p< 0.05). There was no significant difference between eccentric and concentric contractions. The thickness ratio of TrA was the largest at an eccentric curl-up at 30∘, and the smallest at a concentric curl-up at 30∘ (p< 0.05). CONCLUSIONS The most effective angle for curl-up was 30∘. Although there is no difference in the direction of muscle contraction, eccentric curl-up at 30∘ could be considered the most effective posture for abdominal strengthening considering the importance of TrA.
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Affiliation(s)
- Sun-Young Ha
- Department of Physical Therapy, Graduate School of Kyungnam University, Changwon, Korea
| | - DooChul Shin
- Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon, Korea
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Miyachi R, Yamazaki T, Ohno N, Miyati T. Morphological changes in the long axis of the lower leg muscles during isometric contraction in the sitting position. J Phys Ther Sci 2020; 32:828-832. [PMID: 33362354 PMCID: PMC7758609 DOI: 10.1589/jpts.32.828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/09/2020] [Indexed: 12/04/2022] Open
Abstract
[Purpose] To compare the changes in the muscle cross-sectional area (MCSA) along the
long axis of the lower leg muscles at rest and during ankle plantar flexors isometric
contraction and to obtain basic information regarding the movement of lower leg muscles
during ankle plantar flexors contraction. [Participants and Methods] Sixteen healthy young
female participants (20.9 ± 1.2 years) were asked to sit with their ankles in a neutral
ankle position. Images were obtained at rest and during isometric contraction of the ankle
plantar flexors using gravity magnetic resonance imaging. The MCSAs of the triceps surae
and tibialis anterior were measured. [Results] The middle region of the soleus muscle had
a lower MCSA on contraction than at rest. In addition, the medial head of the
gastrocnemius had a lower MCSA on contraction than at rest in the distal quarter.
Moreover, the tibialis anterior had a lower MCSA at rest than on contraction in the middle
region. [Conclusion] The area to be used as an indicator and the movement to be induced
differ depending on the muscle during isometric contraction of the triceps surae.
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Affiliation(s)
- Ryo Miyachi
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, Japan.,Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University: 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
| | - Toshiaki Yamazaki
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University: 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
| | - Naoki Ohno
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University: 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
| | - Tosiaki Miyati
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University: 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
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Ali MS, Abd El-Aziz HG. Effect of whole-body vibration on abdominal thickness and sitting ability in children with spastic diplegia. J Taibah Univ Med Sci 2020; 16:379-386. [PMID: 34140865 PMCID: PMC8178633 DOI: 10.1016/j.jtumed.2020.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/31/2020] [Accepted: 11/10/2020] [Indexed: 11/28/2022] Open
Abstract
Objective Reduced muscle and bone mass, improper muscle function, and varying degrees of mobility dysfunctions are the main complications of cerebral palsy (CP). Many children with CP also present with poor abdominal muscle activation. Whole-body vibration (WBV) is a unique approach for enhancing strength and motor abilities in several clinical conditions. This study aimed to determine the influence of a 12-week WBV intervention on the thickness of the abdominal muscles and the sitting ability of children with diplegia. Methods A total of 30 children with spastic diplegic CP (aged 4–6 years) were randomly divided into two groups (control and experimental). The control group received a selected physical therapy program for 1 h, and the study group received WBV training for 10 min in addition to the same selected program for the control group for 3 times/week over a period of 12 weeks. Thereafter, abdominal muscle thickness and sitting ability were measured using ultrasonography and the Gross Motor Function Measure-88 (GMFM-88, sitting domain). Results Post treatment values revealed significant improvement in the measured variables in favour of the experimental group (p < 0.05), as there was improvement in the thickness of the four abdominal muscles compared to the control group (external oblique: F = 38.783; internal oblique: F = 99.547; transverse abdominis: F = 111.557, and rectus abdominis: F = 129.940, p < 0.05). Additionally, the study group showed a significantly greater improvement in GMFM-88 values compared to the control group (F = 129.940, p < 0.05). Conclusion WBV can be a viable strategy for improving sitting ability and abdominal muscle thickness among children with spastic diplegia.
