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Curso ecografía musculoesquelética Técnica RUSI “Región lumbopélvica”

RUSI: Rehabilitative Ultrasound Imaging 

RUSI 1
Estudio de la pared abdominal con test funcionales.

La formación en la técnica ecográfica RUSI en la región lumbopélvica nos ofrece un abanico de posibilidades a nivel clínico e investigador. A nivel clínico nos dará las herramientas necesarias para poder discriminar trastornos de activación en la musculatura lumbopélvica ofreciendo al Fisioterapeuta la posibilidad de reeducar de manera específica la musculatura en disfunción.

Esta herramienta facilita que podamos involucrar al paciente puesto que el ecógrafo se convierte en un Biofeedback y aminora el tiempo de curación consiguiendo mejor adherencia al tratamiento.

De este modo podemos darles a nuestros pacientes un nuevo servicio que lleva a reeducar su región lumbopélvica facilitando mejor calidad de vida y aminorando su necesidad de servicio de fisioterapia.

A nivel investigador ha demostrado ser una herramienta de alta validez y confianza en las comparaciones con “gold standard”, tanto con resonancia magnética como con electromiografía, por lo que puede ser introducida en estudios de investigación con alto nivel de seguridad.

Esta formación precisa de conocimiento previo en el uso del ecógrafo pues no se formará en conceptos básicos sobre el manejo de ecografía y se requerirá al asistente acredite esta condición.

Para poder realizar este curso se precisa tener el nivel básico.

RUSI 2

Exploración de la pared lumbar y determinación de la activación

RUSI 3
Abordaje del suelo pélvico con vías transabdominal y
transperineal con test funcionales.
RUSI 4

Uso del modo-M para medición de activaciones y biofeedback.

RUSI 5

Ejemplifiaciones de la normalidad

Datos del curso
  • DURACIÓN: 15 horas
  • DIRIGIDO A: Fisioterapeutas y estudiantes de 4rto
  • LUGAR Centre Univers: Calle Comte de Salvatierra, 5-15 – 08006 Barcelona

FECHAS DEL CURSO

  • RUSI BARCELONA: 29 – 30 Enero 2022

HORARIO:

  • Sábados: 9:00 a 14:00 y de 15:00 a 20:30h
  • Domingos: 9:00 a 14:00h
Formación continuada

Siempre nos hemos preocupado que el fisioterapeuta que viene a formarse al curso de ecografía musculoesquelética aprenda, asimile y ponga en práctica esta herramienta de diagnóstico y de uso en la fisioterapia invasiva, para que les saques el máximo partido.

Por ello hemos añadido estas ventajas, desde www.conceptoecografico.com que te ayudarán a consolidar y perfeccionar tu aplicación en la ecografía musculoesquéletica en fisioterapia siempre que lo necesites:

✅ Asesoramiento en la elección, amortización y rentabilización del ecógrafo.
✅ Acceso a los estudios científicos más recientes en ecografía.
✅ Actualización de documentos formativos
✅ Vídeos recordatorios descriptivos con las diferentes exploraciones.
✅ Autotest, para evaluarte siempre que quieras.
✅ Resolución de dudas en webinars periódicos.

