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Nagai T, Miyagami M, Nakamura S, Sakamoto K, Ishikawa K, Okano I, Kasai F, Kudo Y, Kawate N. Relationship between sacral-abdominal wall distance, movement performance, and spinal alignment in osteoporosis: a retrospective study. BMC Geriatr 2024; 24:252. [PMID: 38475741 PMCID: PMC10936102 DOI: 10.1186/s12877-024-04865-x] [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: 08/27/2023] [Accepted: 03/02/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Aging is associated with muscle atrophy, as typified by sarcopenia. Loss of abdominal muscle strength can cause abdominal wall laxity. The purpose of this study was to investigate the relationship between the sacral vertebra-abdominal wall distance (SAD) and movement performance using a simple lateral spine X-ray image for measuring the SAD. METHODS In this retrospective study, we included women aged ≥ 65 years who were attending the outpatient clinic for osteoporosis at our hospital. A total of 287 patients (mean age ± SD, 76.8 ± 7.1 years) with measured SAD were included in the analysis. Patients were divided into two groups based on SAD cutoff (160 mm) and age (75 years), respectively. The patients were examined using the two-foot 20 cm rise test, 3 m Timed Up and Go (TUG) test, two-step test, open-eyed one-leg standing time, and spinal alignment. Normally distributed data are expressed as means (standard deviations) and non-normally distributed data as medians (interquartile range), depending on the results of the Kolmogorov-Smirnov test. Student's t-test and χ2 test were used for between-group comparisons. Regression analysis was performed with SAD as the objective variable. A two-sided p < 0.05 was considered statistically significant. RESULTS The shorter SAD group performed better in the two-step test, TUG test, and open-eyed one-leg standing time (p < 0.001) as well as in the two-foot 20 cm rise test (p < 0.01) compared to the longer SAD group. Spinal alignment was better in the shorter SAD group than in the longer SAD group, with a shorter sagittal vertical axis (p < 0.001), smaller pelvic tilt (p < 0.001), and greater sacral slope (p < 0.05). CONCLUSION SAD was associated with posterior pelvic tilt and movement performance parameters. In addition to testing for osteoporosis, movement performance parameters should be evaluated in women with osteoporosis who are aged ≥ 65 and have greater SAD (≥ 160 mm in this study). The SAD is a new assessment method, and further research is required to verify its validity and reproducibility. This is the first attempt to determine how age and SAD affect movement performance in older adults.
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Affiliation(s)
- Takashi Nagai
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan.
- Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan.
| | - Makoto Miyagami
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Shota Nakamura
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Keizo Sakamoto
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Koji Ishikawa
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Ichiro Okano
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Fumihito Kasai
- Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Yoshifumi Kudo
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Nobuyuki Kawate
- Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
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Immediate Effects of Whole-Body versus Local Dynamic Electrostimulation of the Abdominal Muscles in Healthy People Assessed by Ultrasound: A Randomized Controlled Trial. BIOLOGY 2023; 12:biology12030454. [PMID: 36979147 PMCID: PMC10044981 DOI: 10.3390/biology12030454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023]
Abstract
Dynamic electrostimulation consists of the application of local or global electrostimulation together with physical exercise. This study aimed to investigate the immediate effects of a dynamic electrostimulation session on the thickness of the abdominal musculature, inter-rectus distance, heart rate, blood pressure, and body temperature, and to identify possible differences in its form of application. A total of 120 healthy participants were divided into three groups: the whole-body electrostimulation group, the local electrostimulation group, and the control group without electrical stimulation. All groups performed a single session with the same dynamic exercise protocol. Muscle thickness and inter-rectus distance were evaluated ultrasonographically using the Rehabilitative Ultrasound Imaging technique both at rest and in muscle contraction (the active straight leg raise test) to find the post-intervention differences. The results showed significant differences in immediate post-intervention heart rate, with a smaller increase in the local electrostimulation group compared to the control and whole-body electrostimulation groups. No significant differences were identified between the groups after the interventions in the rest of the variables analyzed. Therefore, a local application, with the same effects as a global application on the abdominal musculature, has fewer contraindications, which makes its use more advisable, especially in populations with cardiorespiratory disorders, for which more research is needed.
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Nuzzo JL. Narrative Review of Sex Differences in Muscle Strength, Endurance, Activation, Size, Fiber Type, and Strength Training Participation Rates, Preferences, Motivations, Injuries, and Neuromuscular Adaptations. J Strength Cond Res 2023; 37:494-536. [PMID: 36696264 DOI: 10.1519/jsc.0000000000004329] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
ABSTRACT Nuzzo, JL. Narrative review of sex differences in muscle strength, endurance, activation, size, fiber type, and strength training participation rates, preferences, motivations, injuries, and neuromuscular adaptations. J Strength Cond Res 37(2): 494-536, 2023-Biological sex and its relation with exercise participation and sports performance continue to be discussed. Here, the purpose was to inform such discussions by summarizing the literature on sex differences in numerous strength training-related variables and outcomes-muscle strength and endurance, muscle mass and size, muscle fiber type, muscle twitch forces, and voluntary activation; strength training participation rates, motivations, preferences, and practices; and injuries and changes in muscle size and strength with strength training. Male subjects become notably stronger than female subjects around age 15 years. In adults, sex differences in strength are more pronounced in upper-body than lower-body muscles and in concentric than eccentric contractions. Greater male than female strength is not because of higher voluntary activation but to greater muscle mass and type II fiber areas. Men participate in strength training more frequently than women. Men are motivated more by challenge, competition, social recognition, and a desire to increase muscle size and strength. Men also have greater preference for competitive, high-intensity, and upper-body exercise. Women are motivated more by improved attractiveness, muscle "toning," and body mass management. Women have greater preference for supervised and lower-body exercise. Intrasexual competition, mate selection, and the drive for muscularity are likely fundamental causes of exercise behaviors in men and women. Men and women increase muscle size and strength after weeks of strength training, but women experience greater relative strength improvements depending on age and muscle group. Men exhibit higher strength training injury rates. No sex difference exists in strength loss and muscle soreness after muscle-damaging exercise.
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Affiliation(s)
- James L Nuzzo
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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Activation asymmetry of the lateral abdominal muscles in response to neurodevelopmental traction technique in children with pelvic asymmetry. BIOMEDICAL HUMAN KINETICS 2023. [DOI: 10.2478/bhk-2023-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Study aim: The aim of the study was to evaluate asymmetry of activation of lateral abdominal muscles (LAM) in response to neurodevelopmental traction technique in children with pelvic asymmetry.
Material and methods: Measurements of LAM activation asymmetry were performed during traction with the force of 5% body weight in two experimental conditions: 1) in neutral position, 2) in 20° posterior trunk inclination. Twenty-three healthy children with pelvic asymmetry participated in the study. To evaluate LAM activation asymmetry ultrasound technology was employed (two Mindray DP660 devices (Mindray, Shenzhen, China)). Activation asymmetry indices for each individual LAM were calculated.
Results: The magnitude of LAM activation asymmetry indexes formed a gradient, with the most profound transversus abdominis (TrA) showing the greatest asymmetry, and the most superficial obliquus externus – the smallest. The inter-muscle differences were most pronounced between the TrA and the two more superficial oblique muscles. There were no correlation between the magnitude of pelvic asymmetry and LAM activation asymmetry.
Conclusions: During the neurodevelopmental traction technique there is a difference in individual LAM activation symmetry, with deeper muscles showing greater asymmetry. The activation asymmetry of the LAM does not seem to be associated with the pelvic asymmetry. Results are similar to those recorded in earlier studies in samples where no pelvic asymmetry were subjected to analysis.
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Hip and knee frontal plane kinematics are not associated with lateral abdominal muscle thickness and trunk muscle endurance in healthy men and women. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-021-00851-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kuzu Ö, Aras B. Sonographic measurement of the neck extensor muscle thickness in patients with fibromyalgia. Musculoskelet Sci Pract 2022; 59:102541. [PMID: 35240562 DOI: 10.1016/j.msksp.2022.102541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/10/2022] [Accepted: 02/24/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this cross-sectional study was to compare cervical extensor muscle thickness measurements in patients with fibromyalgia (FM) with chronic neck pain and an asymptomatic control group, and to examine the relationship between cervical extensor muscle thickness and pain, quality of life, and disability. METHODS The study included 41 patients with FM and 41 asymptomatic control subjects. The thickness of the cervical extensor muscles (multifidus, semispinalis capitis, semispinalis cervicis, splenius capitis and trapezius muscles) was evaluated with ultrasonography. The severity of FM was evaluated with the Fibromyalgia Impact Questionnaire (FIQ), neck disability with the Neck Disability Index (NDI) and pain severity with a Numeric Rating Scale (NRS). RESULTS The mean sonographic thickness values of all the neck extensor muscles were significantly decreased in the FM group compared with the control group (p < 0.001). There were negative correlations between the FIQ and multifidus, splenius capitis and trapezius thickness values. NDI was significantly negatively correlated with multifidus and trapezius thickness. There was no significant correlation between neck extensor muscle thickness and age, duration of FM, and NRS scores. CONCLUSION This study demonstrated a decrease in cervical extensor muscle thickness in patients with FM with chronic neck pain. Cervical extensor muscle morphologies should be considered by the clinician when planning treatment in patients with FM with neck pain.
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Affiliation(s)
- Ömer Kuzu
- Ankara City Hospital, Physical Medicine and Rehabilitation Hospital, Ankara, Turkey.
| | - Berke Aras
- Ankara City Hospital, Physical Medicine and Rehabilitation Hospital, Ankara, Turkey.