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Affiliation(s)
- Mostafa S Ali
- Lecturer of physical therapy for pediatrics, Faculty of Physical Therapy, Cairo University, Egypt
| | - Heba G Abd El-Aziz
- Lecturer of physical therapy for pediatrics, Faculty of Physical Therapy, Cairo University, Egypt
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Effect of the Abdominal Draw-In Maneuver and Bracing on Abdominal Muscle Thickness and the Associated Subjective Difficulty in Healthy Individuals. Healthcare (Basel) 2020; 8:healthcare8040496. [PMID: 33227933 PMCID: PMC7712241 DOI: 10.3390/healthcare8040496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 11/16/2022] Open
Abstract
We evaluated the trunk abdominal muscle thickness while performing different exercises to identify the most effective training and to investigate the subjective difficulty associated with exercising. Twenty-eight men (mean age: 21.6 ± 0.9 years) without orthopedic diseases were enrolled. Ultrasonic imaging was used to measure the thickness of the transversus abdominis (TA), internal oblique, and external oblique muscles while at rest and while performing the abdominal draw-in maneuver and abdominal bracing. Measurements were made in the supine and sitting positions, and the subjective difficulty in performing each exercise was examined using a 5-level evaluation scale. The TA and internal oblique muscle thicknesses were significantly greater during the abdominal draw-in maneuver (ADIM) than during bracing or resting, in the supine and sitting positions. The subjective difficulty of abdominal bracing (AB) was graded significantly higher than that of ADIM. Additionally, a correlation between subjective difficulty and muscle thickness was found for the TA and IO. Our results may contribute to the choice of more effective exercises for spinal stability.
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IJland MM, Lemson J, van der Hoeven JG, Heunks LMA. The impact of critical illness on the expiratory muscles and the diaphragm assessed by ultrasound in mechanical ventilated children. Ann Intensive Care 2020; 10:115. [PMID: 32852710 PMCID: PMC7450159 DOI: 10.1186/s13613-020-00731-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 08/17/2020] [Indexed: 12/26/2022] Open
Abstract
Background Critical illness has detrimental effects on the diaphragm, but the impact of critical illness on other major muscles of the respiratory pump has been largely neglected. This study aimed to determine the impact of critical illness on the most important muscles of the respiratory muscle pump, especially on the expiratory muscles in children during mechanical ventilation. In addition, the correlation between changes in thickness of the expiratory muscles and the diaphragm was assessed. Methods This longitudinal observational cohort study performed at a tertiary pediatric intensive care unit included 34 mechanical ventilated children (> 1 month– < 18 years). Thickness of the diaphragm and expiratory muscles (obliquus interna, obliquus externa, transversus abdominis and rectus abdominis) was assessed daily using ultrasound. Contractile activity was estimated from muscle thickening fraction during the respiratory cycle. Results Over the first 4 days, both diaphragm and expiratory muscles thickness decreased (> 10%) in 44% of the children. Diaphragm and expiratory muscle thickness increased (> 10%) in 26% and 20% of the children, respectively. No correlation was found between contractile activity of the muscles and the development of atrophy. Furthermore, no correlation was found between changes in thickness of the diaphragm and the expiratory muscles (P = 0.537). Decrease in expiratory muscle thickness was significantly higher in patients failing extubation compared to successful extubation (− 34% vs − 4%, P = 0.014). Conclusions Changes in diaphragm and expiratory muscles thickness develop rapidly after the initiation of mechanical ventilation. Changes in thickness of the diaphragm and expiratory muscles were not significantly correlated. These data provide a unique insight in the effects of critical illness on the respiratory muscle pump in children.