Bibliografia de interés

TY – JOUR
T1 – Abdominal muscle function in chronic low back pain patients: Measurement with real-time ultrasound scanning
A1 – Critchley D.J.
A1 – Coutts F.J.
Y1 – 2002///
PD –
AB – Purpose. It has been suggested that transversus abdominis acts as an active stabiliser of the lumbar spine and may be dysfunctional in chronic low back pain patients. Low abdominal hollowing in four-point kneeling is a standard clinical test for transversus abdominis, but is difficult to quantify. Change of muscle thickness may be an indication of transversus abdominis muscle contraction and is measurable with ultrasound scanning. The purpose of this study was to investigate whether there were differences between chronic low back pain and healthy subjects in abdominal muscles’ change of thickness during low abdominal hollowing using ultrasound scanning. Methods. A pilot study established muscle thickness measurements via scanning as having acceptable short-term repeatability. Twenty chronic low back pain patients and 24 controls were scanned at rest and during low abdominal hollowing in four-point kneeling. The thickness and thickness change of obliquus externus, obliquus internus and transversus abdominis were measured via a standardised procedure. Differences between groups were examined using ANOVA. Results. There was a smaller increase in thickness (mean ± SD) of transversus abdominis in the patients (19.15 ± 24.07%) than controls (49.71 ± 26.76%) (p < 0.001). Resting transversus abdominis thickness was not significantly different. There were no significant differences between groups for the other two muscles in thickness change or in resting thickness, or for age, sex, height, weight, exercise level, abdominal surgery or parity. Conclusion. Real-time ultrasound scanning is potentially a practical means of quantifying transversus abdominis performance. A transversus abdominis dysfunction may occur in many chronic low back pain patients and its assessment and rehabilitation should be considered in these people. The validity of using thickness change as a measure of muscle function, the correlation of transversus abdominis dysfunction with other clinical features and the effect of specific retraining all require further investigation.
JO – Physiotherapy
PB –
CY –
VL – 88
IS – 6
PG – 322-332
SP – 322
EP – 332
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L34693073
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Instructing pelvic floor contraction facilitates transversus abdominis thickness increase during low-abdominal hollowing.
A1 – Critchley D.
Y1 – 2002///
PD –
AB – BACKGROUND AND PURPOSE: Low abdominal hollowing in four-point kneeling is used clinically to test and rehabilitate transversus abdominis (TrA) but many people find this exercise difficult to perform. Contracting pelvic floor muscles (PF) during low abdominal hollowing may facilitate contraction of TrA. Thickness increase in the abdominal muscles during low abdominal hollowing has been measured with real-time ultrasound scanning and may indicate muscle contraction. The present study investigated the effect of instructing PF contraction on TrA thickness increase during low abdominal hollowing. METHOD: Twelve females and eight males with no reported pelvic floor dysfunction or low back pain in the last two years were taught low abdominal hollowing in four-point kneeling. Subjects performed low abdominal hollowing with and without instruction to contract PF in random order. Transversus abdominis, obliquus internus (OI) and obliquus externus (OE) thickness were measured with ultrasound scanning at rest and during both tests. RESULTS: Mean increase in TrA thickness during low abdominal hollowing was 49.71% (SD 26.76%), during low abdominal hollowing with PF it was 65.81% (SD 23.53%). Paired Student’s t-tests indicated a significant difference between tests (p = 0.015). There were no significant differences between tests for OE or OI thickness increase. CONCLUSIONS: Instructing healthy subjects to co-contract PF results in greater increase in TrA thickness during low abdominal hollowing in four-point kneeling. This may indicate greater contraction of TrA and thus be useful for clinicians training TrA. Further research could investigate the validity of change of thickness as a measure of abdominal muscle contraction, investigate the effect of instructing PF co-contraction on TrA in patients with low back pain and measure PF and TrA activity simultaneously.
JO – Physiotherapy research international : the journal for researchers and clinicians in physical therapy
PB –
CY –
VL – 7
IS – 2
PG – 65-75
SP – 65
EP – 75
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L35513002
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Transabdominal ultrasound measurement of pelvic floor muscle activity when activated directly or via a transversus abdominis muscle contraction
A1 – Bø K.
A1 – Sherburn M.
A1 – Allen T.
Y1 – 2003///
PD –
AB – Aims: The purpose of the present study was to compare the effectiveness of instruction to contract the pelvic floor muscles (PFM), the transversus abdominis (TrA), and the TrA + PFM visualized as displacement of the pelvic floor by ultrasound. Materials and Methods: Twenty female physical therapists, mean age 41.1 years (range 26-56) participated in the study. A 3.5 MHz 35 mm curved linear array ultrasound transducer (Dornier Medtech) was placed in the mid-sagittal plane immediately suprapubically, angled at 15-30 degrees from the vertical depending on subcutaneous fat and anatomical variations, to image the pelvic floor. Six trials of three maneuvers in random order were performed: contraction of PFM, TrA, and TrA + PFM. Results: In spite of correct contractions assessed by palpation and clinical observation, one subject demonstrated a downward movement of the pelvic floor during PFM contraction on ultrasound. Six subjects (30%) showed a downward movement during a TrA- contraction, and two during the combined TrA + PFM contraction. Instruction to contract PFM produced significantly greater mean displacement: 11.2 mm (95% CI 7.2-15.3) than TrA 4.3 mm (95% CI -0.2-8.8), P < 0.01, and combination: 8.5 mm (95% CI 5.2-12), P = 0.04. Hence, instruction of PFM contraction produced a 61.6% greater displacement of the pelvic floor in the correct direction than a TrA contraction. Conclusions: It is concluded that ultrasound is a more valid method than palpation and clinical observation to assess PFM function, and that instruction to contract the PFM produces a significantly more effective pelvic floor muscle contraction than instruction to perform aTrA contraction. © 2003 Wiley-Liss, Inc.
JO – Neurourology and Urodynamics
PB –
CY –
VL – 22
IS – 6
PG – 582-588
SP – 582
EP – 588
AN –
DO – 10.1002/nau.10139
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L37082635
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – An MRI investigation into the function of the transversus abdominis muscle during “drawing-in” of the abdominal wall
A1 – Hides J.
A1 – Wilson S.
A1 – Stanton W.
A1 – McMahon S.
A1 – Keto H.
A1 – McMahon K.
A1 – Bryant M.
A1 – Richardson C.
Y1 – 2006///
PD –
AB – Study Design. An operator blinded dual modality trial of measurement of the abdominal muscles during “drawing-in” of the abdominal wall. Objectives. 1) To investigate, using magnetic resonance imaging (MRI), the function of the transversus abdominis muscle bilaterally during a drawing-in of the abdominal wall. 2) To validate the use of real-time ultrasound imaging as a measure of the deep abdominal muscle during a drawing-in of the abdominal wall. Summary of Background Data. Previous research has implicated the deep abdominal muscle, transversus abdominis, in the support and protection of the spine and provided evidence that training this muscle is important in the rehabilitation of low back pain. One of the most important actions of the transversus abdominis is to “draw-in” the abdominal wall, and this action has been shown to stiffen the sacroiliac joints. It is hypothesized that in response to a draw in, the transversus abdominis muscle forms a deep musculofascial “corset” and that MRI could be used to view this corset and verify its mechanism of action on the lumbopelvic region. Methods. Thirteen healthy asymptomatic male elite cricket players aged 21.3 ± 2.1 years were imaged using MRI and ultrasound imaging as they drew in their abdominal walls. Measurements of the thickness of the transversus abdominis and internal oblique muscles and the slide of the anterior abdominal fascia were measured using both MRI and ultrasound. Measurement of the whole abdominal cross-sectional area (CSA) was conducted using MRI. Results. Results of the MRI demonstrated that, as a result of draw-in, there was a significant increase in thickness of the transversus abdominis (P < 0.001) and the internal oblique muscles (P < 0.001). There was a significant decrease in the CSA of the trunk (P < 0.001). The mean slide (±SD) of the anterior abdominal fascia was 1.54 ± 0.38 cm for the left side and 1.48 ± 0.35 cm for the right side. Ultrasound measurements of muscle thickness of both transversus abdominis and the internal oblique, as well as fascial slide, correlated with measures obtained using MRI (interclass correlations from 0.78 to 0.95). Conclusions. The MRI results demonstrated that during a drawing-in action, the transversus abdominis contracts bilaterally to form a musculofascial band that appears to tighten (like a corset) and most likely improves the stabilization of the lumbopelvic region. Real-time ultrasound imaging can also be used to measure changes in the transversus abdominis during the draw-in maneuver. ©2006, Lippincott Williams & Wilkins, Inc.
JO – Spine
PB –
CY –
VL – 31
IS – 6
PG – E175-E178
SP – E175
EP – E178
AN –
DO – 10.1097/01.brs.0000202740.86338.df
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L43432147
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Differences in muscle activation patterns during pelvic floor muscle contraction and Valsalva manouevre
A1 – Thompson J.A.
A1 – O’Sullivan P.B.
A1 – Briffa N.K.
A1 – Neumann P.
Y1 – 2006///
PD –
AB – Aims: To investigate the different muscle activation patterns around the abdomino-pelvic cavity in continent women and their effect on pressure generation during a correct pelvic floor muscle (PFM) contraction and a Valsalva maneuver. Methods: Thirteen continent women were assessed. Abdominal, chest wall, and PFM activity and vaginal and intra-abdominal pressure (IAP), were recorded during two tasks: PFM contraction and Valsalva whilst bladder base position was monitored on trans-abdominal ultrasound. A correct PFM contraction was defined as one that resulted in bladder base elevation and a Valsalva resulted in bladder base depression. Results: Comparison of the mean of the normalized EMG activity of all the individual muscle groups was significantly different between PFM contraction and Valsalva (P = 0.04). During a correct PFM contraction, the PFM were more active than during Valsalva (P = 0.001). During Valsalva, all the abdominal muscles (IO (P = 0.006), EO (P < 0.001), RA (P = 0.011)), and the chest wall (P < 0.001) were more active than during PFM contraction. The change in IAP was greater during Valsalva (P = 0.001) but there was no difference in the change in vaginal pressure between PFM contraction and Valsalva (P = 0.971). Conclusions: This study demonstrates a difference in muscle activation patterns between a correct PFM contraction and Valsalva maneuver. It is important to include assessment of the abdominal wall, chest wall, and respiration in the clinical evaluation of women performing PFM exercises as abdominal wall bracing combined with an increase in chest wall activity may cause rises in IAP and PFM descent. © 2005 Wiley-Liss, Inc.
JO – Neurourology and Urodynamics
PB –
CY –
VL – 25
IS – 2
PG – 148-155
SP – 148
EP – 155
AN –
DO – 10.1002/nau.20203
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L43391219
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Normative Pelvic Floor Parameters in Children Assessed by Transabdominal Ultrasound
A1 – Bower W.F.
A1 – Chase J.W.
A1 – Stillman B.C.
Y1 – 2006///
PD –
AB – Purpose: Successful management of dysfunctional voiding in children hinges on retraining inappropriate pelvic floor muscle recruitment. Recently dynamic pelvic floor muscle activity was visualized in adults using transabdominal ultrasound. We evaluated transabdominal ultrasound for visualizing and measuring pelvic floor muscle activity in normative children. Materials and Methods: A total of 21 volunteers, including 10 boys and 11 girls 7 to 16 years old (mean age 11.6) who were free of bladder disorders consented to participate in the study. Subjects were screened and demonstrated normative bladder emptying before being imaged while supine and standing using a sagittal curved linear array 2 to 5 MHz transducer over the suprapubic region. After pelvic floor muscle contraction was explained 4 parameters were measured 3 times each, including the direction of movement/displacement from freeze-frame ultrasound images, and endurance and coordination from ultrasound movie loops. The methodology for digitizing movie data were developed, tested and found to be reliable. New variables of endurance as a percent of maximum coordination amplitude and coordination as the amplitude between maximum and minimum effort were created. Results: Overall 66% and 71% of subjects demonstrated anterior displacement of the pelvic floor during voluntary contraction while lying and standing, respectively, with no significant difference in lying vs standing. However, coordination displacement was greater while lying than standing. During 20-second contractions pelvic floor muscle activity attained peak amplitude at 5.5 seconds, followed by a marked decay with 1 or more cycles of muscular re-recruitment. It was observed that fatigue led to repeat recruitment of the rectus and oblique abdominal muscles. Conclusions: In children free of voiding dysfunction pelvic floor displacement and coordination are highly variable. Noninvasive ultrasound of the pelvic floor provided visual assessment of muscular activity, a biofeedback component for the patient and measurement potential for the therapist. © 2006 American Urological Association.
JO – Journal of Urology
PB –
CY –
VL – 176
IS – 1
PG – 337-341
SP – 337
EP – 341
AN –
DO – 10.1016/S0022-5347(06)00304-1
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L43815363
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Observed changes in lateral abdominal muscle thickness after spinal manipulation: A case series using rehabilitative ultrasound imaging
A1 – Raney N.H.
A1 – Teyhen D.S.
A1 – Childs J.D.
Y1 – 2007///
PD –
AB – Fisheye STUDY DESIGN: Case series. Fisheye BACKGROUND: A clinical prediction rule (CPR) has been developed and validated that accurately identifies a subgroup of patients with low back pain (LBP) likely to benefit from spinal manipulation; however, the mechanism of spinal manipulation remains unclear. The purpose of this case series was to describe changes in lateral abdominal muscle thickness using rehabilitative ultrasound imaging (RUSI) immediately following spinal manipulation in a subgroup of patients positive on the rule. Fisheye CASE DESCRIPTIONS: Data from 9 patients (5 female, 4 male; 18-53 years of age) with a primary complaint of LBP are presented. All patients had symptoms for less than 16 days (range, 3-14 days) and did not have symptoms distal to the knee, satisfying the 2-factor rule for predicting successful outcome from spinal manipulation. The Oswestry Disability Index scores ranged from 8% to 52%. Lateral abdominal muscle thickness was assessed with the patient at-rest and while contracted during an abdominal drawing-in maneuver (ADIM) using RUSI. Measurements were taken before and immediately after spinal manipulation. Patients completed a 15-minute training session of the ADIM prior to assessment, to mitigate the potential for a learning effect to occur. Fisheye OUTCOMES: Based on changes that exceeded the threshold for measurement error, 6 of 9 patients demonstrated an improved ability (11.5%-27.9%) to increase transversus abdominis (TrA) muscle thickness during the ADIM postmanipulation. Additionally, TrA muscle thickness at-rest postmanipulation decreased for 5 patients (11.5%-25.9%), while at-rest internal oblique muscle thickness decreased for 4 patients (6.4%-12.2%). Fisheye DISCUSSION: This case series describes short-term changes in lateral abdominal muscle thickness post spinal manipulation. Although case series have significant limitations, including the fact that no cause-and-effect claims can be made, the decrease in muscle thickness at rest and the greater increase in muscle thickness during the ADIM postmanipulation observed in some of the patients could suggest an improvement in muscular function. Future research is needed to determine if increased muscle thickness is associated with improvements in pain and disability and to further explore neurophysiologic mechanisms of spinal manipulation.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 37
IS – 8
PG – 472-479
SP – 472
EP – 479
AN –
DO – 10.2519/jospt.2007.2523
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47257753
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Assessment of abdominal muscle function during a simulated unilateral weight-bearing task using ultrasound imaging
A1 – Hides J.A.
A1 – Wong I.
A1 – Wilson S.J.
A1 – Belavý D.L.
A1 – Richardson C.A.
Y1 – 2007///
PD –
AB – Fisheye STUDY DESIGN: Cross-sectional study. Fisheye OBJECTIVE: To investigate the function of the transversus abdominis (TrA) and internal oblique (IO) muscles bilaterally during a simulated weight-bearing task using ultrasound imaging. Fisheye BACKGROUND: An important aspect of neuromuscular control at the lumbopelvic region is stabilization. Biomechanical models have predicted that activation of transversely oriented muscles, such as the TrA and IO muscles, can stiffen the sacroiliac joints and actively stabilize the pelvis for weight bearing. Fisheye METHODS AND MEASURES: Nineteen healthy subjects were positioned in supine lying with their right heel against a footplate linked to a force transducer. Each subject performed a static simulated weight-bearing task of the right lower extremity. Ultrasound imaging was used to assess resultant changes in thickness of the IO and TrA muscles, as well as the lateral slide of the anterior abdominal fascia on each side of the abdomen alternately. Muscle thickness and slide of the fascia were assessed at standardized force levels (0% and 25% of body weight). Fisheye RESULTS: Substantial increases (P<.0001) in mean (±SD) thickness of the IO (18.5% ± 9.7%) and TrA (24.7% ± 17.5%) muscles during the weight-bearing task were measured. Lateral movement (slide) of the anterior abdominal fascia of the TrA muscle also occurred (mean ± SD, 1.3 ± 2.0 mm; P = .014) with weight bearing. Changes in muscle thickness and amount of slide were similar for the left and right side of the abdomen (P≥.11). Fisheye CONCLUSION: The findings are consistent with biomechanical models that predicted symmetrical activation of the deep transversely oriented lumbopelvic muscles in healthy subjects in response to a unilateral functional weight-bearing task. Ultrasound imaging as a measurement tool represents a noninvasive method for measuring abdominal muscle function in functional axial loading.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 37
IS – 8
PG – 467-471
SP – 467
EP – 471
AN –
DO – 10.2519/jospt.2007.2417
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47257752
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Rehabilitative ultrasound imaging of the abdominal muscles
A1 – Teyhen D.S.
A1 – Gill N.W.
A1 – Whittaker J.L.
A1 – Henry S.M.
A1 – Hides J.A.
A1 – Hodges P.
Y1 – 2007///
PD –
AB – Rehabilitative ultrasound imaging (RUSI) of the abdominal muscles is increasingly being used in the management of conditions involving musculoskeletal dysfunctions associated with the abdominal muscles, including certain types of low back and pelvic pain. This commentary provides an overview of current concepts and evidence related to RUSI of the abdominal musculature, including issues addressing the potential role of ultrasound imaging in the assessment and training of these muscles. Both quantitative and qualitative aspects associated with clinical and research applications are considered, as are the possible limitations related to the interpretation of measurements made with RUSI. Research to date has utilized a range of methodological approaches, including different transducer placements and imaging techniques. The pros and cons of the various methods are discussed, and guidelines for future investigations are presented. Potential implications and opportunities for clinical use of RUSI to enhance evidence-based practice are outlined, as are suggestions for future research to further clarify the possible role of RUSI in the evaluation and treatment of abdominal muscular morphology and function.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 37
IS – 8
PG – 450-466
SP – 450
EP – 466
AN –
DO – 10.2519/jospt.2007.2558
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47257751
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Ultrasound imaging assessment of abdominal muscle function during drawing-in of the abdominal wall: An intrarater reliability study
A1 – Hides J.A.
A1 – Miokovic T.
A1 – Belavý D.L.
A1 – Stanton W.R.
A1 – Richardson C.A.
Y1 – 2007///
PD –
AB – Fisheye STUDY DESIGN: Test-retest intrarater reli-ability study. Fisheye OBJECTIVE: To examine reliability of abdominal musculature measurements across a broad range of conditions for a physical therapist newly trained in assessment using rehabilitative ultrasound imaging (RUSI). Fisheye BACKGROUND: RUSI has previously been used to assess abdominal muscle function during a drawing-in maneuver of the anterior abdominal wall, and measurements conducted by an experienced assessor have been validated by comparison with magnetic resonance imaging. Few studies have examined the reliability of less experienced operators, and only in isolated measurement conditions. Fisheye METHODS AND MEASURES: Nineteen subjects (11 female, 8 male) without a history of low back pain performed the abdominal drawing-in maneuver in a supine hook-lying position. RUSI was used bilaterally to assess the thickness of the internal oblique (IO) and transversus abdominis (TrA) muscles at rest and on contraction, as well as changes in the length of the TrA muscle (indicated by slide of the anterior abdominal fascia). The reliability of a novice rater who received 8 hours of training was examined (a) across 3 measurements of the same ultrasound image, (b) across 3 separate ultrasound images (averaged for days and sides of abdomen), and (c) across 2 days (averaged for images and sides). Fisheye RESULTS: Reliability of assessing muscle thickness was very high across 3 measurements of the same image (intrarater correlation coefficients [ICC 3,1] were all greater than 0.97), fair to high across 3 images (ICC3,4 = 0.62-0.82), and fair to high across 2 days (ICC 3,6 = 0.63-0.85). Reliability of measuring the slide of the anterior abdominal fascia was very high across measurements from the same image (ICC 3,1 = 0.98) but very low across images (ICC3,4 = 0.44) and across 2 days (ICC3,6 = 0.36). Fisheye CONCLUSIONS: High reliability of a novice rater was demonstrated for some measurement conditions. Measures of reliability for recapturing the image and repetition across days ranged from low to high. Inconsistencies in the pattern of results suggest that for a novice assessor using RUSI, training should be performed and reliability assessed for each abdominal muscle and measurement condition intended to be used for research and clinical practice.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 37
IS – 8
PG – 480-486
SP – 480
EP – 486
AN –
DO – 10.2519/jospt.2007.2416
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47257754
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Ultrasound imaging as a feedback tool in the rehabilitation of trunk muscle dysfunction for people with low back pain
A1 – Henry S.M.
A1 – Teyhen D.S.
Y1 – 2007///
PD –
AB – Fisheye SYNOPSIS: This commentary provides an overview of the current concepts and the emerging evidence related to rehabilitative ultrasound imaging (RUSI) for biofeedback purposes. Specifically, the role of RUSI to assess improvements in trunk muscle performance and motor learning will be discussed, highlighting the importance of retention and transfer testing to assess motor learning. The use of RUSI as an extrinsic (augmented) feedback tool and its ability to provide both knowledge of performance and knowledge of results information will be defined. An analysis of the limited available literature related to the role of RUSI as an augmented feedback tool to enhance motor skill acquisition related to the deep trunk muscles will be provided. Future research directions and priorities are recommended.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 37
IS – 10
PG – 627-634
SP – 627
EP – 634
AN –
DO – 2519/jospt.2007.2555
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47556356
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – A comparison of select trunk muscle thickness change between subjects with low back pain classified in the treatment-based classification system and asymptomatic controls
A1 – Kiesel K.B.
A1 – Underwood F.B.
A1 – Matacolla C.
A1 – Nitz A.J.
A1 – Malone T.R.
Y1 – 2007///
PD –
AB – Fisheye STUDY DESIGN: Cross-sectional descriptive. Fisheye OBJECTIVES: To investigate if muscle thickness change, as measured with rehabilitative ultrasound imaging (RUSI), is different across subgroups of patients with low back pain (LBP), classified in the Treatment-Based Classification (TBC) system, when compared to controls. Fisheye BACKGROUND: Researchers have demonstrated that subgroups of patients with LBP exist and respond differently to treatment, challenging the assertion that LBP is “nonspecific.” The TBC system uses 4 categories (stabilization, mobilization, direction specific exercise, or traction) to subgroup patients. Recently, researchers have demonstrated impairments of the transverse abdominis (TrA) and lumbar multifidus (LM) in those with LBR regardless of classification. Although distinct differences in impairments have been identified between subgroups, TrA and LM impairments have not been studied and may be present across categories of the TBC system. Fisheye METHODS AND MEASURES: RUSI was utilized to measure percent thickness change from rest to contracted state during a voluntary task of the TrA and during an upper extremity task known to activate the LM in 56 subjects classified in the TBC system and 20 controls. Fisheye RESULTS: During the prone upper extremity lifting task with a hand weight, there was a significant group difference for the LM at L4-L5 (P = .03) and at L5-S1 (P = .04), and during volitional activation for the TrA (P<.01). Post hoc testing revealed the differences were between controls and both the direction specific and stabilization categories at the L4-L5 level, between control and direction specific category for the L5-S1 level, and between controls and all 3 categories for the TrA. Fisheye CONCLUSION: Deficits in the ability to generate muscle thickness changes in the TrA and LM occurred across categories of the TBC system. Intervention studies should be performed to determine if intervention can correct these deficits and if deficit corrections are related to outcomes. JO – Journal of Orthopaedic and Sports Physical Therapy PB – CY – VL – 37 IS – 10 PG – 596-607 SP – 596 EP – 607 AN – DO – 10.2519/jospt.2007.2574 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47556352 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Can activity within the external abdominal oblique be measured using real-time ultrasound imaging? A1 – John E.K. A1 – Beith I.D. Y1 – 2007/// PD – AB – Background: Differences in the function of the anterolateral abdominal muscles have been the subject of much investigation, but primarily using electromyography. Recently changes in thickness of transversus abdominis and internal oblique measured from real-time ultrasound images have been shown to represent activity within these muscles. However it is still unclear if such a change in thickness in external oblique similarly represents activity within that muscle. The purpose of this study was to investigate the relationship between change in thickness and muscle activity in the external oblique using real-time ultrasound and surface electromyography. Methods: Simultaneous measurements of electromyography and real-time ultrasound images of external oblique were studied in up to 24 subjects during two tasks compared to the muscle at rest (1) isometric trunk rotation and (2) drawing in the lower abdomen. Findings: Changes in muscle thickness correlated significantly with electromyography during isometric trunk rotation in the majority of subjects but with a significant difference between subjects. In contrast, the relationship between change in thickness and electrical activity in the muscle when drawing in the lower abdomen was significant in less than 50% of subjects and the muscle often got thinner. Interpretation: Thickness changes of external oblique can be used as a valid indicator of electromyography activity during isometric trunk rotation, though the relationship is not as good as previously published data for transversus abdominis. Thickness changes of external oblique measured during lower abdominal drawing in cannot be used to detect activity within this muscle. © 2007 Elsevier Ltd. All rights reserved. JO – Clinical Biomechanics PB – CY – VL – 22 IS – 9 PG – 972-979 SP – 972 EP – 979 AN – DO – 10.1016/j.clinbiomech.2007.07.005 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47430193 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Muscle thickness changes during abdominal hollowing: An assessment of between-day measurement error in controls and patients with chronic low back pain A1 – Mannion A.F. A1 – Pulkovski N. A1 – Gubler D. A1 – Gorelick M. A1 – O’Riordan D. A1 – Loupas T. A1 – Schenk P. A1 – Gerber H. A1 – Sprott H. Y1 – 2008/// PD – AB – Spine stabilization exercises, in which patients are taught to perform isolated contractions of the transverses abdominus (TrA) during “abdominal hollowing”, are a popular physiotherapeutic treatment for low back pain (LBP). Successful performance is typically judged by the relative increase in TrA thickness compared with that of the internal (OI) and external (OE) oblique muscles, measured using ultrasound. The day-to-day measurement error (imprecision) associated with these indices of preferential activation has not been assessed but is important to know since it influences the interpretation of changes after treatment. On 2 separate days, 14 controls and 14 patients with chronic LBP (cLBP) performed abdominal hollowing exercises in hook-lying, while M-mode ultrasound images superimposed with tissue Doppler imaging (TDI) data were recorded from the abdominal muscles (N = 5 on each side). The fascial lines bordering the TrA, OI and OE were digitized, and muscle thicknesses were calculated. The between-day error (intra-observer) was expressed as the standard error of measurement, SEM; SEM as a percentage of the mean gave the coefficient of variation (CV). There were no significant between-day differences for the mean values of resting or maximal thickness for any muscle, in either group (P > 0.05). The median SEM and CV of all thickness variables was 0.71 mm and 10.9%, respectively for the controls and 0.80 mm or 11.3%, respectively for the cLBP patients. For the contraction ratios (muscle thickness contracted/thickness at rest), the CVs were 3-11% (controls) and 5-12% (patients). The CVs were unacceptably high (30-50%, both groups) for the TrA preferential activation ratio (TrA proportion of the total lateral abdominal muscle thickness when contracted minus at rest). In both the controls and patients, the precision of measurement of absolute muscle thickness and relative change in thickness during abdominal hollowing was acceptable, and commensurate with that typical of biological measurements. The TrA preferential activation ratio is too imprecise to be of clinical use. Knowledge of the SEM for these indices is essential for interpreting the clinical relevance of any changes observed following physiotherapy. © 2008 Springer-Verlag.
JO – European Spine Journal
PB –
CY –
VL – 17
IS – 4
PG – 494-501
SP – 494
EP – 501
AN –
DO – 10.1007/s00586-008-0589-x
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L50038646
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Transversus abdominis: Changes in thickness during an incremental upper limb exercise test
A1 – McEvoy M.P.
A1 – Cowling A.J.
A1 – Fulton I.J.
A1 – Williams M.T.
Y1 – 2008///
PD –
AB – The aim of this study was to measure transversus abdominis (TrA) during an incremental fatiguing task. Using real-time ultrasound, TrA thickness was measured in 26 healthy subjects (18-25 years, 9 male) during an unsupported upper limb exercise test (UULEX). Repeatability of changes in TrA thickness during the UULEX was established by using a test-retest process (n=9, intraclass correlation coefficient=0.62 (95% CI 0.38-0.82), standard error of measurement ∼1 (95% CI 0.87-1.08)). Using mixed model analysis with time as an independent variable, TrA thickness changed significantly throughout the UULEX (p < 0.05). Measures of TrA thickness at minutes 10, 11, and 12 were significantly greater than at baseline (p=0.006 (95% CI 0.23-1.35), 0.001 (95% CI 0.45-1.61), and <0.0001 (95% CI 0.77-2.03), respectively). Transversus abdominis was shown to be continuously and increasingly active over the 12 minutes of an incremental bilateral upper limb test in young healthy adults. As increases in TrA thickness occurred at the points of greatest postural and ventilatory demands, these findings may have implications for subjects with musculoskeletal or respiratory impairments who are often challenged by upper limb tasks. Copyright © Informa Healthcare.
JO – Physiotherapy Theory and Practice
PB –
CY –
VL – 24
IS – 4
PG – 265-273
SP – 265
EP – 273
AN –
DO – 10.1080/09593980701773340
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L351896711
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Ultrasound imaging of the lateral abdominal wall muscles in individuals with lumbopelvic pain and signs of concurrent hypocapnia
A1 – Whittaker J.L.
Y1 – 2008///
PD –
AB – The purpose of this study was to compare the change in thickness of transversus abdominis (TrA) and internal oblique (IO) muscles, during resting supine respiration, in individuals with lumbopelvic pain (LP) to those who in addition to LP, demonstrate signs of concurrent hypocapnia (LP&HYPO). B-mode ultrasound images were obtained at the height of inspiration, and at the end of expiration, over three subsequent breaths during a single session. The average percent change in thickness of TrA during resting respiration in the LP&HYPO group (20.8±7.6%) was found to be statistically greater (P<0.001) than that of the LP only group (1.3±5.8%), while the difference between the groups for the percent change in thickness of IO (LP&HYPO 9.2±8.1%, LP 2.0±7.2%) did not differ (P=0.073). These findings suggest that respiratory modulation of TrA thickness, as measured by ultrasound imaging, greater than 20%, detected in a resting supine position, may be associated with an episode of hypocapnia, and if present warrants further investigation. © 2007 Elsevier Ltd. All rights reserved.
JO – Manual Therapy
PB –
CY –
VL – 13
IS – 5
PG – 404-410
SP – 404
EP – 410
AN –
DO – 10.1016/j.math.2007.03.008
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L352140230
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Changes in deep abdominal muscle thickness during common trunk-strengthening exercises using ultrasound imaging
A1 – Teyhen D.S.
A1 – Rieger J.L.
A1 – Westrick R.B.
A1 – Miller A.C.
A1 – Molloy J.M.
A1 – Childs J.D.
Y1 – 2008///
PD –
AB – Fish eye STUDY DESIGN: Cross-sectional study design. Fish eye OBJECTIVES: To characterize changes in muscle thickness in the transversus abdominis (TrA) and internal oblique (IO) muscles during common trunk-strengthening exercises, and to determine whether these changes differ based on age. Fish eye BACKGROUND: Although trunk-strengthening exercises have been found to be useful in treating those with low back pain (LBP), our understanding of the relative responses of the TrA and IO muscles during different exercises is limited. Fish eye METHODS AND MEASURES: Six commonly prescribed trunk-strengthening exercises were performed by 120 subjects (40 subjects per age group: 18-30, 31-40, and 41-50 years). Ultrasound imaging was used to measure the thickness of the TrA and IO during the resting and contracted state of each exercise. The average thickness of the muscles while in the contracted position was divided by the thickness values in the resting position for each exercise, based on 2 performances of each exercise. Two 3-by-6 repeated-measures analyses of variance were used to determine significant changes in muscle thickness of the TrA and IO, based on age group and exercise performed. Fish eye RESULTS: For both muscles, the trunk exercise-by-age interaction effect (TrA, P = .358; IO, P = .217) and the main effect for age (TrA, P = .615; IO, P = .219) were not significant. A significant main effect for trunk exercise for both muscles (P<.001) was found. The horizontal side-support (mean ± SD contracted-rest thickness ratio: TrA, 1.95 ± 0.69; IO, 1.88 ± 0.52) and the abdominal crunch (mean ± SD contracted-rest thickness ratio: TrA, 1.74±0.48; IO, 1.63 ± 0.41) exercises resulted in the greatest change in muscle thickness for both muscles. The abdominal drawing-in maneuver (mean ± SD contracted-rest thickness ratio: TrA, 1.73 ± 0.36; IO, 1.14 ± 0.33) and quadruped opposite upper and lower extremity lift (mean ± SD contracted-rest thickness ratio: TrA, 1.59 ± 0.49; 10,1.25 ± 0.36) exercises resulted in changes in TrA muscle thickness with minimal changes in IO muscle thickness. Fish eye CONCLUSION: Changes in TrA and IO muscle thickness differed across 6 commonly prescribed trunk-strengthening exercises among healthy subjects without LBP. These differences did not vary by age. This information may be useful for informing exercise prescription. Fish eye LEVEL OF EVIDENCE: Therapy, level 5.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 38
IS – 10
PG – 596-605
SP – 596
EP – 605
AN –
DO – 10.2519/jospt.2008.2897
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L352486760
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Transversus Abdominis and Obliquus Internus Activity During Pilates Exercises: Measurement With Ultrasound Scanning
A1 – Endleman I.
A1 – Critchley D.J.
Y1 – 2008///
PD –
AB – Endleman I, Critchley DJ. Transversus abdominis and obliquus internus activity during Pilates exercises: measurement with ultrasound scanning. Objective: To assess activity of transversus abdominis (TrA) and obliquus internus abdominis (OI) muscles during classical Pilates exercises performed correctly and incorrectly, and with or without equipment. Design: Repeated-measures descriptive study. Setting: Pilates studio. Participants: A volunteer sample of women (n=18) and men (n=8), mean age ± SD (43±14y), with more than 6 months classical Pilates training and no back pain or other condition likely to influence abdominal muscle activity. Interventions: Participants performed Pilates imprint, hundreds A and B, roll-up, and leg-circle exercises on a mat. The hundreds exercise was also performed on a reformer (sliding platform). Mat imprint and hundreds exercises were instructed to be performed correctly (with abdominal drawing-in) or incorrectly (without drawing-in). Main Outcome Measure: Thickness of TrA and OI middle fibers measured with ultrasound imaging. Results: TrA thickness increased during the mat imprint, hundreds A, hundreds B, leg-circle, and roll-up exercises (all P=.001) compared with resting. OI thickness increased during the mat imprint, hundreds A, hundreds B, leg-circle (all P=.001), and roll-up exercises (P=.002) compared with resting. TrA thickness during reformer hundreds B was greater than during mat hundreds B (P=.011); OI thicknesses were not different for this comparison. During incorrect imprint, neither TrA or OI thicknesses were different to resting. TrA and OI muscle thicknesses were moderately correlated (R=.410; P=.001). Conclusions: This study provides the first evidence that a selection of classic Pilates exercises activates TrA and OI. Use of the reformer exercise machine can result in greater TrA activation in some exercises. TrA and OI did not function independently during these exercises. Research into the training effects of Pilates or in patient populations can be undertaken using ultrasonography in submaximal exercises. © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.
JO – Archives of Physical Medicine and Rehabilitation
PB –
CY –
VL – 89
IS – 11
PG – 2205-2212
SP – 2205
EP – 2212
AN –
DO – 10.1016/j.apmr.2008.04.025
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L352604203
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Reliability of Rehabilitative Ultrasound Imaging of the Transversus Abdominis and Lumbar Multifidus Muscles
A1 – Koppenhaver S.L.
A1 – Hebert J.J.
A1 – Fritz J.M.
A1 – Parent E.C.
A1 – Teyhen D.S.
A1 – Magel J.S.
Y1 – 2009///
PD –
AB – Koppenhaver SL, Hebert JJ, Fritz JM, Parent EC, Teyhen DS, Magel JS. Reliability of rehabilitative ultrasound imaging of the transversus abdominis and lumbar multifidus muscles. Objectives: To evaluate the intraexaminer and interexaminer reliability of rehabilitative ultrasound imaging (RUSI) in obtaining thickness measurements of the transversus abdominis (TrA) and lumbar multifidus muscles at rest and during contractions. Design: Single-group repeated-measures reliability study. Setting: University and orthopedic physical therapy clinic. Participants: A volunteer sample of adults (N=30) with current nonspecific low back pain (LBP) was examined by 2 clinicians with minimal RUSI experience. Interventions: Not applicable. Main Outcome Measures: Thickness measurements of the TrA and lumbar multifidus muscles at rest and during contractions were obtained by using RUSI during 2 sessions 1 to 3 days apart. Percent thickness change was calculated as thicknesscontracted-thicknessrest/thicknessrest. Intraclass correlation coefficients (ICC) were used to estimate reliability. Results: By using the mean of 2 measures, intraexaminer reliability point estimates (ICC3,2) ranged from 0.96 to 0.99 for same-day comparisons and from 0.87 to 0.98 for between-day comparisons. Interexaminer reliability estimates (ICC2,2) ranged from 0.88 to 0.94 for within-day comparisons and from 0.80 to 0.92 for between-day comparisons. Reliability estimates comparing measurements by the 2 examiners of the same image (ICC2,2) ranged from 0.96 to 0.98. Reliability estimates were lower for percent thickness change measures than the corresponding single thickness measures for all conditions. Conclusions: RUSI thickness measurements of the TrA and lumbar multifidus muscles in patients with LBP, when based on the mean of 2 measures, are highly reliable when taken by a single examiner and adequately reliable when taken by different examiners. © 2009 American Congress of Rehabilitation Medicine.
JO – Archives of Physical Medicine and Rehabilitation
PB –
CY –
VL – 90
IS – 1
PG – 87-94
SP – 87
EP – 94
AN –
DO – 10.1016/j.apmr.2008.06.022
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L354068793
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Altered response of the anterolateral abdominal muscles to simulated weight-bearing in subjects with low back pain
A1 – Hides J.A.
A1 – Belavý D.L.
A1 – Cassar L.
A1 – Williams M.
A1 – Wilson S.J.
A1 – Richardson C.A.
Y1 – 2009///
PD –
AB – An important aspect of neuromuscular control at the lumbo-pelvic region is stabilization. Subjects with low back pain (LBP) have been shown to exhibit impairments in motor control of key muscles which contribute to stabilization of the lumbo-pelvic region. However, a test of automatic recruitment that relates to function has been lacking. A previous study used ultrasound imaging to show that healthy subjects automatically recruited the transversus abdominis (TrA) and internal oblique (IO) muscles in response to a simulated weight-bearing task. This task has not been investigated in subjects with LBP. The aim of this study was to compare the automatic recruitment of the abdominal muscles among subjects with and without LBP in response to the simulated weight-bearing task. Twenty subjects with and without LBP were tested. Real-time ultrasound imaging was used to assess changes in thickness of the TrA and internal oblique IO muscles as well as lateral movement (“slide”) of the anterior fascial insertion of the TrA muscle. Results showed that subjects with LBP showed significantly less shortening of the TrA muscle (P < 0.0001) and greater increases in thickness of the IO muscle (P = 0.002) with the simulated weight-bearing task. There was no significant difference between groups for changes in TrA muscle thickness (P = 0.055). This study provides evidence of changes in motor control of the abdominal muscles in subjects with LBP. This test may provide a functionally relevant and non-invasive method to investigate the automatic recruitment of the abdominal muscles in people with and without LBP. © 2008 Springer-Verlag.
JO – European Spine Journal
PB –
CY –
VL – 18
IS – 3
PG – 410-418
SP – 410
EP – 418
AN –
DO – 10.1007/s00586-008-0827-2
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L50335650
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Onset in abdominal muscles recorded simultaneously by ultrasound imaging and intramuscular electromyography
A1 – Vasseljen O.
A1 – Fladmark A.M.
A1 – Westad C.
A1 – Torp H.G.
Y1 – 2009///
PD –
AB – Delayed onset of muscle activity in abdominal muscles has been related to low back pain. To investigate this in larger clinical trials it would be beneficial if non-invasive and less cumbersome alternatives to intramuscular electromyography (EMG) were available. This study was designed to compare onset of muscle activity recorded by intramuscular EMG to onset of muscle deformations by ultrasound imaging. Muscle deformations were recorded by two ultrasound imaging modes at high time resolution (m-mode and tissue velocity) in separate sessions and compared to simultaneously recorded intramuscular EMG in three abdominal muscles. Tissue velocity imaging was converted to strain rate which measures deformation velocity gradients within small regions, giving information about the rate of local tissue shortening or lengthening along the beam axis. Onsets in transversus abdominis (TrA), obliquus internus abdominis (OI) and obliquus externus abdominis (OE) were recorded during rapid arm flexions in ten healthy subjects. During ultrasound m-mode recordings, the results showed that mean onsets by EMG were detected 7 ms (95% CI of mean difference; ±4 ms) and 2 ms (95% CI of mean difference; ±6 ms) before concurrent ultrasound m-mode detected onsets in TrA and OI, respectively. In contrast, OE onset was recorded 54 ms (95% CI of bias; ±16 ms) later by EMG compared to ultrasound m-mode. The discrepancy of ultrasound m-mode to accurately record onset in OE was practically corrected in the ultrasound-based strain rate recordings. However, this could only be applied on half of the subjects due to the angle dependency between the ultrasound beam and the direction of the contraction in strain rate recordings. The angle dependency needs to be further explored. © 2007 Elsevier Ltd. All rights reserved.
JO – Journal of Electromyography and Kinesiology
PB –
CY –
VL – 19
IS – 2
PG – e23-e31
SP – e23
EP – e31
AN –
DO – 10.1016/j.jelekin.2007.07.013
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L354132252
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Ultrasound Characteristics of the Deep Abdominal Muscles During the Active Straight Leg Raise Test
A1 – Teyhen D.S.
A1 – Williamson J.N.
A1 – Carlson N.H.
A1 – Suttles S.T.
A1 – O’Laughlin S.J.
A1 – Whittaker J.L.
A1 – Goffar S.L.
A1 – Childs J.D.
Y1 – 2009///
PD –
AB – Teyhen DS, Williamson JN, Carlson NH, Suttles ST, O’Laughlin SJ, Whittaker JL, Goffar SL, Childs JD. Ultrasound characteristics of the deep abdominal muscles during the active straight leg raise test. Objective: To determine whether changes in the transversus abdominis (TrA) and internal oblique (IO) muscles, as seen on ultrasound imaging, during the active straight leg raise (ASLR) test differ between subjects with and without unilateral lumbopelvic pain. Design: Cross-sectional, case-control study. Setting: Clinical laboratory. Participants: Subjects (n=15) with unilateral symptoms in the lumbopelvic region and age-matched and sex-matched control subjects (n=15). Interventions: Bilateral measurements of the deep abdominal muscles (TrA and IO) were obtained simultaneously using ultrasound imaging to compare the percent change in muscle thickness from rest with (1) immediately on raising, (2) after a 10-second hold, and (3) within 5 seconds after returning the lower extremity to the plinth. Main Outcome Measure: Percent change in muscle thickness of both muscles from rest to the other 3 time intervals during the ASLR test. Results: The 3-way group × side measured × time and 2-way side measured × time interactions were not significant for either the TrA (P≥.34) or the IO (P≥.14) muscles. The 2-way interaction group × time was significant for both the TrA (P=.003) and the IO (P=.02) muscles. On lifting the lower extremity, the control group demonstrated a 23.7% and 11.2% increase in TrA and IO muscle thickness, respectively, while those with lumbopelvic pain demonstrated a 6.4% and 5.7% increase in TrA and IO muscle thickness, respectively. Conclusions: Although subjects with unilateral lumbopelvic pain demonstrated a smaller increase in muscle thickness, during the ASLR test there appears to be a symmetrical response in both of the deep abdominal muscles regardless of which lower extremity is lifted during the ASLR test or the unilateral nature of the symptoms. This study attests to the potential construct validity of using the ASLR test to assess different motor control strategies of the TrA and IO muscles in subjects with unilateral lumbopelvic pain. © 2009 American Congress of Rehabilitation Medicine.
JO – Archives of Physical Medicine and Rehabilitation
PB –
CY –
VL – 90
IS – 5
PG – 761-767
SP – 761
EP – 767
AN –
DO – 10.1016/j.apmr.2008.11.011
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L354510799
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – The effect of averaging multiple trials on measurement error during ultrasound imaging of transversus abdominis and lumbar multifidus muscles in individuals with low back pain
A1 – Koppenhaver S.L.
A1 – Parent E.C.
A1 – Teyhen D.S.
A1 – Hebert J.J.
A1 – Fritz J.M.
Y1 – 2009///
PD –
AB – STUDY DESIGN: Clinical measurement, reliability study. OBJECTIVES: To investigate the improvements in precision when averaging multiple measurements of percent change in muscle thickness of the transversus abdominis (TrA) and lumbar multifidus (LM) muscles. BACKGROUND: Although the reliability of TrA and LM muscle thickness measurements using rehabilitative ultrasound imaging (RUSI) is good, measurement error is often large relative to mean muscle thickness. Additionally, percent thickness change measures incorporate measurement error from both resting and contracted conditions. METHODS: Thirty volunteers with nonspecific low back pain participated. Thickness measurements of the TrA and LM muscles were obtained using RUSI at rest and during standardized tasks. Percent thickness change was calculated with the formula (thicknesscontraded thicknessrest/thicknessrest. Standard error of measurement (SEM) quantified precision when using 1 or a mean of 2 to 6 consecutive measurements. RESULTS; Compared to when using a single measurement, SEM of both the TrA and LM decreased by nearly 25% when using a mean of 2 measures, and by 50% when using the mean of 3 measures. Little precision was gained by averaging more than 3 measurements. CONCLUSION: When using RUSI to determine percent change in TrA and LM muscle thickness, intraexaminer measurement precision appears to be optimized by using an average of 3 consecu-tive measurements.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 39
IS – 8
PG – 604-611
SP – 604
EP – 611
AN –
DO – 10:2519/jospt.2009.3088
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L355119030
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Changes in abdominal muscle thickness measured by ultrasound are not associated with recovery in athletes with longstanding groin pain associated with resisted hip adduction.
A1 – Jansen J.A.
A1 – Mens J.M.
A1 – Backx F.J.
A1 – Stam H.J.
Y1 – 2009///
PD –
AB – STUDY DESIGN: Longitudinal single-cohort study. BACKGROUND: Athletes with longstanding groin pain associated with resisted hip adduction have been shown to have abnormal activation of the transversus abdominis (TA). Therefore, exercises targeting the TA to help stabilize the lumbopelvic area are generally used in the rehabilitation of these athletes. OBJECTIVES: To investigate if (1) changes in abdominal muscle resting thickness and changes in relative thickness during lower extremity tasks after 14 weeks of intervention are related to changes in clinical status and (2) the changes in abdominal muscle resting/relative thickness are significant postintervention. METHODS: In 21 athletes with longstanding groin pain associated with resisted hip adduction, ultrasound imaging of the abdominal musculature on the right side was performed at rest, during the active straight-leg raise (left and right), and during bilateral isometric hip adduction. Athletes then followed a 14-week rehabilitation protocol. Clinical outcome measured by self-reported sports restriction and change in abdominal muscle resting and relative thickness during lower extremity tasks were evaluated. RESULTS: There was an overall significant decrease in self-reported sports restriction after intervention for this group of athletes. Apart from a significant negative correlation for changes in TA resting thickness, no significant association between changes in abdominal muscle thickness and change in self-reported sports restriction were found. Postintervention, TA resting thickness was significantly increased but relative thickness during the lower extremity tasks was found not to be statistically different for all muscles, except for a decreased relative thickness of obliquus externus abdominus (OE) during the active straight-leg raise for the left lower extremity. CONCLUSION: There was no association between changes in abdominal muscle resting thickness and relative thickness during lower extremity tasks, and change in self-reported sports restriction after a period of physical therapy in athletes with longstanding groin pain associated with resisted hip adduction. Although this study was designed as a single-cohort longitudinal study, the data suggest that the intervention described can change TA resting thickness. The intervention did not influence abdominal muscle relative thickness during lower extremity tasks.
JO – The Journal of orthopaedic and sports physical therapy
PB –
CY –
VL – 39
IS – 10
PG – 724-732
SP – 724
EP – 732
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L355850189
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Changes in lateral abdominal muscle thickness during the abdominal drawing-in maneuver in those with lumbopelvic pain.
A1 – Teyhen D.S.
A1 – Bluemle L.N.
A1 – Dolbeer J.A.
A1 – Baker S.E.
A1 – Molloy J.M.
A1 – Whittaker J.
A1 – Childs J.D.
Y1 – 2009///
PD –
AB – STUDY DESIGN: Controlled laboratory study. OBJECTIVES: To determine if changes in transversus abdominis (TrA) and internal oblique (IO) muscle thickness and side-to-side symmetry differ in individuals with and without unilateral lumbopelvic pain while at rest and during the abdominal drawing-in maneuver (ADIM). BACKGROUND: Although the ADIM has been found to produce a symmetrical change in TrA and IO muscle thickness in healthy subjects, how these muscles are activated in those with unilateral lumbopelvic pain during the ADIM remains unknown. METHODS: Fifteen subjects with lumbopelvic pain and 15 age- and gender-matched control subjects were recruited. To investigate a similar subgroup of patients with lumbopelvic pain that has been used in previous research, subjects were required to have unilateral symptoms, a positive sacroiliac provocation test, and a positive active straight-leg raise test. Ultrasound images were obtained bilaterally at 2 different points during each trial of the ADIM: (1) at rest and (2) while maintaining the ADIM. Average percent change in thickness of the TrA and IO muscles was obtained over 3 trials. RESULTS: The percent change in thickness of the TrA was 20.9% less in those with lumbopelvic pain compared to the control group (P = .035), while the percent change in IO thickness was equivalent between groups (P = .522). No differences were observed for the TrA or IO muscles between the symptomatic and asymptomatic sides in those with (TrA, P = .263; IO, P = .172) or without (TrA, P = .780; IO, P = .635) lumbopelvic pain during the ADIM. Changes in TrA muscle thickness were greater than the IO muscle during the ADIM for both groups (P<.001). Specifically, the increases in TrA muscle thickness in those with and without lumbopelvic dysfunction were 32.7% and 47.3% greater, respectively, compared to changes in the IO muscle. CONCLUSIONS: Individuals with unilateral lumbopelvic pain demonstrated a smaller increase in thickness of the TrA muscle during the ADIM. This finding provides an element of construct validity for the use of the ADIM for assessing TrA muscle thickness in those with unilateral lumbopelvic pain. However, both groups demonstrated a symmetrical side-to-side change in TrA and IO muscle thickness despite the symptomatic group having unilateral symptoms. Further, we detected a preferential change in TrA muscle thickness during the ADIM in both groups.
JO – The Journal of orthopaedic and sports physical therapy
PB –
CY –
VL – 39
IS – 11
PG – 791-798
SP – 791
EP – 798
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L355860692
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Induced Transducer Orientation During Ultrasound Imaging: Effects on Abdominal Muscle Thickness and Bladder Position
A1 – Whittaker J.L.
A1 – Warner M.B.
A1 – Stokes M.J.
Y1 – 2009///
PD –
AB – The use of ultrasound imaging (USI) by physiotherapists to assess muscle behavior in clinical settings is increasing. However, there is relatively little evidence of whether the clinical environment is conducive to valid and reliable measurements. Accurate USI measurements depend on maintaining a relatively stationary transducer position, because motion may distort the image and lead to erroneous conclusions. This would seem particularly important during dynamic studies typical of a physiotherapy assessment. What is not known is how much transducer motion can occur before error is introduced. The aim of this study is to shed some light on this question. Eight healthy volunteers (19 to 52 y) participated. USI images were taken of the lateral abdominal wall (LAW) and bladder base (midline suprapubic) at various manually induced transducer orientations (approximately -10 to 10° about 3 axes of rotation), which were quantified by a digital optical motion capture system. Measurements of transversus abdominis (TrA) thickness and bladder base position (cranial /caudal and anterior/posterior) were calculated. Repeated measures analysis of variance was performed to determine if the measurements obtained at the induced transducer orientations were statistically different (p < 0.05) from an image corresponding to a reference or starting transducer orientation. Motion analysis data corresponding to measurements that did not differ from reference image measurements were summarized to provide a range of acceptable transducer motion (relative to the pelvis) for clockwise (CW)/counter-clockwise (CCW) rotation, cranial/caudal tilting, medial/lateral tilting and inward/outward displacement. There were no significant changes in TrA thickness measurements if CW/CCW transducer motion was <9° and cranial/caudal or medial/lateral transducer tilting was <5°. Further, there were no significant changes in measurements of bladder base position if CW/CCW transducer motion was <10°, cranial/caudal or medial/lateral transducer tilting was <10° and 8°, respectively and inward/outward motion was <8 mm. These findings provide guidance on acceptable amounts of transducer motion relative to the pelvis when generating measurements of TrA thickness and bladder base position. Future sonographic studies and clinical assessment investigating these parameters could take these findings into account to improve imaging technique reliability. (E-mail: j.l.whittaker@soton.ac.uk). © 2009 World Federation for Ultrasound in Medicine & Biology. JO – Ultrasound in Medicine and Biology PB – CY – VL – 35 IS – 11 PG – 1803-1811 SP – 1803 EP – 1811 AN – DO – 10.1016/j.ultrasmedbio.2009.05.018 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L50616387 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Core muscle use in superficial and deep abdominal muscles with a Crunchless Abs video A1 – Petrofsky J.S. A1 – Prowse M. A1 – Bains G.S. A1 – Sharma A. A1 – Batt J. A1 – Gunda S. Y1 – 2009/// PD – AB – With an increase emphasis in society on technical achievements, exercise is not a priority or part of daily life. As such, core muscles are weak and back injury is becoming a national health care problem in the United States. In the present investigation, the subjects were 5 males and 4 females whose average age was 26.5+/-4.5 years. These subjects evaluated a new type of exercise program. The exercise program was on video tape (Crunchless Abs) and lasted approximately 20 minutes. The exercises were specifically designed to exercise the superficial and deep core muscles together. Abdominal crunches only exercise one or two muscle groups. During the exercise, muscle use was evaluated using the electromyogram and 2 D ultrasound to evaluate which muscles are contracting. Seven exercises were examined here. For the 7 exercises examined, there was significantly more muscle use and greater work than for abdominal crunches. More importantly, muscle use included deep and superficial muscles and engaged many different muscles in differing areas of the core of the body. Work was as high as 622% that of an abdominal crunch with average work of 312% that of an abdominal crunch with the Crunchless Abs video. Thus, this program is a better workout than that seen with crunches. JO – Journal of Applied Research PB – CY – VL – 9 IS – 3 PG – 89-99 SP – 89 EP – 99 AN – DO – UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L358030663 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – A rehabilitative ultrasound imaging investigation of lateral abdominal muscle thickness in healthy aging adults. A1 – Stetts D.M. A1 – Freund J.E. A1 – Allison S.C. A1 – Carpenter G. Y1 – 2009/// PD – AB – PURPOSE: Rehabilitative ultrasound imaging (RUSI) is used to evaluate lateral abdominal muscle size and function during the abdominal drawing-in maneuver (ADIM), an exercise used to improve lumbar spine stability. Little is known about the size and performance of these muscles in healthy aging adults. The purpose of this study was to investigate, using RUSI, the size and symmetry of the lateral abdominal muscles bilaterally at rest and during the ADIM in healthy older adults and the reliability of these measurements. METHODS: Three ultrasound images of the right and left lateral abdominal muscles were taken at rest and during the ADIM in 12 healthy older adults. Thickness of the transversus abdominis muscles (TrA), internal oblique (IO), and external oblique (EO) were measured for all images. Intraclass correlation coefficients were computed using model 3, form 1 (ICC3,1). Two ratios of the abdominal muscles were calculated in the relaxed and contracted states. Paired t-tests were used to compare relaxed muscle thickness to contracted muscle thickness for all 3 muscles for each side. To test further for interactions of side and contractile state, 2 x 2 repeated measures ANOVAs were performed. Side-to-side differences in absolute and relative thickness were assessed with paired t-tests for the TrA and IO muscles. Absolute and relative side-to-side muscle symmetry indices were computed for each muscle at rest. RESULTS: There was a significant difference in muscle thickness between the contracted and relaxed states for both the TrA and IO. There was no significant difference between left/right muscle thickness for the TrA or IO at rest or during the ADIM. The TrA nearly doubled in size while thickness of the IO + EO stayed relatively constant during the ADIM. Reliability for absolute muscle thickness was generally excellent: ICCs3,1 ranged from 0.95 to 1.00 for intra-image reliability; 0.77 to 0.97 for inter-image reliability. CONCLUSIONS: These findings support symmetrical and preferential activation of the TrA during the ADIM in healthy older adults. Continued research on the use of RUSI as a tool for both assessment and intervention in older adults is needed. JO – Journal of geriatric physical therapy (2001) PB – CY – VL – 32 IS – 2 PG – 16-22 SP – 16 EP – 22 AN – DO – UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L355884810 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – No relation between pelvic belt tests and abdominal muscle thickness behavior in athletes with long-standing groin pain. measurements with ultrasound A1 – Jansen J. A1 – Mens J. A1 – Backx F. A1 – Stam H. Y1 – 2010/// PD – AB – Objective: To investigate whether abdominal muscle thickness in athletes with long-standing adduction-related groin pain (LAGP) differs between subgroups with a positive or no response to a pelvic belt. The response to a pelvic belt is defined positive in case of a decrease ≥1 on a Likert pain scale (0-10) during the squeeze test (SQT) or a decrease ≥1 on the active straight leg raise (ASLR) test score (0-10). DESIGN: Cross-sectional study. SETTING: Physical therapy practice. PATIENTS: Fifty athletes with LAGP. INDEPENDENT VARIABLES: Squeeze test and ASLR test. MAIN OUTCOME MEASURES: First, the effect of a pelvic belt on pain during the SQT and the ASLR test score was evaluated. Then, thickness of m. transversus abdominis (TA) and m. obliquus internus (OI) was measured using ultrasound during rest, ASLR left and right, and SQT. RESULTS: Of the 50 participants, 25 (50%) experienced a decrease in pain during the SQT when wearing a pelvic belt and 10 (20%) improved in ASLR performance with a pelvic belt. Thickness of TA and OI at rest (both cases P >.08) and relative thickness compared with rest during tasks (in all cases P >.12) revealed no significant difference when comparing the 2 subgroups based on the belt response during the SQT or ASLR. CONCLUSIONS: Using these methods, abdominal muscle thickness behavior in athletes with LAGP did not differ between the subgroups based on a positive or no response to a pelvic belt. However, the ultrasound method used may not have been sensitive enough to reveal differences between groups. © 2010 by Lippincott Williams & Wilkins.
JO – Clinical Journal of Sport Medicine
PB –
CY –
VL – 20
IS – 1
PG – 15-20
SP – 15
EP – 20
AN –
DO – 10.1097/JSM.0b013e3181c9679f
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L358206694
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The Relationship of Transversus Abdominis and Lumbar Multifidus Activation and Prognostic Factors for Clinical Success With a Stabilization Exercise Program: A Cross-Sectional Study
A1 – Hebert J.J.
A1 – Koppenhaver S.L.
A1 – Magel J.S.
A1 – Fritz J.M.
Y1 – 2010///
PD –
AB – Hebert JJ, Koppenhaver SL, Magel JS, Fritz JM. The relationship of transversus abdominis and lumbar multifidus activation and prognostic factors for clinical success with a stabilization exercise program: a cross-sectional study. Objective: To examine the relationship between prognostic factors for clinical success with a stabilization exercise program and lumbar multifidus (LM) and transversus abdominis (TrA) muscle activation assessed using rehabilitative ultrasound imaging (RUSI). Design: Cross-sectional study. Setting: Outpatient physical therapy clinic. Participants: Volunteers with current low back pain (N=40). Intervention: Not applicable. Main Outcome Measures: We examined the relationship between prognostic factors associated with clinical success with a stabilization exercise program (positive prone instability test, age <40y, aberrant movements, straight leg raise >91°, presence of lumbar hypermobility) and degree of TrA and LM muscle activation assessed by RUSI. Results: Significant univariate relationships were identified between LM muscle activation and the number of prognostic factors present (Pearson correlation coefficient [r] =-.558, P=.001), as well as the individual factors of a positive prone instability test (point biserial correlation coefficient [rpbis]=.376, P=.018) and segmental hypermobility (rpbis=.358, P=.025). The multivariate analyses indicated that after controlling for other variables, the addition of the variable “number of prognostic factors present” resulted in a significant increase in R2 (P=.006). No significant univariate or multivariate relationships were observed between the prognostic factors and TrA muscle activation. Conclusions: Decreased LM muscle activation, but not TrA muscle activation, is associated with the presence of factors predictive of clinical success with a stabilization exercise program. Our findings provide researchers and clinicians with evidence regarding the construct validity of the prognostic factors examined in this study, as well as the potential clinical importance of the LM muscle as a target for stabilization exercises. © 2010 American Congress of Rehabilitation Medicine.
JO – Archives of Physical Medicine and Rehabilitation
PB –
CY –
VL – 91
IS – 1
PG – 78-85
SP – 78
EP – 85
AN –
DO – 10.1016/j.apmr.2009.08.146
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L358020290
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Changes in Transversus Abdominis Thickness With Use of the Abdominal Drawing-In Maneuver During a Functional Task
A1 – McGalliard M.K.
A1 – Dedrick G.S.
A1 – Brismée J.M.
A1 – Cook C.E.
A1 – Apte G.G.
A1 – Sizer Jr. P.S.
Y1 – 2010///
PD –
AB – Objective: The purpose of this study was to examine an individual’s ability to produce an increase in transversus abdominis (TrA) thickness during the performance of a functional task with the use of the abdominal drawing-in maneuver (ADIM). Design: Within-subject repeated measures analysis of variance was used to examine the effects of the ADIM and a loaded forward-reaching activity on the dependent variable of TrA thickness. Setting: Laboratory. Participants: Convenience sample of 8 women and 8 men, asymptomatic, with a mean age of 27.6 ± 7.1 years. Interventions: Ultrasound imaging measurements were recorded during 4 conditions: (1) while the patient was standing without the ADIM; (2) while the patient was standing with the ADIM; (3) during a loaded forward-reaching activity without the ADIM; and (4) during a loaded forward-reaching activity with the ADIM. Main Outcome Measures: Thickness of the TrA muscle. Results: The measurement obtained by an investigator blinded to the condition revealed statistically significant differences in the thickness of the TrA between all uncontracted conditions as compared with all contracted conditions. No statistically significant difference in the thickness of the TrA in the contracted states during quiet standing versus loaded forward reach was observed. Conclusion: Subjects in this study demonstrated the ability to voluntarily activate the TrA during upright static and functional tasks. Additionally, the TrA thickness may change in a direction-specific manner. These findings support a protective role of the ADIM during functional activity and may add information to ways for promoting low back pain prevention. Future studies should include the effectiveness in the use of ADIM during functional tasks for the prevention of low back pain. © 2010 American Academy of Physical Medicine and Rehabilitation.
JO – PM and R
PB –
CY –
VL – 2
IS – 3
PG – 187-194
SP – 187
EP – 194
AN –
DO – 10.1016/j.pmrj.2010.01.015
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L358544296
NS –
N1 – Exclusion reason: 5.- Wrong study design; SAMUEL FERNANDEZ (2018-04-07 01:41:19)(Select): FALTABA EL PDF;
ER –