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Endo A, Yakabi A, Kubo A. Effect of interferential current on deep abdominal muscle thickness. J Phys Ther Sci 2022; 34:306-310. [PMID: 35400830 PMCID: PMC8989490 DOI: 10.1589/jpts.34.306] [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: 11/26/2021] [Accepted: 01/01/2022] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We aimed to investigate the effects of various modulated interferential
currents on deep abdominal muscle thicknesses of healthy participants using ultrasound
imaging. [Participants and Methods] We recruited twenty-two healthy male participants for
this study. We compared the rate of change in muscle thickness of the abdominal muscles
under different stimulation interferential current conditions. [Results] The change in
interclass correlation coefficient of muscle thickness for each electrical stimulation by
attached electrode altering was 0.738–0.998, indicating normal to good reliability. The
rate of change for all muscle thicknesses under interferential current at 2.5 kHz and
20 Hz was significantly greater than that under the other conditions. [Conclusion] An
interferential current at 2.5 kHz and 20 Hz is a feasible and reproducible way to train
the abdominal muscles.
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Affiliation(s)
- Ayumu Endo
- Department of Rehabilitation, Shioya Hospital, International University of Health and Welfare, Japan
| | - Akihiro Yakabi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara, Tochigi 324-8501, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara, Tochigi 324-8501, Japan
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Ultrasonographic Changes of Abdominal Muscles in Subjects with and without Chronic Low Back Pain. Healthcare (Basel) 2022; 10:healthcare10010123. [PMID: 35052287 PMCID: PMC8775819 DOI: 10.3390/healthcare10010123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/20/2022] Open
Abstract
Chronic low back pain (CLBP) is a prevalent disfunction in the spine, affecting both women and men. The implication of the abdominal muscles in this disfunction has been studied, including wrong breathing patterns or inactivity of this area. However, there is a lack of studies examining changes in thickness of abdominal with ultrasonography. Thus, the aim of this study is to analyze the differences in the thickness of abdominal muscles at rest and during breathing between subjects with and without CLBP. A total of 72 subjects were divided in two groups: participants with CLBP (n = 36) and participants without CLBP (n = 36). In both groups, the thickness of the four abdominal muscles was measured and compared at rest and during breathing with ultrasonography. In TrA and IO there were no significant differences between groups, but those subjects with CLBP increased the muscle thickness more than participants without pain during breathing. In EO there were no differences in muscle thickness between groups and between rest and breathing. In RA, subjects with CLBP showed less muscle thickness than subjects without pain during breathing, but no changes were found at rest. In conclusion, the deepest abdominal muscles, TrA and IO, appear to increase their thickness and RA appear to decrease more in subjects with CLBP, in comparison with healthy participants.
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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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Bladder Base Displacement during Abdominal Muscles Contraction and Functional Activities in Primiparous Women Assessed by Transabdominal Ultrasound: A Descriptive Study. J Clin Med 2021; 11:jcm11010025. [PMID: 35011767 PMCID: PMC8745356 DOI: 10.3390/jcm11010025] [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: 11/23/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 12/01/2022] Open
Abstract
This study described the response of the bladder base (BB) by transabdominal ultrasound in primiparous women during movements that activate the abdominopelvic cavity musculature and cause variations in intra-abdominal pressure (IAP). A descriptive cross-sectional study was conducted in 64 primiparous women at eight weeks after uncomplicated delivery. BB displacement was measured using a 5-MHz convex transducer in a suprapubic position. Participants were asked to perform the isolated contraction of pelvic floor musculature (PFM) and transverse abdominis (TrA), cough at high lung volume and trunk flexion with and without maximal voluntary contraction of PFM. PFM contraction elevated the BB in all but one participant, whereas TrA contraction caused the BB to ascend in 56% of the women and descend in the rest; their combined contraction rose the BB in 65% of the women although the effect was greater with only PFM contraction (p < 0.01). The BB descended in all participants during coughing and trunk flexion although the descent was inferior with the joint maximal voluntary contraction of PFM (p < 0.01). In conclusion, TrA contraction must be assessed individually in puerperal women since its effect on the BB varies among subjects. During movements increasing IAP, such as coughing or curl-ups, the anticipatory contraction of PFM reduces bladder descent although not sufficiently to counteract bladder displacement.
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Are There Any Differences in Abdominal Activation between Women and Men during Hypopressive Exercises? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136984. [PMID: 34210004 PMCID: PMC8297145 DOI: 10.3390/ijerph18136984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 12/22/2022]
Abstract
This study analyzes the effects of hypopressive exercises on the abdominal thickness of healthy subjects and compares the performance between women and men. We conducted a transversal observational study in 98 subjects (63% women). The muscle thickness is analyzed in transversus abdominis, internal oblique, external oblique, and rectus abdominis with ultrasound imaging at rest and during the hypopressive exercise (HE) in supine and standing position. Comparisons between rest and hypopressive exercise are carried out in the two different positions and between women and men. In the supine position, there is a significant activation of the transversus abdominis and internal oblique during hypopressive exercise (p < 0.001), and it is similar in both sexes, the external oblique is only activated significantly by men (p < 0.001) and rectus abdominis had no significant activation (p > 0.05). Our results show that standing transversus abdominis and external oblique significantly increased their thickness during HE with higher effects in men. Internal oblique also increased significantly, but with higher effects in women, and rectus abdominis had no significant increase. Men had similar effects to women during HE, with an activation of the deepest abdominal muscles. The unequal anatomy and the position could explain the different results obtained between the sexes.
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The reliability of rehabilitative ultrasound to measure lateral abdominal muscle thickness: A systematic review and meta-analysis. Musculoskelet Sci Pract 2021; 53:102357. [PMID: 33743453 DOI: 10.1016/j.msksp.2021.102357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Variations in rehabilitative ultrasound imaging (RUSI) protocols may alter lateral abdominal muscle (LAM) thickness measurements. A standardised protocol is required for clinicians to accurately compare LAM thickness changes. OBJECTIVE In healthy and lower back pain (LBP) populations, to assess the 1) overall reliability of RUSI to diagnose LAM thickness via meta-analysis, 2) reliability of ultrasound variables to diagnose LAM thickness via systematic review, and 3) propose a RUSI protocol for the LAM using variables associated with excellent reliability (intraclass correlation coefficient [ICC] >0.9). DESIGN Systematic review and meta-analysis. METHOD Databases were searched from January 2000 for studies reporting the reliability of RUSI on the LAM at rest. Title, abstract and full-text screening were performed. Reference lists of reviews and included full-text articles were scanned for further articles. Study characteristic, ultrasound procedure and reliability data were extracted, and article quality assessed. Data was synthesised using meta-analysis to determine the overall reliability for RUSI in different subgroups; calculation of the mean ICCs and standard error of measurements of protocol variables; and narrative synthesis of protocols to contrast those of differing reliability. RESULTS Twenty-seven articles, involving 884 participants were included. Reliability ranged from good-to-excellent (ICC 0.859-0.958) in all subgroups. Protocols ranged in subject selection and position, examiner experience, transducer position with the comprehensiveness of protocol description the main limitation of the reviewed literature. Based on the findings an ultrasound protocol was proposed. CONCLUSIONS RUSI variables for the LAM at rest show moderate-to-excellent reliability; future research should explore reliability following the proposed protocol.
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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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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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Pain Catastrophizing Is Related to Static Postural Control Impairment in Patients with Nonspecific Chronic Low Back Pain: A Cross-Sectional Study. Pain Res Manag 2020; 2020:9629526. [PMID: 33193926 PMCID: PMC7641713 DOI: 10.1155/2020/9629526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/01/2020] [Accepted: 10/10/2020] [Indexed: 12/29/2022]
Abstract
Purpose Pain catastrophizing may contribute to the altered trunk muscle activity in patients with nonspecific chronic low back pain (NSCLBP). It is unclear if pain catastrophizing influences static postural control in patients with NSCLBP. This study aimed to investigate the relationship between pain catastrophizing and static postural control in NSCLBP patients. Methods Sixty-eight participants with NSCLBP and 40 healthy participants were recruited. Postural control was assessed by the sway area and the sway length of the center of pressure (COP) during balance tests. Pain catastrophizing in participants with NSCLBP was assessed by the Pain Catastrophizing Scale (PCS). Bilateral transversus abdominis (TrA) activation was evaluated by ultrasound imaging-measured percent change in muscle thickness. Associations between COP parameter and PCS/subscales of PCS were examined by multiple linear regression (MLR). Results Our results observed a larger COP sway area in NSCLBP group under eyes-closed condition (p < 0.001) and a lower level of voluntary activation of the bilateral TrA (p < 0.001), compared with the healthy control group. The MLR analyses revealed that the COP area sway under eyes-closed condition was significantly associated with the PCS score/helplessness score of PCS, voluntary activation of the left TrA, and age in participants with NSCLBP (β = 0.222/0.236, 0.341/0.344, and 0.328/0.325; p=0.045/0.033, 0.002, and 0.004, resp.). Conclusions Static postural control was associated with pain catastrophizing, voluntary activation of TrA, and age in participants with NSCLBP. This indicated that pain catastrophizing may affect postural control and should be considered when interpreting balance test results and managing NSCLBP.
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Romero-Morales C, Bravo-Aguilar M, Ruiz-Ruiz B, Almazán-Polo J, López-López D, Blanco-Morales M, Téllez-González P, Calvo-Lobo C. Current advances and research in ultrasound imaging to the assessment and management of musculoskeletal disorders. Dis Mon 2020; 67:101050. [PMID: 32711897 DOI: 10.1016/j.disamonth.2020.101050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Currently evidence-based practice has given scientific weight to the physical therapist profession; it is essential that all medical professional and physical therapists know the usefulness of new tools that optimize the effectiveness of their interventions and allow the growing of the scientific knowledge base. The use of ultrasound imaging (USI) by physiotherapists has evolved in recent years, consolidating as an increasingly standardized technique, low cost compared to other imaging techniques, quickly of execution, feasible and reliable tool. USI offers a wide range of opportunities in clinical practice as well as in different research areas. Therefore, ultrasound has been currently used as a diagnostic tool by physicians and in recent years there has been an expansion of the use of ultrasound equipment by non-physicians professionals such as physical therapist or physical trainers, who incorporates USI as a means of assessing musculoskeletal system architecture and composition, musculoskeletal changes in dysfunction, pain or injury conditions, as an interventional technique assisting echo-guided procedures or using the visual real-time information as a biofeedback in control motor approaches, as guiding tool in clinical decisions as well as to improve the understanding of tissue adaptations to exercise or movement. The purpose of this article is to review and provide an overview about the currently research of the USI applications and their benefits for the diagnosis and management in individuals with musculoskeletal conditions.