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Affiliation(s)
- Marloes M IJland
- Department of Intensive Care Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Joris Lemson
- Department of Intensive Care Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Johannes G van der Hoeven
- Department of Intensive Care Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Leo M A Heunks
- Department of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Postbox 7057, 1007MB, Amsterdam, The Netherlands.
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Narouei S, Barati AH, Akuzawa H, Talebian S, Ghiasi F, Akbari A, Alizadeh MH. Effects of core stabilization exercises on thickness and activity of trunk and hip muscles in subjects with nonspecific chronic low back pain. J Bodyw Mov Ther 2020; 24:138-146. [PMID: 33218502 DOI: 10.1016/j.jbmt.2020.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 05/07/2020] [Accepted: 06/07/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Changes in trunk and hip muscles are believed to be important in subjects with nonspecific chronic low back pain (NSCLBP), but little is known about specific changes, or how they might be affected by core stabilization exercises. The aim of this study was to compare six key muscles before and after these exercises. METHODS Thirty two NSCLBP patients were assigned randomly into two groups: exercise (n = 17) and control (n = 15). On 5 days per week for 4 weeks, the Exercise group performed 16 core stabilization exercises and the Control group received transcutaneous electrical nerve stimulation and a 'hot-pack'. Surface electromyography (EMG) was used to assess maximum bilateral activity of transversus abdominis (TrA), multifidus (MF) and gluteus maximus (Gmax) muscles. Ultrasound imaging was used to measure the rest and contracted thickness of these muscles. Pain and disability were assessed using a visual analogue scale (VAS) and the Oswestry Disability Index. RESULTS When left and right-side muscle data were combined, two-way ANOVAs showed a nonsignificant interaction effect for all dependent variables (P > 0.05), significant time effects on resting muscle thickness for TrA (P = 0.01), MF (P = 0.041) and Gmax (P = 0.003), EMG signals of TrA (P = 0.038), pain and disability (P = 0.000). There were a significant group effect on contracted thickness for TrA (P = 0.032) and Gmax (P = 0.026) and disability (P = 0.017). CONCLUSIONS Core stabilization exercises increased contracted thickness of TrA and Gmax muscles and decreased disability in subjects with NSCLBP.
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Affiliation(s)
- Shideh Narouei
- Tehran University, School of Sport Medicine Sciences, Iran
| | - Amir Hossein Barati
- Shahid beheshti University, Shahid Shahriari Square, Daneshjou Boulevard, Shahid Chamran Highway, Tehran, Iran.
| | | | - Saeed Talebian
- Tehran University, School of Rehabilitation Sciences, Iran
| | - Fateme Ghiasi
- Zahedan University of Medical Sciences, School of Rehabilitation Sciences, Iran
| | - Asghar Akbari
- Zahedan University of Medical Sciences, School of Rehabilitation Sciences, Iran
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Kim Y, Kim J, Nam H, Kim HD, Eom MJ, Jung SH, Han N. Ultrasound Imaging of the Trunk Muscles in Acute Stroke Patients and Relations With Balance Scales. Ann Rehabil Med 2020; 44:273-283. [PMID: 32721990 PMCID: PMC7463119 DOI: 10.5535/arm.19125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 10/30/2019] [Indexed: 01/22/2023] Open
Abstract
Objective To examine the correlation between ultrasonographic trunk muscle parameters and balance scales in mild acute stroke patients. Methods A total of 55 stroke patients with hemiparesis and motor power grade ≥4 in the manual motor test were included. The Scale for the Assessment and Rating of Ataxia (SARA), Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and Trunk Control Test (TCT) were used to evaluate patient balance function. Ultrasonographic parameters were measured on both non-paretic and paretic sides of the rectus abdominis, external oblique, internal oblique, transversus abdominis, and erector spinae muscles. Resting thickness and contraction thickness were measured in all muscles, and contractility and contractility ratio were calculated based on measured thicknesses. The differences between paretic and non-paretic muscle parameters, and the correlation between ultrasonographic parameters and balance scales were analyzed. Stroke patients were divided into two groups according to their fall risk. Ultrasonographic measurements between the two groups were compared. Results All muscles’ contraction thickness and contractility were significantly different between paretic and non-paretic sides (p<0.001). Contractility ratios of all trunk muscles showed a significant correlation with SARA, BBS, TUG, and TCT (p<0.05). Contractility ratios of all muscles were significantly different between high- and low-risk fall groups (p<0.05). Conclusion The contractility ratio in stroke patients reflects their balance disturbance and fall risk and it may serve as a new parameter for ultrasound imaging of trunk muscles.