TY – JOUR
T1 – Resting thickness of transversus abdominis is decreased in athletes with longstanding adduction-related groin pain
A1 – Jansen J.
A1 – Weir A.
A1 – Dénis R.
A1 – Mens J.
A1 – Backx F.
A1 – Stam H.
Y1 – 2010///
PD –
AB – The purpose of the study was to compare thickness of the transversus abdominis (TA) and obliquus internus (OI) muscles between athletes with and without longstanding adduction-related groin pain (LAGP). Forty two athletes with LAGP and 23 controls were included. Thickness of TA and OI were measured with ultrasound imaging on the right side of the body during rest. Relative muscle thickness (compared to rest) was measured during the active straight leg raise (ASLR) left and right, and during isometric hip adduction. TA resting thickness was significantly smaller in injured subjects with left-sided (4.0 ± 0.82 mm; P < 0.001) or right-sided (4.3 ± 0.64 mm; P = 0.015) groin complaints compared with controls (4.9 ± 0.90 mm). No significant differences between patients and controls in TA or OI relative thickness during the ASLR and isometric hip adduction were found (all cases P ≥ 0.15). In conclusion, TA resting thickness is smaller in athletes with LAGP and may thus be a risk factor for (recurrent) groin injury. This may have implications for therapy and prevention of LAGP. © 2009 Elsevier Ltd. All rights reserved.
JO – Manual Therapy
PB –
CY –
VL – 15
IS – 2
PG – 200-205
SP – 200
EP – 205
AN –
DO – 10.1016/j.math.2009.11.001
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L50762517
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The effect of experimental groin pain on abdominal muscle thickness
A1 – Jansen J.A.C.G.
A1 – Poot B.
A1 – Mens J.M.A.
A1 – Backx F.J.G.
A1 – Stam H.J.
Y1 – 2010///
PD –
AB – It is not clear whether abnormal abdominal muscle behavior in athletes with longstanding groin pain is a risk factor for groin pain or is caused by groin pain itself. Therefore, this study investigated whether anticipation of experimental groin pain influences abdominal muscle behavior. METHODS: In 14 healthy athletes, abdominal muscle thickness was measured using ultrasound under conditions of anticipated groin pain and acute groin pain. Groin pain was induced using superficial electrical skin stimulation. Tasks evaluated were isometric hip adduction and active straight leg raise (ASLR) left. RESULTS: The m. transversus abdominis and m. obliquus internus showed a significant decrease in thickness during “anticipation of pain” compared with “no pain” and “pain” during both hip adduction and ASLR (P values <0.04). For m. obliquus externus, a significant increase in thickness was found only during “pain” compared with “no pain” and “anticipation of pain” for ASLR (P<0.004). DISCUSSION: If ASLR or hip adduction is associated with anticipated groin pain, abdominal muscle behavior is different from a pain-free situation and from a painful situation. These results suggest that abnormal abdominal muscle behavior found in athletes with longstanding groin pain may be caused by a pain anticipatory motor strategy. This may have implications for rehabilitation. © 2010 by Lippincott Williams & Wilkins. JO – Clinical Journal of Pain PB – CY – VL – 26 IS – 4 PG – 300-305 SP – 300 EP – 305 AN – DO – 10.1097/AJP.0b013e3181b8cde2 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L358700380 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Ultrasound imaging transducer motion during clinical maneuvers: Respiration, active straight leg raise test and abdominal drawing in A1 – Whittaker J.L. A1 – Warner M.B. A1 – Stokes M.J. Y1 – 2010/// PD – AB – Clinical use of ultrasound imaging by physiotherapists is increasing; however, the clinical setting may be problematic due to variability inherent in the environment. As transducer motion interferes with accurate measurement, this study aimed to measure handheld transducer motion, relative to the pelvis, during a clinical simulation involving typical maneuvers employed in a physiotherapy assessment of the lumbopelvic region. Transducer motion about three axes and through one plane was measured (Vicon, Oxford, UK) on 12 participants during three clinical maneuvers at four abdominal imaging sites. Data were grouped and means used to determine discrepancies in transducer and pelvic motion for each imaging site/maneuver combination. None of the conditions produced large transducer motions relative to the pelvis and all findings were within previously established guidelines for acceptable amounts of transducer motion. These findings suggest that an ultrasound transducer can be held relatively stationary in a clinical setting, for the maneuvers tested. © 2010 World Federation for Ultrasound in Medicine & Biology. JO – Ultrasound in Medicine and Biology PB – CY – VL – 36 IS – 8 PG – 1288-1297 SP – 1288 EP – 1297 AN – DO – 10.1016/j.ultrasmedbio.2010.04.020 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L50975788 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Retraining motor control of abdominal muscles among elite cricketers with low back pain A1 – Hides J.A. A1 – Stanton W.R. A1 – Wilson S.J. A1 – Freke M. A1 – McMahon S. A1 – Sims K. Y1 – 2010/// PD – AB – The purpose of this study was to document the effect of a staged stabilization training program on the motor control of the anterolateral abdominal muscles in elite cricketers with and without low back pain (LBP). Changes in the cross-sectional area of the trunk, the thickness of the internal oblique and transversus abdominis (TrA) muscles and the shortening of the TrA muscle in response to an abdominal drawing-in task were measured at the start and completion of a 13-week cricket training camp. Measures were performed using ultrasound imaging and magnetic resonance imaging. Participants from the group with LBP underwent a stabilization training program that involved performing voluntary contractions of the multifidus, TrA and pelvic floor muscles, while receiving feedback from ultrasound imaging. By the end of the training camp, the motor control of cricketers with LBP who received the stabilization training improved and was similar to that of the cricketers without LBP. © 2009 John Wiley & Sons A/S. JO – Scandinavian Journal of Medicine and Science in Sports PB – CY – VL – 20 IS – 6 PG – 834-842 SP – 834 EP – 842 AN – DO – 10.1111/j.1600-0838.2009.01019.x UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L359840558 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Reliability and relationship between 2 measurements of transversus abdominis dimension taken during an abdominal drawing-in maneuver using a novel approach of ultrasound imaging A1 – Jhu J.-L. A1 – Chai H.-M. A1 – Jan M.-H. A1 – Wang C.-L. A1 – Shau Y.-W. A1 – Wang S.-F. Y1 – 2010/// PD – AB – OBJECTIVES: The primary purpose was to develop a reliable method for measuring muscle length changes of the transversus abdominis (TrA) during contraction. The secondary purpose was to investigate the relationship between changes in thickness and length (as indicated by the lateral sliding of the anterior muscle-fascia junction) of the TrA muscle during an abdominal drawing-in maneuver. We also provide data on between-day reliability of change in thickness (ΔT) of the TrA. BACKGROUND: Ultrasound imaging measurements of TrA thickness at rest (Thr) and during maximal contraction (Thm) have been shown to be reliable. However, limited data exist on quantifying changes in TrA length (as indicated by the lateral sliding of the muscle-fascia junction [Δx]) and ΔT during contraction. METHODS: Eighteen healthy adults (mean ± SD age, 22.6 ± 2.5 years) participated in this study. Brightness mode ultrasound images of the TrA were collected at rest and during an abdominal drawing-in maneuver. Subjects were examined by the same examiner twice within a 48-hour period. ΔT, ΔT/Thr, Thr, Thm, and Δx of the TrA were calculated. Medial-lateral movement of the transducer during measurement was corrected through a custom-written program that used an internal marker created by an echo-absorptive thread attached to the skin. Intraclass correlation coefficients (ICC3,1), within-subject coefficient of variance, and standard error of measurement were calculated. The relationship between ΔT and adjusted Δx of the TrA muscle was investigated. RESULTS: The ICC values for Thr, Thm, and ΔT of the TrA muscle were greater than 0.75, with the exception of the left ΔT (0.62) and left ΔT/Thr (0.49). After adjusting for medial-lateral motion of the transducer, the ICC values of adjusted Δx were above 0.75, and the within-subject coefficient of variance was below 10%. There was no significant correlation between ΔT and adjusted Δx of the TrA. CONCLUSION: Ultrasound imaging measurements of TrA thickness and length change were shown to be reliable using a novel method to control for medial-lateral transducer motion. Measuring different but unrelated dimensional changes in the TrA might provide further insight as to the function of the TrA. JO – Journal of Orthopaedic and Sports Physical Therapy PB – CY – VL – 40 IS – 12 PG – 826-832 SP – 826 EP – 832 AN – DO – 10.2519/jospt.2010.3000 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L360156846 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Abdominal hollowing and lateral abdominal wall muscles’ activity in both healthy men & women: An ultrasonic assessment in supine and standing positions A1 – Manshadi F.D. A1 – Parnianpour M. A1 – Sarrafzadeh J. A1 – Azghani M.R. A1 – Kazemnejad A. Y1 – 2011/// PD – AB – The objective of this study was to investigate the effects of Abdominal Hollowing (AH) maneuver on External Oblique (EO), Internal Oblique (IO) and Transversus Abdominis (TrA) muscles in both healthy men and women during the two postures of supine and upright standing. The study was conducted on 43 asymptomatic volunteers (22 males and 21 females) aged 19-44 (27.8 ± 6.4) years. Rehabilitative Ultrasonic Imaging (RUSI) was simultaneously performed to measure muscle thickness in both rest and during AH maneuvers while activation of the TrA during AH was controlled by Pressure Biofeedback (PBF) device. Mixed-model ANOVA with repeated measures design, and Pearson correlation tests were used to analyze the data. Muscle thickness of all muscles was significantly higher for male subjects (F> 6.2, p< 0.017). The interaction effect of gender and muscle status was significant only for IO (F= 7.458, p= 0.009) indicating that AH maneuver increased the thickness of IO in men. Interaction effect of posture and muscle status on muscular thickness indicated that changing position only affects the resting thickness of TrA (F= 5.617, p= 0.023). Standing posture significantly affected the TrA contraction ratio (t= 3.122, p= 0.003) and TrA preferential activation ratio (t= 2.76, p= 0.008). There was no relationship between age and muscle thickness (r= 0.262, p= 0.09). The PBF has been introduced as a clinical and available device for monitoring TrA activity, while RUSI showed that both TrA and IO muscles had activated after AH maneuver. We recommend performing further investigations using electromyography and RUSI simultaneously at more functional postures such as upright standing. © 2009.
JO – Journal of Bodywork and Movement Therapies
PB –
CY –
VL – 15
IS – 1
PG – 108-113
SP – 108
EP – 113
AN –
DO – 10.1016/j.jbmt.2009.10.004
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L50827979
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Immediate effects of lumbar spine manipulation on the resting and contraction thickness of transversus abdominis in asymptomatic individuals
A1 – Puentedura E.J.
A1 – Landers M.R.
A1 – Hurt K.
A1 – Meissner M.
A1 – Mills J.
A1 – Young D.
Y1 – 2011///
PD –
AB – STUDY DESIGN: Randomized, blinded, controlled crossover trial. OBJECTIVE: To determine if thrust joint manipulation (TJM) to the lumbar spine would result in changes to the resting and contraction thickness of transversus abdominis (TrA) in healthy individuals. BACKGROUND: Recent studies have demonstrated an immediate decrease in resting thickness and an increase in contraction thickness in TrA following lumbar TJM in patients with low back pain (LBP) who met a clinical prediction rule (CPR) for spinal manipulation. This observed phenomenon has not been investigated in healthy individuals. METHODS: Thirty-five healthy participants were randomly assigned to receive a TJM or sham manipulation treatment. All participants received instruction on how to produce an isolated concentric contraction of the TrA that involved visual ultrasound imaging biofeedback. Data were analyzed using ultrasound imaging to measure changes in thickness of the TrA at rest and during contraction, following the administration of each treatment. RESULTS: There were no interactions observed between treatment and time for TrA muscle thickness at rest (P = .351) and during the contracted state (P = .761). CONCLUSION: Our results indicate that TJM to the lumbar spine does not appear to affect the resting or contraction thickness of TrA in healthy individuals. These findings are in contrast to previous research in which patients with LBP who met a CPR demonstrated an immediate decrease in resting thickness and an increase in contraction thickness in TrA following lumbar TJM.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 41
IS – 1
PG – 13-21
SP – 13
EP – 21
AN –
DO – 10.2519/jospt.2011.3311
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L361139493
NS –
N1 – Exclusion reason: 7.- Wrong patient population;
ER –

TY – JOUR
T1 – Inter-rater reliability of ultrasound imaging of the trunk musculature among novice raters
A1 – Teyhen D.S.
A1 – George S.Z.
A1 – Dugan J.L.
A1 – Williamson J.
A1 – Neilson B.D.
A1 – Childs J.D.
Y1 – 2011///
PD –
AB – CONCLUSIONS: Good to excellent reliability was obtained for all measures by novice raters. Minimal differences in reliability were noted between the different measurement techniques to assess lateral abdominal muscle thickness.
JO – Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
PB –
CY –
VL – 30
IS – 3
PG – 347-356
SP – 347
EP – 356
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L602063300
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Effect of pilates mat exercises and conventional exercise programmes on transversus abdominis and obliquus internus abdominis activity: Pilot randomised trial
A1 – Critchley D.J.
A1 – Pierson Z.
A1 – Battersby G.
Y1 – 2011///
PD –
AB – Pilates training is said to increase Transversus abdominis (TrA) and Obliquus internus (OI) activation during exercise and functional activities.34 Pain-free health club members with no Pilates experience, mean (SD) age 30(7) years, were randomised to Pilates mat exercises or strength training. Participants exercised unsupervised twice-weekly for eight weeks. TrA and OI thickness (a proxy for muscle activity at the low-medium efforts of our exercises) were measured with ultrasound pre- and post-training during Pilates exercises ‘Imprint’ (an abdominal drawing-in manoeuvre) and ‘Hundreds A’ (lying supine, arms slightly raised, hips and knees flexed to 90°) and ‘Hundreds B’ (as A, with neck flexion) and functional postures sitting and standing.Pilates participants had increased TrA thickness in Hundreds A [all values mean (SD) mm]: 3.7(1.3) pre-intervention, 4.7(1.1) post-intervention (P = 0.007); and decreased OI muscle thickness during Imprint: 11.7(2.8) pre-intervention, 10.8(3.5) post-intervention (P = 0.008). Strength training participants had greater OI thickness during Imprint (P = 0.014), Hundreds A (P = 0.018) and Hundreds B (P = 0.004) than Pilates participants post-intervention. There were no changes in muscle thickness at rest or during functional postures.Pilates training appears to increase TrA activity but only when performing Pilates exercises. Further research is required into Pilates in clinical populations and how to increase deep abdominal activation during functional activities. © 2010 Elsevier Ltd.
JO – Manual Therapy
PB –
CY –
VL – 16
IS – 2
PG – 183-189
SP – 183
EP – 189
AN –
DO – 10.1016/j.math.2010.10.007
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L51147959
NS –
N1 – Exclusion reason: 7.- Wrong patient population;
ER –