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Affiliation(s)
- Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
| | - María Bravo-Aguilar
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
| | - Beatriz Ruiz-Ruiz
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, 15403, Ferrol, Spain
| | - Jaime Almazán-Polo
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, 15403, Ferrol, Spain.
| | - María Blanco-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
| | - Patricia Téllez-González
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
| | - César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040, Madrid, Spain
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17
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Emami M, Rahmani N, Mohseni Bandpei MA, Biglarian A. Reliability of Ultrasound Imaging of the Trunk Musculature in Athletes with and without Hamstring Injuries. THE ARCHIVES OF BONE AND JOINT SURGERY 2020; 8:531-536. [PMID: 32884975 PMCID: PMC7443065 DOI: 10.22038/abjs.2020.46102.2262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Trunk muscles play an important role in providing both mobility and stability during dynamic tasks in athletes. The purpose of this study was to evaluate the within-day and between-day reliability of ultrasound (US) in measuring abdominal and lumbar multifidus muscle (MF) thickness in athletes with and without hamstring strain injury (HSI). METHODS Fifteen male soccer players (18-30 years old) with and without HSI were evaluated using two US probes (50 mm linear 7.5 MHZ and 70 mm curvilinear 5 MHz). The abdominal muscle thickness as well as the cross sectional area (CSA) of the MF was measured. To determine within and between days reliabilities, the second and third measurements were repeated with two hours and one week intervals, respectively. RESULTS Intraclass correlation coefficients for athletes with and without HSI demonstrated good to high reliability for the abdominal muscle thickness (0.82 and 0.93) and CSA of the MF muscle (0.84 and 0.89, respectively). CONCLUSION Our results indicated that US seemed to be a reliable instrument to measure abdominal and lumbar multifidus muscle thickness in soccer players with and without HSI. However, further studies are recommended to support the present study findings in other athletes.
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Affiliation(s)
- Mahnaz Emami
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Nahid Rahmani
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Ali Mohseni Bandpei
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan
| | - Akbar Biglarian
- Department of Biostatistics, Social determinants of health and research center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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18
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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: 15] [Impact Index Per Article: 3.8] [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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19
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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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20
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Hanawa Y, Kubo A, Onoda K. Differences in the transversus abdominis thickness during various motor tasks in the supine position. J Phys Ther Sci 2020; 31:975-978. [PMID: 32038067 PMCID: PMC6893159 DOI: 10.1589/jpts.31.975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 09/19/2019] [Indexed: 12/01/2022] Open
Abstract
[Purpose] The aim of this study was to evaluate simple and efficient transversus
abdominis exercises performed in the supine position using ultrasonography. [Participants
and Methods] Sixteen healthy males performed six motor tasks including left shoulder
flexion, draw-in, left straight leg raise, and the vocalization of vowel sounds (55–60 dB,
65–70 dB, and 75–80 dB), in a random order while in the supine position. The thicknesses
of the transversus abdominis, internal oblique, and external oblique were measured using
ultrasonography. [Results] There was a significant increase in the transversus abdominis
thickness during the draw-in and vocalization tasks than during other tasks. With respect
to draw-in and the three vowel sound volumes, there was a significant difference between
draw-in and the 65–70 dB sound. However, there was no significant difference in the
transversus abdominis thickness between draw-in and the three vocalization tasks.
[Conclusion] These results suggest that the vocalization of vowel sounds is an effective
and easy way to exercise the transversus abdominis for patients experiencing difficulty in
performing draw-in exercises.
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Affiliation(s)
- Yuta Hanawa
- Department of Rehabilitation, Shioya Hospital, International University of Health and Welfare: 77 Tomita, Yaita-shi, Tochigi 329-2145, Japan
| | - Akira Kubo
- Department of Physical Therapy, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Japan
| | - Kou Onoda
- Department of Physical Therapy, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Japan
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21
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Tuinman PR, Jonkman AH, Dres M, Shi ZH, Goligher EC, Goffi A, de Korte C, Demoule A, Heunks L. Respiratory muscle ultrasonography: methodology, basic and advanced principles and clinical applications in ICU and ED patients-a narrative review. Intensive Care Med 2020; 46:594-605. [PMID: 31938825 PMCID: PMC7103016 DOI: 10.1007/s00134-019-05892-8] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 12/02/2019] [Indexed: 02/06/2023]
Abstract
Respiratory muscle ultrasound is used to evaluate the anatomy and function of the respiratory muscle pump. It is a safe, repeatable, accurate, and non-invasive bedside technique that can be successfully applied in different settings, including general intensive care and the emergency department. Mastery of this technique allows the intensivist to rapidly diagnose and assess respiratory muscle dysfunction in critically ill patients and in patients with unexplained dyspnea. Furthermore, it can be used to assess patient-ventilator interaction and weaning failure in critically ill patients. This paper provides an overview of the basic and advanced principles underlying respiratory muscle ultrasound with an emphasis on the diaphragm. We review different ultrasound techniques useful for monitoring of the respiratory muscle pump and possible therapeutic consequences. Ideally, respiratory muscle ultrasound is used in conjunction with other components of critical care ultrasound to obtain a comprehensive evaluation of the critically ill patient. We propose the ABCDE-ultrasound approach, a systematic ultrasound evaluation of the heart, lungs and respiratory muscle pump, in patients with weaning failure.
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Affiliation(s)
- Pieter R Tuinman
- Department of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands.,Amsterdam Leiden Intensive Care Focused Echography (ALIFE), Amsterdam, The Netherlands
| | - Annemijn H Jonkman
- Department of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Martin Dres
- Department of Pulmology and Medical Intensive Care, APHP Sorbonne Université, Pitié-Salpêtrière Hospital, Paris, France
| | - Zhong-Hua Shi
- Department of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands.,Department of Critical Care Medicine, Capital Medical University, Beijing Tiantan Hospital, Beijing, 100050, China
| | - Ewan C Goligher
- Interdepartmental Division of Critical Care Medicine and Department of Medicine, University of Toronto, Toronto, ON, Canada.,Critical Care Medicine, University Health Network, Toronto General Hospital, Toronto, ON, Canada
| | - Alberto Goffi
- Interdepartmental Division of Critical Care Medicine and Department of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Critical Care Medicine, Department of Medicine, St. Michael's Hospital, Toronto, ON, Canada
| | - Chris de Korte
- Department of Radiology, Radboud UMC, Nijmegen, The Netherlands
| | - Alexandre Demoule
- Department of Pulmology and Medical Intensive Care, APHP Sorbonne Université, Pitié-Salpêtrière Hospital, Paris, France
| | - Leo Heunks
- Department of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands.
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22
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Moghadam N, Ghaffari MS, Noormohammadpour P, Rostami M, Zarei M, Moosavi M, Kordi R. Comparison of the recruitment of transverse abdominis through drawing-in and bracing in different core stability training positions. J Exerc Rehabil 2019; 15:819-825. [PMID: 31938704 PMCID: PMC6944888 DOI: 10.12965/jer.1939064.352] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 11/22/2019] [Indexed: 11/22/2022] Open
Abstract
There are many proposed core stability exercises in a variety of positions; however, it is not clear that in which position, activation of transverse abdominis muscle is utmost. We aimed to compare the activation of transverse abdominis muscle in different core stability exercise positions through ultrasound imaging. in a 20 subjects' study we compared the effectiveness of drawing-in and bracing maneuvers on transverse abdominis in different core stability exercise positions (supine, hook lying, supine with 90° flexed knee and hip, supine with stretched knees and 90° flexed hips, bridge, bridge with one stretched knee and Bird dog). We used activation ratio and preferential activation ratio as measurements of transverse abdominis activation. Abdominal Bracing in the bridge position showed the highest activation of transverse abdominis (P<0.05). The results showed significantly higher activation of transverse abdominis, measured by preferential activation ratio, in bridge position during abdominal bracing.
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Affiliation(s)
- Navid Moghadam
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Selk Ghaffari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Pardis Noormohammadpour
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Rostami
- Brain and Spinal Cord Injuries Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Zarei
- Department of Orthopedics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mersad Moosavi
- Department of Orthopedics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Kordi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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23
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Abuín-Porras V, de la Cueva-Reguera M, Benavides-Morales P, Ávila-Pérez R, de la Cruz-Torres B, Pareja-Galeano H, Blanco-Morales M, Romero-Morales C. Comparison of the Abdominal Wall Muscle Thickness in Female Rugby Players Versus Non-Athletic Women: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2019; 56:E8. [PMID: 31881780 PMCID: PMC7022579 DOI: 10.3390/medicina56010008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 12/18/2022]
Abstract
Background and Objectives: Rugby players engage in demanding, high loading muscular activity in the spine. Study of the abdominal wall architecture in female rugby athletes is relevant to the possible muscular asymmetry secondary to sport practice and the relationship between the abdominal wall and the pelvic floor muscles. Activation of the transversus abdominis (TrAb) generates an increase in the bladder neck muscle. Moreover, an increased interrecti distance (IRD) is related to urinary incontinence and has a higher prevalence in athletic women. The aim of the present study was to compare and quantify, with ultrasound imaging (USI), the thickness of the transversus abdominis (TrAb), external oblique (EO), internal oblique (IO), rectus abdominis (RA), and interrecti distance (IRD) in female rugby players versus non-athletic women in order to improve upon existing knowledge about abdominal wall configuration in female athletes. Materials and Methods: A sample of 32 women was recruited at the Universidad Europea Research Lab and divided in two groups: a rugby group (n = 16) and a non-athletic women group (n = 16). The thickness of the TrAb, EO, IO, RA, and IRD were assessed by USI in both groups. Results: There were statistically significant differences for the ultrasound evaluation thickness of the right TrAb (p = 0.011; d = 0.10), EO (p = 0.045; d = 0.74), IO (p = 0.003; d = 1.32), and RA (p = 0.001; d = 1.38) showing a thickness increase for the rugby group with respect to the control group. For the IRD thickness, there were no significant differences (p > 0.05) between groups. Conclusions: An increased TrAb, IO, EO, and RA thickness may be shown in female rugby players versus non-athletic women. Nevertheless, statistically relevant differences were not found for the IRD between both groups.