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Affiliation(s)
- Yunho Kim
- Department of Physical Medicine and Rehabilitation, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jeeyoung Kim
- Department of Physical Medicine and Rehabilitation, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Heesung Nam
- Department of Physical Medicine and Rehabilitation, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hyun Dong Kim
- Department of Physical Medicine and Rehabilitation, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Mi Ja Eom
- Department of Physical Medicine and Rehabilitation, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sang Hoon Jung
- Department of Physical Medicine and Rehabilitation, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Nami Han
- Department of Physical Medicine and Rehabilitation, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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The Effects of Thrust Joint Manipulation on the Resting and Contraction Thickness of Transversus Abdominis in Patients With Low Back Pain: A Randomized Control Trial. J Manipulative Physiol Ther 2020; 43:339-355. [PMID: 32709514 DOI: 10.1016/j.jmpt.2019.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 04/12/2019] [Accepted: 04/19/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the immediate changes in resting and contracted thickness of the transversus abdominis (TrA) muscle after application of thrust joint manipulation (TJM) vs sham manipulation in participants with low back pain. METHODS A pretest-posttest randomized controlled trial design was performed. Consecutive subjects satisfying eligibility criteria completed patient-report outcome baseline measures, pretreatment rehabilitative ultrasound imaging (RUSI) measurements, followed by the randomly assigned intervention then, post-treatment RUSI measurements, and post-treatment & final patient-reported outcome measures. To compare the outcomes of TJM and sham manipulation on the TrA muscle thickness, a 2-by-2 analysis of variance (treatment [TJM and sham manipulation]) by time (pretreatment and post-treatment) was completed for both the TrA muscle thickness at rest and muscle thickness during contraction. Descriptive statistics including independent-sample t tests for continuous variables and χ2 tests for categorical variables were used to analyze differences in patient-reported outcome measures between groups. RESULTS Sixty-seven eligible participants agreed to participate. No significant interactions were identified for either muscle thickness at rest or contraction. CONCLUSION This study did not support the hypothesis that manipulation would result in greater changes in TrA thickness at rest or during contraction in participants with low back pain. Based on prior research that identified subgroups of participants likely to respond to manipulation, future research should include participants more likely to respond favorably to TJM. This study was a priori registered with clinicaltrails.gov (NCT02558855).
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Axial loading and posture cues in contraction of transversus abdominis and multifidus with exercise. Sci Rep 2020; 10:11218. [PMID: 32665555 PMCID: PMC7360744 DOI: 10.1038/s41598-020-67509-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 05/22/2020] [Indexed: 11/16/2022] Open
Abstract
Astronauts are at increased risk of spine injury. With a view to developing training approaches for the muscles of the spine in microgravity, this study examined the effects of axial loading and postural cues on the contraction of transversus abdominis and lumbar multifidus in supine lying using a novel exercise device (GravityFit). Thirty (18 males and 12 females) endurance-trained runners without a history of spinal pain aged 33–55 years were recruited. Magnetic resonance imaging (MRI) was performed under one rest and five exercise conditions, which involved variations in axial loading and postural cues. Whole volume of the abdominal and lumbar paraspinal muscles was imaged and transversus abdominis thickness and length and multifidus anteroposterior and mediolateral thickness measured. Transversus abdominis contraction was greatest in the ‘stretch tall plus arm extension’ (length, − 15%, P < 0.001; thickness, + 19%, P < 0.001) and ‘stretch tall plus arm extension and thoracic cue’ (length, − 16%, P < 0.001; thickness, + 18%, P < 0.001) conditions. The contraction of multifidus was the greatest in the ‘arm extension and thoracic cue’ (anteroposterior, + 3.0%, P = 0.001; mediolateral, − 4.2%, P < 0.001) and ‘stretch tall plus arm extension and thoracic cue’ (anteroposterior, + 6.0%, P < 0.001; mediolateral, − 2.1%, P = 0.022) conditions. This study provides proof-of-principle for an exercise approach that may be used to facilitate the automatically contraction of the transversus abdominis and multifidus muscles. Axial loading of the body, with or without arm loading, most consistently led to contraction of the transversus abdominis and lumbar multifidus muscles, and regional differences existed in the contraction within the muscles.