TY – JOUR
T1 – The relationships between inter-recti distance measured by ultrasound imaging and abdominal muscle function in postpartum women: A 6-month follow-up study
A1 – Liaw L.-J.
A1 – Hsu M.-J.
A1 – Liao C.-F.
A1 – Liu M.-F.
A1 – Hsu A.-T.
Y1 – 2011///
PD –
AB – STUDY DESIGN: A prospective longitudinal study. BACKGROUND: Diastasis recti abdominis (DRA) is defined as an increase in the inter-recti distance (IRD), or width of the linea alba. It is a common occurrence in women postpartum. Little information exists on the short- and long-term recovery of IRD and the relationship between changes in IRD and the functional performance of the abdominal muscles. OBJECTIVES: To investigate the natural recovery of IRD and abdominal muscle strength and endurance in women between 7 weeks and 6 months postpartum, and to examine the relationship between IRD and abdominal muscle function. METHODS: Forty postpartum (25-37 years of age) and 20 age-matched, nulliparous females participated. IRD was measured at 4 locations (upper and lower margin of the umbilical ring, and 2.5 cm above and below the umbilical ring) with a 7.5-MHz linear ultrasound transducer. Trunk flexion and rotation strength and endurance were measured with manual muscle testing and curl-ups. Evaluation was conducted at 4 to 8 weeks and 6 to 8 months after childbirth in postpartum women, and only once for the nulliparous female controls. RESULTS: During follow-up, the IRD at 2.5 cm above the umbilical ring and at the upper margin of the umbilical ring decreased (P = .013 and P = .002, respectively). The strength and static endurance of the abdominal muscles improved over time (P<.05). A negative correlation between IRD and abdominal muscle function at 7 weeks and 6 months postpartum was found (r = 0.34 to 0.51; P<.05, except for trunk flexion strength at 6 months postpartum [P = .064]). In addition, IRD changes between 7 weeks and 6 months postpartum were correlated with improvement in trunk flexion strength (Spearman rho = 0.38, P = .040). At 6 months after childbirth, postpartum women had greater mean ± SD IRDs at all 4 locations (from cranial to caudal: 1.80 ± 0.72, 2.13 ± 0.65, 1.81 ± 0.62, and 1.16 ± 0.58 cm) than those of nulliparous females (0.85 ± 0.26, 0.99 ± 0.31, 0.65 ± 0.23, and 0.43 ± 0.17 cm) (all P<.001). All abdominal strength and endurance measurements were less than those of nulliparous females (all P<.001). CONCLUSIONS: The IRD and abdominal muscle function of postpartum women improved but had not returned to normal values at 6 months after childbirth. Future research is essential to explore the need for intervention and, if needed, the effectiveness of specific intervention to reduce the size of IRD in postpartum women.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 41
IS – 6
PG – 435-443
SP – 435
EP – 443
AN –
DO – 10.2519/jospt.2011.3507
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L361893179
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Reliability of ultrasound measures of the abdominal muscles: Effect of task and transducer position
A1 – Larivière C.
A1 – Gagnon D.
A1 – De Oliveira Junior E.
A1 – Henry S.M.
A1 – Dumas J.-P.
Y1 – 2011///
PD –
AB – Purpose: To assess the reliability of ultrasonographic measures of abdominal muscles during different automatic tasks and to test whether a foam cube that controls the tilt and pressure applied on the transducer enhances reliability. Relevance: Reliable ultrasonographic measures are required to substantiate neuromuscular impairments (atrophy, poor motor control) of abdominal muscles in back pain patients. The use of automatic tasks instead of the abdominal drawing-in maneuver (ADIM) volitional task has the potential to increase reliability. Imbedding the transducer in a dense foam cube may help control pressure and tilting but the effect on reliability remains unknown. Participants: 15 healthy (8 men) and 15 patients (5 men) with non-specific chronic low-back pain. Methods: The three tasks performed while supine were the: (1) contralateral straight leg raise (SLH), (2) bilateral hooklying leg rising (HLR) and (3) ADIM (healthy subjects only). Two 8-seconds videos of the anterolateral abdominal wall (from rest to contraction) were collected on each side, with and without the use of the foam cube. One of the two raters repeated the testing 7-14 days later to assess intra-rater reliability. Analysis: Muscle thicknesses of the transversus abdominus (TrA), internal oblique (IO) and external oblique (EO) muscles were calculated at rest and during contraction. The generalizability theory was applied to assess intra-rater (2 Days×2 Images) and inter-rater (2 Raters×2 Images) reliability. Coefficients of dependability (ID, analogous to ICC) and standard error of measurement (SEM) expressed as a percentage of the grand mean were computed. Results: In contrast to the ADIM where the TrA thickness change increased significantly more (101%) than IO (33%) and EO (-1%), the automatic tasks (SLR and HLR) recruited the TrA less preferentially (30-40%) relative to IO (11-17%; P < 0.05) and EO (25-33%; P > 0.05). The reliability results were comparable between the three tasks, with intra-rater [ID: 0.67-0.95; SEM: 8-19%] being better than inter-rater [ID: 0.48-0.93; SEM: 12-25%] reliability results across variables (rest and contractions), muscles, tasks, sides and foam cube conditions. The use of the foam cube significantly (P = 0.05) but only slightly (by 1.2%) decreased INTER-rater SEM scores (no effect on ID scores and INTRA-rater reliability). Conclusions: While not as specific as the ADIM for TrA recruitment, the SLR and HLR automatic tasks showed comparable reliability results. The use of a foam cube to control the tilting and pressure applied on the transducer had limited effect reliability. Implications: The use of automatic tasks to study abdominal muscle function provides outcome measures that are independent of any rehabilitation program, thus providing an unbiased assessment, an important consideration particularly when the ADIM is a component of a lumbar stabilization program. Although the use of a foam cube leads to marginal gains in terms of reliability, it can be easily applied clinically and consequently, is recommended to standardize the placement of the ultrasound transducer.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 97
IS – (Dumas J.-P.) Université De Sherbrooke, École De Réadaptaion, Sherbrooke, Canada
PG – eS383-eS384
SP – eS383
EP – eS384
AN –
DO – 10.1016/j.physio.2011.04.002
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L71882696
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Ultrasound Measurement of Transversus Abdominis During Loaded, Functional Tasks in Asymptomatic Individuals: Rater Reliability
A1 – Watson T.
A1 – McPherson S.
A1 – Fleeman S.
Y1 – 2011///
PD –
AB – To examine the ability of 2 clinicians to consistently measure recorded contractions of the transversus abdominis (TrA) muscle via ultrasound imaging (USI) during lifting and reaching tasks typical of everyday or work-related activities. Design: Methodologic survey that measured inter- and intrarater reliability. Setting: University laboratory. Participants: A subset of 54 cine-loop images that were randomly selected from 6 randomly selected asymptomatic adults from a larger study that consisted of a sample of convenience of 20 asymptomatic adults, with a mean (SD) age of 18.8 ± 2.5 years and mean (SD) body mass index of 25.5 ± 3.5 kg/m2. Main Outcome Measures: Thickness changes in the TrA muscle at rest and during contraction while performing 5 functional, loaded tasks. Intraclass correlation coefficients (ICC) were used to estimate reliability. ICC model 2,1 was used for all reliability analyses on 3 TrA muscle measures: minimum thickness, maximum thickness, and percentage change in muscle thickness. Percentage thickness change of TrA muscle was calculated as ([thicknessmax – thicknessmin]/thicknessmin) × 100. Results: Two clinicians both scored 9 trials of 6 randomly selected participants (54 cine loops). Rater 1 scored these images again 28 days later. All image information (participant, trial, task, and testing session) was masked. Interrater ICC (2,1) for TrA muscle measures were moderate (0.71 rested state, 0.83 contracted state, 0.81 percentage change of muscle thickness); and high for intrarater ICC (2,1) (0.97 rested state, 0.99 contracted state, and 0.95% change in muscle thickness). Conclusion: This study provides data for ensuring acceptable reliability of USI measures of TrA muscle thickness and thickness changes taken during loaded and functional activities. This study is the first to examine interrater and intrarater reliability of recorded cine loop images of asymptomatic adults in upright positions on 3 measures of TrA muscle activation (minimum, maximum, and percent change in muscle thickness). Reliable USI measures of TrA muscle thickness changes meet the ongoing need for clinicians’ knowledge of proper and sufficiently adequate muscle activation in the clinical setting to assist progression of lumbar stabilization exercises. © 2011 American Academy of Physical Medicine and Rehabilitation.
JO – PM and R
PB –
CY –
VL – 3
IS – 8
PG – 697-705
SP – 697
EP – 705
AN –
DO – 10.1016/j.pmrj.2011.03.015
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L51513634
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Ultrasound measurement of deep abdominal muscle activity in sitting positions with different stability levels in subjects with and without chronic low back pain
A1 – Rasouli O.
A1 – Arab A.M.
A1 – Amiri M.
A1 – Jaberzadeh S.
Y1 – 2011///
PD –
AB – The purpose of this study was to investigate the changes in the thickness of the transversus abdominis (TrA) and internal oblique (IO) muscles in three sitting postures with different levels of stability. The technique of ultrasound imaging was used for individuals with and without chronic low back pain (LBP). A sample of 40 people participated in this study. Subjects were categorised into two groups: with LBP (N = 20) and without LBP (N = 20). Changes in the thickness of tested muscles were normalized under three different sitting postures to actual muscle thickness at rest in the supine lying position and were expressed as a percentage of thickness change. The percentage of thickness change in TrA and IO increased as the stability of the sitting position decreased in both groups. However, the percentages of thickness change in all positions were less in subjects with LBP. There was a significant difference in thickness change in TrA when sitting on a gym ball between subjects with and without LBP but no difference was found when sitting on a chair. There was no significant difference in thickness change in IO in all positions between the two groups. Our findings indicate that difference in the percentage of thickness change in TrA between subjects with and without LBP increases as the stability of sitting position decreases. © 2011 Elsevier Ltd.
JO – Manual Therapy
PB –
CY –
VL – 16
IS – 4
PG – 388-393
SP – 388
EP – 393
AN –
DO – 10.1016/j.math.2011.01.009
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L51277610
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Investigation of abdominal muscle thickness changes after spinal manipulation in patients who meet a clinical prediction rule for lumbar stabilization
A1 – Konitzer L.N.
A1 – Gill N.W.
A1 – Koppenhaver S.L.
Y1 – 2011///
PD –
AB – STUDY DESIGN: Prospective case series. OBJECTIVES: To investigate changes in abdominal muscle thickness with ultrasound imaging, after spinal manipulative therapy (SMT), in a subgroup of patients with low back pain (LBP) who meet a proposed clinical prediction rule for lumbar stabilization exercise (LSE). BACKGROUND: The characteristics of a subgroup of patients with LBP who respond clinically to LSE has been proposed. Although the pathoanatomical characteristics of this subgroup have not been determined, clinicians often assume that this type of LBP is related, in part, to neuromuscular deficits of the lateral abdominal muscles. Recent evidence suggests that SMT may facilitate abdominal muscle activity and, therefore, enhance exercises targeting these deficits. METHODS: Nineteen patients (mean age . SD, 32.5 . 7.8 years; 11 female) with LBP, who met the criteria for LSE, underwent ultrasound imaging of the transversus abdominis (TrA) and internal oblique (IO) muscles before, immediately after, and 3 to 4 days after lumbopelvic SMT. Measurements of resting thickness, contracted thickness during the abdominal drawing-in maneuver, and percent thickness change from rest to contraction of the TrA and IO muscles were analyzed with repeated-measures analysis of variance. Numeric pain rating scale and Oswestry Disability Index data were also collected. RESULTS: No significant differences in resting, contracted, or percent thickness change in the TrA or IO were found over the 3 time periods. There were statistically significant reductions in numeric pain rating scale and Oswestry Disability Index scores, but mean differences failed to meet the minimal clinically important difference. CONCLUSION: The results provide preliminary evidence that TrA and IO muscle resting and contracted thicknesses do not change post-SMT in patients with LBP in the LSE subgroup. In addition, while reductions in pain and disability were noted, they were not clinically meaningful.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 41
IS – 9
PG – 666-674
SP – 666
EP – 674
AN –
DO – 10.2519/jospt.2011.3685
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L362501893
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Discriminative and reliability analyses of ultrasound measurement of abdominal muscles recruitment
A1 – Ferreira P.H.
A1 – Ferreira M.L.
A1 – Nascimento D.P.
A1 – Pinto R.Z.
A1 – Franco M.R.
A1 – Hodges P.W.
Y1 – 2011///
PD –
AB – Rehabilitative ultrasound imaging has a great potential to be used as a tool in the assessment of trunk muscle function in patients with low back pain (LBP). However, a further investigation of the discriminative ability of this tool as well as the effect of operators’ levels of training on reliability is warranted. Discriminative analysis of ultrasound and electromyography (EMG) measurements of transversus abdominus (TrA), obliquus internus (OI), and obliquus externus (OE) muscles function between people with and without LBP and the effect of operator’s training on reliability of TrA muscle function of chronic LBP patients were conducted. For the discriminative study, measurements were collected from 10 subjects with LBP and 10 matched controls during isometric low load tasks with their limbs suspended. For the reliability study, in stage 1 the reliability of single ultrasonographic static images involved 4 operators (1 trained and 3 non-trained), whereas, in stage 2, two operators (1 trained and 1 non-trained) were used to determine the reliability of TrA thickness change. Methods used in the statistical analysis were pearson correlation and receiver operating characteristic curve for the discriminative study and intraclass correlation coefficient (ICC) for the reliability study. While ultrasound measures of OE muscle function showed poor association with EMG (r = 0.28, p = 0.22), TrA and OI function showed moderate to excellent association (TrA: r = 0.74, p < 0.000; OI: r = 0.85, p < 0.000). Ultrasound and EMG measures of TrA and OI function discriminated LBP patients from controls. Reliability of the assessment of TrA function with a trained operator (ICC = 0.92; 95% CI: 0.81-0.97) was substantially higher than a non-trained one (ICC = 0.44; 95% CI: -0.41-0.78).In conclusion, ultrasound measures of deep trunk function is a valid discriminative tool in LBP but highly dependent on operator’s level of training. © 2011 Elsevier Ltd.
JO – Manual Therapy
PB –
CY –
VL – 16
IS – 5
PG – 463-469
SP – 463
EP – 469
AN –
DO – 10.1016/j.math.2011.02.010
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L51316138
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Comparison of lateral abdominal muscle thickness between weightlifters and matched controls
A1 – Sitilertpisan P.
A1 – Pirunsan U.
A1 – Puangmali A.
A1 – Ratanapinunchai J.
A1 – Kiatwattanacharoen S.
A1 – Neamin H.
A1 – Laskin J.J.
Y1 – 2011///
PD –
AB – Objective: To compare lateral abdominal muscle thickness between weightlifters and matched controls. Design: A case control study design. Setting: University laboratory. Subjects: 16 female Thai national weightlifters and 16 matched controls participated in this study. Main outcome measures: Ultrasound imaging with a 12-MHz linear array was used to measure the resting thickness of transversus abdominis (TrA), internal oblique (IO) and total thickness (Total) of lateral abdominal muscle (LAM) on the right side of abdominal wall. The absolute muscle thickness and the relative contribution of each muscle to the total thickness were determined. Results: Weightlifters had significantly thicker absolute TrA and IO muscles than matched controls (p < 0.01). Further, the relative thickness of the IO was significantly greater in weightlifters than matched controls (p < 0.05). Conclusions: The findings of this study suggest that routine Olympic style weight training among female weightlifters appears to result in preferential hypertrophy or adaptation of the IO muscle. © 2011 Elsevier Ltd.
JO – Physical Therapy in Sport
PB –
CY –
VL – 12
IS – 4
PG – 171-174
SP – 171
EP – 174
AN –
DO – 10.1016/j.ptsp.2011.02.002
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L51312504
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The effect of lumbar posture on abdominal muscle thickness during an isometric leg task in people with and without non-specific low back pain
A1 – Pinto R.Z.
A1 – Ferreira P.H.
A1 – Franco M.R.
A1 – Ferreira M.C.
A1 – Ferreira M.L.
A1 – Teixeira-Salmela L.F.
A1 – Oliveira V.C.
A1 – Maher C.
Y1 – 2011///
PD –
AB – This study investigated the effect of lumbar posture on function of transversus abdominis (TrA) and obliquus internus (OI) in people with and without non-specific low back pain (LBP) during a lower limb task. Rehabilitative ultrasound was used to measure thickness change of TrA and OI during a lower limb task that challenged the stability of the spine. Measures were taken in supine in neutral and flexed lumbar postures in 30 patients and 30 healthy subjects. Data were analysed using a two-way (groups, postures) ANOVA. Our results showed that lumbar posture influenced percent thickness change of the TRA muscle but not for OI. An interaction between group and posture was found for TrA thickness change (F1,56 = 6.818, p = 0.012). For this muscle, only healthy participants showed greater thickness change with neutral posture compared to flexed (mean difference = 6.2%; 95% CI: 3.1-9.3%; p < 0.001). Comparisons between groups for both muscles were not significant. Neutral lumbar posture can facilitate an increase in thickness of the TrA muscle while performing a leg task, however this effect was not observed for this muscle in patients with LBP. No significant difference in TrA and OI thickness change between people with and without non-specific LBP was found. © 2011 Elsevier Ltd.
JO – Manual Therapy
PB –
CY –
VL – 16
IS – 6
PG – 578-584
SP – 578
EP – 584
AN –
DO – 10.1016/j.math.2011.05.010
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L51493776
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Morphological change of muscle-fascia junctions of transversus abdominis in asymptomatic participantsea dynamic ultrasonographic study
A1 – Chen Y.-H.
A1 – Chai H.-M.
A1 – Wang C.-L.
A1 – Shau Y.-W.
A1 – Wang S.-F.
Y1 – 2012///
PD –
AB – Background The transversus abdominis (TrA) is the deepest abdominal muscle which is connected to the lumbar spine via thoracolumbar fascia [1]. Patients with chronic low back pain demonstrated a deficit in the performance of the TrA. Previous studies focus on measuring sliding of the anterior muscle-fascia junction of TrA. Purpose This study is to investigate the thickness and sliding of posterior muscle-fascia junction of TrA by establishing (1) the reliability of measuring; (2) the relationship between the anterior and posterior sites of the TrA. Methods Asymptomatic participants (n=20) were positioned in hook-lying to perform abdominal drawing-in maneuver (ADIM) viewed in B-mode with 5-12 MHz linear Ultrasound transducer. The outcome variables included the resting thickness (Thr), the thickness during contraction (Thc), DT (change of thickness), and ΔX (change of sliding length). Intra-class correlation coefficient (ICC) was used to test the reliability. The relationship between the US measurements of the anterior and posterior muscle-fascia junctions of the TrA were analyzed with Pearson correlation. Results Measuring the thickness and sliding of muscle-fascia junction of posterior site of the TrA showed good reliability (ICC(3,3)=0.888-0.978). The correlation between the measurements between the anterior and posterior sites of the TrA were moderate to good (Pearson correlation (r) =0.41-0.74). Discussion 1) Measuring the musculofascial corset from the posterior site using ultrasonography is reliable; 2) the US measurements at both anterior and posterior sites of the TrA provide comprehensive evaluation to the fascia of TrA.
JO – Journal of Bodywork and Movement Therapies
PB –
CY –
VL – 16
IS – 2
PG – 156-157
SP – 156
EP – 157
AN –
DO – 10.1016/j.jbmt.2012.01.071
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L70898217
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Sonographic features of the abdominal wall perimuscular connective tissues in people with and without lumbopelvic pain
A1 – Whittaker J.L.
A1 – Stokes M.
Y1 – 2012///
PD –
AB – Background The abdominal wall muscles are important for spinal control and under normal circumstances function in a coordinated manner to pressurize the abdominal cavity and transfer loads around the trunk through the perimuscular connective tissue (PMCT).1 There is evidence of functional deficits (ranging from delayed onset and diminished responses, to excessive responses) in individuals with LPP2 however little is known about the PMCT in this population. Ultrasound imaging (USI) provides a non-invasive method to quantify PMCT thickness3 and may be able to identify differences in the resting characteristics of these tissues in the abdominal wall of persons with LPP. Methods Brightness-mode USI was used to measure the resting thickness of the PMCT (figure) associated with the four abdominal muscles in 50 participants (25 with and 25 without LPP, aged 46.6±8.0 and 36.3±9.4 years respectively). Results Cohorts did not differ in gender, body mass index (BMI) or parity. However, the LPP group was slightly older (p=0.01). Total PMCT thickness did not correlate with age or gender however did with BMI. The LPP cohort had significantly thicker PMCT (0.55 ± 0.02cm) than the control group (0.43 ± 0.02cm; ANCOVA adjusted for BMI, p=0.007). Conclusions This is the first investigation to consider the resting thickness of the PMCT associated with the abdominal muscles and the first to report differences in persons with LPP. These findings are not attributable to characteristics such as BMI, age or gender. Possible causes include remodelling driven by increased loading or altered movement patterns, chronic inflammation or genetic factors. (Figure Presented).
JO – Journal of Bodywork and Movement Therapies
PB –
CY –
VL – 16
IS – 2
PG – 150-151
SP – 150
EP – 151
AN –
DO – 10.1016/j.jbmt.2012.01.063
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L70898209
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Transversus abdominis, internal oblique and external oblique thickening change during a voluntary contraction in individuals with chronic low back pain
A1 – Fernandes R.
A1 – Da Silva P.A.
A1 – Pool-Goudzwaard A.
Y1 – 2012///
PD –
AB – Introduction Ultrasound (US) imaging has been used in rehabilitation to evaluate muscle morphology and function in persons with neuromusculoskeletal disorders such as low back pain [Teyhen, 2007]. To date, the use of US in low back pain research has focused on transversus abdominis (TrA) and multifidus muscles, because dysfunction of these muscles have been linked to low back pain [Hungerford, Gilleard, & Hodges, 2003]. Using US to quantify muscle size relies on its ability to measure muscle thickness and cross sectional area. Rehabilitative US imaging has been found to have good within and between rater reliability (ICC 0.62 to 1.00), especially when used by experienced examiners and/or when multiple measurements are averaged [Hebert, Koppenhaver, Parent, & Fritz, 2009]. At low levels of contraction, the extent of TrA thickening measured using US is reported to be a valid method of assessment compared with Magnetic Resonance Imaging (MRI) indices of muscle thickness [Hides et al., 2006]. To date studies comparing abdominal muscle thickness changes between healthy controls and individuals with chronic low back pain (CLBP) during a voluntary contraction of TrA show contradictory results: Ones found no significant difference between the two groups [Gorbet, Selkow, & Hart, 2010)], whereas others showed a significantly reduced ability in the patient group compared with controls [Critchley & Coutts, 2002]. Considering the presented findings, it seems important to clarify the abdominal muscle thickness changes in individuals with CLBP during a voluntary contraction of TrA. Methods For this cross-sectional study participants are individuals with persistent LBP with or without referred pain (of a non-radicular nature) for at least 3 months and with age between 18 and 65 years. Transversus Abdominis (TrA), Internal Oblique (IO) and External Oblique (EO) muscle function is measured as a change in thickness with ultrasound imaging. Participants perform a voluntary TrA contraction in supine lying position and during the active straight leg raise test. Results The results will be presented according the resting thickness, contracted thickness and thickness change of the abdominal muscles (TrA, OI and OE) in this sample of individuals with CLBP. Discussion Discussion will focus on the relation between the obtained results concerning to resting thickness, contracted thickness and thickness change of the abdominal muscles and some mechanisms associated with pain in individuals with CLBP.
JO – Journal of Biomechanics
PB –
CY –
VL – 45
IS – (Pool-Goudzwaard A.) Department of Neuroscience, Erasmus MC, University Medical Center, Rotterdam, Netherlands
PG – S502
SP – S502
EP –
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L615424828
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Reliability of real-time ultrasound measurement of transversus abdominis thickness in healthy trained subjects
A1 – Gnat R.
A1 – Saulicz E.
A1 – Miadowicz B.
Y1 – 2012///
PD –
AB – Purpose: To investigate intra- and inter-rater reliability of the ultrasound measurement of transversus abdominis (TrA) thickness and thickness change (difference between thickness at rest and during contraction) in asymptomatic, trained subjects. To define the number of repeated measurements that provide acceptable level of reliability. To investigate variability of the measurements over time of 5 days and the reliability of duplicate analysis of images. Methods: A single-group repeated-measures design was used to assess reliability. Healthy volunteers (n = 10) were subjected to 1-week training in voluntary activation of TrA. Real-time ultrasound imaging and subsequent measurement of the TrA thickness at rest and during voluntary contraction were repeated on Monday, Wednesday and Friday of the next week. Results: Using a single repeated measurement, intraclass correlation coefficients (ICCs) for TrA thickness were: 0.86-0.95 (intra-rater), 0.86-0.92 (inter-rater); and for TrA thickness change: 0.34-0.56 (intra-rater), 0.47-0.61 (interrater). Using the mean of three repeated measurements respective values were: 0.97, 0.96-0.98; and 0.81-0.84, 0.80-0.90. No significant differences were found between mean values of TrA thickness as well as thickness change obtained on three consecutive measurement days. Duplicate analysis of the images was highly reliable with ICCs of 0.89-0.99. Conclusions: Two repeated measurements for TrA thickness and at least three measurements for TrA thickness change are needed to achieve acceptable levels of intraand inter-rater reliability. In healthy trained volunteers TrA thickness and thickness change are relatively stable parameters over a 5-day period. Duplicate analysis of the same images by two blinded observers is reliable. © Springer-Verlag 2012.
JO – European Spine Journal
PB –
CY –
VL – 21
IS – 8
PG – 1508-1515
SP – 1508
EP – 1515
AN –
DO – 10.1007/s00586-012-2184-4
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L51859503
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Influence of inward pressure of the transducer on lateral abdominal muscle thickness during ultrasound imaging
A1 – Ishida H.
A1 – Watanabe S.
Y1 – 2012///
PD –
AB – Study Design: Controlled laboratory study, technical note. Objectives: The purpose of this study was to quantify changes in the thickness of the transversus abdominis, internal oblique, and external oblique muscles induced by different inward pressures of the transducer during ultrasound imaging (USI). Background: USI of the lateral abdominal muscles is increasingly used in managing musculoskeletal dysfunction. However, to the best of our knowledge, no study has evaluated the influence of different inward pressures of the transducer on the lateral abdominal muscle thickness during USI. Methods: Thirty healthy male volunteers participated in this study. The thickness of the transversus abdominis, internal oblique, and external oblique muscles was measured with USI by the same rater in 4 conditions of inward pressures of 0.5, 1.0, 2.0, and 4.0 N. Intraclass correlation coefficients (ICC1,1), with 95% confidence intervals, were calculated, and a repeated-measures analysis of variance was used to assess the influence of inward pressure on the thickness of the lateral abdominal muscles. Results: The thickness of the transversus abdominis, internal oblique, and external oblique muscles was significantly different among the 4 conditions (P<.038). The mean difference between the 0.5-N and 4.0-N conditions was greater than the minimal detectable change of the 0.5-N condition in the lateral abdominal muscles. Conclusion: The difference in magnitude produced by the forces under different conditions was meaningful. When using a technique that involves a handheld transducer, the examiner should attempt to maintain consistent inward pressure of the transducer during USI to quantify the thickness of lateral abdominal muscles. Copyright ©2012 Journal of Orthopaedic & Sports Physical Therapy.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 42
IS – 9
PG – 815-818
SP – 815
EP – 818
AN –
DO – 10.2519/jospt.2012.4064
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L365662729
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Association between changes in electromyographic signal amplitude and abdominal muscle thickness in individuals with and without lumbopelvic pain.
A1 – Whittaker J.L.
A1 – McLean L.
A1 – Hodder J.
A1 – Warner M.B.
A1 – Stokes M.J.
Y1 – 2013///
PD –
AB – Validation study. To investigate the association between changes in electromyographic (EMG) signal amplitude and sonographic measures of muscle thickness of 4 abdominal muscles, during 2 clinical tests, in adults with and without lumbopelvic pain. There is a trend in rehabilitation to use ultrasound imaging (USI) to determine the extent of abdominal muscle contraction. However, the literature investigating the relationship between abdominal muscle thickness change and level of activation is inconclusive and has not included clinically relevant tasks. Simultaneous recording from fine-wire EMG and USI was performed for 4 abdominal muscles, in 7 adults with lumbopelvic pain (mean ± SD age, 29.7 ± 12.0 years) and 7 adults without lumbopelvic pain (32.0 ± 10.6 years), during an active straight leg raise (ASLR) test and an abdominal drawing-in maneuver (ADIM). Cross-correlation functions and linear regression analyses were used to describe the relationship between the 2 measures. Analyses of variance were used to compare individuals with and without lumbopelvic pain, with an alpha set at .05. Across all muscles, peak cross-correlation values were low (ASLR, r = 0.28 ± 0.09; ADIM, r = 0.35 ± 0.11), and there was large variability in associated time lags (ASLR, τ = 0.69 ± 2.56 seconds; ADIM, τ = 0.53 ± 3.75 seconds). Regression analyses did not detect a systematic pattern of association between EMG signal amplitude and USI measurements, and analyses of variance revealed no differences between cohorts. These results suggest a weak relationship between EMG amplitude and abdominal muscle thickness change measured with USI during the ADIM and ASLR, and raise questions about thickness change derived from USI as a measure of muscular activity for the abdominal musculature.
JO – The Journal of orthopaedic and sports physical therapy
PB –
CY –
VL – 43
IS – 7
PG – 466-477
SP – 466
EP – 477
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L563040494
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Comparison of the sonographic features of the abdominal wall muscles and connective tissues in individuals with and without lumbopelvic pain
A1 – Whittaker J.L.
A1 – Fcampt
A1 – Warner M.B.
A1 – Stokes M.
Y1 – 2013///
PD –
AB – STUDY DESIGN: Cross-sectional, case-control study. OBJECTIVES: To measure and compare the resting thickness of the 4 abdominal wall muscles, their associated perimuscular connective tissue (PMCT), and interrecti distance (IRD) in persons with and without lumbopelvic pain (LPP), using ultrasound imaging. BACKGROUND: The muscles and PMCT of the abdominal wall assist in controlling the spine. Functional deficits of the abdominal wall muscles have been detected in populations with LPP. Investigations of the abdominal wall in those with LPP are primarily concerned with muscle, most commonly the transversus abdominis (TrA) and internal oblique (IO). Because the abdominal wall functions as a unit, all 4 abdominal muscles and their associated connective tissues should be considered concurrently. METHODS: B-mode ultrasound imaging was used to measure the resting thickness of the rectus abdominis (RA), external oblique, IO, and TrA muscles; the PMCT planes; and IRD in 50 male and female subjects, 25 with and 25 without LPP (mean ± SD age, 36.3 ± 9.4 and 46.6 ± 8.0 years, respectively). Univariate correlation analysis was used to identify covariates. Analyses of covariance (ANCOVAs) and the Kruskal-Wallis test (IRD) were used to compare cohorts (α = .05). RESULTS: The LPP cohort had less total abdominal muscle thickness (LPP mean ± SD, 18.9 ± 3.0 mm; control, 20.3 ± 3.0 mm; ANCOVA adjusted for body mass index, P = .03), thicker PMCT (LPP, 5.5 ± 0.2 mm; control, 4.3 ± 0.2 mm; ANCOVA adjusted for body mass index, P = .007), and wider IRD (LPP, 11.5 ± 2.0 mm; control, 8.4 ± 1.8 mm; Kruskal-Wallis, P = .005). Analysis of individual muscle thickness revealed no difference in the external oblique, IO, and TrA, but a thinner RA in the LPP cohort (LPP mean ± SD, 7.8 ± 1.5 mm; control, 9.1 ± 1.2 mm; ANCOVA adjusted for body mass index, P<.001). CONCLUSION: To our knowledge, this is the first study to investigate the morphological characteristics of all 4 abdominal muscles and PMCT in individuals with LPP. The results suggest that there may be altered loading of the PMCT and linea alba secondary to an altered motor control strategy involving a reduced contribution of the RA. Further, the change in RA and connective tissue morphology may be more evident than changes in external oblique, IO, and TrA thickness in persons with LPP. The causes and functional implications of these changes warrant further investigation, as does the role of the RA muscle in the development and persistence of LPP. Copyright © 2013 Journal of Orthopaedic & Sports Physical Therapy.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 43
IS – 1
PG – 11-19
SP – 11
EP – 19
AN –
DO – 10.2519/jospt.2013.4450
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L368375343
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Concurrent validity of calipers and ultrasound imaging to measure interrecti distance.
A1 – Chiarello C.M.
A1 – McAuley J.A.
Y1 – 2013///
PD –
AB – Clinical measurement, concurrent validity criterion standard. To determine the concurrent validity of digital nylon calipers in comparison to ultrasound imaging (USI) for the measurement of interrecti distance (IRD). Diastasis rectus abdominis is the abnormal increase in the width of the linea alba, measured as IRD. A diastasis rectus abdominis can compromise mechanical trunk function in both genders. IRD has been accurately measured with USI but requires costly equipment and extensive examiner training. Digital nylon calipers are inexpensive and easy to use, but their use to measure IRD has not been validated. A sample of convenience of 56 individuals (11 men, 45 women) was measured. A single examiner was assigned to each tool (calipers or USI), and IRD was measured at 2 locations (above and below the umbilicus) under 2 conditions (abdominal muscles at rest and abdominal muscles contracted). All measurements were made during a single session, and examiners were blinded to measurements with the other tool. Above the umbilicus, the measurements of IRD with calipers were similar to those made with USI, with intraclass correlation coefficients (model 3,2) of 0.79 with abdominal muscles at rest and 0.71 with abdominal muscles contracted. The absolute mean difference between the caliper and USI measurements of IRD above the umbilicus was 0.03 cm larger with the calipers when the abdominal muscles were at rest and 0.03 cm smaller when the abdominal muscles were contracted. The values of IRD obtained with the caliper and USI techniques were not comparable when obtained below the umbilicus. The calipers are a valid tool for measuring IRD above the umbilicus in males and females. Measuring IRD with calipers below the umbilicus should not be considered valid, using USI as the criterion standard. This may reflect anatomical variation of the linea alba or a limitation of the calipers to assess IRD at the same depth as USI.
JO – The Journal of orthopaedic and sports physical therapy
PB –
CY –
VL – 43
IS – 7
PG – 495-503
SP – 495
EP – 503
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L563040495
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Clinimetric analysis of pressure biofeedback and transversus abdominis function in individuals with stabilization classification low back pain
A1 – Grooms D.R.
A1 – Grindstaff T.L.
A1 – Croy T.
A1 – Hart J.M.
A1 – Saliba S.A.
Y1 – 2013///
PD –
AB – OBJECTIVE: To determine if a proposed clinical test (pressure biofeedback) could detect changes in transversus abdominis (TrA) muscle thickness during an abdominal drawing-in maneuver. BACKGROUND: Pressure biofeedback may be used to assess abdominal muscle function and TrA activation during an abdominal drawing-in maneuver but has not been validated. METHODS: Forty-nine individuals (18 men, 31 women) with low back pain who met stabilization classification criteria underwent ultrasound imaging to quantify changes in TrA muscle thickness while a pressure transducer was used to measure pelvic and spine position during an abdominal drawing-in maneuver. A paired t test was used to compare differences in TrA activation ratios between groups (able or unable to maintain pressure of 40 ± 5 mmHg). The groups were further dichotomized based on TrA activation ratio (high, greater than 1.5; low, less than 1.5). Sensitivity, specificity, and likelihood ratios were calculated. RESULTS: There was not a significant difference (P = .57) in TrA activation ratios (able to maintain pressure, 1.59 ± 0.28; unable to maintain pressure, 1.54 ± 0.24) between groups. The pressure biofeedback test had low sensitivity of 0.22 (95% confidence interval [CI]: 0.10, 0.42) but moderate specificity of 0.77 (95% CI: 0.58, 0.89), a positive likelihood ratio of 0.94 (95% CI: 0.33, 2.68), and a negative likelihood ratio of 1.02 (95% CI: 0.75, 1.38). CONCLUSION: Successful completion on pressure biofeedback does not indicate high TrA activation. Unsuccessful completion on pressure biofeedback may be more indicative of low TrA activation, but the correlation and likelihood coefficients indicate that the pressure test is likely of minimal value to detect TrA activation. Copyright © 2013 Journal of Orthopaedic & Sports Physical Therapy.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 43
IS – 3
PG – 184-193
SP – 184
EP – 193
AN –
DO – 10.2519/jospt.2013.4397
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L368475418
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Gender Differences on Ultrasound Imaging of Lateral Abdominal Muscle Thickness in Asymptomatic Adults: A Pilot Study
A1 – Rho M.
A1 – Spitznagle T.
A1 – Van Dillen L.
A1 – Maheswari V.
A1 – Oza S.
A1 – Prather H.
Y1 – 2013///
PD –
AB – Objective: To describe gender and side-to-side differences in lateral abdominal wallmuscle thickness at rest and during contraction in asymptomatic adults.Design: Cross-sectional observational study.Setting: Tertiary university outpatient musculoskeletal clinic.Patients: Asymptomatic, healthy adults.Methods: A single examiner with training in ultrasound (US) assessment evaluated allsubjects and used a different hand to guide the US transducer on each side. Bilateralanteroposterior measurements of transversus abdominis (TrA) and internal oblique (IO) thickness were assessed at rest and during maximal contraction with the use of an abdominal draw-in maneuver (ADM). Three sets of data points were obtained on 12 subjects to determine intrarater reliability within a single session. Main Outcome Measurements: Anteroposterior thickness of TrA and IO muscles (cm). Results: A total of 20 subjects (mean age, 29.3 years; range, 23-46 years; 8 men and 12 women; mean body mass index, 24.4 kg/m2; range, 18.9-34.9 kg/m2) were examined. Atrest, men had greater TrA and IO thickness compared with women (men, 0.55, and women,0.35, P = .01; and men, 0.95, and women, 0.77, P= .04, respectively). At rest, there were no side-to-side differences of TrA or IO muscles for both genders. With an ADM, womendemonstrated a significant percent change in thickness of their TrA muscle compared with men (women, 0.77, and men, 0.29, P= .001). No significant difference was found between men and women in the percent change of IO thickness with ADM (women, 0.20, and men,0.12, P = .24). There was excellent intrarater reliability for measurements of the right abdominal muscles (intraclass correlation coefficient = 0.92-0.95) and moderate-to-goodintrarater reliability for measurements of the left abdominal muscles (intraclass correlationcoefficient = 0.62-0.92). Conclusions: Asymptomatic men have greater TrA and IO thickness at rest compared with asymptomatic women; however, women demonstrated a greater percent change in TrA thickness with an ADM compared with men. © 2013 American Academy of Physical Medicine and Rehabilitation.
JO – PM and R
PB –
CY –
VL – 5
IS – 5
PG – 374-380
SP – 374
EP – 380
AN –
DO – 10.1016/j.pmrj.2013.03.003
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L52535989
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Body mass normalisation for ultrasound measurements of lumbar multifidus and abdominal muscle size
A1 – Nuzzo J.L.
A1 – Mayer J.M.
Y1 – 2013///
PD –
AB – The purpose of this study was to determine if ratio scaling or allometric scaling is the more appropriate method for normalising ultrasound measurements of lumbar multifidus and abdominal muscle size to body mass. In a convenience sample of 62 male career firefighters, cross-sectional area and thickness of the lumbar multifidus, as well as, thicknesses of the external oblique, internal oblique, and transverse abdominal muscles were assessed with ultrasonography. Ratio scaling entailed dividing muscle size by body mass, while allometric scaling entailed dividing muscle size by body mass raised to a power. Significant positive correlations (r = 0.25 to 0.49, p < 0.05) existed between body mass and all muscle size measurements, except for transverse abdominal thickness (r = 0.21, p = 0.100). Ratio scaling was deemed inappropriate for normalising the muscle size measurements, because it merely reversed the direction of the correlations between body mass and the muscle size measurements (r = -0.31 to -0.50, p < 0.05), with external oblique abdominal thickness representing the only exception (r = -0.17, p = 0.192). Allometric scaling with derived allometric parameters was deemed appropriate for normalising muscle size measurements, because it caused the correlations between body mass and muscle size to become insignificant and near to zero (r = -0.06 to 0.00, p > 0.05). The current study provides allometric parameters that can be used to normalise muscle size measurements to body mass in male firefighters. Future research is needed to establish reference databases of population-specific allometric parameters in other groups. © 2012 Elsevier Ltd.
JO – Manual Therapy
PB –
CY –
VL – 18
IS – 3
PG – 237-242
SP – 237
EP – 242
AN –
DO – 10.1016/j.math.2012.10.011
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L52297568
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Reliability of ultrasound measurement of automatic activity of the abdominal muscle in participants with and without chronic low back pain
A1 – Arab A.M.
A1 – Rasouli O.
A1 – Amiri M.
A1 – Tahan N.
Y1 – 2013///
PD –
AB – Background: Ultrasound (US) imaging has been considered as a non-invasive technique to measure thickness and estimate relative abdominal muscle activity. Although some studies have assessed the reliability of US imaging, no study has assessed the reliability of US measurement of automatic activity of abdominal muscles in positions with different levels of stability in participants with chronic low back pain (cLBP). The purpose of this study was to investigate within-day and between-days reliability of US thickness measurements of automatic activity of the abdominal muscles in asymptomatic participants and within-day reliability in those with cLBP.Methods: A total of 20 participants (10 with cLBP, 10 healthy) participated in the study. The reliability of US thickness measurements at supine lying and sitting positions (sitting on a chair, sitting on a gym ball with both feet on the ground or lifting one foot off the floor) were assessed. We evaluated within-day reliability in all participants and between-days reliability in asymptomatic participants.Results: We found high ICC scores (0.85-0.95) and also small SEM and MDC scores in both groups. The reliability of the measurements was comparable between participants with and without LBP in each position but the SEMs and MDCs was slightly higher in patient group compared with healthy group. It indicates high intra-tester reliability for the US measurement of the thickness of abdominal muscles in all positions.Conclusion: US imaging can be used as a reliable method for assessment of automatic activity of abdominal muscles in positions with low levels of stability in participants with and without LBP. © 2013 Arab et al.; licensee BioMed Central Ltd.
JO – Chiropractic and Manual Therapies
PB –
CY –
VL – 21
IS – 1
PG –
SP –
EP –
AN –
DO – 10.1186/2045-709X-21-37
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L52848534
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Co-contractive Activation of the Superficial Multifidus During Volitional Preemptive Abdominal Contraction
A1 – Matthijs O.C.G.
A1 – Dedrick G.S.
A1 – James C.R.
A1 – Brismée J.-M.
A1 – Hooper T.L.
A1 – McGalliard M.K.
A1 – Sizer P.S.
Y1 – 2014///
PD –
AB – Objective: To investigate whether the superficial multifidus (MF) muscle at the lower lumbar spine displayed co-contraction during volitional preemptive abdominal contraction (VPAC) through the abdominal drawing-in maneuver (ADIM) or the abdominal bracing maneuver (ABM) in 3 different postural positions. Design: A within-subject cohort design. Setting: A clinical laboratory. Participants: A healthy convenience sample of 21 women and 13 men; mean age (SD), 25.5 ± 6.5 years. Methods: We collected surface electromyographic measurements for the superficial MF at the L5 vertebral level and abdominal wall muscles. Ultrasound imaging was used during screening and testing sessions for confirming transverse abdominis muscle activation while subjects maintained a relaxed state without volitional abdominal contraction (no-VPAC) and performed ADIM and ABM in 3 postural positions: supine, 4-point kneeling, and upright standing. Main Outcome Measurement: The frequency of superficial MF co-contraction occurrences (percentage of the total number of conditions) was measured during ADIM and ABM in 3 different postural positions. Data Analyses: A Cochran Q test for k-related samples (α = 0.05) was used for data analysis. Results: Activation of the abdominal wall by using either VPAC strategy resulted in a significantly greater MF co-contraction occurrence when compared with no-VPAC in each position. The ABM produced a significantly higher MF co-contractive occurrence versus the ADIM in the supine position. Conclusion: Both VPAC strategies produced a co-contractive MF response, which appears to be important for lumbar segmental stabilization and control. Analysis of the results suggests that VPAC strategies are appropriate for coactivating the MF, which can enhance spinal protection and rehabilitation responses. © 2014 American Academy of Physical Medicine and Rehabilitation.
JO – PM and R
PB –
CY –
VL – 6
IS – 1
PG – 13-21
SP – 13
EP – 21
AN –
DO – 10.1016/j.pmrj.2013.08.606
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L52854954
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The importance of a normal breathing pattern for an effective abdominal-hollowing maneuver in healthy people: An experimental study
A1 – Ha S.-M.
A1 – Kwon O.-Y.
A1 – Kim S.-J.
A1 – Choung S.-D.
Y1 – 2014///
PD –
AB – Context: A normal breathing pattern while performing the abdominal-hollowing (AH) maneuver or spinal-stabilization exercise is essential for the success of rehabilitation programs and exercises. In previous studies, subjects were given standardized instructions to control the influence of respiration during the AH maneuver. However, the effect of breathing pattern on abdominal-muscle thickness during the AH maneuver has not been investigated. Objective: To compare abdominal-muscle thickness in subjects performing the AH maneuver under normal and abnormal breathing-pattern conditions and to investigate the effect of breathing pattern on the preferential contraction ratio (PCR) of the transverse abdominis. Design: Comparative, repeated-measures experimental study. Setting: University research laboratory. Participants: 16 healthy subjects (8 male, 8 female) from a university population. Measurement: A real-time ultrasound scanner was used to measure abdominal-muscle thickness during normal and abnormal breathing patterns. A paired t test was used to assess the effect of breathing pattern on abdominal-muscle thickness and PCR. Results: Muscle thickness in the transverse abdominis and internal oblique muscles was significantly greater under the normal breathing pattern than under the abnormal pattern (P < .05). The PCR of the transverse abdominis was significantly higher under the normal breathing pattern compared with the abnormal pattern (P < .05). Conclusion: The results indicate that a normal breathing pattern is essential for performance of an effective AH maneuver. Thus, clinicians should ensure that patients adopt a normal breathing pattern before performing the AH maneuver and monitor transverse abdominis activation during the maneuver. © 2014 Human Kinetics, Inc.
JO – Journal of Sport Rehabilitation
PB –
CY –
VL – 23
IS – 1
PG – 12-17
SP – 12
EP – 17
AN –
DO – 10.1123/JSR.2012-0059
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L1372247231
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Training of Transversus Abdominis Activation in the Supine Position With Ultrasound Biofeedback Translated to Increased Transversus Abdominis Activation During Upright Loaded Functional Tasks
A1 – McPherson S.L.
A1 – Watson T.
Y1 – 2014///
PD –
AB – Objective: To determine whether healthy adults successfully completing transversus abdominis (TrA) muscle activation training in the supine position with clinician and ultrasound (US) imaging feedback increase their TrA activation during lifting and reaching tasks performed in the standing position. Design: Prospective longitudinal within-subject, repeated-measures (RM) study. Setting: University laboratory. Participants: A total of 19 of 24 asymptomatic adult volunteers met inclusion criteria. Methods: Each adult performed 3 trials of 5 functional tasks before receiving any training. They were then briefed on the abdominal draw-in maneuver via educational materials. Next, each adult received individualized TrA activation training while in the supine position with clinician and US feedback of TrA activation. At 5 minutes after TrA activation training, each adult who met the criterion during training performed 3 trials of these same 5 functional tasks. Tasks were randomized during these test sessions. Adults who returned 5 months later (n= 10) were tested again on 3 trials of 3 of these tasks. No feedback was provided during test sessions. Recorded cine loop images were obtained via US per trial and masked for TrA measurement. Main Outcome Measurements: Resting state (minimum thickness) and contraction state (maximum thickness) of TrA were measured per recorded trial by a clinician who was shown to have high reliability. The percentage of change in TrA thickness {[(thicknessmax – thicknessmin)/ thicknessmin]× (100)} was the primary outcome measure. Trial averages were formed per measure per task per test session per adult. Results: A 2-test sessions (pretraining, 5-minutes post-training)× 5 tasks RM analysis of variance (N= 19) indicated a significant and large effect for test sessions (P< .001, η2= 0.808) and moderate effect for tasks (P= .011; η2= 0.164). Likewise, a 3-test sessions (pretraining, 5-minutes posttraining, 5 months post-training)× 3 tasks RM analysis of variance (n= 10) indicated a significant and large test sessions effect (P< .001, η2= 0.57) and no task effect. Overall, the percent change in TrA thickness increased after the TrA activation training program and was maintained at 5 months; similar patterns of improvement were noted across test sessions and tasks. Conclusion: Asymptomatic adults successfully completing a short session of TrA activation training in the supine position with US feedback of TrA activation were able to increase their TrA activation during loaded lifting and reaching tasks for at least 5 months. © 2014 American Academy of Physical Medicine and Rehabilitation.
JO – PM and R
PB –
CY –
VL – 6
IS – 7
PG – 612-623
SP – 612
EP – 623
AN –
DO – 10.1016/j.pmrj.2013.11.014
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L52991836
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Ultrasound measurements of lumbar multifidus and abdominal muscle size in firefighters
A1 – Nuzzo J.L.
A1 – Haun D.W.
A1 – Mayer J.M.
Y1 – 2014///
PD –
AB – CONCLUSIONS: The majority of lumbar multifidus and abdominal muscle size measurements in firefighters are similar to the general population and soldiers. The larger lumbar multifidus CSA in firefighters compared with the general population warrants further study. These data provide a basis for future research using ultrasonography to assess muscle size in firefighters and other workers in physically-demanding occupations.
JO – Journal of Back and Musculoskeletal Rehabilitation
PB –
CY –
VL – 27
IS – 4
PG – 427-433
SP – 427
EP – 433
AN –
DO – 10.3233/BMR-140463
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L600360357
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Inter-rectus distance in postpartum women can be reduced by isometric contraction of the abdominal muscles: A preliminary case-control study
A1 – Pascoal A.G.
A1 – Dionisio S.
A1 – Cordeiro F.
A1 – Mota P.
Y1 – 2014///
PD –
AB – Objectives: To determine the effect of isometric contraction of the abdominal muscles on inter-rectus distance in postpartum women. Design: Preliminary case-control study. Setting: Research laboratory. Participants: Ten postpartum women {mean age 30 [standard deviation (SD) 4] years; mean weight 58 (SD 7) kg; mean height 159 (SD 4) cm} and 10 nulliparous (control) women [mean age 28 (SD 2) years; mean weight 56 (SD 6) kg; mean height 160 (SD 6) cm]. Interventions: Ultrasound images from the anterior abdominal wall were recorded at rest (supine position) and during an abdominal isometric contraction, with the subject actively performing an abdominal crunch (crook lying position). Two-way analysis of variance was used to compare the inter-rectus distance between groups (postpartum vs control) and between levels of abdominal muscle activation (rest vs isometric contraction). Main outcome measures: Inter-rectus distance 2. cm above the level of the umbilicus. Results: The inter-rectus distance was significantly greater in the postpartum group compared with the control group [14.7 (SD 3.1) mm vs 9.6 (SD 2.8) mm; mean difference 5.1. mm; 95% confidence interval (CI) 3.4 to 6.8]. The inter-rectus distance was significantly lower during isometric contraction compared with rest [10.7 (SD 3.1) mm vs 13.4 (SD 3.1) mm; mean difference 2.8. mm; 95% CI 1.2 to 4.5]. No interaction was found between group and muscle contraction. Conclusions: The inter-rectus distance was significantly higher in postpartum women compared with controls, and significantly lower during isometric contraction of the abdominal muscles (abdominal crunch) compared with rest.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 100
IS – 4
PG – 344-348
SP – 344
EP – 348
AN –
DO – 10.1016/j.physio.2013.11.006
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L53017761
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Assessment of transverse abdominal muscle symmetry by ultrasonography
A1 – Myśliwiec A.
A1 – Kuszewski M.
A1 – Saulicz E.
A1 – Linek P.
A1 – Wolny T.
A1 – Białach M.
A1 – Posłuszny A.
Y1 – 2014///
PD –
AB – CONCLUSIONS: 1. Differences in the distance between the transverse abdominal muscle and the linea alba on left and right side of the body were discovered in the study group. 2. No correlations were found between the presence of an asymmetry and lumbar pain in the study group.
JO – Ortopedia, traumatologia, rehabilitacja
PB –
CY –
VL – 16
IS – 4
PG – 427-434
SP – 427
EP – 434
AN –
DO – 10.5604/15093492.1119620
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L616324725
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Interrater and intrarater reliability of transverse abdominal and lumbar multifidus muscle thickness in subjects with and without low back pain
A1 – Djordjevic O.
A1 – Djordjevic A.
A1 – Konstantinovic L.
Y1 – 2014///
PD –
AB – 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.
JO – The Journal of orthopaedic and sports physical therapy
PB –
CY –
VL – 44
IS – 12
PG – 979-988
SP – 979
EP – 988
AN –
DO – 10.2519/jospt.2014.5141
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L606711038
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The abdominal drawing-in manoeuvre for detecting activity in the deep abdominal muscles: Is This clinical tool reliable and valid?
A1 – Kaping K.
A1 – Äng B.O.
A1 – Rasmussen-Barr E.
Y1 – 2015///
PD –
AB – Objective: The abdominal drawing-in manoeuvre (ADIM) is a common clinical tool for manually assessing whether a preferential activation of the deep abdominal muscles in patients with low back pain (LBP) is correct or not. The validity and reliability of manual assessment of the ADIM are, however, as yet unknown. This study evaluated the concurrent and discriminative validity and reliability of the manually assessed ADIM. Design: Single-blinded cross-sectional study. Settings: General population in Stockholm County, Sweden. Participants: The study sample comprised 38 participants seeking care for LBP, and 15 healthy subjects. Measures: The manual ADIM was assessed as correct or not following a standard procedure. Ultrasound imaging (USI) was used as the concurrent reference (gold standard) for the manually assessed ADIM by calculating a ratio of the change in muscle thickness between the resting and the contracted states: the correlation between manual test and USI was calculated. Discriminative validity was analysed by calculating sensitivity and specificity. A sample of 24 participants was analysed with ê coefficients for interobserver reliability between two raters. Results: The concurrent validity between the manual ADIM and the ADIM-USI ratios showed poor correlations (r=0.130.40). The discriminative validity of the manually assessed ADIM to predict LBP showed a sensitivity/specificity of 0.30/0.73, while the ADIM USI ratio to predict LBP showed 0.19/0.87. The interobserver reliability for the manually assessed ADIM revealed substantial agreement: K=0.71, CI (95%) 0.41 to 1.00. Conclusions: Although the interobserver reliability of the manually assessed ADIM was high, the concurrent and discriminative validity were both low for examining the preferential activity of the deep abdominal muscles. Neither the manually assessed ADIM nor the ultrasound testing discriminated between participants with LBP and healthy subjects regarding preferential activity of the transversus muscle as this ability/ inability was also present in healthy subjects.
JO – BMJ Open
PB –
CY –
VL – 5
IS – 12
PG –
SP –
EP –
AN –
DO – 10.1136/bmjopen-2015-008711
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L608798567
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Measurement of abdominal muscle thickness using ultrasound: A reliability study on patients with chronic nonspecific low back pain
A1 – Khademi J.
A1 – Bandpei M.A.M.
A1 – Abdollahi I.
A1 – Arabloo A.M.
A1 – Darvishi H.
A1 – Aghamiri S.S.
Y1 – 2015///
PD –
AB – Background and purpose: The purpose of this study was to assess the Within-day and Between-days reliability of abdominal muscles size measurement in patients with chronic non-specific low back pain (LBP) using ultrasound (US). Materials and methods: In this study, 15 patients with chronic non-specific LBP (20-50 years old) were recruited. The reliability of the abdominal muscle size (External and Internal oblique, and Transversus abdominis) was assessed in a relaxed and contraction state by a real time US. Two images were taken on the same day with an hour interval to assess the within day reliability and the third image was taken a week later to determine the between- days reliability. Results: Within-day and between-days reliability of abdominal muscles thickness measurements using US in patients with nonspecific chronic LBP in both rest and contraction state found to be high, ICC = 0.90 for within and ICC=0.85 for between-days of Transversus abdominis muscle in rest state and ICC= 0.82 and 0.86 in contraction state, respectively. For Internal oblique muscle, ICC=0.90 (82%) and ICC=0.88 (88%) were found for within-day and between-days in rest and contraction state, respectively. Within-day and between-days reliability at rest of ICC=0.86 (79%) and in contraction state of ICC=0.79 (75%) were demonstrated for External Oblique muscle. Conclusion: Results of the present study suggest US as a reliable method to evaluate the thickness of the abdominal muscles which could be used as a reliable tool in the assessment of patients and also in evaluating the effect of different therapeutic interventions.
JO – Journal of Mazandaran University of Medical Sciences
PB –
CY –
VL – 24
IS – 122
PG – 265-273
SP – 265
EP – 273
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L605959772
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Behaviour of the Linea Alba during a curl-up task in diastasis rectus abdominis: A new interpretation with clinical implications
A1 – Lee D.
A1 – Hodges P.
Y1 – 2015///
PD –
AB – Background: The distance between the rectus abdominis muscles widens (diastasis rectus abdominis; DRA) in most pregnant women by their third trimester. Some recover by six months (∼60%) but many have not at 1 year. DRA disrupts the mechanical contribution of the abdominal wall to lumbopelvic function and has cosmetic consequences that are a concern for many patients. Rehabilitation of DRA generally aims to reduce inter-rectus distance (IRD), based on the assumption that restoration of alignment of the rectus abdominis muscles will restore function. An alternative view is that approximation of the rectus abdominis muscles may compromise control of abdominal contents and the lumbopelvic region secondary to slackening of the fascias of the linea alba between the recti. Lateral tension from activation of the lateral abdominal muscle, transversus abdominis (TrA) may widen the DRA, but enhance tension of the linea alba with advantages for lumbopelvic function. Purpose: This study tested the hypothesis that the clinical objective to narrow the IRD may be counterproductive for optimal control of the abdomen, and although enhanced activation of lateral abdominal muscle may widen the IRD, this may lead to more optimal control of the anterior fascias. This hypothesis was tested by comparison of the effect of different abdominal muscle activation patterns on the properties of the linea alba as measured by conventional ultrasound measures of IRD and a novel measure of distortion of the linea alba in participants with and without DRA. Methods: Twenty-six women with DRA and 17 controls participated. Curl-up tasks were performed automatically (Auto-CU) and with pre-activation of the TrA muscle (TrACU), which pulls laterally and tenses the linea alba. The anterior abdominalwall was imaged with an ultrasound transducer placed immediately above the umbilicus and halfway between this point and the xiphoid. IRD was measured using a standard technique at rest and while sustaining the curl-up task. A ‘distortion index’ was measured as an estimate of the linea alba tension. This measure was derived by comparison of the actual path of the linea alba between the two recti and the shortest path between these points. Greater difference between these measures (i.e. greater distortion) was interpreted as an indication of poorer load transfer and abdominal support. Measures were compared between tasks (rest, Auto-CU, TrA-CU), groups and measurement points with an ANOVA. Results: When women with DRA performed the Auto- CU task the IRD reduced from resting values, but the linea alba was distorted by the abdominal contents. Although preactivation of TrA during the TrA-CU lessened the reduction of IRD (wider separation than the Auto-CU), there was less distortion of the linea alba. The IRD and distortion index did not change from rest or differ between tasks for control participants. Conclusion(s): These findings show that IRD narrowing in parous women with DRA leads to slackening of the linea alba and increases the potential for distortion by abdominal contents. Implications: The clinical implication is that IRD widening by TrA contraction, which has been discouraged in rehabilitation, may improve functional and cosmetic outcomes, despite encouraging some increase in IRD widening.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 101
IS – (Lee D.) Diane Lee and Associates, Surrey, Canada
PG – eS580-eS581
SP – eS580
EP – eS581
AN –
DO – 10.1016/j.physio.2015.03.3403
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72114342
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The relationship between transversus abdominis thickness and abdominal pressure during successful and unsuccessful abdominal draw-in maneuvers
A1 – Sugimoto H.
A1 – Momose K.
Y1 – 2015///
PD –
AB – Background: It has been recommended that one of the possible treatment for low back pain is the abdominal drawin maneuver (ADIM) produced by selective activation of transversus abdominis (TrA). Ultrasound imaging (USI) or pressure biofeedback unit (PBU) for ADIM has been recommended. The validity of USI is high since it is one of the methods that can actually carry out imaging of the muscle thickness. However, relationships between muscle thickness and changes in abdominal pressure are unknown. We hypothesize that successful selective contraction (SSC) of TrA during ADIM may be negatively correlated with changes in abdominal pressure. We also hypothesize that unsuccessful selective contraction (USSC) of TrA during ADIM may not be correlated with changes in abdominal pressure. Purpose: This study aimed to investigate the relationships between transversus abdominis thickness from USI and abdominal pressure changes from the PBU during ADIM. Methods: Eighteen male healthy volunteers participated in this study. The measurement was performed with subjects in prone position. The transducer of USI was positioned at the intersection of anterior axillary line with the midline between the last rib and ilium on the mid-axillary axis. The inflatable bag of PBU, which was used to measure abdominal pressure, was placed centrally beneath the abdomen with the lower edge at the level of the anterior superior iliac spines. Subjects were given standard instructions as follows: “take your belly button up maximally and in towards your spine, and don’t move pelvic or spinal position” Muscle thickness and abdominal pressure were measured three times during both conditions at end-expiration of rest and during ADIM. Muscle thickness data were normalized by calculating increase in thickness from resting thickness. Abdominal pressure data were normalized by calculating increase or decrease in pressure from resting pressure. Subjects were classified into 2 groups as follows: “SSC” group which is defined as subjects whose muscle thickness of TrA during ADIM increased and muscle thickness of EO during ADIM did not increase; and “USSC” group which is defined as subjects are not classified as SSC. To examine the relationships of SSC and USSC between TrA muscle thickness and abdominal pressure Pearson product-moment correlation coefficient was employed. Statistical significance was set at p < 0.05. Results: USSC did not reveal correlations with abdominal pressure changes (r = 0.13, p = 0.52). SSC reveal correlations with abdominal pressure changes (r = 0.42, p = 0.02), however, the result of this study was positive correlation. Conclusion(s): The results suggested that correlation between TrA thickness and abdominal pressure in SSC was not negative in maximal ADIM. It is difficult to use abdominal pressure induced PBU for successful ADIM, because there is positive correlation with TrA thickness and abdominal pressure. However, it is unknown that correlation between TrA thickness and abdominal pressure in SSC was not negative. Implications: Abdominal pressure during prone position measurement of PBU may be not suitable as feedback for ADIM. On the other hand, USI for which imaging of the deep and surface abdominal muscles is actually carried out, may be a more suitable and preferred method.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 101
IS – (Momose K.) Shinshu University, Physical Therapy, Matsumoto, Japan
PG – eS1454-eS1455
SP – eS1454
EP – eS1455
AN –
DO – 10.1016/j.physio.2015.03.1419
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72115443
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Ultrasound imaging in the classroom to teach in vivo anatomy and arthrokinematics to first year physical therapy students
A1 – Maher R.
A1 – Hale S.
Y1 – 2015///
PD –
AB – Background: Ultrasound is a safe and effective tool for imaging soft tissue and is used by physical therapists in research and practice for looking at muscle function. Purpose: To examine the effects of musculoskeletal ultrasound (MSK-US) demonstrations on students in-class experience and understanding of anatomy and arthrokinematic principles. Methods: A faculty member with MSK-US experience oriented students and identified structures. One demonstration covered the abdomino and lumbo-pelvic regions with students observing the superficial and deep abdominal muscles, mulitifidii, pelvic floor muscles, bladder and fascia at rest, during sit ups, core stability exercises, pelvic floor exercises, coughing, laughing and valsalva. A second demonstration observed the joint slide/glide associated with joint mobilizations which was quantified using on screen calipers. Students completed questionnaires anonymously via an online survey builder. A 5-point Likert scale graded responses which ranged from 5 (strongly agree) to 1 (strongly disagree). Results: 100% of respondents (79% response rate) agreed that MSK-US stimulated their interest, in addition to improving their knowledge and understanding. Furthermore, they gained a clinical perspective and synthesized what they were learning. Comments were extremely positive and included the following: MSK-US brought lecture to life. . .. added the missing piece of seeing and understanding”, “it’s one thing to be told what’s going on, another thing entirely to see it happen”, “seeing. . . inside the body”, “it was beneficial to see the amount the shoulder moves during joint mobilizations and this is something I didn’t quite understand before the demonstration”, “I liked that it was interactive” and “being able to visualize the difficulty in controlling pelvic floor and abdominal muscles”. Conclusion(s): MSK-US brings anatomy to life and underlines the clinical relevance of why the students are learning it. Students embrace it and are actively engaged in the classroom. Clearly ultrasound has applications beyond those of routine diagnoses. Implications: MSK-US is an invaluable and novel tool to use in the classroom and has the ability to powerfully supplement didactic and laboratory experiences for physical therapy students. MSK-US provides real time static and dynamic views regarding how manual techniques and other factors such as posture, adipose and activities can affect muscle and joint function the effects of which may not be apparent by observation or palpation.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 101
IS – (Maher R.; Hale S.) Shenandoah University, Physical Therapy, Winchester, United States
PG – eS928-eS929
SP – eS928
EP – eS929
AN –
DO – 10.1016/j.@physio.2015.03.1773
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72114774
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – A comparison of lateral abdominal muscles thickness during bridging exercises with stable versus unstable support in healthy individuals
A1 – Lee K.
A1 – Kim M.
A1 – Ha H.
A1 – Ko Y.
A1 – Lee H.
A1 – Jeong J.
A1 – Lee W.
Y1 – 2015///
PD –
AB – Background: Abdominal muscle strengthening exercises have been suggested to improve functions and decrease pain in subject with lowback pain. However, the effective exercise posture has been controversial. Purpose: The aim of this study was to evaluate the most effective static bridging exercise utilizing stable and unstable support, for measuring the thickness of abdominal muscles, specifically the EO, IO and TrA in supine, prone and flank positions, with rehabilitative ultrasound image (RUSI). Methods: Forty-five volunteers participated. Specifically, rehabilitative ultrasound images were used to measure the muscle thickness for the external oblique, internal oblique and transversus abdominis muscles. The 6-types of static bridging exercises, namely the supine, prone, and flank bridging exercises, each performed with stable and unstable support, were used. Results: Thickness of all muscles was significantly increased during supine versus flank bridging exercises, and prone versus flank with stable support (P = 0.000-0.012), but not in supine versus prone. Furthermore, muscle thickness was significantly increased in supine versus prone bridging, supine vs. flank and prone vs. flank (P = 0.000-0.029) with unstable support. However, when comparing the differences within each muscle, there was no significant increase the thickness within the same bridging exercise with stable versus unstable support, with the exception of the IO muscle during prone. Conclusion(s): These findings suggest bridging exercises utilizing unstable support are not more effective on increasing the muscle thickness for deep abdominal muscles than those utilizing stable support. In healthy individuals, contraction of abdominal muscles is more effective on maintaining posture, when the muscles are engaged as agonists against gravity, and not as effective in providing support. Implications: Bridging exercise and various support condition were used for autonomous activation of lumbar stabilization muscles. To increase the lumbar stabilizers, especially deep abdominal muscle, unstable support had been suggested to low back pain patients. But this condition can be dangerous when they do these bridging exercises. Our result showed the main consequence of increased abdominal muscle thickness is in maintaining the trunk posture against gravity, not in difference of support. So proper application of unstable support is needed when treat the patients with low back pain.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 101
IS – (Ha H.) Samsung Medical Center, Physical Medicine and Rehabilitation, Seoul, South Korea
PG – eS847-eS848
SP – eS847
EP – eS848
AN –
DO – 10.1016/j.physio.2015.03.1668
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72114671
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – A randomized controlled trial comparing McKenzie therapy and motor control exercises on the recruitment of trunk muscles in people with chronic low back pain: A trial protocol
A1 – Halliday M.H.
A1 – Ferreira P.H.
A1 – Hancock M.J.
A1 – Clare H.A.
Y1 – 2015///
PD –
AB – Objective: To investigate if McKenzie exercises when applied to a cohort of patients with chronic LBP who have a directional preference demonstrate improved recruitment of the transversus abdominis compared to motor control exercises when measurements were assessed from ultrasound images. Design: A randomized blinded trial with a 12-month follow-up. Setting: The Physiotherapy department of Concord Hospital a primary health care environment. Participants: 70-adults with greater than three-month history of LBP who have a directional preference. Interventions: McKenzie techniques or motor control exercises for 12-sessions over eight weeks. Main outcome measures: Transversus abdominus thickness measured from real time ultrasound images, pain, global perceived effect and capacity to self-manage. Discussion: This study will be the first to investigate the possible mechanism of action that McKenzie therapy and motor control exercises have on the recruitment of the transversus abdominus in a cohort of low back pain patients sub-classified with a directional preference. Patients receiving matched exercises according to their directional preference are believed to have better outcomes than those receiving unmatched exercises. A better understanding of the mechanism of action that specific treatments such as motor control exercises or McKenzie exercises have on patients classified with a directional preference will allow therapist to make a more informed choice about treatment options.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 101
IS – 2
PG – 232-238
SP – 232
EP – 238
AN –
DO – 10.1016/j.physio.2014.07.001
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L600341995
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Abdominal exercises affect inter-rectus distance in postpartum women: A two-dimensional ultrasound study
A1 – Sancho M.F.
A1 – Pascoal A.G.
A1 – Mota P.
A1 – Bø K.
Y1 – 2015///
PD –
AB – Objectives: To compare inter-rectus distance (IRD) at rest between women who had a vaginal delivery with women who had a caesarean section, and to describe the effect of different abdominal exercises on IRD. Setting: Physiotherapy practice. Design: Cross-sectional experimental study. Participants: Thirty-eight postpartum primiparous mothers with a singleton baby (vaginal delivery: n=. 23; caesarean section: n=. 15). Interventions: Two-dimensional ultrasound images from the abdominal wall were recorded at rest and at the end position of abdominal crunch, drawing-in and drawing-in. +. abdominal crunch exercises. IRD measurements at rest, above and below the umbilicus, were compared between the two groups (vaginal delivery and caesarean section). IRD was also measured above and below the umbilicus during three abdominal exercises in both groups. Main outcome measures: IRD 2. cm above and below the umbilicus. Results: No significant differences in IRD, either above or below the umbilicus, were found between the vaginal delivery and caesarean section groups. IRD above the umbilicus was significantly reduced during abdominal crunch exercises compared with at rest {mean 21.7 [standard deviation (SD) 7.6]. mm vs 25.9 (SD 9.0). mm; mean difference 4.2. mm; 95% confidence interval (CI) 0.5 to 7.9}. IRD below the umbilicus was significantly greater during drawing-in exercises compared with at rest [16.0 (SD 8.1). mm vs 11.4 (SD 4.9). mm; mean difference 4.5. mm; 95% CI 1.6 to 7.4]. Conclusion: In contrast to existing recommendations for abdominal strength training among postpartum women, this study found that abdominal crunch exercises reduced IRD, and drawing-in exercises were ineffective for reducing IRD. Further basic studies and randomised controlled trials are warranted to explore the effect of abdominal training on IRD.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 101
IS – 3
PG – 286-291
SP – 286
EP – 291
AN –
DO – 10.1016/j.physio.2015.04.004
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L605039189
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Validity of Inter-rectus Distance Measurement in Postpartum Women Using Extended Field-of-View Ultrasound Imaging Techniques
A1 – Keshwani N.
A1 – Mathur S.
A1 – McLean L.
Y1 – 2015///
PD –
AB – CONCLUSION: Panoramic USI and acoustic standoff pads are valid methods of increasing FOV to measure IRD. In this study, USI measurements were limited to IRDs of less than or equal to 3 finger widths, based on palpation.
JO – The Journal of orthopaedic and sports physical therapy
PB –
CY –
VL – 45
IS – 10
PG – 808-813
SP – 808
EP – 813
AN –
DO – 10.2519/jospt.2015.6143
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L611076115
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Reliability and Validity of Transversus Abdominis Measurement at the Posterior Muscle-Fascia Junction with Ultrasonography in Asymptomatic Participants
A1 – Chen Y.-H.
A1 – Chai H.-M.
A1 – Yang J.-L.
A1 – Lin Y.-J.
A1 – Wang S.-F.
Y1 – 2015///
PD –
AB – Objective The purposes of this study were (1) to establish the intrarater sliding and change in thickness of the transversus abdominis (TrA) measurement at the posterior muscle-fascia junction and (2) to examine the relationship between the muscle thickness and sliding of the TrA at the anterior and posterior sites. Methods Asymptomatic participants (n = 20) were placed into the hook-lying position to perform the abdominal drawing-in maneuver viewed in B-mode with a 5- to 12-MHz linear ultrasound transducer. The outcome variables included the resting thickness, the thickness during contraction, the change of thickness, and the change of sliding length. Both intraclass correlation coefficient and Pearson correlation were used for analysis. Results Measuring the thickness and sliding of the TrA at the posterior muscle-fascia junction showed good reliability (intraclass correlation coefficient (3,3), 0.89-0.98). The correlations between the sliding measurements of the TrA at the anterior and posterior sites were moderate to good (r = 0.41-0.74). Conclusion This study found that measuring the musculofascial corset from the posterior site using ultrasonography is reliable, allowing for ultrasound measurements at both the anterior and posterior sites of the TrA to provide a comprehensive evaluation of the TrA fascia.
JO – Journal of Manipulative and Physiological Therapeutics
PB –
CY –
VL – 38
IS – 8
PG – 581-586
SP – 581
EP – 586
AN –
DO – 10.1016/j.jmpt.2014.12.010
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L606078237
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Effects of bridge exercises with a sling and vibrations on abdominal muscle thickness in healthy adults
A1 – Gong W.-T.
Y1 – 2015///
PD –
AB – In the present study, we aimed to examine the changes in the thickness of the transversus abdominis (TrA) and internal oblique (Io) muscles using ultrasonography in adults who performed bridge exercises with the abdominal drawing-in maneuver and a sling and received micro vibrations. In total, 32 subjects were divided into a therapy (n = 16) and control (n = 16) groups. The therapy group completed nine sets, with four repetitions, of bridge exercises with the sling and received vibrations. The control group completed nine sets, with four repetitions, of bridge exercises with the sling and did not receive vibrations. The thicknesses of the TrA and Io muscles were measured in both groups using ultrasonography before and after therapy. According to the pressure applied to the biofeedback unit, both groups showed significant changes in the thicknesses of the TrA and Io muscles after therapy (P <0.05). The change in the thickness of the TrA muscle after therapy was significantly different between the 2 groups when the pressures applied at 38, 42, and 46 mmHg (P <0.05). Moreover, the change in the thickness of the Io muscle did not significantly different between the 2 groups at any of the pressures applied (P >0.05). These findings indicate that approximately 15 minutes of vibrations during bridge exercises on unstable surfaces with a sling facilitates the activation of the deep trunk muscles and further enhances the activation of the TrA.
JO – Journal of Back and Musculoskeletal Rehabilitation
PB –
CY –
VL – 28
IS – 4
PG – 645-649
SP – 645
EP – 649
AN –
DO – 10.3233/BMR-140560
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L607639003
NS –
N1 – Exclusion reason: 7.- Wrong patient population;
ER –