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Affiliation(s)
- Vanesa Abuín-Porras
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.d.l.C.-R.); (P.B.-M.); (R.Á.-P.); (H.P.-G.); (M.B.-M.); (C.R.-M.)
| | - Mónica de la Cueva-Reguera
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.d.l.C.-R.); (P.B.-M.); (R.Á.-P.); (H.P.-G.); (M.B.-M.); (C.R.-M.)
| | - Pedro Benavides-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.d.l.C.-R.); (P.B.-M.); (R.Á.-P.); (H.P.-G.); (M.B.-M.); (C.R.-M.)
| | - Rocío Ávila-Pérez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.d.l.C.-R.); (P.B.-M.); (R.Á.-P.); (H.P.-G.); (M.B.-M.); (C.R.-M.)
| | | | - Helios Pareja-Galeano
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.d.l.C.-R.); (P.B.-M.); (R.Á.-P.); (H.P.-G.); (M.B.-M.); (C.R.-M.)
| | - María Blanco-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.d.l.C.-R.); (P.B.-M.); (R.Á.-P.); (H.P.-G.); (M.B.-M.); (C.R.-M.)
| | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.d.l.C.-R.); (P.B.-M.); (R.Á.-P.); (H.P.-G.); (M.B.-M.); (C.R.-M.)
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24
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Mitchell UH, Johnson AW, Owen PJ, Rantalainen T, Belavy D. Transversus abdominis and multifidus asymmetry in runners measured by MRI: a cross-sectional study. BMJ Open Sport Exerc Med 2019; 5:e000556. [PMID: 31548902 PMCID: PMC6733389 DOI: 10.1136/bmjsem-2019-000556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 12/15/2022] Open
Abstract
Objective The transversus abdominis muscle (TrA) is active during running as a secondary respiratory muscle and acts, together with the multifidus, as trunk stabiliser. The purpose of this study was to determine size and symmetry of TrA and multifidus muscles at rest and with contraction in endurance runners without low back pain. Design Cross-sectional study. Setting A medical imaging centre in Melbourne, Australia. Participants Thirty middle-aged (43years±7) endurance-trained male (n=18) and female (n=12) runners without current or history of low back pain. Outcome measures MRI at rest and with the core engaged. The TrA and multifidus muscles were measured for thickness and length (TrA) and anteroposterior and mediolateral thickness (multifidus). Muscle activation was extrapolated from rest to contraction and compared with the same and contralateral side. Paired t-tests were performed to compare sides and contraction status. Results Left and right TrA and multifidus demonstrated similar parameters at rest (p>0.05). However, with contraction, the right TrA and multifidus (in mediolateral direction) were 9.2% (p=0.038) and 42% (p<0.001) thicker, respectively, than their counterparts on the left. There was no TrA thickness side difference with contraction in left-handed participants (p=0.985). When stratified by sex, the contracted TrA on the right side remained 8.4% thicker, but it was no longer statistically significant (p=0.134). The side difference with contraction of the TrA became less with increasing training age. Conclusions Right-handed long-term runners without low back pain exhibit a greater right side core muscle activation when performing an isometric contraction. This activation preference diminishes with increasing training age.
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Affiliation(s)
- Ulrike H Mitchell
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - A Wayne Johnson
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Patrick J Owen
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - Timo Rantalainen
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Daniel Belavy
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
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25
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Pirri C, Todros S, Fede C, Pianigiani S, Fan C, Foti C, Stecco C, Pavan P. Inter‐rater reliability and variability of ultrasound measurements of abdominal muscles and fasciae thickness. Clin Anat 2019; 32:948-960. [DOI: 10.1002/ca.23435] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/27/2019] [Accepted: 06/26/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Carmelo Pirri
- Physical and Rehabilitation Medicine, University of Rome “Tor Vergata” Rome Italy
| | - Silvia Todros
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials University of Padova Italy
| | - Caterina Fede
- Department of Neuroscience University of Padova Padova Italy
| | - Silvia Pianigiani
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials University of Padova Italy
| | - Chenglei Fan
- Department of Neuroscience University of Padova Padova Italy
| | - Calogero Foti
- Physical and Rehabilitation Medicine, University of Rome “Tor Vergata” Rome Italy
| | - Carla Stecco
- Department of Neuroscience University of Padova Padova Italy
| | - Piero Pavan
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials University of Padova Italy
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26
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Ultrasonographic assessment of patellar tendon thickness at 16 clinically relevant measurement sites - A study of intra- and interrater reliability. J Bodyw Mov Ther 2019; 23:344-351. [PMID: 31103118 DOI: 10.1016/j.jbmt.2019.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 02/02/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To determine intra- and interrater reliability of ultrasonographic imaging (USI) measurements of patellar tendon (PT) thickness using 16 measurement sites covering the entire tendon. DESIGN Reliability study. SETTING Physiotherapy outpatient clinic. PARTICIPANTS Twenty healthy and physically active volunteers (9 women). Mean age: 24 years (SD ± 2.73). Mean body mass: 75.8 kg (SD ± 11.8). MAIN OUTCOME MEASURES Intraclass correlation coefficient (ICC) and 95% limits of agreement (LOA) in cm and in percentage relative to the mean PT thickness. RESULTS Intrarater reliability ranged from 0.59 to 0.87 and 0.59 to 0.93 for examiners I and II, respectively. Interrater reliability ranged from 0.37 to 0.89. Measurement precision for examiner I ranged from 0.05 to 0.09 cm (17.5%-26.7%) while ranging from 0.04 to 0.13 cm (13.3%-38.7%) for examiner II. Interrater measurement precision ranged from 0.07 to 0.15 cm (19.1%-42.5%). CONCLUSION In an attempt to replicate daily clinical USI practice, this was the first study extensively assessing reliability throughout the full range of the patellar tendon - revealing a considerable variation in intra- and interrater reliability as well as measurement precision throughout the 16 individual PT sites. In a clinical context, the low interrater reliability and precision found at the proximal tendon insertion site may have implications for USI of the symptomatic PT, as this is the site mainly associated with underlying pathologic changes. Further reliability studies are needed to clarify the region-specific reliability of the full length PT.
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27
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Goubert D, Meeus M, Willems T, De Pauw R, Coppieters I, Crombez G, Danneels L. The association between back muscle characteristics and pressure pain sensitivity in low back pain patients. Scand J Pain 2019; 18:281-293. [PMID: 29794309 DOI: 10.1515/sjpain-2017-0142] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 02/24/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Some low back pain (LBP) patients recover after every pain episode whereas others develop chronicity. Research indicates that the amount of atrophy and fat infiltration differs between patients with LBP. Also enhanced pain sensitivity is present only in a subgroup of LBP patients. The relationship between pain sensitivity and muscular deformations in LBP, is however unexplored. This study examined the association between pressure pain sensitivity and the structural characteristics of the lumbar muscles in three different groups of non-specific LBP patients. METHODS This cross-sectional study examined the total cross-sectional area (CSA), fat CSA, muscle CSA and muscle fat index (MFI) of the lumbar multifidus (MF) and erector spinae (ES) at level L4 by magnetic resonance imaging in 54 patients with non-specific LBP (23 recurrent LBP, 15 non-continuous chronic LBP and 16 continuous chronic LBP). Pressure pain thresholds were measured at four locations (lower back, neck, hand and leg) by a manual pressure algometer and combined into one "pain sensitivity" variable. As a primary outcome measure, the association between pain sensitivity and muscle structure characteristics was investigated by multiple independent general linear regression models. Secondly, the influence of body mass index (BMI) and age on muscle characteristics was examined. RESULTS A positive association was found between pain sensitivity and the total CSA of the MF (p=0.006) and ES (p=0.001), and the muscle CSA of the MF (p=0.003) and ES (p=0.001), irrespective of the LBP group. No association was found between pain sensitivity and fat CSA or MFI (p>0.01). Furthermore, a positive association was found between BMI and the fat CSA of the MF (p=0.004) and ES (p=0.006), and the MFI of the MF (p<0.01) and ES (p=0.003). Finally, a positive association was found between age with the fat CSA of the MF (p=0.008) but not with the fat CSA of the ES (p>0.01), nor the MFI of the MF (p>0.01) and ES (p>0.01). CONCLUSIONS A higher pain sensitivity is associated with a smaller total and muscle CSA in the lumbar MF and ES, and vice versa, but results are independent from the LBP subgroup. On the other hand, the amount of fat infiltration in the lumbar muscles is not associated with pain sensitivity. Instead, a higher BMI is associated with more lumbar fat infiltration. Finally, older patients with LBP are associated with higher fat infiltration in the MF but not in the ES muscle. IMPLICATIONS These results imply that reconditioning muscular tissues might possibly decrease the pain sensitivity of LBP patients. Vice versa, therapy focusing on enhancement of pain sensitivity might also positively influence the CSA and that way contribute to the recovery of LBP. Furthermore, the amount of lumbar muscle fat seems not susceptible to pain sensitivity or vice versa, but instead a decrease in BMI might decrease the fat infiltration in the lumbar muscles and therefore improve the muscle structure quality in LBP. These hypothesis apply for all non-specific LBP patients, despite the type of LBP.