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Zheng Y, Shin H, Kamper DG, Hu X. Automatic Detection of Contracting Muscle Regions via the Deformation Field of Transverse Ultrasound Images: A Feasibility Study. Ann Biomed Eng 2020; 49:354-366. [PMID: 32632530 DOI: 10.1007/s10439-020-02557-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/25/2020] [Indexed: 11/28/2022]
Abstract
Accurate identification of contracting muscles can help us to understand the muscle function in both physiological and pathological conditions. Conventional electromyography (EMG) have limited access to deep muscles, crosstalk, or instability in the recordings. Accordingly, a novel framework was developed to detect contracting muscle regions based on the deformation field of transverse ultrasound images. We first estimated the muscle movements in a stepwise calculation, to derive the deformation field. We then calculated the divergence of the deformation field to locate the expanding or shrinking regions during muscle contractions. Two preliminary experiments were performed to evaluate the feasibility of the developed algorithm. Using concurrent intramuscular EMG recordings, Experiment I verified that the divergence map can capture the activity of superficial and deep muscles, when muscles were activated voluntarily or through electrical stimulation. Experiment II verified that the divergence map can only capture contracting muscles but not muscle shortening during passive movements. The results demonstrated that the divergence can individually capture the activity of muscles at different depths, and was not sensitive to muscle shortening during passive movements. The proposed framework can automatically detect the regions of contracting muscle, and could potentially serve as a tool to assess the functions of a group of muscles concurrently.
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Affiliation(s)
- Yang Zheng
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, 116 Manning Drive, 10206B Mary Ellen Jones Bldg, Chapel Hill, NC, 27599-7575, USA
| | - Henry Shin
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, 116 Manning Drive, 10206B Mary Ellen Jones Bldg, Chapel Hill, NC, 27599-7575, USA
| | - Derek G Kamper
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, 116 Manning Drive, 10206B Mary Ellen Jones Bldg, Chapel Hill, NC, 27599-7575, USA
| | - Xiaogang Hu
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, 116 Manning Drive, 10206B Mary Ellen Jones Bldg, Chapel Hill, NC, 27599-7575, USA.