TY – JOUR
T1 – Ultrasound measurement of deep and superficial abdominal muscles thickness during standing postural tasks in participants with and without chronic low back pain
A1 – Ehsani F.
A1 – Arab A.M.
A1 – Jaberzadeh S.
A1 – Salavati M.
Y1 – 2016///
PD –
AB – Background Activity of deep abdominal muscles increases the lumbar stability. Majority of previous studies indicated abdominal muscle activity dysfunction during static activity in patients with low back pain (LBP). However, the number of studies that evaluated deep abdominal muscle activity in dynamic standing activities in patients is limited, while this assessment provides better understanding of pain behavior during these activities. Objective Investigation of superficial and deep abdominal muscles activity in participants with chronic LBP as compared to healthy individuals during standing tasks. Design Case control study. Methods Ultrasound imaging was used to measure the thickness of transverse abdominis (TrA), internal oblique (IO) and external oblique (EO) muscles in female participants with (N = 45) and without chronic LBP (CLBP) (N = 45) during tests. The Biodex Balance System was used to provide standing tasks. The thickness of each muscle in a standing task was normalized to actual thickness at rest in the supine lying position to estimate its activity. Results The results indicate increases in thickness of all muscles in both groups during dynamic as compared to static standing tasks (P < 0.05, ES > 0.5). Lower percentages of thickness change for TrA muscle and higher for EO muscle were found in the patients as compared to healthy individuals during all tests (P < 0.05, ES > 1.28). Conclusions Higher activity of superficial than deep abdominal muscles in patients as compared to healthy individuals during standing tasks indicates motor control dysfunction in patients with CLBP. Standing tasks can discriminate the individuals with and without LBP and can be progressively used in training.
JO – Manual Therapy
PB –
CY –
VL – 23
IS – (Jaberzadeh S.) Department of Physiotherapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
PG – 98-105
SP – 98
EP – 105
AN –
DO – 10.1016/j.math.2016.01.003
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L608944941
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Reliability of Abdominal Muscle Stiffness Measured Using Elastography during Trunk Rehabilitation Exercises
A1 – MacDonald D.
A1 – Wan A.
A1 – McPhee M.
A1 – Tucker K.
A1 – Hug F.
Y1 – 2016///
PD –
AB – The aim of this study was to assess the intra-session and inter-rater reliability of shear modulus measured in abdominal muscles during two commonly used trunk stability exercises. Thirty healthy volunteers performed a series of abdominal hollow and abdominal brace tasks. Supersonic shear imaging was used to measure the shear modulus (considered an index of muscle tension) of the four anterior trunk muscles: obliquus externus abdominis, obliquus internus abdominis, transversus abdominis and rectus abdominis. Because of measurement artifacts, internus abdominis and transversus abdominis data were not analyzed for 36.7% and 26.7% of the participants, respectively. These participants exhibited thicker superficial fat layers than the others. For the remaining participants, fair to excellent intra-session and inter-rater reliability was observed with moderate to high intra-class coefficients (0.45-0.97) and low to moderate standard error of measurement values (0.38-3.53 kPa). Reliability values were consistently greater for superficial than for deeper muscles.
JO – Ultrasound in Medicine and Biology
PB –
CY –
VL – 42
IS – 4
PG – 1018-1025
SP – 1018
EP – 1025
AN –
DO – 10.1016/j.ultrasmedbio.2015.12.002
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L608678150
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Evaluation of pelvic floor muscles activity with and without abdominal maneuvers in subjects with and without low back pain
A1 – Ehsani F.
A1 – Arab A.M.
A1 – Assadi H.
A1 – Karimi N.
A1 – Shanbehzadeh S.
Y1 – 2016///
PD –
AB – BACKGROUND: There was controversy in finding of studies related pelvic floor muscle (PFM) rehabilitation of subjects with low back pain (LBP), while this issue is very important for treatment of subjects with LBP. OBJECTIVE: The purpose of this study was to evaluate PFM contraction in three conditions of alone and with abdominal hollowing (AH) or abdominal bracing (AB) maneuvers in subjects with and without chronic LBP. METHODS: Subjects were divided into two groups: subjects with LBP (N = 25) and without LBP (N = 27). PFM contraction alone and during contraction with AH or AB maneuvers was measured. The amount of bladder base movement was measured as an indicator of PFM activity. RESULTS: There were no differences in PFM activity between subjects with and without chronic LBP, when PFM contracted alone (P = 0.60), contracted with AH (P = 0.12) and AB maneuver (P = 0.54). Our data revealed that contraction of the PFM alone produce greater displacement of the bladder base than contraction of the PFM with AH (P = 0.005) or AB maneuver (P = 0.001) in both groups. However, no significant difference was found between contraction of the PFM with AH and AB maneuver in individuals with LBP (P = 0.31). CONCLUSION: It seems that PFM contraction alone is more effective than PFM contraction with AH or AB maneuvers in lifting the pelvic floor in subjects with and without LBP.
JO – Journal of Back and Musculoskeletal Rehabilitation
PB –
CY –
VL – 29
IS – 2
PG – 241-247
SP – 241
EP – 247
AN –
DO – 10.3233/BMR-150620
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L610582819
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Abdominal hollowing and bracing strategies increase joint stability in the trunk region during sudden support surface translation but not in the lower extremities
A1 – Kim M.
A1 – Kim Y.
A1 – Oh S.
A1 – Suh D.
A1 – Eun S.-D.
A1 – Yoon B.
Y1 – 2016///
PD –
AB – BACKGROUND AND OBJECTIVE: Application of hollowing and bracing, abdominal activation strategies (AAS), has focused on improving trunk stability. This study aimed to clarify the AAS effect on body sway during support surface translation while standing. MATERIALS AND METHODS: Twenty healthy subjects (10 male, 10 female; aged 25.45 ± 3.22 years) performed hollowing, bracing, and natural strategies while standing, and exerted to maintain their balance during forward and backward translation. Ultrasonography evaluations confirmed the appropriate application of the 3 strategies by measuring abdominal muscle thickness. Additionally, a motion analysis system was used to capture the whole body sway along the sagittal plane. RESULTS: During backward translation, angular displacements of the trunk were significantly different among the 3 strategies (upper thoracic: F = 13.758, p < 0.001; lower thoracic: F = 8.477, p = 0.001; and lumbopelvis: F = 8.651, p = 0.001). AAS significantly decreased the sway by 25-36% in all inter-spinal segments compared with the natural strategy (p < 0.05). During forward translation, only angular displacement of the lower thoracic was significantly different among the 3 strategies (F = 7.640, p = 0.002), and bracing decreased the sway by 33.48% compared with the natural strategy (p = 0.003). No significant differences were seen between hollowing and bracing during forward and backward translation. CONCLUSIONS: AAS increased joint stability only in the trunk where joints are adjacent to abdominal muscles, but not in the lower extremities. The low impact of AAS on the lower extremities might have important implications on the paradigm of standing balance. JO – Journal of Back and Musculoskeletal Rehabilitation PB – CY – VL – 29 IS – 2 PG – 317-325 SP – 317 EP – 325 AN – DO – 10.3233/BMR-150633 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L610582798 NS – N1 – Exclusion reason: 5.- Wrong study design; ER – TY – JOUR T1 – The effect of motor control training on abdominal muscle contraction during simulated weight bearing in elite cricketers A1 – Hides J.A. A1 – Endicott T. A1 – Mendis M.D. A1 – Stanton W.R. Y1 – 2016/// PD – AB – Objectives: To investigate whether motor control training alters automatic contraction of abdominal muscles in elite cricketers with low back pain (LBP) during performance of a simulated unilateral weight-bearing task. Design: Clinical trial. Methods: 26 male elite-cricketers attended a 13-week cricket training camp. Prior to the camp, participants were allocated to a LBP or asymptomatic group. Real-time ultrasound imaging was used to assess automatic abdominal muscle response to axial loading. During the camp, the LBP group performed a staged motor control training program. Following the camp, the automatic response of the abdominal muscles was re-assessed. Results: At pre-camp assessment, when participants were axially loaded with 25% of their own bodyweight, the LBP group showed a 15.5% thicker internal oblique (IO) muscle compared to the asymptomatic group (p = 0.009). The post-camp assessment showed that participants in the LBP group demonstrated less contraction of the IO muscle in response to axial loading compared with the asymptomatic group. A trend was found in the automatic recruitment pattern of the transversus abdominis (p = 0.08). Conclusions: Motor control training normalized excessive contraction of abdominal muscles in response to a low load task. This may be a useful strategy for rehabilitation of cricketers with LBP. JO – Physical Therapy in Sport PB – CY – VL – 20 IS – (Endicott T.) School of Physiotherapy, Australian Catholic University, Brisbane, Australia PG – 26-31 SP – 26 EP – 31 AN – DO – 10.1016/j.ptsp.2016.05.003 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L610491298 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Establishing Immediate Reliability of Sonographic Measurements of the Transversus Abdominis in Asymptomatic Adults Performing Upright Loaded Functional Tasks in a Clinical Context Without Delayed Recorded Measurement A1 – McPherson S. A1 – Watson T. A1 – Pate L. Y1 – 2016/// PD – AB – METHODS: A single-group repeated-measures reliability study was conducted on 12 healthy participants without low back pain. Six of these adults reported a prior history of abdominal drawing-in maneuver training without sonographic measurement. The participants performed 3 trials of neutral standing, a loaded forward reach, and a loaded box lift under rest and with abdominal drawing-in maneuver instructions; task order was randomized. Transversus abdominis thickness measurements were obtained by an experienced rater using B-mode sonography in real-time via electronic calipers twice on the same static image during all trials by a rater. The rater was masked to group assignment and on-screen measurement output and required to respond to trivia questions between repeated measurements. JO – Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine PB – CY – VL – 35 IS – 8 PG – 1681-1691 SP – 1681 EP – 1691 AN – DO – 10.7863/ultra.15.09065 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L617205198 NS – N1 – Exclusion reason: 5.- Wrong study design; ER – TY – JOUR T1 – Measurement of superficial and deep abdominal muscle thickness: an ultrasonography study A1 – Tahan N. A1 – Khademi-Kalantari K. A1 – Mohseni-Bandpei M.A. A1 – Mikaili S. A1 – Baghban A.A. A1 – Jaberzadeh S. Y1 – 2016/// PD – AB – 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. JO – Journal of physiological anthropology PB – CY – VL – 35 IS – 1 PG – 17 SP – 17 EP – AN – DO – 10.1186/s40101-016-0106-6 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L616702601 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Sonography of the abdominal muscles thickness during rest and contraction before and after food consumption A1 – Tahan N. A1 – Mohseni Bandpei M.A. A1 – Mikaeili S. A1 – Bagheban A.A. Y1 – 2016/// PD – AB – Introduction: Ultrasound imaging is a non-invasive method for observing changes in muscle thickness of the abdominal muscles. Accurate measurements depend on the control of all potential sources of error. In this study we investigated whether the level of stomach fullness might be a source of error not only in the resting thickness but also in contractile thickness (abdominal hallowing maneuver) abdominal muscles. Materials and Methods: Thirty healthy male subjects ranging in age from 18 to 26 years volunteered for this study. Ultrasound image of the four abdominal muscles on both sides were obtained at rest (at the end of exhalation) and during abdominal hallowing maneuver before and after food consumption. Abdominal muscle thickness was assessed using a 3.5 MHZ linear head transducer in B-mode condition. Results: The mean thickness for right and left rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles at rest before food consumption were 10.8-10.7, 6.2-6.1, 8.6-8.3, 4.1-4.1 mm, respectively and after food consumption were 10.3-10.3, 5.6-5.5, 7.3-7.3, 3.4-3.6 mm, respectively. The mean thickness for right and left rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles during Abdominal Hollowing Maneuver before food consumption were 11-10.8, 6.1-6.3, 10-10. 5.3-5.5 mm, respectively and after food consumption were 10.5-10.6, 5.7-5.7, 8.8-8.7, 4.4-4.5 mm, respectively. Conclusion: After food consumption the thicknesses of all abdominal muscles in both sides are decreased, and therefore, food consumption must be considered when measuring abdominal muscle thickness using sonography. JO – Koomesh PB – CY – VL – 18 IS – 2 PG – 243-249 SP – 243 EP – 249 AN – DO – UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L613710123 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Within-day and between-day reliability of thickness measurements of abdominal muscles using ultrasound during abdominal hollowing and bracing maneuvers A1 – Aboufazeli M. A1 – Afshar-Mohajer N. Y1 – 2017/// PD – AB – Ultrasonography imaging has been used as a non-invasive method to estimate the thickness and relative activities of the abdominal muscles in patients with lower back pain (LBP). However, the statistical reliability of US thickness measurements of abdominal muscles, including transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) muscles during abdominal hollowing (AH) and abdominal bracing (AB) maneuvers has not been well-investigated. This study was performed on a total of 20 female subjects (10 with LBP and 10 without LBP) in the age range of 25-55 years to assess within-day and between-day reliability of the measurements. US measurements on maneuvers were repeated after two hours for the within-day reliability and after five days for the between-day reliability assessment. High intra-class correlation coefficient (ICC) values (>0.75) for within-day and between-day reliability assessments during AH maneuver were concluded. The ICC values were moderate for reliability assessment during AB. The ICC values for AH were greater than AB both for within- and between-day reliabilities. The small standard error of measurement and minimal detectable change values (0.16-0.78 and 0.44 to 2.15, respectively) were found for both AH and AB. We recommend real-time US imaging as a reliable way of determining the thicknesses of the TrA and IO muscle (and to some extent, EO muscle) for both healthy and LBP patients.
JO – Journal of Bodywork and Movement Therapies
PB –
CY –
VL –
IS – (Afshar-Mohajer N., nima.a-mohajer@jhu.edu) Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
PG –
SP –
EP –
AN –
DO – 10.1016/j.jbmt.2017.03.006
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L614748814
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The effect of low back pain on trunk muscle size/function and hip strength in elite football (soccer) players
A1 – Hides J.A.
A1 – Oostenbroek T.
A1 – Franettovich Smith M.M.
A1 – Mendis M.D.
Y1 – 2016///
PD –
AB – Low back pain (LBP) is a common problem in football (soccer) players. The effect of LBP on the trunk and hip muscles in this group is unknown. The relationship between LBP and trunk muscle size and function in football players across the preseason was examined. A secondary aim was to assess hip muscle strength. Twenty-five elite soccer players participated in the study, with assessments conducted on 23 players at both the start and end of the preseason. LBP was assessed with questionnaires and ultrasound imaging was used to assess size and function of trunk muscles at the start and end of preseason. Dynamometry was used to assess hip muscle strength at the start of the preseason. At the start of the preseason, 28% of players reported the presence of LBP and this was associated with reduced size of the multifidus, increased contraction of the transversus abdominis and multifidus muscles. LBP decreased across the preseason, and size of the multifidus muscle improved over the preseason. Ability to contract the abdominal and multifidus muscles did not alter across the preseason. Asymmetry in hip adductor and abductor muscle strength was found between players with and without LBP. Identifying modifiable factors in players with LBP may allow development of more targeted preseason rehabilitation programmes.
JO – Journal of sports sciences
PB –
CY –
VL – 34
IS – 24
PG – 2303-2311
SP – 2303
EP – 2311
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L616573524
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Automatic activity of deep and superficial abdominal muscles during stable and unstable sitting positions in individuals with chronic low back pain
A1 – Arab A.M.
A1 – Shanbehzadeh S.
A1 – Rasouli O.
A1 – Amiri M.
A1 – Ehsani F.
Y1 – 2017///
PD –
AB – Objective: The purpose of this study was to assess muscle thickness changes in the deep and superficial abdominal muscles, during sitting on stable and unstable surfaces in subjects with and without chronic low back pain (CLBP). Method: A cross-sectional study was conducted involving 40 participants (20 CLBP and 20 healthy). Ultrasound imaging was used to assess changes in the thickness of the Transversus abdominis (TrA), Internal Oblique (IO), Rectus abdominis (RA) and External oblique (EO) muscles. Muscle thickness under two different sitting postures; (sitting on a chair and sitting on a Swiss ball), was normalized to actual muscle thickness at rest in the supine lying position and was expressed as a percentage of thickness change of muscles. Result: The results showed significantly greater thickness changes in RA muscle in the CLBP patients compared to the healthy subjects, during both stable and unstable sitting positions. Also, significantly lower thickness changes in TrA muscle was observed in subjects with CLBP compared to those without CLBP, during unstable sitting position. Conclusion: There was an imbalance between the automatic activity of TrA and RA muscles in the subjects with CLBP, compared to the pain-free controls, during an unstable sitting position. Therefore, it is necessary to pay attention, to the altered automatic activity of the abdominal muscles while utilizing a Swiss ball, for rehabilitation of subjects with CLBP.
JO – Journal of Bodywork and Movement Therapies
PB –
CY –
VL –
IS – (Ehsani F., Fatemehehsani59@yahoo.com) Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan, Iran
PG –
SP –
EP –
AN –
DO – 10.1016/j.jbmt.2017.10.009
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L619143392
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Can Sonography Be Used to Estimate Deep Abdominal Muscle Activation in Different Static Arm Positions While Standing?
A1 – Eriksson Crommert M.
A1 – Unsgaard-Tøndel M.
A1 – Vasseljen O.
Y1 – 2017///
PD –
AB – CONCLUSIONS: The results indicate that sonographic recordings of the obliquus internus abdominis and transversus abdominis in different static arm positions while standing provide reliable measurements of muscle thickness. However, in light of previously reported electromyographic data, the results raise some concerns regarding the validity of using thickness measurements as proxies for muscle activation in positions that may induce passive muscle deformation.
JO – Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
PB –
CY –
VL – 36
IS – 1
PG – 129-139
SP – 129
EP – 139
AN –
DO – 10.7863/ultra.15.12057
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L617651000
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Differential increase in the thickness of abdominal muscles during different squat exercises in college athletes
A1 – Lee Y.-J.
A1 – Lim O.-B.
A1 – Cynn H.-S.
A1 – Yi C.-H.
Y1 – 2017///
PD –
AB – BACKGROUND: The squat exercise is frequently used to develop muscle strength of the lower back, hip, and knee regions to improve physical performance. OBJECTIVE: To investigate the effects of squat exercises involving three types of isometric hip contractions and two types of wall conditions on the thickness of abdominal muscles in college athletes. METHODS: Twenty-seven college athletes, 17 men and 10 women, took part in the study. Subjects performed the standard squat without hip contraction, the isometric hip adduction squat, and the isometric hip abduction squat with and without using a wall. Abdominal thickness was measured with an ultrasound and presented as muscle thickness ratio. RESULTS: The transversus abdominis (TrA) and internal oblique (IO) thickness ratio was significantly greater during the isometric hip adduction squat exercise compared to the standard and isometric hip abduction squat exercises. The TrA and IO thickness ratio in the isometric hip abduction squat exercise was significantly higher than that in the standard squat exercise. The external oblique (EO) thickness ratio was significantly higher in the squat exercise without wall compared to the squat exercise with wall. CONCLUSIONS: Isometric hip adduction squat exercise may be an effective method for increasing the TrA and IO thickness ratio while performing the squat exercise without wall may help increase the EO thickness ratio.
JO – Isokinetics and Exercise Science
PB –
CY –
VL – 25
IS – 3
PG – 193-200
SP – 193
EP – 200
AN –
DO – 10.3233/IES-171102
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L617969992
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – The Effect of Current Low Back Pain on Volitional Preemptive Abdominal Activation During a Loaded Forward Reach Activity
A1 – Nagar V.R.
A1 – Hooper T.L.
A1 – Dedrick G.S.
A1 – Brismée J.-M.
A1 – McGalliard M.K.
A1 – Sizer P.S.
Y1 – 2017///
PD –
AB – 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.
JO – PM and R
PB –
CY –
VL – 9
IS – 2
PG – 127-135
SP – 127
EP – 135
AN –
DO – 10.1016/j.pmrj.2016.05.019
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L613145708
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Ultrasound imaging transducer motion during standing postural tasks with and without using transducer fixator
A1 – Ehsani F.
A1 – Salavati M.
A1 – Arab A.M.
A1 – Dolati M.H.
Y1 – 2017///
PD –
AB – Background Changes in the orientation of ultrasound (US) transducer relative to the body surface during dynamic standing tests can affect US measurements. Objective The purpose of the study was to evaluate ultrasound imaging transducer motion while measuring the lateral abdominal muscle thickness during standing tasks with and without using transducer fixator (TF). Design Cross-sectional experimental study. Methods A digital optical motion analysis system was used to assess the motions of US transducer during double-leg stance in different levels of platform stability of Biodex Balance System (BBS) (static, levels 6 and 3) with and without using TF in 45 healthy individuals. In addition, lateral abdominal muscle thickness was evaluated by US imaging. Results The results indicated that the amount of angular and linear transducer motions during static and dynamic standing tasks significantly decreased by the use of TF as compared to the conditions without TF (P < 0.001, effect size> 0.84). Conclusion TF can significantly control US transducer motions within acceptable threshold limits during standing postural task. This may improve the clinical application of US imaging.
JO – Musculoskeletal Science and Practice
PB –
CY –
VL – 32
IS – (Dolati M.H.) Biomedical Engineering Department, Kosar Hospital, Semnan University of Medical Sciences, Semnan, Iran
PG – 57-63
SP – 57
EP – 63
AN –
DO – 10.1016/j.msksp.2017.08.009
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L619247447
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Contraction of the transverse abdominal muscle in pelvic girdle pain is enhanced by pain provocation during the task
A1 – Mens J.M.
A1 – Pool-Goudzwaard A.
Y1 – 2017///
PD –
AB – Background Understanding of the pathogenesis of pain in the lumbopelvic region remains a challenge. It is suggested that lumbopelvic pain is related to decreased contraction of the transverse abdominal muscles (TrA). Objective To investigate how pain provoked by a task influences TrA contraction during that task. Design A case-control cross-sectional study. Method We recruited 40 non-pregnant women with persistent pregnancy-related posterior pelvic girdle pain (PGP) and 33 parous women (healthy controls) without PGP. TrA thickness was measured by ultrasound at various levels of bilateral hip adduction, with increments of 20 N from 0 to 140 N. Pain during the tests was registered. Results After correction for the level of adduction force, TrA thickness increase during pain-provoking tests of participants with PGP was 6.3 percentage points higher than in their pain-free tests (p = 0.01) and 0.91 percentage points higher than in the pain-free tests of healthy controls (p < 0.01). Conclusion TrA contraction in PGP is enhanced when a task provokes pain. These results may have consequences for the treatment of persistent pregnancy-related posterior pelvic girdle pain. JO – Musculoskeletal Science and Practice PB – CY – VL – 32 IS – (Pool-Goudzwaard A.) MOVE Research Institute, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Netherlands PG – 78-83 SP – 78 EP – 83 AN – DO – 10.1016/j.msksp.2017.09.001 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L619246958 NS – N1 – Exclusion reason: 5.- Wrong study design; ER – TY – JOUR T1 – Magnetic resonance imaging and ultrasonography of the lumbar multifidus muscle: Comparison of two different modalities A1 – Hides J.A. A1 – Richardson C.A. A1 – Jull G.A. Y1 – 1995/// PD – AB – Study Design. An operator-blinded dual modality trial of measurement of lumbar multifidus muscle cross-sectional area was performed. Objective. To compare two imaging modalities used for measurement of the lumbar multifidus muscle. Methods. Ten normal female subjects aged 21-31 years ware imaged on two separate days using magnetic resonance imaging and ultrasound imaging. Bilateral measurements were made at each vertebral level from L2-S1. Results. No significant difference was demonstrated between cross-sectional area measurements made with the two different modalities. Measurement of multifidus were symmetrical between left and right sides of the spine. For both modalities, a significant difference was demonstrated in the cross- sectional area of multifidus between each vertebral level from L2-S1. Conclusions. The present study indicated that if a strict protocol for ultrasound imaging is adhered to, real-time ultrasound imaging can be used to document muscle size in young adults. Further studies are required to validate the technique in older subjects and in different conditions. JO – Spine PB – CY – VL – 20 IS – 1 PG – 54-58 SP – 54 EP – 58 AN – DO – UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L25016066 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Rehabilitative ultrasound imaging of the posterior paraspinal muscles A1 – Stokes M. A1 – Hides J. A1 – Elliott J. A1 – Kiesel K. A1 – Hodges P. Y1 – 2007/// PD – AB – Fisheye SYNOPSIS: Interest in rehabilitative ultrasound imaging (RUSI) of the posterior paraspinal muscles is growing, along with the body of literature to support integration of this technique into routine physical therapy practice. This clinical commentary reviews how RUSI can be used as an evaluative and treatment tool and proposes guidelines for its use for the posterior muscles of the lumbar and cervical regions. Both quantitative and qualitative applications are described, as well as measurement reliability and validity. Measurement of morphological characteristics of the muscles (morphometry) in healthy populations and people with spinal pathology are described. Preliminary normal reference data exist for measurements of cross-sectional area (CSA), linear dimensions (muscle depth/thickness and width), and shape ratios. Compared to individuals without low back pain, changes in muscles’ size at rest and during the contracted state have been observed using RUSI in people with spinal pathology. Visual observation of the image during contraction indicates that RUSI may be a valuable biofeedback tool. Further investigation of many of these observations is required using controlled studies to provide conclusive evidence that RUSI enhances clinical practice. JO – Journal of Orthopaedic and Sports Physical Therapy PB – CY – VL – 37 IS – 10 PG – 581-595 SP – 581 EP – 595 AN – DO – 10.2519/jospt.2007.2599 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47556351 NS – N1 – Exclusion reason: 5.- Wrong study design; ER – TY – JOUR T1 – Intrarater and interrater reliability of assessment of lumbar multifidus muscle thickness using rehabilitative ultrasound imaging A1 – Wallwork T.L. A1 – Hides J.A. A1 – Stanton W.R. Y1 – 2007/// PD – AB – Fisheye STUDY DESIGN: Within-session intrarater and interrater reliability study. Fisheye OBJECTIVE: To establish the intrarater and interrater reliability of thickness measurements of the multifidus muscle in a parasagittal plane, conducted by an experienced ultrasound operator and a novice assessor. Fisheye BACKGROUND: There is considerable evidence for the important role of the multifidus muscle in segmental stabilization of the lumbar spine. The cross-sectional area of the multifidus muscle has been assessed in healthy subjects and patients with low back pain using real-time ultrasound imaging. However, few studies have measured the thickness of the multifidus muscle using a parasagittal view. Fisheye METHODS AND MEASURES: The thickness of the multifidus muscle was measured at rest, using real-time ultrasound imaging, in 10 subjects without a history of low back pain, at the levels of the L2-3 and L4-5 zygapophyseal joints. The measure was carried out 3 times at each level by 2 assessors (1 experienced, 1 novice). Intrarater (model 3) and interrater (model 2) reliability was assessed by calculation of an F statistic (analysis of variance), the intraclass correlation coefficient (ICC), and the standard error of measurement (SEM). Fisheye RESULTS: On the basis of an average of 3 trials, the 2 operators showed very high interrater agreement on the measurement of thicknesses at the L2-3 level (ICC2,3 = 0.96; 95% CI: 0.84 to 0.99) and the L4-5 vertebral level (ICC2,3 = 0.97; 95% CI: 0.87 to 0.99), with no systematic differences in muscle size across operators (P>.05). Interrater reliability was relatively lower for the L2-3 level (ICC2,1 = 0.85; 95% CI: 0.51 to 0.96) than the L4-5 level (ICC2,1 = 0.87; 95% CI: 0.52 to 0.97) when a single trial per rater was used, but these values still indicated a high level of agreement. In addition, the novice and experienced operator produced reliable intrarater measurements at L2-3 (ICC3,1 = 0.89; 95% CI: 0.72 to 0.97 and 0.94; 95% CI: 0.86 to 0.99) and at L4-5 (ICC 3,1 = 0.88; 95% CI: 0.68 to 0.97 and 0.95; 95% CI: 0.86 to 0.99), with no systematic differences in muscle size across trials (P>.05). The consistently low SEM values also indicate low measurement error. Fisheye CONCLUSION: A novice and an experienced assessor were both able to reliably perform this measure at rest for 2 vertebral levels using real-time ultrasound imaging. An average of 3 trials produced higher interrater reliability scores, though using a single trial per rater was also reliable.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 37
IS – 10
PG – 608-612
SP – 608
EP – 612
AN –
DO – 10.2519/jospt.2007.2418
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47556353
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Influence of feedback schedule in motor performance and learning of a lumbar multifidus muscle task using rehabilitative ultrasound imaging: A randomized clinical trial
A1 – Herbert W.J.
A1 – Heiss D.G.
A1 – Basso D.M.
Y1 – 2008///
PD –
AB – Background and Purpose: Low back pain (LBP) may be associated with inadequate multifidus muscle function. Varying the frequency and timing of feedback may enhance acquisition and retention of multifidus muscle recruitment during exercise. Subjects: Subjects without LBP (n=30) were randomly assigned to a constant (CON) or variable (VAR) feedback group. Twenty-eight subjects (mean age=28 years, SD=8.0; mean body mass index=24 kg/m2, SD=0.70) completed training, and 23 completed retention testing. Methods: Eight training sessions over 4 weeks included multifidus muscle exercise with rehabilitative ultrasound imaging (RUSI) feedback. Retention was assessed at 1 week and ≥1 month. Results: At the start, both groups had similar performances of multifidus muscle recruitment (Fisher exact test, P=.26). Early in training, the CON group had good success (mean=80%) that was maintained at session 8 (mean=84%), with no difference between sessions 1 and 8 (Wilcoxon signed rank test, P=.19, 95% confidence interval [CI]=-9%, 42%). The VAR group gradually increased success (Wilcoxon signed rank test, P=.002, 95% CI=17%, 59%) between sessions 1 and 8. Both groups sustained their session 8 success when tested for short-term retention at 1 week (CON group: Wilcoxon signed rank test, P=.79; VAR group: Wilcoxon signed rank test, P=.36). At the long-term retention test, the VAR group outperformed the CON group (Wilcoxon score test, P=.04), indicating superior motor learning. Discussion and Conclusion: Variable feedback provided by RUSI resulted in greater success in lumbar multifidus muscle recruitment up to 3 to 4 months after training. © 2008 American Physical Therapy Association.
JO – Physical Therapy
PB –
CY –
VL – 88
IS – 2
PG – 261-269
SP – 261
EP – 269
AN –
DO – 10.2522/ptj.20060308
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L351196719
NS –
N1 – Exclusion reason: 7.- Wrong patient population;
ER –