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Affiliation(s)
- Dorien Goubert
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent Campus Heymans (UZ) 3 B3, Corneel Heymanslaan 10, Ghent, Belgium, Phone: +3293325374, Fax: +32 9 332 38 11; andPain in Motion International Research Group
| | - Mira Meeus
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium;Pain in Motion International Research Group.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Tine Willems
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Robby De Pauw
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Iris Coppieters
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; andPain in Motion International Research Group
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Khosravi F, Peolsson A, Karimi N, Rahnama L. Scapular Upward Rotator Morphologic Characteristics in Individuals With and Without Forward Head Posture: A Case-Control Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:337-345. [PMID: 29761537 DOI: 10.1002/jum.14693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 04/14/2018] [Accepted: 04/18/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES There are several reports suggesting that forward head posture contributes to alterations in scapular kinematics and muscle activity, leading to the development of shoulder problems. Currently, it is unknown whether forward head posture alters the thickness of the scapular muscles. The aim of this study was to compare the thickness of the serratus anterior and upper and lower trapezius muscles at rest and during loaded isometric contractions in individuals with and without forward head posture. METHODS Twenty individuals with forward head posture and 20 individuals with normal head posture participated in this case-control study. Three separate ultrasound images of the serratus anterior and upper and lower trapezius muscles were captured under 2 randomized conditions: at rest and during a loaded isometric contraction. RESULTS The thickness of each muscle significantly increased from rest to the loaded isometric contraction (P < .001). The only difference between the groups was that the thickness of the serratus anterior muscle at rest in the normal-posture group was larger than that in the forward-posture group (P = .01). CONCLUSIONS Forward head posture appears to be related to atrophy of the serratus anterior muscle, which may contribute to the development of shoulder problems. Further research is required to identify more about the association of forward head posture with the imbalance of shoulder girdle muscles and the impact of head posture on upper quadrant pain.
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Affiliation(s)
- Fariba Khosravi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Anneli Peolsson
- Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden
| | - Noureddin Karimi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Leila Rahnama
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Morales CR, Sanz DR, Reguera MDLC, Martínez SF, González PT, Pascual BM. Proprioceptive Stabilizer™ training of the abdominal wall muscles in healthy subjects: a quasi-experimental study. Rev Assoc Med Bras (1992) 2018; 64:1134-1138. [DOI: 10.1590/1806-9282.64.12.1134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 04/22/2018] [Indexed: 05/30/2023] Open
Abstract
SUMMARY The present quasi-experimental study aimed to assess the transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) thickness in healthy subjects with the proprioceptive Stabilizer™ training in abdominal wall muscles. A sample of 41 healthy participants (age: 31.9 ± 4.5 y; height: 1.7 ± 0.1 m; weight: 68.3 ± 13.1 kg; body mass index, BMI: 22.9 ± 2.7 kg/m2) were recruited to participate in this study. Ultrasound images of the EO, IO, TrA, rectus anterior (RA) and interrecti distance (IRD) were measured and analyzed by the ImageJ software. Measurements were made at rest and during the abdominal drawing-maneuver (ADIM) developed by the patients with the Stabilizer™ located in the low back holding 40 mmHg for 10 seconds with a visual stimulus provided by a circular pressure marker. Ultrasound measurements for the abdominal wall muscles showed statistically significant differences (Π < .05) for a thickness decrease of the EO, IO and a thickness increase of TrA. A proprioceptive Stabilizer™ training produced a thickness increase in TrA muscle and a thickness decrease in EO and IO muscles in healthy subjects. These findings suggest that a proprioceptive Stabilizer™ training could be useful in individuals with low back pain and lumbopelvic pain.
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Abstract
BACKGROUND The purpose of the study was to investigate the plantar fascia and heel fat pad stiffness and thickness parameters in females and compare these values with those of males. METHODS This study was carried out in 60 healthy sedentary participants (30 female, 30 male) between the ages of 19 and 50 years. Shear wave velocity (SWV) and thickness of the plantar fascia and heel fat pad were measured with an ultrasonography device. RESULTS Males had a higher plantar fascia ( P = .037) and heel fat pad ( P = .001) thickness compared with females, but SWV of the plantar fascia ( P = .673), heel fat pad microchamber layer ( P = .240), and heel fat pad macrochamber layer ( P = .636) were similar in both groups. Body mass had a strong correlation with the plantar fascia ( r = 0.64, P < .001) and heel fat pad thickness ( r = 0.68, P < .001). Height had a moderate correlation with the plantar fascia ( r = 0.44, P < .001) and heel fat pad thickness ( r = 0.42, P = .001). CONCLUSION Plantar fascia and heel fat pad stiffness were similar in both genders; however, females had a lower plantar fascia and heel fat pad thickness compared with males. Correlation analysis results suggest that higher plantar fascia and heel fat pad thickness in males may be related to higher body mass and height. LEVELS OF EVIDENCE Level III: Retrospective comparative study.
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Affiliation(s)
- Serkan Taş
- Physiotherapy and Rehabilitation Department, Hacettepe University, Beytepe Hospital, Ankara, Turkey (ST)
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Emami F, Yoosefinejad AK, Razeghi M. Correlations between core muscle geometry, pain intensity, functional disability and postural balance in patients with nonspecific mechanical low back pain. Med Eng Phys 2018; 60:39-46. [PMID: 30077486 DOI: 10.1016/j.medengphy.2018.07.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 07/04/2018] [Accepted: 07/22/2018] [Indexed: 12/17/2022]
Abstract
Patients with low back pain (LBP) have reduced core muscle geometry and impaired postural balance. Impaired trunk control was shown to be associated with poor balance and limited functional mobility in these patients. However, the relationship between muscle geometry and postural balance is unclear. This study aimed to determine the correlation of core muscle geometry with pain intensity, functional disability and postural balance in patients with chronic nonspecific mechanical LBP. Thirty patients aged 20-50 years were enrolled. Ultrasound imaging was used to assess their muscle geometry. The participants completed a numerical rating scale (NRS) for pain severity, and the Persian version of the Roland-Morris Disability Questionnaire (PRMDQ). To estimate static balance, they were asked to perform the single leg stance test. Dynamic balance was assessed with the Y-balance test. Significant correlations were found between NRS scores and bilateral multifidus cross-sectional area during rest (r ≥ - 0.31, P ≤ 0.04) and contraction (r ≥ - 0.37, P ≤ 0.02). NRS scores correlated significantly with bilateral multifidus thickness during rest (r ≥ - 0.31, P ≤ 0.04) and contraction (r ≥ - 0.28, P ≤ 0.04). Significant correlations were also observed for PRMDQ scores with thickness (r ≥ - 0.35, P = 0.04) and cross-sectional area of the multifidus muscles (r ≥ - 0.33, P = 0.04) bilaterally during contraction. A significant correlation was found between Y-balance scores and right abdominal muscle thickness during rest and contraction (r ≥ 0.34, P ≤ 0.04). Core muscle geometry correlated with pain, functional disability indices and dynamic balance in these patients.
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Affiliation(s)
- Farahnaz Emami
- Department of Physiotherapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Chamran Blvd., Abivardi 1 Street, Shiraz, Iran; Rehabilitation Sciences of Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Amin Kordi Yoosefinejad
- Department of Physiotherapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Chamran Blvd., Abivardi 1 Street, Shiraz, Iran; Rehabilitation Sciences of Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohsen Razeghi
- Department of Physiotherapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Chamran Blvd., Abivardi 1 Street, Shiraz, Iran; Rehabilitation Sciences of Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Gogola A, Gnat R, Zaborowska M, Dziub D, Gwóźdź M. Asymmetry of activation of lateral abdominal muscles during the neurodevelopmental traction technique. J Bodyw Mov Ther 2018; 22:46-51. [PMID: 29332756 DOI: 10.1016/j.jbmt.2017.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 03/12/2017] [Accepted: 03/27/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the symmetry and pattern of activation of lateral abdominal muscles (LAM) in response to neurodevelopmental traction technique. DESIGN AND PARTICIPANTS Measurements of LAM thickness were performed in four experimental conditions: during traction with the force of 5% body weight (5% traction): 1) in neutral position, 2) in 20° posterior trunk inclination; during traction with the force of 15% body weight (15% traction): 3) in neutral position, 4) in 20° posterior trunk inclination. Thirty-seven healthy children participated in the study. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES To evaluate LAM activation level ultrasound technology was employed (two Mindray DP660 devices (Mindray, Shenzhen, China) with 75L38EA linear probes). An experiment with repeated measurements of the dependent variables was conducted. RESULTS Side-to-side LAM activation asymmetry showed relatively high magnitude, however, significant difference was found only in case of the obliquus externus (OE) during stronger traction (P < 0.05). The magnitude of LAM thickness change formed a gradient, with the most profound transversus abdominis (TrA) showing the smallest change, and the most superficial OE - the greatest. The inter-muscle differences were most pronounced between the OE and TrA (P < 0.001). CONCLUSIONS During the neurodevelopmental traction technique there is a difference in individual LAM activation level, with deeper muscles showing less intense activation. In statistical terms, the only signs of side-to-side asymmetry of LAM activation are visible in case of the OE, however, the magnitude of asymmetry is relatively high. The results allow to identify patterns of activation of LAM in children showing typical development that will serve as a reference in future studies in children with neurological disorder.