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Kennedy VL, Flavell CA, Doma K. Intra-rater reliability of transversus abdominis measurement by a novice examiner: Comparison of "freehand" to "probe force device" method of real-time ultrasound imaging. ULTRASOUND (LEEDS, ENGLAND) 2020; 27:156-166. [PMID: 32549895 DOI: 10.1177/1742271x19831720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 01/04/2019] [Indexed: 11/16/2022]
Abstract
A "free hand" real-time-ultrasound method is commonly applied to measure transversus abdominis. Potentially, this increases transversus abdominis measurement error due to uncontrolled variability in probe to skin force, inclination, and roll, particularly for novice examiners. This single-group repeated-measures reliability study compared the intra-rater reliability of transversus abdominis thickness and activation measurement by a novice examiner between free hand and a standardized probe force device method. The examiner captured ultrasound videos of transversus abdominis in a single session in healthy participants (n = 33). Free hand ultrasound featured uncontrolled probe force, inclination, and roll, while probe force device method ultrasound standardized these parameters. Images of transversus abdominis at rest and contracted were measured and transversus abdominis activation calculated. Intraclass correlation coefficient, coefficient of variation, standard error of measurement, and worthwhile differences were calculated. The probe force device method resulted in greater reliability (intraclass correlation coefficient = 0.75-0.96) and lower measurement error (coefficient of variation = 8.89-28.7%) compared to free hand (intraclass correlation coefficient = 0.63-0.93; coefficient of variation = 6.52-29.4%). Reliability was good for all measurements except free hand TrA-C, which was moderate. TrA-C had the lowest reliability, followed by contracted thickness of the transverse abdominis, with resting thickness of the transverse abdominis being highest. Worthwhile differences were lower using a probe force device method versus free hand for resting thickness of the transverse abdominis and contracted thickness of the transverse abdominis and similar for TrA-C. Standardization using probe force device method ultrasound to measure transversus abdominis improved intra-rater reliability in a novice examiner. Use of a probe force device method is recommended to improve reliability through reduced sources of measurement error. Probe force device method intra- and inter-rater reliability in examiners of varying experience, in clinical populations, and to visualize other structures merits exploration.
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Affiliation(s)
| | | | - Kenji Doma
- James Cook University, Townsville, Australia
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Cheung WK, Cheung JPY, Lee WN. Role of Ultrasound in Low Back Pain: A Review. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1344-1358. [PMID: 32192782 DOI: 10.1016/j.ultrasmedbio.2020.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/27/2020] [Accepted: 02/04/2020] [Indexed: 06/10/2023]
Abstract
Low back pain is one of most common musculoskeletal disorders around the world. One major problem clinicians face is the lack of objective assessment modalities. Computed tomography and magnetic resonance imaging are commonly utilized but are unable to clearly distinguish patients with low back pain from healthy patients with respect to abnormalities. The reason may be the anisotropic nature of muscles, which is altered in function, and the scans provide only structural assessment. In view of this, ultrasound may be helpful in understanding the disease as it is performed in real-time and comprises different modes that measure thickness, blood flow and stiffness. By the use of ultrasound, patients with low back pain have been found to differ from healthy patients with respect to the thickness and stiffness of the transversus abdominis, thoracolumbar fascia and multifidus. The study results are currently still not conclusive, and further study is necessary to validate. Future work should focus on quantitative assessment of these tissues to provide textural, structural, hemodynamic and mechanical studies of low back pain. This review highlights the current understanding of how medical ultrasound has been used for diagnosis and study of low back pain and discusses potential new applications.
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Affiliation(s)
- Wing Ki Cheung
- Department of Orthopaedics and Traumatology, University of Hong Kong, Pokfulam, SAR, China
| | - Jason Pui Yin Cheung
- Department of Orthopaedics and Traumatology, University of Hong Kong, Pokfulam, SAR, China.
| | - Wei-Ning Lee
- Department of Electrical and Electronic Engineering, Biomedical Engineering Programme, University of Hong Kong, Pokfulam, SAR, China
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ShahAli S, Shanbehzadeh S, ShahAli S, Ebrahimi Takamjani I. Application of Ultrasonography in the Assessment of Abdominal and Lumbar Trunk Muscle Activity in Participants With and Without Low Back Pain: A Systematic Review. J Manipulative Physiol Ther 2020; 42:541-550. [PMID: 31864437 DOI: 10.1016/j.jmpt.2019.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 05/05/2019] [Accepted: 05/10/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The purpose of this study was to systematically review the literature regarding which condition (task, position, or contraction type), changes in muscle thickness could be interpreted as muscle activity of trunk muscles. METHODS Studies that assessed the correlation between changes in muscle thickness measured with ultrasonography (US) and electromyography (EMG) activity were included. Only the data related to abdominal and lumbar trunk muscles in participants with or without low back pain were extracted. The PubMed, ScienceDirect, Ovid MEDLINE, Scopus, Springer, and Cumulative Index to Nursing and Allied Health Literature databases were searched from inception to August 2018. Two independent raters appraised the quality of the included studies using the Critical Appraisal Skills Program checklist. RESULTS Fourteen studies were included. The results revealed significant correlations between US and EMG measures for the lumbar multifidus and erector spinae muscle during most contraction levels and postures. For transverse abdominis and internal oblique, US and EMG measures were correlated during low load abdominal drawing or bracing. The correlations were influenced by trunk position for higher intensities of contraction. For the external oblique muscle, correlation was observed only during trunk rotation. CONCLUSION Changes in muscle thickness should not be interpreted as muscle activity for all tasks, positions, and contraction types. Only during prime movement tasks performed with isometric contraction could muscle thickness change be considered as muscle activity. Also, upright postures influenced the relationship between changes in muscle thickness and muscle activity for abdominal muscles.