TY – JOUR
T1 – Effect of stabilization training on multifidus muscle cross-sectional area among young elite cricketers with low back pain
A1 – Hides J.
A1 – Stanton W.
A1 – McMahon S.
A1 – Sims K.
A1 – Richardson C.
Y1 – 2008///
PD –
AB – Fisheye STUDY DESIGN: A single-blinded, pretreatment-posttreatmertt assessment. Fisheye OBJECTIVES: To investigate, using ultrasound imaging, the cross-sectional area (CSA) of the lumbar multifidus muscle at 4 vertebral levels (L2, L3, L4, L5) in elite cricketers with and without low back pain (LBP), and to document the effect of a staged stabilization training program on multifidus muscle CSA. Fisheye BACKGROUND: Despite high fitness levels and often intensive strength training programs, athletes still suffer LBP. The incidence of LBP among Australian cricketers is 8% and as high as 14% among fast bowlers. Previous researchers have found that the multifidus muscle contributes to segmental stability of the lumbopelvic region; however, the CSA of this muscle has not been previously assessed in elite cricketers. Fisheye METHODS AND MEASURES: CSAs of the multifidus muscles were assessed at rest on the left and right sides for 4 vertebral levels at the start and completion of a 13-week cricket training camp. Participants who reported current or previous LBP were placed in a rehabilitation group. The stabilization program involved voluntary contraction of the multifidus, transversus abdominis, and pelvic floor muscles, with real-time feedback from rehabilitative ultrasound imaging (RUSI), progressed from non-weight-bearing to weight-bearing positions and movement training. Pain scores (using a visual analogue scale) were also collected from those with LBP. Fisheye RESULTS: The CSAs of the multifidus muscles at the L5 vertebral level increased for the 7 cricketers with LBP who received the stabilization training, compared with the 14 cricketers without LBP who did not receive rehabilitation (P = .004). In addition, the amount of muscle asymmetry among those with LBP significantly decreased (P = .029) and became comparable to cricketers without LBP. These effects were not evident for the L2, L3, and L4 vertebral levels. There was also a 50% decrease in the mean reported pain level among the cricketers with LBP. Fisheye CONCLUSION: Multifidus muscle atrophy can exist in highly active, elite athletes with LBP. Specific retraining resulted in an improvement in multifidus muscle CSA and this was concomitant with a decrease in pain. Fisheye LEVEL OF EVIDENCE: Therapy, level 2b.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 38
IS – 3
PG – 101-108
SP – 101
EP – 108
AN –
DO – 10.2519/jospt.2008.2658
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L351364950
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Rehabilitative ultrasound measurement of select trunk muscle activation during induced pain
A1 – Kiesel K.B.
A1 – Uhl T.
A1 – Underwood F.B.
A1 – Nitz A.J.
Y1 – 2008///
PD –
AB – Rehabilitative ultrasound imaging (RUSI) is considered a valid method to measure muscle activation in key spinal muscles in asymptomatic subjects. Research measuring muscle activation with RUSI in painful subjects is limited. The aim of this study was to determine if changes in muscle activation from experimentally induced pain can be measured by RUSI. Six male subjects performed tasks known to activate the transverse abdominis (TrA) and lumbar multifidus (LM) while RUSI measurements of muscle thickness were obtained during control and hypertonic saline conditions. The abdominal draw-in maneuver was used to volitionally activate the TrA and a series of upper extremity lifting tasks were used to automatically activate the LM. Pain was induced by injecting 5% hypertonic saline into the longissimus muscle adjacent to the LM at the L4 level. The percent change in muscle thickness from rest to contraction represented muscle activation. Activation was significantly less (p<0.01) during the painful condition on 4 of the 5 tasks performed for the LM and on the task performed for the TrA. These results indicate that RUSI can be used to measure pain-related changes in deep trunk muscle activation. Future research should include a larger sample size and women. © 2006 Elsevier Ltd. All rights reserved.
JO – Manual Therapy
PB –
CY –
VL – 13
IS – 2
PG – 132-138
SP – 132
EP – 138
AN –
DO – 10.1016/j.math.2006.10.003
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L351391985
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – The effect of lumbar stabilising exercises on cross sectional area of the multifidus muscle in chronic low back pain
A1 – Kumar R.
A1 – Thom J.
A1 – Jones J.
Y1 – 2009///
PD –
AB – Background: The multifidus muscle is one of the main core stabilising muscles of the lumbar spine. The cross-sectional area (CSA) of multifidus can be measured by ultrasound which shows it is often wasted in subjects with chronic low back pain (CLBP). Clinical weakness of the lumbar core stability muscles is commonly found in people with CLBP and core stability exercises (CSE) are frequently prescribed to increase strength and improve function. We set out to investigate the effect of CSE on the CSA of multifidus in university volunteers with CLBP. Methods: 20 members of the university with at least 3 months CLBP were recruited by advertising on the university intranet and notice boards. They underwent a 6 weeks home programme of CSE with back care education and weekly telephone progress checks. Prior to the intervention and at completion, the CSA of right and left multifidus muscles were measured at the L5 level using a portable ultrasound machine. Three measures of the CSA were taken on each side and the mean calculated. This was done by a physiotherapist with no prior experience. In addition pain intensity (visual analogue scale – VAS) and back pain related disabilty (Roland Morris Disability Questionnaire – RMDQ) were also measured. Ethics approval was granted by School’s Ethics Committee and written informed consent was taken. Paired sample t-tests was used to determine if there was a statistically significant difference between the three outcome measures before and after the intervention. Results: 19 of the 20 (aged 23-45 years; 12 female) participants completed the study. All participants had had CLBP for longer than 3 years. Comparison of the before and after measures showed a significant improvement in all 3 outcome measures. CSA; pre 5.88 +/-0.790 sq cm; post 6.40 +/-0.95 sq cm (p=<.001): VAS; pain pre 5.16 +/-1.30; post 2.37=/-1.11 (p= <.000): RMDQ; pre 6.37 +/-2.24; post 2.89 +/-1.63 (p=<.000). Conclusions: In this unblinded, uncontrolled MSC dissertation study in volunteers with CLBP, a home programme of core stability exercises increased the CSA of multifidus as well as significantly improving pain and disability. Some of this effect may have been related to the back care advice which encouraged activity and exercise. By demonstrating an increase in CSA of multifidus this study suggests CSE actually do improve the structure of multifidus and so have an important part to play in the management of CLBP. The intervention can be performed at home and prescribed in primary care, thus avoiding the necessity for subjects to come to hospital. It also demonstrates that ultrasound is relatively easy and reliable in the hands of untrained clinicians. It could also be used as a clinical outcome measure to assess compliance and the efficacy of treatment. As a result of this study a blinded controlled study of this intervention in NHS patients referred to a physiotherapy department is being performed. JO – Rheumatology PB – CY – VL – 48 IS – (Jones J.) Dept of Rheumatology, North West Wales NHS Trust, Bangor, United Kingdom PG – i155 SP – i155 EP – AN – DO – 10.1093/rheumatology/kep741 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L70324745 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – The effect of chronic low back pain on size and contraction of the lumbar multifidus muscle A1 – Wallwork T.L. A1 – Stanton W.R. A1 – Freke M. A1 – Hides J.A. Y1 – 2009/// PD – AB – Decreases in the size of the multifidus muscle have been consistently documented in people with low back pain. Recently, ultrasound imaging techniques have been used to measure contraction size of the multifidus muscle, via comparison of the thickness of the muscle at rest and on contraction. The aim of this study was to compare both the size (cross-sectional area, CSA) and the ability to voluntarily perform an isometric contraction of the multifidus muscle at four vertebral levels in 34 subjects with and without chronic low back pain (CLBP). Ultrasound imaging was used for assessments, conducted by independent examiners. Results showed a significantly smaller CSA of the multifidus muscle for the subjects in the CLBP group compared with subjects from the healthy group at the L5 vertebral level (F = 29.1, p = 0.001) and a significantly smaller percent thickness contraction for subjects of the CLBP group at the same vertebral level (F = 6.6, p = 0.02). This result was not present at other vertebral levels (p > 0.05). The results of this study support previous findings that the pattern of multifidus muscle atrophy in CLBP patients is localized rather than generalized but also provided evidence of a corresponding reduced ability to voluntarily contract the atrophied muscle. © 2008 Elsevier Ltd. All rights reserved.
JO – Manual Therapy
PB –
CY –
VL – 14
IS – 5
PG – 496-500
SP – 496
EP – 500
AN –
DO – 10.1016/j.math.2008.09.006
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L50339082
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The effect of unilateral muscle pain on recruitment of the lumbar multifidus during automatic contraction. An experimental pain study
A1 – Dickx N.
A1 – Cagnie B.
A1 – Parlevliet T.
A1 – Lavens A.
A1 – Danneels L.
Y1 – 2010///
PD –
AB – Changes in control of the multifidus muscle are a likely contributor to low back pain (LBP), however, the underlying mechanisms of these changes are not well understood. To date it remains uncertain if pain has a selective effect on the multifidus muscles, in line with the observations of the selective changes in structure in acute LBP, or a more generalized effect. The objective of this study is to help to elucidate whether acute unilateral muscle pain alters the activation of the multifidus specific at the level and side of the pain or has a more widespread effect. An experimental pain protocol using hypertonic saline was applied to induce unilateral low back muscle pain. Automatic activity of the multifidus muscle during arm lifts was evaluated with dynamic ultrasound measurement, by assessing muscle thickness change during contraction. Multifidus activity of 15 healthy subjects was compared in a non-pain and in a pain condition, at different spinal levels (L3-L4-L5) and at both body sides. Unilateral induced pain at one segmental level reduced muscle thickness increase during contraction, at both body sides and at different lumbar levels. These results do suggest that unilateral pain may have a more widespread effect on multifidus muscle recruitment, affecting the left and right muscles, at different lumbar levels. © 2010 Elsevier Ltd.
JO – Manual Therapy
PB –
CY –
VL – 15
IS – 4
PG – 364-369
SP – 364
EP – 369
AN –
DO – 10.1016/j.math.2010.02.002
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L50821218
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Effect of 2 lumbar spine postures on transversus abdominis muscle thickness during a voluntary contraction in people with and without low back pain
A1 – Pinto R.Z.
A1 – Ferreira P.H.
A1 – Franco M.R.
A1 – Ferreira M.L.
A1 – Ferreira M.C.
A1 – Teixeira-Salmela L.F.
A1 – Maher C.G.
Y1 – 2011///
PD –
AB – Objective: The present study investigated the effect of 2 different lumbar spine postures, neutral and flexed lumbar postures, on transversus abdominis (TrA) muscle function during a voluntary contraction (hollowing and draw-in maneuver) in people with and without low back pain (LBP). Methods: Thirty participants with LBP and 30 healthy participants were recruited for this cross-sectional study. Transversus abdominis muscle function was measured as a change in thickness with ultrasound imaging. Participants performed voluntary TrA contraction in a supine lying position with the lumbar spine in neutral and flexed postures. Data were analyzed using a 2-way (groups, postures) analysis of variance. Results: Lumbar posture influenced TrA function during a voluntary contraction in people with and without LBP. There was a significant main effect of posture (F1,58 = 16.140, P < .001). Neutral lumbar posture improved participants’ ability to recruit TrA in both group (mean difference, 7.5%; 95% confidence interval, 3.8%-11.3%). No significant differences were found between healthy subjects and those with LBP. Conclusions: The results of the present study showed that, in subjects performing a voluntary TrA contraction, the neutral lumbar posture improves the ability to increase change in TrA thickness. This study found no significant difference in TrA thickness change between healthy subjects and those with nonspecific LBP. © 2011 National University of Health Sciences.
JO – Journal of Manipulative and Physiological Therapeutics
PB –
CY –
VL – 34
IS – 3
PG – 164-172
SP – 164
EP – 172
AN –
DO – 10.1016/j.jmpt.2011.02.009
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L361600810
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Behavior of the lumbar multifidus during lower extremity movements in people with recurrent low back pain during symptom remission
A1 – Macdonald D.A.
A1 – Dawson A.P.
A1 – Hodges P.W.
Y1 – 2011///
PD –
AB – STUDY DESIGN: Cross-sectional design. OBJECTIVES: To investigate lumbar multifidus (LM) thickness differences, using ultrasound imaging in people during remission from recurrent low back pain (LBP) and healthy participants, during the following lower extremity movements: (1) active straight leg raise (ASLR), (2) crook-lying active leg raise (CLR), and (3) prone straight leg raise (PSLR). BACKGROUND: ASLR, CLR, and PSLR are used clinically to challenge the ability of the trunk muscles to control spinal motion in people with LBP, and it is believed that decreased LM activity is related to altered spinal control in this population. However, it is unclear whether LM behavior differs between healthy individuals and people with recurrent LBP during symptom remission in such tasks. METHODS: The present study used ultrasound imaging to measure LM percentage thickness change parasagitally at the L4-5 and L5-S1 levels in people with recurrent LBP during symptom remission and in healthy participants, during the ASLR, CLR, and PSLR tasks. RESULTS: LM percentage thickness change was greater in the recurrent LBP group than in healthy participants during the PSLR task (P<.01) and greater in both groups during the PSLR than the ASLR and CLR tasks (P<.01). LM percentage thickness change was greatest at L4-5 in both groups (P<.01) and during all tasks (P≤.02). No difference was found in LM percentage thickness change between groups in either the ASLR (P = .70) or CLR (P = .69) task. CONCLUSIONS: These data suggest that, during symptom remission, individuals with recurrent LBP, compared to healthy individuals, may have greater activity in at least some parts of the LM. Further investigation is required to determine whether the LM percentage thickness change observed in this study may be explained by differential changes in deep and/or superficial fibers of LM activity. This observation may have implications for clinical practice, but requires further investigation. J Orthop Sports Phys Ther 2011;41(3):155-164, Epub 4 January 2011. JO – Journal of Orthopaedic and Sports Physical Therapy PB – CY – VL – 41 IS – 3 PG – 155-164 SP – 155 EP – 164 AN – DO – 10.2519/jospt.2011.3410 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L361486746 NS – N1 – Exclusion reason: 5.- Wrong study design; ER – TY – JOUR T1 – Association between changes in abdominal and lumbar multifidus muscle thickness and clinical improvement after spinal manipulation A1 – Koppenhaver S.L. A1 – Fritz J.M. A1 – Hebert J.J. A1 – Kawchuk G.N. A1 – Childs J.D. A1 – Parent E.C. A1 – Gill N.W. A1 – Teyhen D.S. Y1 – 2011/// PD – AB – STUDY DESIGN: Prospective case series. OBJECTIVE: To examine the relation between improved disability and changes in abdominal and lumbar multifidus (LM) thickness using ultrasound imaging following spinal manipulative therapy (SMT) in patients with low back pain (LBP). BACKGROUND: Although there is a growing body of literature demonstrating physiologic effects following the application of SMT, few studies have attempted to correlate these changes with clinically relevant outcomes. METHODS: Eighty-one participants with LBP underwent 2 thrust SMT treatments and 3 assessment sessions within 1 week. Transversus abdominis (TrA), internal oblique (IO), and LM muscle thickness was assessed during each session, using ultrasound imaging of the muscles at rest and during submaximal contractions. The Modified Oswestry Disability Index was used to quantify participants’ improvement in LBP-related disability. Stepwise hierarchical multiple linear regression and repeated-measures analysis of variance were performed to examine the multivariate relationship between change in muscle thickness and clinical improvement over time. RESULTS: After controlling for the effects of age, sex, and body mass index, change in contracted LM muscle thickness was predictive of improved disability at 1 week (P = .02). As expected, larger increases in contracted LM muscle thickness at 1 week were associated with larger improvements in LBP-related disability. Contrary to our hypothesis, significant decreases in both contracted TrA and IO muscle thickness were observed immediately following SMT; but these changes were transient and unrelated to whether participants experienced clinical improvements. CONCLUSION: These findings provide evidence that clinical improvement following SMT is associated with increased thickening of the LM muscle during a submaximal task. LEVEL OF EVIDENCE: Prognosis, level 4. JO – Journal of Orthopaedic and Sports Physical Therapy PB – CY – VL – 41 IS – 6 PG – 389-399 SP – 389 EP – 399 AN – DO – 10.2519/jospt.2011.3632 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L361893176 NS – N1 – Exclusion reason: 5.- Wrong study design; ER – TY – JOUR T1 – Changes in transversus abdominis and obliquus internus activity following different kinds of physiotherapy A1 – Critchley D.J. A1 – Hurley M.V. Y1 – 2011/// PD – AB – Purpose: To investigate if transversus abdominis (TrA) and obliquus internus (OI) muscle thickness (a proxy for muscle activity in these muscles) changes following spinal stabilisation exercises or other forms of physiotherapy in people with chronic low back pain (cLBP). To investigate if changes in muscle thickness are related to clinical outcome. Relevance: Spinal stabilisation exercises are moderately effective in cLBP. Their mechanisms of effect are said include change in TrA and OI muscle activity. There is little evidence to support this claim. Participants: 212 people, 136 (64%) female, mean (range) 44 (18-76) years old, with 7.4 (0.25-52) years history of non-specific cLBP referred to physiotherapy. Methods: Participants were randomised to spinal stabilisation exercises (small-group supervised individualised exercises; aims included increasing TrA activation), individual physiotherapy (manual therapy and exercise according to clinicians’ reasoning, some were taught spinal stabilisation exercises), or physiotherapist-led pain management (including small-group supervised general exercise). Participants had left and right TrA and OI muscle thickness measured with real-time ultrasound in relaxed supine lying, supine lying with low abdominal drawing-in, and relaxed standing. Pain was measured with numerical analogue scale, disability with Roland-Morris questionnaire. Data collection occurred before and six months after randomisation. Analysis: Comparisons of muscle thickness between different treatment groups and between ‘improvers’ (participants with >50% pain reduction) and ‘non-improvers’ (≤50% pain reduction) were made using analysis of covariance with baseline data as covariate. Results reported are mean(SD) of sum of left and right muscle in mm. Results: 169 participants were reassessed. 101 provided complete ultrasound data, 32 were not measured because they did not attend reassessment in person, and in 36 (21%) ultrasound images were not sufficiently clear to be confidently measured. Participants not measured reported greater disability and pain, weighed more, and had higher BMI. Following interventions, both TrA and OI thickness was unchanged in all three test positions and there was no between-group differences in either muscle (all p > 0.1). In relaxed supine lying, for all groups combined, ‘improvers’ (n = 60) TrA thickness was 6.0(1.6) at baseline and 5.9(1.8) at six months; ‘non-improvers’ (n = 41)was 6.1(1.7) and 6.0(1.6) (p = 0.74). In supine drawing-in, all ‘improvers’ TrA thickness was 10.2(3.4) at baseline and 10.7(3.0) at six months; ‘nonimprovers’ was 9.7(3.2) and 9.9(2.6) (p = 0.28). In relaxed standing, all ‘improvers’ TrA thickness was 7.7(2.7) at baseline and 8.5(3.5) at six months; ‘non-improvers’ was 7.9(2.6) and 8.5(2.9) (p = 0.61). Spinal stabilisation participants alone had no differences in TrA thickness in any positions between ‘improvers’ (n = 18) and ‘non-improvers’ (n = 16) (p > 0.2). Clinical results have been reported previously (Critchley et al., 2007), all groups improved equally in pain and disability. Conclusions: There were no differences in TrA thickness (activity) following treatment between specific spinal stabilisation exercise and general exercise groups or between participants with >50% pain reduction and those without. Future research could investigate other spinal stabilisation treatment mechanisms, including non-physiological mechanisms, and identify subgroups for whom spinal stabilisation exercises are effective. Implications: Pain reduction following spinal stabilisation training appears to be unrelated to change in transversus abdominis activity which does not support the use of specific spinal stabilisation exercises people with in non-specific cLBP.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 97
IS – (Hurley M.V.) St. George’s University of London, School of Rehabilitation Sciences, Faculty of Health and Social Care, London, United Kingdom
PG – eS244-eS245
SP – eS244
EP – eS245
AN –
DO – 10.1016/j.physio.2011.04.002
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L71882507
NS –
N1 – Exclusion reason: 4.- Abstracts from Congress, Symposium…;
ER –