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Affiliation(s)
- Anna Gogola
- Department of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland.
| | - Rafał Gnat
- Department of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland; Motion Analysis Laboratory, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
| | - Małgorzata Zaborowska
- Faculty of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
| | - Dorota Dziub
- Faculty of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
| | - Michalina Gwóźdź
- Faculty of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
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Navarro Brazález B, Torres Lacomba M, Arranz Martín B, Sánchez Méndez O. Respuesta muscular durante un ejercicio hipopresivo tras tratamiento de fisioterapia pelviperineal: valoración con ecografía transabdominal. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.ft.2017.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Martin C, Olivier B, Benjamin N. Asymmetrical abdominal muscle morphometry is present in injury free adolescent cricket pace bowlers: A prospective observational study. Phys Ther Sport 2017; 28:34-42. [PMID: 28963917 DOI: 10.1016/j.ptsp.2017.08.078] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 08/10/2017] [Accepted: 08/21/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This study aimed to determine if abdominal muscle thickness, activation and symmetry are associated with prospective in-season injury among adolescent cricket pace bowlers. DESIGN A quantitative, prospective, observational study design was used. SETTING Data was collected at an indoor venue at a secondary school. PARTICIPANTS 28 injury-free, male, adolescent pace bowlers between the ages of 13 and 18 participated. MAIN OUTCOME MEASURES Muscle thickness of the transversus abdominis (TA), internal oblique (IO) and external oblique (EO) muscles were measured at rest and during an abdominal drawing-in maneuver (ADIM) i.e. activation, using ultrasound imaging. Incidence of injury was monitored monthly during the cricket season. RESULTS Thickness of the non-dominant IO at rest was greater than the dominant side for pace bowlers who remained injury free during the cricket season (p = 0.01, effect size (ES) = 0.65). This was, however not the case for bowlers who sustained injuries (p = 0.47; ES = 0.24). TA percentage change during ADIM (activation) on the dominant side was less in bowlers who sustained non-contact injuries compared to those who remained injury free (p = 0.03; ES = 1.17). CONCLUSIONS Asymmetry in IO thickness may play a protective role against injury, whilst poor TA activation on the dominant side may pose a risk to injury.
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Affiliation(s)
- Candice Martin
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
| | - Benita Olivier
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
| | - Natalie Benjamin
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
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Cho WS, Park CB, Lim JH. The Effect of Trunk Strengthening Exercise using Oscillation on Trunk Muscle Thickness and Balance. ACTA ACUST UNITED AC 2017. [DOI: 10.13066/kspm.2017.12.2.91] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Chi-Bok Park
- Dept. of Physical Therapy, Graduate School of Dongshin University
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Linek P, Saulicz E, Wolny T, Myśliwiec A. Body Mass Normalization for Ultrasound Measurements of Adolescent Lateral Abdominal Muscle Thickness. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:775-782. [PMID: 27943381 DOI: 10.7863/ultra.16.03086] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/23/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The purpose of this study was to determine the value of the allometric parameter for ultrasound measurements of the thickness of the oblique external (OE), internal (OI), and transversus abdominis (TrA) muscles in the adolescent population. The allometric parameter is the slope of the linear regression line between the log transformed body mass and log transformed muscle size measurement. METHODS The study included 321 adolescents between the ages of 10 and 17, consisting of 160 boys and 161 girls. The participants were recruited from local schools and attended regular school classes at normal grade levels. All individuals with no signs of scoliosis (screening with use of a scoliometer), and no surgical procedures performed on the trunk area were included. A real-time ultrasound B-scanner with a linear array transducer was used to obtain images of the lateral abdominal muscles from both sides of the body. RESULTS The correlation between body mass and the OE muscle was r = 0.69; the OI muscle r = 0.68; and the TrA muscle r = 0.53 (in all cases, P < .0001). The allometric parameter for the OE was 0.88296; the OI 0.718756; and the TrA 0.60986. Using these parameters, no significant correlations were found between body mass and the allometric-scaled thickness of the lateral abdominal muscles. CONCLUSIONS Significant positive correlations exist between body mass and lateral abdominal muscle thickness assessed by ultrasound imaging. Therefore, it is reasonable to advise that the values of the allometric parameters for OE, OI, and TrA obtained in this study should be used in other studies performed on adolescents.
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Affiliation(s)
- Pawel Linek
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Edward Saulicz
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Tomasz Wolny
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Andrzej Myśliwiec
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
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Linek P. The importance of body mass normalisation for ultrasound measurement of the transversus abdominis muscle: The effect of age, gender and sport practice. Musculoskelet Sci Pract 2017; 28:65-70. [PMID: 28189038 DOI: 10.1016/j.msksp.2017.01.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 01/17/2017] [Accepted: 01/30/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Some studies have not considered body mass as a confounder in TrA analysis, which may have led to improper interpretation of results. OBJECTIVES To assess the differences in the effect of age, gender and physical activity between normalised for body mass and actual values of the TrA as well as to establish the effect of age, gender and physical activity on normalised for body mass TrA thickness in adolescents. DESIGN The study was a cross-sectional study conducted at selected primary and secondary schools, and colleges in the Silesian region of Poland. METHOD A real-time ultrasound was used to obtain images of the TrA muscle. Body mass normalisation for TrA thickness was performed with allometric scaling and the following equation: Allometric-scaled TrA = TrA thickness/body mass0.61. RESULTS Analysis has shown that boys have significantly thicker muscle by 0.27 mm (95% CI 0.04-0.50) than girls, and those who practise sports have thicker muscle by 0.30 mm (95% CI 0.06-0.52) than non-active individuals. For allometric-scaled TrA, there were no significant effects (p > 0.50). There was a significant correlation between participants age and the actual value of the TrA (r = 0.42, p < 0.05). The correlation between age and allometric-scaled TrA was insignificant and close to zero (r = -0.006, p = 0.93). CONCLUSIONS An analysis of TrA thickness without body mass normalisation can deliver improper interpretation of study results. Thus, it is recommended in future researches to analyse TrA thickness measurement after normalisation rather than actual values. In the adolescent population, there is no effect of gender, age and physical activity on allometric-scaled TrA thickness.
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Affiliation(s)
- Pawel Linek
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
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Whittle CJ, Flavell CA, Gordon SJ. Methodological consistency and measurement reliability of transversus abdominis real time ultrasound imaging in chronic low back pain populations: a systematic review. PHYSICAL THERAPY REVIEWS 2017. [DOI: 10.1080/10833196.2017.1287151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Connie Jean Whittle
- College of Healthcare Sciences, James Cook University, Douglas Campus , Townsville, Australia
| | - Carol Ann Flavell
- College of Healthcare Sciences, James Cook University, Douglas Campus , Townsville, Australia
| | - Susan Jayne Gordon
- College of Healthcare Sciences, James Cook University, Douglas Campus , Townsville, Australia
- School of Health Sciences, Flinders University , Bedford Park, Australia
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Linek P, Saulicz E, Wolny T, Myśliwiec A. Assessment of the abdominal muscles at rest and during abdominal drawing-in manoeuvre in adolescent physically active girls: A case-control study. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:118-124. [PMID: 30356579 PMCID: PMC6188935 DOI: 10.1016/j.jshs.2015.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 05/30/2015] [Accepted: 07/05/2015] [Indexed: 06/06/2023]
Abstract
BACKGROUND An impact of regular physical activity (RPA) on the abdominal muscles may be significant when comparing various symptomatic groups. However, there is lack comprehensive information in this field. The objective of this study was to assess the lateral abdominal wall at rest and during abdominal drawing-in manoeuvre in adolescent physically active girls in different body positions. METHODS One hundred and forty-four female students, 13-17 years of age, participated in the study. Participants were divided into 2 groups based on a physical activity (PA) statement. Measurements of the thickness of the abdominal muscles at rest and during abdominal drawing-in manoeuvre were made in the supine and standing positions by ultrasound imaging. RESULTS Compared to the control group, activities of the obliquus internus and transversus abdominis muscles were higher in the regular PA group by 8.9% (95%CI: 3.1-14.7) and 36% (95%CI: 19.1-47.5), respectively. In the RPA group, the transversus abdominis preferential activation ratio was greater by 0.03 (95%CI: 0.01-0.04), and the contraction ratio was greater by a mean value of 0.35 (95%CI: 0.18-0.46). CONCLUSION RPA does not have any effect on the resting thickness of the abdominal muscles in the supine and standing positions. Girls performing RPA have a greater ability to perform an independent activation and greater contractions of the transversus abdominis.
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Jung JH, Lee SY. The effect of resistance exercise direction for hip joint stabilization on lateral abdominal muscle thickness. J Exerc Rehabil 2016; 12:424-428. [PMID: 27807520 PMCID: PMC5091057 DOI: 10.12965/jer.1632652.326] [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: 06/08/2016] [Accepted: 09/27/2016] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine the effects of resistance direction in hip joint stabilization exercise on change in lateral abdominal muscle thickness in healthy adults. Twenty-six healthy adults were randomly allocated to either a hip stabilization exercise by hip straight resistance group (n=12) or a hip diagonal resistance group (n=14). The outcome measures included contraction thickness ratio in transversus abdominis (TrA), internal oblique (IO) and external oblique, and TrA lateral slide were assessed during the abdominal drawing-in maneuver by b-mode ultrasound. The researcher measured the abdominal muscle thickness of each participant before the therapist began the intervention and at the moment intervention was applied. There was a significant difference in lateral abdominal muscle thickness between the straight resistance exercise of hip joint group and the diagonal resistance exercise of hip joint group. Significant differences were found between the two groups in the percentage of change of muscle thickness of the TrA (P=0.018) and in the thickness ratio of the TrA (P=0.018). Stability exercise accompanied by diagonal resistance on the hip joint that was applied in this study can induce automatic contraction of the IO and TrA, which provides stability to the lumbar spine.