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Affiliation(s)
- Shabnam ShahAli
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sanaz Shanbehzadeh
- Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Shiva ShahAli
- School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ismail Ebrahimi Takamjani
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Amerijckx C, Goossens N, Pijnenburg M, Musarra F, van Leeuwen DM, Schmitz M, Janssens L. Influence of phase of respiratory cycle on ultrasound imaging of deep abdominal muscle thickness. Musculoskelet Sci Pract 2020; 46:102105. [PMID: 32217268 DOI: 10.1016/j.msksp.2019.102105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/20/2019] [Accepted: 12/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND It is difficult to evaluate the transversus abdominis (TrA) and internal oblique (IO) due to their dual role in both trunk control and breathing. OBJECTIVES To investigate whether TrA and IO thickness as measured by ultrasound differs across the respiratory cycle in upright standing. DESIGN Observational study. METHODS Thickness of TrA and IO was measured with ultrasound in 67 subjects in upright standing. Measures were performed 3 times and by 2 assessors, at the end of relaxed expiration, at the end of a full inspiration, and at the end of full expiration. Differences were assessed by ANOVA. Intra- and inter-rater reliability (of a single measure and the average of 3 measures) were assessed by intra-class correlation (ICC). RESULTS Thickness of the TrA and IO was higher at full expiration than at the end of relaxed expiration (p < 0.001), and in turn compared to at full inspiration (p < 0.001). Intra-rater reliability was excellent at all respiratory phases (ICC 0.76-0.87). Whereas inter-rater reliability for a single measure was only fair to good for TrA (ICC 0.52-0.71) and good to excellent for IO (ICC 0.61-0.78), the inter-rater reliability of the average was excellent at all respiratory phases (ICC 0.75-0.90). CONCLUSIONS Thickness of TrA and IO increases when lung volume decreases. The intra- and inter-rater reliability of an average measure were excellent at the end of relaxed expiration, full inspiration and full expiration. This provides new opportunities to evaluate the deep abdominal muscles, and their role in respiration, in a physiotherapeutic setting.
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Affiliation(s)
- Charlotte Amerijckx
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590, Diepenbeek, Belgium.
| | - Nina Goossens
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590, Diepenbeek, Belgium.
| | - Madelon Pijnenburg
- Department of Allied Health Professions, Fontys University of Applied Sciences, 5600, AH,Eindhoven, the Netherlands.
| | - Frank Musarra
- PhysioMusarra, Physiotherapy Rehabilitation Center, 61121, Pesaro, Italy.
| | - Daniel M van Leeuwen
- Department of Allied Health Professions, Fontys University of Applied Sciences, 5600, AH,Eindhoven, the Netherlands; The Hague University of Applied Sciences, 2501 EH, The Hague, the Netherlands.
| | - Marc Schmitz
- SonoSkills-SonoScience, 6041, KG, Roermond, the Netherlands.
| | - Lotte Janssens
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590, Diepenbeek, Belgium.
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