TY – JOUR
T1 – Characteristics of doppler ultrasonography following repetitive mckenzie lumbar flexion and extension exercises in healthy young volunteers
A1 – Al-Obaidi S.
A1 – Asbeutah A.
A1 – Hassan N.
A1 – Boben S.
Y1 – 2011///
PD –
AB – Purpose: To investigate the cardiovascular responses following two commonly prescribed McKenzie exercises; extension in lying (EIL) and flexion in lying (FIL) on the basic clinical cardiovascular parameters; and to determine their effects on the aortic diameter and blood flow velocity following 3 sets of exercise repetition (10, 15, and 20 repetitions) of each exercise, in healthy young volunteers utilizing Doppler ultrasonography. Relevance: It has been previously demonstrated that McKenzie FIL and EIL exercises commonly, used in the management of low back pain are associated with increased myocardial demand in proportion to increased exercise repetitions specifically, following 15 and 20 repetitions. However, the effect on aortic diameter (AD), peak systolic velocity (PSV) and the end diastolic velocity (EDV), and resistive index (RI), has not been explored. Participants: Twenty-five subjects aged 21-34 years (mean 28.32, SD = 3.42) without a history of cardiovascular or cardiopulmonary disease participated in the study. Methods: Each participant performed three sets of exercise repetitions (10, 15 and 20) of FIL, with a 5 minutes rest between each set. The subject then performed EIL in the same manner. Heart rate (HR), and blood pressure (BP) were recorded before, after a 5 minutes rest interval, and immediately after each set of repetitions. A Doppler ultrasound machine equipped with curvi-linear 5-2MHz transducer was used to measure the abdominal aorta diameter 2 cmabove the bifurcation and to measure PSV, EDV, and RI on the same site. Color Doppler was used to visualize the flow patterns within the aorta. Analysis: Descriptive statistics, One-way Analysis Of Variance (ANOVA) for repeated measures was used to compare the dependent measurements obtained after performing the assigned exercises following 10, 15, and 20 repetitions. Scheffe multiple-comparison post hoc analysis was used to determine which set of repetitions in a given exercise significantly differed from the others. The level of significance was set at 0.05. Paired t-tests were used to compare the cardiovascular responses of the two exercises at rest and following the 3 repetition sets. Results: Both FIL and EIL caused an increase in HR, systolic blood pressure, rate pressure products, PSV, and RI in proportion to exercise repetitions (p < 0.00) more significant in FIL than EIL specifically following 15 and 20 repetitions of FIL (p < 0.00). Conclusions: Both EIL and FIL tend to increases the cardiovascular responses significantly following 20 repetitions but more following FIL. The 10 repetitions of both exercises appear to be a safe exercise load. Implications: Knowledge of the cardiovascular baseline status and responses to exercise load during testing and or treatment is clinically important, specifically, that many of our patients may have or are at risk of developing a cardiovascular or cerebrovascular incidences that they may be unaware of. Patients should be instructed not to exceed the prescribed exercise repetitions.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 97
IS – (Hassan N.; Boben S.) Kuwait University, Department of Physical Therapy, Kuwait, Kuwait
PG – eS61
SP – eS61
EP –
AN –
DO – 10.1016/j.physio.2011.04.002
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L71882252
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Activities of back muscle at static muscle contraction during pelvic anterior tilt with nutation of sacrum
A1 – Abiko T.
A1 – Takei H.
A1 – Shimamura R.
A1 – Abiko Y.
A1 – Yamamoto J.
A1 – Sakasai T.
A1 – Ogawa D.
A1 – Kamiya A.
A1 – Souma M.
A1 – Shindo K.
Y1 – 2011///
PD –
AB – Purpose: The purpose of this study was to consider the best way for activating lumbar multifidus muscles during pelvic anterior-tilt with nutation of sacrum by using rehabilitative ultrasound imaging (RUSI) and electromyography (EMG). Relevance: Lumbar multifidus (LM) plays a key role in providing trunk stability during dynamic tasks. Several abnormal characteristics have been identified in the LM in low back pain subjects. When Erector Spinae (ES) act in excess, it is suggested that the activities of LM become ineffective. Quantification of ES and LM activation may be helpful in determining effective exercise. Participants: Experiments were conducted 10 healthy male adults (mean age = 26.0). Each of the participants gave his documented consent after having been orally informed about purpose of this study. Methods: We measured low back muscles on 3 angle of pelvic tilt (moderated anterior-tilt, neutral position and moderated posterior-tilt) and different percentage of resistance (rest, 10%, 25%, 50%, 75%, 100% maximum voluntary contraction: MVC). The task was static muscle contraction of them during pelvic anterior-tilt with nutation of sacrum at prone on the edge of the bed and hanging subject’s legs. RUSI was measured muscle thickness of the left LM and surface EMG was recorded from the right thoracic erecter spinae (TES), lumbar erecter spinae (LES) and LM. Analysis: Percent thickness change was calculated as thickness contracted/thickness rest. Activities of the muscles measured by EMG during performing tasks were normalized to percentages of MVC. Two-way analysis of variance (ANOVA)was used to compare the difference in the activities of the different muscles as the factors between 6 different percentage of resistance and the 3 angle of pelvic tilt. Games-Howell test was used for a post hoc test and values of <0.05 were considered statistically significant. SPSS 17.0 statistical software was used to perform all the analysis. Results: From RUSI and EMG results, neutral position and moderated posterior-tilt increased LM activation significantly compared with moderated anterior-tilt. In neutral position, activity of TES increased in resistance of 75% and 100% compared with that of 10%. However, activities of LES and LM increased in resistance of 100% only compared with that of 10%. To reach resistance of 75%, activity of TES got larger than those of LES and LM. Conclusions: It indicated that activity of TES got larger than those of LES and LM to reach resistance of 75%. This suggested that activity of TES increased easily with strong resistance. On the contrary, activity of LM increased easily with mild resistance. The present findings suggested that neutral position and moderated posterior tilt of pelvis with mild resistance facilitated LM without over-activation of TES at this task. Implications: These results highlight the importance of pelvic angle and resistance when subjects with low back pain activate LM.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 97
IS – (Shindo K.) Tokyo Metropolitan Rehabilitation Hospital, Rehabilitation Medicine, Tokyo, Japan
PG – eS24
SP – eS24
EP –
AN –
DO – 10.1016/j.physio.2011.04.002
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L71882199
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Ultrasound measures of the lumbar multifidus: Effect of task and transducer position on reliability
A1 – Lariviere C.
A1 – Gagnon D.
A1 – De Oliveira E.
A1 – Henry S.
A1 – Dumas J.-P.
Y1 – 2011///
PD –
AB – BACKGROUND CONTEXT: Reliable ultrasonographic (US) measures are required to characterize neuromuscular impairments (atrophy, poor motor control) of the lumbar multifidus (LuM) muscles in back pain patients. The intrarater and interrater reliability of these measures may depend on the selected assessment task as well as on a better standardization of the transducer location on the skin. PURPOSE: To quantify the intra- and interrater reliability of US measures of the LuM during contractions associated with 2 distinct tasks and to assess whether standardizing the transducer position on the skin with a template enhances reliability. STUDY DESIGN/SETTING: Single-group reliability study in a laboratory setting. PATIENT SAMPLE: 15 healthy (8 men) and 15 patients (5 men) with non-specific chronic low-back pain. OUTCOME MEASURES: Muscle thickness. METHODS: Subjects performed 2 tasks while positioned prone on a table: (1) contralateral arm lifting of a small weight (1.5 to 3 pounds depending on subject mass) and (2) contralateral leg lifting with the knee flexed at 90°. Two 7-s videos of the LuM (from rest to contraction) were collected on each side with a curvilinear transducer positioned at the L3 level (z2 cm from midline). Videos were collected with and without the use of a template allowing the same repositioning of the transducer from day to day and from rater to rater using skin blemishes as reference points. Raters #1 and #2 carried out the US measures on the first day (interrater reliability) and rater #1 repeated the testing 7-14 days later (intrarater reliability). Muscle thicknes of the LuM (L2 and L4 levels) was measured at rest and during contraction and the percent thickness change (%Change) was derived. The generalizability theory was applied to assess intrarater (2 Days-2 Images) and interrater (2 Raters-2 Images) reliability, while simulating the average of 3 images. Indexes of dependability (ID, analogous to intraclass correlation coefficient) and standard errors of measurement (SEM) expressed as a percentage of the mean were computed. RESULTS: LuM thicknesses at rest were 28.0±6.1 mm at L2 and 32.3±6.7 mm at L4. The corresponding thickness increases during contraction were 8.2 mm (%Change530%) and 7.7 mm (%Change524%), with no or negligible differences between tasks.The reliability results of thickness measures at L2 and L4 (at rest and during contraction) were not significantly different between the tasks. Intrarater reliability [ID: 0.89 to 0.94; SEM: 4 to 7%] was better than interrater reliability [ID: 0.68 to 0.79; SEM: 9 to 12%] across vertebral levels, tasks, sides and template conditions. The corresponding %Change parameter showed much lower reliability results (intrarater: ID: 0.50 to 0.66, SEM: 21 to 26%; interrater: ID: 0.31 to 0.48, SEM: 31 to 39%). The poorer interrater relative to intrarater reliability results were partly explained by statistically significant biases detected between raters at L2 (0.2 to 0.7 mm) and more so at L4 (2.8 to 4.1 mm). The use of the template significantly (p<.05) but marginally improved intrarater reliability (IDs: from 0.87 to 0.89; SEMs: from 6.8 to 6.1%). CONCLUSIONS: Optimal reliability requires the use of a single rater and the averaging of at least 3 images per visit. The %Change parameter, while useful to compare individuals, has limited potential to detect therapeutic effects. Arm or leg lifting tasks have similar reliability. Given the time required to build a template, its use is not recommended.
JO – Spine Journal
PB –
CY –
VL – 11
IS – 10
PG – 149S
SP – 149S
EP –
AN –
DO – 10.1016/j.spinee.2011.08.359
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L70558395
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Abdominal and lumbar multifidus muscle size and symmetry at rest and during contracted States. Normative reference ranges.
A1 – Teyhen D.S.
A1 – Childs J.D.
A1 – Stokes M.J.
A1 – Wright A.C.
A1 – Dugan J.L.
A1 – George S.Z.
Y1 – 2012///
PD –
AB – The purpose of this study was to establish reference values for abdominal and lumbar multifidus muscles at rest and while contracted in a sample of active healthy adults. Three hundred forty participants (mean age ± SD, 21.8 ± 3.9 years; 96 females and 244 males) completed the study. Ultrasound imaging was used to assess the thickness of the transversus abdominis, internal and external oblique, rectus abdominis, and lumbar multifidus muscles. Additionally, the cross-sectional area of the rectus abdominis was assessed. Although males had significantly thicker muscles than females (P < .05), the relative change in thickness during specified tasks was equivalent. Overall, relative muscle thickness and symmetry were similar to previous studies using smaller sample sizes. These findings provide a robust data set of muscle thickness values measured by ultrasound imaging and can be used for comparison to those with pain, abnormal function, and pathologic conditions. JO – Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine PB – CY – VL – 31 IS – 7 PG – 1099-1110 SP – 1099 EP – 1110 AN – DO – UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L365865595 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain A1 – Koppenhaver S.L. A1 – Fritz J.M. A1 – Hebert J.J. A1 – Kawchuk G.N. A1 – Parent E.C. A1 – Gill N.W. A1 – Childs J.D. A1 – Teyhen D.S. Y1 – 2012/// PD – AB – Understanding the clinical characteristics of patients with low back pain (LBP) who display improved lumbar multifidus (LM) muscle function after spinal manipulative therapy (SMT) may provide insight into a potentially synergistic interaction between SMT and exercise. Therefore, the purpose of this study was to identify the baseline historical and physical examination factors associated with increased contracted LM muscle thickness one week after SMT. Eighty-one participants with LBP underwent a baseline physical examination and ultrasound imaging assessment of the LM muscle during submaximal contraction before and one week after SMT. The relationship between baseline examination variables and 1-week change in contracted LM thickness was assessed using correlation analysis and hierarchical multiple linear regression. Four variables best predicted the magnitude of increases in contracted LM muscle thickness after SMT. When combined, these variables suggest that patients with LBP, (1) that are fairly acute, (2) have at least a moderately good prognosis without focal and irritable symptoms, and (3) exhibit signs of spinal instability, may be the best candidates for a combined SMT and lumbar stabilization exercise (LSE) treatment approach. © 2012. JO – Journal of Electromyography and Kinesiology PB – CY – VL – 22 IS – 5 PG – 724-731 SP – 724 EP – 731 AN – DO – 10.1016/j.jelekin.2012.03.004 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L51964725 NS – N1 – Exclusion reason: 5.- Wrong study design; ER – TY – JOUR T1 – Measurement of segmental lumbar spine flexion and extension using ultrasound imaging A1 – Chleboun G.S. A1 – Amway M.J. A1 – Hill J.G. A1 – Root K.J. A1 – Murray H.C. A1 – Sergeev A.V. Y1 – 2012/// PD – AB – STUDY DESIGN: Clinical measurement, technicalnote BJECTIVES: To describe a technique to measure interspinous process distance using ultrasound (US) imaging, to assess the reliability of the technique, and to compare the US imaging measurements to magnetic resonance imaging (MRI) measurements in 3 different positions of the lumbar spine. BACKGROUND: Segmental spinal motion has been assessed using various imaging techniques, as well as surgically inserted pins. However, some imaging techniques are costly (MRI) and some require ionizing radiation (radiographs and fluoroscopy), and surgical procedures have limited use because of the invasive nature of the technique. Therefore, it is important to have an easily accessible and inexpensive technique for measuring lumbar segmental motion to more fully understand spine motion in vivo, to evaluate the changes that occur with various interventions, and to be able to accurately relate the changes in symptoms to changes in motion of individual vertebral segments. METHODS: Six asymptomatic subjects participated. The distance between spinous processes at each lumbar segment (L1-2, L2-3, L3-4, L4-5) was measured digitally using MRI and US imaging. The interspinous distance was measured with subjects supine and the lumbar spine in 3 different positions (resting, lumbar flexion, and lumbar extension) for both MRI and US imaging. The differences in distance from neutral to extension, neutral to flexion, and extension to flexion were calculated. RESULTS: The measurement methods had excellent reliability for US imaging (intraclass correlation coefficient [ICC3,3] = 0.94; 95% confidence interval: 0.85, 0.97) and MRI (ICC3,3 = 0.98; 95% confidence interval: 0.95, 0.99). The distance measured was similar between US imaging and MRI (P>.05), except at L3-4 flexion-extension (P = .003). On average, the MRI measurements were 1.3 mm greater than the US imaging measurements. CONCLUSION: This study describes a new method for the measurement of lumbar spine segmental flexion and extension motion using US imaging. The US method may offer an alternative to other imaging techniques to monitor clinical outcomes because of its ease of use and the consistency of measurements compared to MRI. © 2012 Journal of Orthopaedic and Sports Physical Therapy.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 42
IS – 10
PG – 880-885
SP – 880
EP – 885
AN –
DO – 10.2519/jospt.2012.3915
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L365801839
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The relationship between lumbar multifidus muscle function and performance on the single-leg squat task
A1 – Neill S.
A1 – Creaby M.
A1 – Hides J.
A1 – Crowley G.
A1 – Smith M.
Y1 – 2012///
PD –
AB – Introduction: Clinical tests such as a single-leg squat are used to evaluate control of the trunk, pelvis, hip and knee during functional weight bearing tasks. One important function of the kinetic chain is effective load transfer and distribution of forces. Deficits in control of the trunk have been shown to be predictive of knee injuries in athletes. Furthermore, decreased size of the lumbar multifidus muscle at the lumbo-sacral junction was predictive of lower limb injuries in football players. The lumbar multifidus muscle plays an important role in weightbearing as it controls the lumbar lordosis. In the clinical situation, the size and ability to voluntarily contract multifidus can be assessed using ultrasound imaging. Researchers have not yet evaluated the relationship between the motor control assessments for the multifidus and the single leg squat test. Methods: Twenty asymptomatic male military recruits (Age mean 22 years±2.9) performed three single-leg squat trials on their dominant leg. An experienced musculoskeletal physiotherapist rated the mediolateral position of the knee during these performances from frontal plane video, with a previously validated scoring system. Knee position ratings were “over-foot” or “medial-to-foot”. Bilateral ultrasound images of lumbar multifidus were captured and measured to determine muscle size, symmetry and function (ability to voluntarily contract the muscle in prone lying) Using knee “over-foot” and “medial-to-foot” groups, repeated measures MANOVA for upper lumbar (L2-L3) and lower lumbar (L4-L5) multifidus were performed to determine differences in muscle size, symmetry and function between “over-foot” and “medial-to-foot” groups. Results: Individuals who performed the single-leg squat inappropriately (medial-to-foot) were less able to voluntarily contract their upper lumbar multifidus (L2-L3) on the non-weight bearing side, compared to appropriate performers (p=0.05). Discussion: Possible explanations for this finding may relate to the proprioceptive role of the multifidus muscle and its ability to control the lumbar lordosis in weightbearing. Combining these two clinical tests may be useful for pre-season screening, and may direct the clinician to treatment of the trunk muscles. Future studies could investigate the effects of training the multifidus muscle on the performance of the single leg squat.
JO – Journal of Science and Medicine in Sport
PB –
CY –
VL – 15
IS – (Crowley G.) Amberley Health Centre, RAAF Amberley, Australia
PG – S335-S336
SP – S335
EP – S336
AN –
DO – 10.1016/j.jsams.2012.11.815
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L70968909
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Reliability of 2 ultrasonic imaging analysis methods in quantifying lumbar multifidus thickness
A1 – Wong A.Y.L.
A1 – Parent E.
A1 – Kawchuk G.
Y1 – 2013///
PD –
AB – STUDY DESIGN: Reliability study. OBJECTIVES: To compare the within- and between-day intrarater reliability of rehabilitative ultrasound imaging (RUSI) using static images (static RUSI) and video clips (video RUSI) to quantify multifidus muscle thickness at rest and while contracted. Secondary objectives were to compare the measurement precision of averaging multiple measures and to estimate reliability in individuals with and without low back pain (LBP). BACKGROUND: Although intrarater reliability of static RUSI in measuring multifidus thickness has been established, using video RUSI may improve reliability estimates, as it allows examiners to select the optimal image from a video clip. Further, multiple measurements and LBP status may affect RUSI reliability estimates.METHODS: Static RUSI and video RUSI were used to quantify multifidus muscle thickness at rest and during contraction and percent thickness change in 27 volunteers (13 without LBP and 14 with LBP). Three static RUSI images and 3 video RUSI video clips were collected in each of 2 sessions 1 to 4 days apart. Reliability and precision were assessed using intraclass correlation coefficients, standard error of measurement, minimal detectable change, bias, and 95% limits of agreement. RESULTS: Using an average of 2 measures yielded optimal measurement precision for static RUSI and video RUSI. Based on the average of 2 measures obtained under the same circumstance, there was no significant difference in the reliability estimates between static RUSI and video RUSI across all testing conditions. Reliability point estimates (intraclass correlation coefficient model 3,2) of multifidus thickness were 0.99 for within-day comparisons and ranged from 0.93 to 0.98 for between-day comparisons. The within- and between-day intraclass correlation coefficients (model 3,2) of percent thickness change ranged from 0.97 to 0.99 and from 0.80 to 0.90, respectively. The exploratory analysis showed no significant difference in the reliability estimates between asymptomatic and LBP participants across most testing conditions. CONCLUSION: Both RUSI methods yielded high reliability estimates for multifidus muscle measurements. Using an average of 2 measures obtained optimal measurement precision. Overall, video RUSI is a reliable surrogate for static RUSI for multifidus muscle measurements and has the additional advantage of requiring shorter data collection time. Copyright © 2013 Journal of Orthopaedic and Sports Physical Therapy.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 43
IS – 4
PG – 251-262
SP – 251
EP – 262
AN –
DO – 10.2519/jospt.2013.4478
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L368675000
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Lumbar multifidus muscle thickness does not predict patients with low back pain who improve with trunk stabilization exercises
A1 – Zielinski K.A.
A1 – Henry S.M.
A1 – Ouellette-Morton R.H.
A1 – Desarno M.J.
Y1 – 2013///
PD –
AB – Objective: To understand lumbar multifidus (LM) muscle activation as a clinical feature to predict patients with low back pain (LBP) who are likely to benefit from stabilization (STB) exercises. Design: Prospective, cohort study. Setting: Outpatient physical therapy clinics. Participants: Persons with LBP were recruited for this study. Subjects (N=25) were classified as either eligible to receive STB exercises or ineligible on the basis of current clinical prediction rules. Interventions: Six weeks of STB treatment. Main Outcome Measures: Before and after treatment, subjects underwent rehabilitative ultrasound imaging to quantify LM-muscle activation and completed disability and pain questionnaires. Analyses were performed to examine the (1) relation between LM-muscle activation and current clinical features used to predict patients with LBP likely to benefit from STB exercises, (2) LM-muscle activation between the STB-eligible and STB-ineligible groups before and after STB treatment, and (3) relation between LM-muscle activation before STB treatment and (a) disability and (b) pain outcomes after treatment for both groups. Results: No relation was found between LM-muscle activation and the number of clinical features. Before STB treatment, LM-muscle activation between the STB-eligible and STB-ineligible groups did not differ. After STB treatment, LM-muscle activation differed between the groups; however, this interaction was because the LM-muscle activation for the STB-eligible group decreased after treatment while that for the STB-ineligible group increased after treatment. Finally, only the STB-eligible group had a significant reduction in disability following treatment; however, no relation was found between LM-muscle activation before treatment and (a) disability or (b) pain outcomes after treatment in the STB-eligible group. Conclusions: LM-muscle activation does not appear to be a clinical feature that predicts patients with LBP likely to benefit from STB exercises. © 2013 by the American Congress of Rehabilitation Medicine.
JO – Archives of Physical Medicine and Rehabilitation
PB –
CY –
VL – 94
IS – 6
PG – 1132-1138
SP – 1132
EP – 1138
AN –
DO – 10.1016/j.apmr.2012.12.001
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L52410185
NS –
N1 – Exclusion reason: {{vote.get(‘exclusion_reason’)}};
ER –