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Affiliation(s)
- Ju-Hyeon Jung
- Department of Physical Therapy, Gimhae College, Gimhae, Korea
| | - Sang-Yeol Lee
- Department of Physical Therapy, College of Science, Kyungsung University, Busan, Korea
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The Effect of Distractive Function on Volitional Preemptive Abdominal Contraction During a Loaded Forward Reach in Normal Subjects. PM R 2016; 8:944-952. [PMID: 27060647 DOI: 10.1016/j.pmrj.2016.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 03/23/2016] [Accepted: 03/30/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Volitional preemptive abdominal contraction (VPAC) is used to protect the spine and prevent injury. No published studies to data have examined the effect of distraction on VPAC use during function. OBJECTIVE To examine the effect of an auditory distraction ("Stroop task") on healthy subjects' ability to sustain VPAC by use of the abdominal drawing-in maneuver during loaded forward reach. DESIGN Within-subjects, repeated-measure cohort design. SETTING Clinical laboratory setting. PARTICIPANTS Convenience sample of 42 healthy individuals (ages 20-57 years). METHODS Transversus abdominis (TrA) thickness was measured with M-mode ultrasound imaging. Each subject performed Stroop versus no Stroop during 4 conditions: (1) without VPAC, quiet standing; (2) with VPAC, quiet standing; (3) without VPAC, forward reach; and (4) with VPAC, forward reach. An investigator blinded to the conditions measured the first 10 subjects to establish intratester reliability of probe/transducer placement and TrA measurement. DATA REDUCTION TrA thickness (mm) change represented VPAC performance. A single investigator measured onscreen TrA thickness twice at each second from second-6 through -10 on a recorded ultrasound imaging sequence. RESULTS A 2 (Stroop) × 4 (Activity) repeated-measures analysis of variance found no significant Stroop × Activity interaction [F(3, 93) = 0.345, P = .793] and no main effect for Stroop [F (1,31) = 1.324, P = .259] but found a significant main effect for activity [F (3,93) = 17.729, P < .001]. Tukey post-hoc pairwise comparisons demonstrated significant differences between VPAC versus no-VPAC conditions, except between quiet standing/yes-VPAC and loaded forward reach/no-VPAC conditions (P = .051). The interclass correlation coefficient (3,2) for probe/transducer placement reliability was 0.87, 0.91, 0.92, and 0.93 for conditions 1-4, respectively. The interclass correlation coefficient (3,2) for TrA measurement reliability was 0.96, 0.99, 0.99, and 0.99 for conditions 1-4, respectively. CONCLUSION A distracting executive function (Stroop task) did not produce a significant negative impact on normal individuals' ability to sustain a VPAC during quiet standing or loaded forward reach activities. LEVEL OF EVIDENCE II.
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Tahan N, Khademi-Kalantari K, Mohseni-Bandpei MA, Mikaili S, Baghban AA, Jaberzadeh S. Measurement of superficial and deep abdominal muscle thickness: an ultrasonography study. J Physiol Anthropol 2016; 35:17. [PMID: 27553830 PMCID: PMC4995748 DOI: 10.1186/s40101-016-0106-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/25/2016] [Indexed: 11/20/2022] Open
Abstract
Background Real-time ultrasound imaging is a valid method in the field of rehabilitation. The ultrasound imaging allows direct visualization for real-time study of the muscles as they contract over the time. Measuring of the size of each abdominal muscle in relation to the others provides useful information about the differences in structure, as well as data on trunk muscle activation patterns. The purpose of this study was to assess the size and symmetry of the abdominal muscles at rest in healthy adults and to provide a reference range of absolute abdominal muscle size in a relatively large population. Method A total 156 healthy subjects with the age range of 18–44 years were randomly recruited. The thickness of internal oblique, external oblique, transverse abdominis, and rectus abdominis muscles was measured at rest on both right and left sides using ultrasound. Independent t test was used to compare the mean thickness of each abdominal muscle between males and females. Differences on side-to-side thicknesses were assessed using paired t test. The association between abdominal muscle thicknesses with gender and anthropometric variables was examined using the Pearson correlation coefficient. Results A normal pattern of increasing order of mean abdominal muscle thickness was found in both genders at both right and left sides: transverse abdominis < external oblique < internal oblique < rectus abdominis. There was a significant difference on the size of transverse abdominis, internal oblique, and external oblique muscles between right and left sides in both genders. Males had significantly thicker abdominal muscles than females. Age was significantly correlated with the thickness of internal oblique, external oblique, and rectus abdominis muscles. Body mass index was also positively correlated with muscle thickness of rectus abdominis and external oblique. Conclusions The results provide a normal reference range for the abdominal muscles in healthy subjects and may be used as an index to find out abnormalities and also to evaluate the effectiveness of different interventions.
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Affiliation(s)
- Nahid Tahan
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Khosro Khademi-Kalantari
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mohseni-Bandpei
- Iranian Research Centre on Aging, Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Evin, Tehran, Iran
| | - Saeed Mikaili
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shapour Jaberzadeh
- Faculty of Medicine, Nursing and Health Sciences, School of Primary Health Care, Monash University, Melbourne, Australia
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Nagar VR, Hooper TL, Dedrick GS, Brismée JM, McGalliard MK, Sizer PS. The Effect of Current Low Back Pain on Volitional Preemptive Abdominal Activation During a Loaded Forward Reach Activity. PM R 2016; 9:127-135. [PMID: 27390055 DOI: 10.1016/j.pmrj.2016.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 05/17/2016] [Accepted: 05/19/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND A volitional preemptive abdominal contraction (VPAC) supports trunk stability during functional activity. Pain-free individuals can sustain VPAC during function, but such has not been reported for individuals with current low back pain (cLBP). OBJECTIVE To examine whether cLBP affects VPAC performance during a loaded forward reach (LFR) task. DESIGN Observational crossover study. SETTING Laboratory. PARTICIPANTS A total of 18 controls and 17 subjects with cLBP with pain ratings of 1/10 to 4/10 on a visual analog scale. INTERVENTIONS Transverse abdominis (TrA) thickness measurements were recorded by blinded researchers from M-mode ultrasound imaging during 4 conditions: (1) quiet standing without abdominal drawing-in maneuver (ADIM); (2) quiet standing with ADIM; (3) LFR without ADIM; and (4) LFR with ADIM. A physical therapist with 29 years of experience collected historical and examination data. MAIN OUTCOME MEASURES TrA muscle thickness (mm). RESULTS A 2 (group) × 2 (contraction) × 2 (reach) analysis of variance demonstrated a significant group × contraction interaction (F [1, 31] = 4.499, P = .04) where ADIM produced greater TrA thickness increases in PLBP subjects (2.18 mm) versus controls (1.36 mm). We observed a significant main effect for reach (F [1, 31] = 14.989, P < .001), where LFR activity produced a greater TrA thickness (6.15 ± 2.48 mm) versus quiet standing (5.30 ± 2.12 mm). CONCLUSIONS Subjects with cLBP demonstrated a greater increase in TrA activation during ADIM versus controls.
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Affiliation(s)
- Vittal R Nagar
- Center for Rehabilitation Research, SAHS, Texas Tech University Health Sciences Center, Lubbock, TX; Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, KY(∗)
| | - Troy L Hooper
- Center for Rehabilitation Research, SAHS, Texas Tech University Health Sciences Center, Lubbock, TX(†)
| | - Gregory S Dedrick
- Doctor of Physical Therapy Program, Campbell University, Buies Creek, NC(‡)
| | - Jean-Michel Brismée
- Center for Rehabilitation Research, SAHS, Texas Tech University Health Sciences Center, Lubbock, TX(§)
| | - Michael K McGalliard
- Center for Rehabilitation Research, SAHS, Texas Tech University Health Sciences Center, Lubbock, TX; Doctor of Physical Therapy Program, Harding University, Searcy, AR(¶)
| | - Phillip S Sizer
- Center for Rehabilitation Research, SAHS, Texas Tech University Health Sciences Center, 3601 4th St., Stop 6280, Lubbock, TX 79430-6280(#).
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Suárez-Gómez A, Sánchez-Vega J, Suárez-González F, Peral-Pacheco D, Dorado-Martin JJ, Suárez-Gómez M. [Nutritional status of the population over 65 years of age in the city of Badajoz]. Semergen 2016; 43:80-84. [PMID: 27156230 DOI: 10.1016/j.semerg.2016.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 01/27/2016] [Accepted: 03/06/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Nutritional status is strongly associated with the level of health and quality of life of the population, and is especially relevant in the case of the elderly. OBJECTIVE The aim was to study the nutritional status in a population of non-institutionalised over 65 year-olds in the city of Badajoz, describing the sociodemographic variables, biochemical parameters, and functional assessment. MATERIAL AND METHODS A descriptive study was performed using a design population, which was randomised and stratified in health centres of the city, with a sample size of 298 patients being obtained. The sociodemographic variables included gender, age, educational level, anthropometric analysis with estimated body mass index, and percentage fat weight. Statistical tests were performed using SPSS v.15 statistical package. RESULTS The prevalence of overweight and obesity as measured by fat weight was 61.9% (56.1-67.8), with a body mass index of 65.8% (60.2-71.4). It was higher in women, with a fat weight of 67.3% (2.56 to 2.73) and a body mass index of 71.8% (2.64 to 2.78). The nutritional status of the population according to the questionnaire "Know your nutritional health" was rated "good". CONCLUSION The most common nutritional problem in the non-institutionalised population over 65 years in the city of Badajoz is obesity, especially in women, and in people with low educational level. This high prevalence suggests that health education on a better lifestyle in this population should be a priority.
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Affiliation(s)
- A Suárez-Gómez
- Departamento de Ciencias Biomédicas, Facultad de Medicina de Badajoz, Badajoz, España.
| | | | - F Suárez-González
- Centro de Salud San Roque, Badajoz, España; Cátedra de Medicina de Familia SEMERGEN-Universidad de Extremadura, Badajoz, España
| | - D Peral-Pacheco
- Departamento de Terapéutica Médico Quirúrgica, Facultad de Medicina, Badajoz, España
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Gondhalekar GA, Kumar SP, Eapen C, Mahale A. Reliability and Validity of Standing Back Extension Test for Detecting Motor Control Impairment in Subjects with Low Back Pain. J Clin Diagn Res 2016; 10:KC07-11. [PMID: 26894091 PMCID: PMC4740619 DOI: 10.7860/jcdr/2016/14987.7142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 11/24/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Low back pain is a chronic health problem with high socioeconomic impact. Specific diagnosis or treatment approach has not yet effectively established to treat chronic low back pain. Standing Back Extension Test is one of the clinical measures to detect the passive extension subgroup of Motor Control Impairment (MCI); which could have an impact on spinal stability leading to recurrent chronic low back pain. Reliability and validity of this test is not fully established. AIM To determine the intra-rater and inter-rater reliability and concurrent validity of the Standing Back Extension Test for detecting MCI of the lumbar spine. MATERIALS AND METHODS A total of 50 subjects were included in the study, 25 patients with Non Specific Low Back Pain (NSLBP) (12 men, 13 women) and 25 healthy controls (12 men, 13 women) were recruited into the study. All subjects performed the test movement. Two raters blinded to the subjects rated the test performance as either 'Positive' or 'Negative' based on the predetermined rating protocol. The thickness of Transverse Abdominis (TrA) muscle was assessed using Rehabilitative Ultrasound Imaging (RUSI). STATISTICAL TEST USED For reliability, the kappa coefficient with percent agreement was calculated and for assessing the validity Receiver Operator Characteristic (ROC) curves and Area under the Curve (AUC) were constructed. RESULTS The standing back extension test showed very good intra-rater (k=0.87 with an agreement of 96%) and good inter-rater (k=0.78 with an agreement of 94%) reliability and high AUC for TrA muscle. CONCLUSION The standing back extension test was found to be a reliable and a valid measure to detect passive extension subgroup for MCI in subjects with low back pain.
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Affiliation(s)
- Gauri A Gondhalekar
- Junior Executive, Department of Physiotherapy, Breach Candy Hospital Trust, Mumbai, India
| | - Senthil P Kumar
- Professor, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation (MMIPR), Maharishi Markandeshwar University (MMU), Mullana-Ambala, Haryana, India
| | - Charu Eapen
- Associate Professor Department of Physiotherapy, Kasturba Medical College, Manipal University, KMC Hospital, Attavara, Mangalore, Karnataka, India
| | - Ajit Mahale
- Professor and Head, Department of Radio-diagnosis and Imaging, Kasturba Medical College, Mangalore and KMC Hospitals, Mangalore, Karnataka, India
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Davies P, Grace FM, Lewis MP, Sculthorpe N. Observation of Age-Related Decline in the Performance of the Transverse Abdominis Muscle. PM R 2015; 8:45-50. [PMID: 26070806 DOI: 10.1016/j.pmrj.2015.05.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 05/20/2015] [Accepted: 05/29/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Previous research has shown that the performance of skeletal muscle declines with advancing age. Coordination of the transverse abdominis (TrA), a deep postural muscle, has been shown to be reduced in persons with low back pain. No previous research has studied the effect of age on the activation on this muscle. OBJECTIVE To assess the effect of age on TrA activation in response to rapid arm abduction. DESIGN Cross-sectional cohort study. SETTING University exercise physiology laboratory. PARTICIPANTS A total of 18 adult men (aged 27 ± 7.0 years) for the younger group and 11 older adults (5 men and 6 women, aged 59.6 ± 4.0 years) were recruited for this study. METHOD Participants were positioned on a treatment table and performed a series of rapid arm abduction movements with their right arm while the activation of the TrA muscle was recorded using ultrasound imaging. Onset of arm abduction was measured using surface electromyography and synchronized with the ultrasound through the ultrasound unit's electrocardiogram channel. The mean time difference between the 2 events was calculated during post-hoc analysis. MAIN OUTCOME MEASUREMENTS A Mann-Whitney test was performed to test for differences in the onset performance of the TrA muscle between the 2 groups. RESULTS Results showed that the older group was significantly slower than the younger group in engaging their TrA in response to the rapid arm abduction (P = .036). A separate analysis of the older group data showed that no significant differences existed between the male and female participants that could potentially have acted as a confounding factor for the main finding (P = .126). CONCLUSIONS This study shows that older adults were slower than younger adults in activating their TrA muscle in response to rapid arm abduction. This delay has the potential to lead to increased occasions when the low back is unprotected, increasing the likelihood of injury or low back pain.
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Affiliation(s)
- Paul Davies
- University of Wolverhampton, Institute of Sport, Gorway Road, Walsall, West Midlands WS1 3BD, United Kingdom(∗).
| | - Fergal M Grace
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, Scotland(†)
| | - Mark P Lewis
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Science, Loughborough University, Loughborough, UK(‡)
| | - Nicholas Sculthorpe
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, Scotland(¶)
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Uthaikhup S, Wannaprom N, Kummaung P. Effects of gender and hand dominance on size of the lower trapezius muscle. Muscle Nerve 2015; 52:576-9. [DOI: 10.1002/mus.24570] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 01/02/2015] [Accepted: 01/07/2015] [Indexed: 01/21/2023]
Affiliation(s)
- Sureeporn Uthaikhup
- Department of Physical Therapy; Faculty of Associated Medical Sciences, Chiang Mai University; Chiang Mai 50200 Thailand
- Back, Neck and Other Joint Pain Research Group, Khon Kaen University; Khon Kaen Thailand
| | - Nipaporn Wannaprom
- Department of Physical Therapy; Faculty of Associated Medical Sciences, Chiang Mai University; Chiang Mai 50200 Thailand
| | - Panuwat Kummaung
- Department of Physical Therapy; Faculty of Associated Medical Sciences, Chiang Mai University; Chiang Mai 50200 Thailand
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Heidari P, Farahbakhsh F, Rostami M, Noormohammadpour P, Kordi R. The role of ultrasound in diagnosis of the causes of low back pain: a review of the literature. Asian J Sports Med 2015; 6:e23803. [PMID: 25883773 PMCID: PMC4393543 DOI: 10.5812/asjsm.23803] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 08/01/2014] [Indexed: 11/16/2022] Open
Abstract
Context: Low back pain (LBP) is among the most prevalent musculoskeletal conditions in the developed countries. It is a common problem causing disability and imposing a huge economic burden to individuals and state organizations. Imaging plays an important role in diagnosis of the etiology of LBP. Evidence Acquisition: The electronic databases included: PubMed (1950 to present), Ovid SP Medline (1950 to present) and ISI (1982 to present) and Google Scholar. In every search engine another search was performed using various permutations of the following keywords: ultrasonography, ultrasound imaging, low back pain, back muscles, paraspinal muscles, multifidus, transverse abdominis, muscle size, spinal canal, sacroiliac joint and spondylolisthesis. Results: Magnetic resonance imaging (MRI) is widely used in evaluation of patients with LBP; however, high costs, limited availability and contraindications for its use have restricted MRI utilization. In a quest for a less expensive and readily available tool to investigate LBP, clinicians and researchers found ultrasonography (US) as an alternative. In this review we discuss the US application in diagnosis of some common causes of non-specific chronic LBP. Discussed topics include evaluation of spinal canal diameter, paraspinal and transabdominal muscles, sacroiliac joint laxity, pregnancy related LBP, sacroiliitis, and spondylolisthesis using US in patients with LBP. Conclusions: While the first researches on employing ultrasound in diagnosis of patients with LBP had been focused on spinal canal diameter, recent studies have been mostly performed to evaluate the role of transabdominal and paraspinal muscles on core stability and thereby LBP occurrence. On the other side, Doppler ultrasonography has recently played an important role in objective measurement of joint laxity as a common etiology for LBP. Doppler imaging also in pregnant patients with LBP has been recommended as a safe and sensitive method. As conclusion, according to recent and most prestigious studies, focusing more on transabdominal muscle thickness can be considered as future approach in investigations.
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Affiliation(s)
- Pedram Heidari
- Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Farzin Farahbakhsh
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
- Departement of Spine, Noorafshar Rehabilitation and Sports Medicine Hospital, Tehran, IR Iran
| | - Mohsen Rostami
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | | | - Ramin Kordi
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Ramin Kordi, Sports Medicine Research Center, Tehran University of Medical Sciences, P.O.Box: 14395-578, Tehran, IR Iran. Tel: +98-2188630227-8, E-mail:
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Gungor HR, Agladioglu K. Clarification of terminology: sonographic appearance of the pronator quadratus muscle in healthy volunteers. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:174. [PMID: 25542957 DOI: 10.7863/ultra.34.1.174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Harun R Gungor
- Department of Orthopedics and Traumatology (H.R.G.), Department of Radiology (K.A.), Pamukkale University, Denizli, Turkey
| | - Kadir Agladioglu
- Department of Orthopedics and Traumatology (H.R.G.), Department of Radiology (K.A.), Pamukkale University, Denizli, Turkey
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Interrater and intrarater reliability of transverse abdominal and lumbar multifidus muscle thickness in subjects with and without low back pain. J Orthop Sports Phys Ther 2014; 44:979-88. [PMID: 25366083 DOI: 10.2519/jospt.2014.5141] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Two-group, repeated-measures reliability study. OBJECTIVES To determine interrater and intrarater reliability of ultrasound measurements of transverse abdominal (TrA) and lumbar multifidus (LM) muscle thickness, during rest and contraction, in subjects with low back pain (LBP) and healthy subjects over 3 consecutive days, performed by an experienced and a novice rater. BACKGROUND Previous reliability studies of TrA or LM thickness did not simultaneously account for muscle state, rater experience, and multiday assessment in large subject samples. METHODS The 2 raters measured TrA and LM thickness on 3 consecutive days in 42 healthy subjects and 56 subjects with LBP, during rest and contraction, and calculated the percent thickness change from rest to contraction. Intraclass correlation coefficients (ICC(2,k)) and 95% minimal detectable change in thickness were derived for a single measure (day 1) and an average measure (days 1-3). RESULTS The interrater ICC(2,1) values for single-measure thickness (LBP group, 0.71-0.87; healthy group, 0.94-1.00) were similar to those for average-measure thickness (LBP group, 0.73-0.84; healthy group, 0.93-1.00). Both interrater ICC(2,1) and ICC(2,3) were lower for the relative thickness change (0.61-0.96). Intrarater ICC(2,1) values across 3 consecutive days were high for both raters across the 2 groups (LBP group, 0.95-1.00; healthy group, 0.93-1.00), albeit lower for the relative thickness change (0.79-0.99). The 95% minimal detectable changes were < 0.3 mm for the TrA and < 2 mm for the LM (but, in most cases, less than 10% of average thickness). CONCLUSION Both experienced and trained novice raters provided reliable measurements of TrA and LM thickness in participants with LBP and healthy participants, during rest and contraction. One-time measurements were similar to averaged measurements. Small absolute errors were observed. Public trial registry: Australian New Zealand Clinical Trials Registry ACTRN12613001077752.
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