TY – JOUR
T1 – Inter-session reliability of the measurement of the deep and superficial layer of lumbar multifidus in young asymptomatic people and patients with low back pain using ultrasonography
A1 – Liu I.-S.
A1 – Chai H.-M.
A1 – Yang J.-L.
A1 – Wang S.-F.
Y1 – 2013///
PD –
AB – Study design: Reliability study. Objective: To investigate the inter-session reliability of measuring the thickness of deep (dMF) and superficial layer of lumbar multifidus (sMF) using ultrasonography for participants with and without low back pain (LBP). Background: The lumbar multifidus is an important muscle in maintaining spinal stability. The dMF is considered important in maintaining tonic contraction and joint stability. Motor control impairment is also discovered in patients with LBP. However, no study to date has investigated the method of observing both the sMF and dMF through ultrasound imaging (USI). Methods: Twenty subjects aged 18-35 years old with LBP (N=10) and without LBP (N=10) were recruited. Every subject extended the upper trunk in prone lying with maximal isometric contraction. Simultaneously, the examiner measured the thickness of the dMF and the sMF using ultrasonography after ensuring the muscle belly was located. The participants performed three trials of isometric trunk extension in each session, with 30. min between each session. The reliability of measuring the change of thickness is represented by the intra-class correlation coefficient (ICC). Results: Through averaging three trials of measurement, the reliability of measuring the thickness of the dMF or the sMF in static or in the contracted condition, and the change of the thickness during contraction, is reliable (ICC=0.84-1.00). Conclusions: The intra-rater inter-session reliability of measurement of the dMF and the sMF with USI has been established. This method could be applied to the qualification of the activation level of the dMF and the sMF with specific tasks. © 2013 Elsevier Ltd.
JO – Manual Therapy
PB –
CY –
VL – 18
IS – 6
PG – 481-486
SP – 481
EP – 486
AN –
DO – 10.1016/j.math.2013.04.006
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L52603318
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Comparison between muscle activation measured by electromyography and muscle thickness measured using ultrasonography for effective muscle assessment
A1 – Kim C.-Y.
A1 – Choi J.-D.
A1 – Kim S.-Y.
A1 – Oh D.-W.
A1 – Kim J.-K.
A1 – Park J.-W.
Y1 – 2014///
PD –
AB – In this study, we aimed to compare the intrarater reliability and validity of muscle thickness measured using ultrasonography (US) and muscle activity via electromyography (EMG) during manual muscle testing (MMT) of the external oblique (EO) and lumbar multifidus (MF) muscles. The study subjects were 30 healthy individuals who underwent MMT at different grades. EMG was used to measure the muscle activity in terms of ratio to maximum voluntary contraction (MVC) and root mean square (RMS) metrics. US was used to measure the raw muscle thickness, the ratio of muscle thickness at MVC, and the ratio of muscle thickness at rest. One examiner performed measurements on each subject in 3 trials. The intrarater reliabilities of the % MVC RMS and raw RMS metrics for EMG and the % MVC thickness metrics for US were excellent (ICC = 0.81-0.98). There was a significant difference between all the grades measured using the % MVC thickness metric (p< 0.01). Further, this % MVC thickness metric of US showed a significantly higher correlation with the EMG measurement methods than with the others (r= 0.51-0.61). Our findings suggest that the % MVC thickness determined by US was the most sensitive of all methods for assessing the MMT grade. © 2014 Elsevier Ltd.
JO – Journal of Electromyography and Kinesiology
PB –
CY –
VL – 24
IS – 5
PG – 614-620
SP – 614
EP – 620
AN –
DO – 10.1016/j.jelekin.2014.07.002
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L53260413
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Multifidus muscle size and percentage thickness changes among patients with unilateral chronic low back pain (CLBP) and healthy controls in prone and standing
A1 – Sweeney N.
A1 – O’Sullivan C.
A1 – Kelly G.
Y1 – 2014///
PD –
AB – The aim of this study was to determine if differences exist in lumbar multifidus (LM) thickness at rest and during activation, between individuals with chronic low back pain (CLBP) and controls. Lumbar multifidus thickness was assessed via rehabilitative ultrasound imaging (RUSI), and was performed in prone and standing both at rest and during muscle activation i.e. with a contralateral arm lift (CAL). Twenty participants were assessed; ten CLBP participants and ten controls. Rehabilitative ultrasound imaging was used to measure LM thickness and percentage thickness change at L4/L5 and L5/S1 in four positions; prone at rest, prone during activation with a CAL, standing at rest, and standing during activation with a CAL. Independent and paired t-tests were used to calculate differences in LM thickness and percentage thickness change between groups, and also between sides in the CLBP group. There was a significant difference in LM percentage thickness change in standing during activation with a CAL; the CLBP demonstrated a greater percentage thickness increase at L5/S1 compared to the controls, (p=0.05). There were no differences between groups at the L4/L5 level for this position. There were no differences between the groups for LM thickness or percentage thickness change in prone or standing at rest, or during activation with a CAL in prone. Within the CLBP group, no significant between side differences were found. These results give preliminary insight into possible differences in LM contractile behaviour during functional movements in CLBP, however, larger scale research is warranted.
JO – Manual Therapy
PB –
CY –
VL – 19
IS – 5
PG – 433-439
SP – 433
EP – 439
AN –
DO – 10.1016/j.math.2014.04.009
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L601334975
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Ultrasound imaging: intraexaminer and interexaminer reliability for multifidus muscle thickness assessment in adults aged 60 to 85 years versus younger adults
A1 – Sions J.M.
A1 – Velasco T.O.
A1 – Teyhen D.S.
A1 – Hicks G.E.
Y1 – 2014///
PD –
AB – CONCLUSION: Ultrasound imaging reliability for measurements of multifidus thickness at rest and during a CLL among older adults is consistent with previously published findings for younger adults. Among older adults, it may be preferable to have a single examiner conduct USI assessments.
JO – The Journal of orthopaedic and sports physical therapy
PB –
CY –
VL – 44
IS – 6
PG – 425-434
SP – 425
EP – 434
AN –
DO – 10.2519/jospt.2014.4584
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L602069859
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Development of a new ultrasound-based system for tracking motion of the human lumbar spine: Reliability, stability and repeatability during forward bending movement trials
A1 – Cuesta-Vargas A.I.
Y1 – 2015///
PD –
AB – The aim of this study was to develop a new method for quantifying intersegmental motion of the spine in an instrumented motion segment L4-L5 model using ultrasound image post-processing combined with an electromagnetic device. A prospective test-retest design was employed, combined with an evaluation of stability and within- and between-day intra-tester reliability during forward bending by 15 healthy male patients. The accuracy of the measurement system using the model was calculated to be ± 0.9° (standard deviation = 0.43) over a 40° range and ± 0.4 cm (standard deviation = 0.28) over 1.5 cm. The mean composite range of forward bending was 15.5 ± 2.04° during a single trial (standard error of the mean = 0.54, coefficient of variation = 4.18). Reliability (intra-class correlation coefficient = 2.1) was found to be excellent for both within-day measures (0.995-0.999) and between-day measures (0.996-0.999). Further work is necessary to explore the use of this approach in the evaluation of biomechanics, clinical assessments and interventions.
JO – Ultrasound in Medicine and Biology
PB –
CY –
VL – 41
IS – 7
PG – 2049-2056
SP – 2049
EP – 2056
AN –
DO – 10.1016/j.ultrasmedbio.2015.02.015
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L603617135
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Swiss ball enhances lumbar multifidus activity in chronic low back pain
A1 – Scott I.R.
A1 – Vaughan A.R.S.
A1 – Hall J.
Y1 – 2015///
PD –
AB – Objectives: This study examined the effects of sitting surfaces on the cross-sectional area of lumbar multifidus (LM) in patients with Chronic Low Back Pain (CLBP) and healthy controls (HC). Design: Cross-Sectional Case Controlled Study. Setting: Isle of Man Institute of Sport. Participants: 40 age and sex matched, sporting participants aged 18-45 years, recruited from private physiotherapy practice patients (n=20 CLBP, 16 male, 4 female, and n=20 healthy controls, 16 males and 4 females). Main Outcome Measures: Cross-sectional area of LM was measured using rehabilitative ultrasound imaging. Results: Swiss Ball (SB) was more effective at stimulating LM than a Stable Surface (SS) in both groups: CLBP:SB:12.3(cm2) (SD:3.6), SS:10.15 (SD:2.6), p<0.0001; HC:SB:12.5 (SD:2.7), SS:11.3 (SD:2.9), p<0.0001). No significant differences between groups were noted. No differences between left and right side cross-sectional areas between or within groups were noted. Conclusion: Cross-sectional area of LM increased as the lability of the surface increased, demonstrating that SB was more effective at stimulating LM activity than a non-labile surface. This confirms current clinical practice and supports the use of a labile surface in spinal rehabilitation. The lack of LM asymmetry within and between groups is discussed.
JO – Physical Therapy in Sport
PB –
CY –
VL – 16
IS – 1
PG – 40-44
SP – 40
EP – 44
AN –
DO – 10.1016/j.ptsp.2014.02.007
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L53151240
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Characteristics of Trunk Control during Crook-Lying Unilateral Leg Raising in Different Types of Chronic Low Back Pain Patients
A1 – Ohe A.
A1 – Kimura T.
A1 – Goh A.-C.
A1 – Oba A.
A1 – Takahashi J.
A1 – Mogami Y.
Y1 – 2015///
PD –
AB – Study Design. Cross-sectional observational study. Objective. To quantitatively clarify the characteristics of trunk control during unilateral leg-raising movement in different types of nonspecific chronic low back pain (NS-CLBP) patients who were identified by aggravation of symptoms during trunk movement. Summary of Background Data. Although there is a need to classify NS-CLBP patients for clinical decision making in physical therapy, the characteristics of trunk control during unilateral leg-raising movement in different types of NS-CLBP patients have not been quantitatively analyzed in previous studies by simultaneously measuring the lumbar spine movement, trunk muscle activity, and leg movement. Methods. Thirty NS-CLBP patients, of whom 13 were aggravated by trunk flexion (flexion group) and 17 were aggravated by trunk extension (extension group), and 30 healthy controls performed crook-lying unilateral leg-raising movement on the painful side in patient group and the dominant leg in controls. During the unilateral leg-raising movement, pressure changes produced by the movement of the lumbar lordotic curve, measured by a custom-made recording device, were used as indices of the lumbar spine movement. Trunk muscle activities were recorded by surface electromyography and diagnostic ultrasonography. The pressure changes and trunk muscle activities were statistically compared among the 3 groups. Results. At foot-off during unilateral leg-raising movement, the extension group demonstrated increase in pressure changes, whereas the flexion group and controls demonstrated decrease in pressure changes. Bilateral external obliques muscle activities in the extension group were significantly larger than those in the flexion group and controls (P < 0.05). Conclusion. This study demonstrated that the characteristics of trunk control during unilateral leg-raising movement were different depending on the types of NS-CLBP patients. These results indicate that patients with NS-CLBP might select compensatory trunk control strategies subconsciously to prevent the manifestation of LBP. These results also suggest the importance of the different characteristics of trunk control during active limb movement in the clinical reasoning process for the management of different types of NS-CLBP patients. JO – Spine PB – CY – VL – 40 IS – 8 PG – 550-559 SP – 550 EP – 559 AN – DO – 10.1097/BRS.0000000000000828 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L608425294 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Comparative analysis of motor control stability and strengthening program in treatment of chronic low back pain among male weight lifters A1 – Thomas A. Y1 – 2015/// PD – AB – Background: Chronic low back pain is a common problem which affects the majority low back pain is the most expensive health care problem in those between ages of 20 and 50 and in that 50% of all injuries in adolescent power lifters were to the low back. Recent focus in the physiotherapy management of the patient with Chronic low back pain has been the specific training of muscles surrounding the lumbar spine whose primary role is considered to be the provision of the dynamic stability and segmental control to the spine. There is sufficient evidence to suggest that motor control exercise therapy targeting the transverse abdominis and multifidus appears effective in enhancing segmental stability, reducing low back pain, enhancing functional ability and reducing recurrence rates in patients with low back pain. Purpose: The purpose of this study is to introduce motor control exercise as an intervention method for the treatment of low back pain among weight lifters. This study also serves as an initial step in a research process that would explore motor control exercises as a useful addition to other interventions, as there is a paucity of clinical research studies that examine the efficacy of this technique. Very few studies have been done to compare the effectiveness of strengthening and general exercises, and there are no studies comparing motor control exercises and strengthening exercises. Methods: Experimental design, Random sampling, Variables – VAS scale, Oswestry disability scale, Fear Avoidance Belief Questionnaire, Pressure biofeedback, Ultra sound scanning for Transverse abdominis and Multifidus. 22 intercollegiate men weight lifters were selected as subjects, age ranged from 20 to 28 years. Subjects were screened to identify those who are not suitable for exercise management of their low back pain because of significant co-morbidity such as serious spinal pathology or contraindication to exercise. Procedure – 22 male subjects are randomized into two groups, Group A and Group B, 11 subjects in each group. Questionnaires and Ultra sound scanning taken prior to the treatment for all 22 subjects. Group A received motor control stability exercises and Group B received strengthening exercises for 8 weeks and each session lasted with 45 minutes. After 8 weeks again the same questionnaires are applied and ultra sound scanning done to see the outcome of exercise program. Results: Repeated measure of analysis of co-variance applied to find out the differences among the adjusted means. Repeated measure of analysis of co-variance is a more sophisticated method of analysis of variance. Whenever the “f” ratio was found to be significant, Scheffe’s post hoc test was applied to assess the differences between the adjusted means if any.0.05 level of confidence was fixed to test the level of significance. The result shows that motor control exercise has significant improvement (p 0.05) compared to strengthening exercise. Conclusion(s): The motor control exercise is important to improve the functional ability and pain reduction in chronic low back pain subjects. Implications: This can be basis for research for the functional performance level in chronic low back pain patients. JO – Physiotherapy (United Kingdom) PB – CY – VL – 101 IS – (Thomas A.) JSS College of Physiotherapy, Physiotherapy, Mysore, India PG – eS1512 SP – eS1512 EP – AN – DO – org/10.1016/j.physio.2015.03.1495 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72115519 NS – N1 – Exclusion reason: 4.- Abstracts from Congress, Symposium…; ER – TY – JOUR T1 – Examination of inner unit muscle function with a diagnostic ultrasonic imaging device A1 – Ubukata H. A1 – Maruyama H. A1 – Huo M. Y1 – 2015/// PD – AB – Background: Urinary incontinence seriously affects the social aspects of women’s quality of life. Many cases of urinary incontinence involve stress urinary incontinence, and pelvic floor muscle (PFM) exercises are often performed as treatment. However, the PFMs are deeply located within the body, making conscious PFM contraction difficult. The inner unit muscles include the PFMs, transverse abdominis (TrA), lumbar multifidus (LM), and diaphragm, all of which are actively coordinated. Purpose: We examined each muscle of the inner unit with a diagnostic ultrasonic imaging device and measured various muscle parameters during different motion tasks to determine the contribution and function of each muscle during PFM exercises. Methods: Eleven healthy women without urinary incontinence or previous birth experience were evaluated during (1) rest, (2) maximal contraction of the TrA, (3) maximal contraction of the PFMs, (4) maximal co-contraction of the TrA and LM, and (5) maximal co-contraction of the TrA and PFM with knee resistance. The thickness and cross-sectional area of the TrA and LM and the pelvic floor elevation were measured with a diagnostic ultrasonic imaging device. SPSS 17.0 for Windows was used for statistical analysis. The interclass correlation coefficient was calculated to determine the measurement reliability. Pearson’s product-moment correlation analysis and single regression analysis of the relevancy of each muscle were performed. One-way repeated measures analysis of variance was performed to compare the muscle parameters during the motion tasks. When significant differences were present, the Bonferroni method was used as a post hoc comparison test. A significance level of 0.05 was used for all measurements. The study protocol and purpose were explained to all subjects, and written informed consent was obtained. The study was conducted in accordance with the Helsinki Declaration. Results: The interclass correlation coefficient (1, 1) of each measurement was >0.71 for the TrA, >0.85 for the LM, and >0.98 for the PFMs. The PFMs, LM, and TrA exhibited a positive correlation. Significant regression was shown in the single regression analysis. The TrA thickness and LM cross-sectional area were significantly higher with the added resistance than during the resting state (p < 0.05). The pelvic floor elevation was significantly higher with the synchronous contraction and resistance (p < 0.05). Conclusion(s): The measurement reliability for each muscle during each motion task was >0.71, indicating a high level of credibility. These results suggest that indirect assessment of the PFMs is possible by examination of the LM or TrA. Additionally, contraction of a single muscle of the inner unit resulted in simultaneous contraction of the other muscles comprising the unit, and higher muscle activity was obtained by adding resistance. Implications: In healthy women, the LM, TrA, and PFMs cooperate with and move in relation to one another. While conventional urinary incontinence exercises contraction of the PFMs only, a greater training effect is expected by coordinated contraction of the inner unit. The present study will help to establish more effective physical therapy protocols to reduce urinary incontinence.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 101
IS – (Huo M.) Himeji Dokkyo University, Himeji, Japan
PG – eS1552-eS1553
SP – eS1552
EP – eS1553
AN –
DO – org/10.1016/j.physio.2015.03.1549
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72115573
NS –
N1 – Exclusion reason: 4.- Abstracts from Congress, Symposium…;
ER –

TY – JOUR
T1 – Measurement of lumbar multifidus muscle contraction by ultrasonography and electromyography
A1 – Kasai T.
A1 – Itoh C.
A1 – Wakayama S.
Y1 – 2015///
PD –
AB – Background: The lumbar multifidus (LM) muscle plays a key role in lumbar motor control. These interventions are used for the treatment of low back pain. LM muscle activities are measured by electromyography (EMG) and ultrasonography (US). US offers a noninvasive method to measure muscle activation and has gained popularity in various aspects of low back pain. US data compared to EMG activity has been performed in prone subjects, but few studies of the LM combining US and EMG in antigravity postures have been performed. Purpose: The aim of this study was to compare LM muscle activities in 3 postures by US and EMG. Methods: Subjects were 25 normal, healthy, male volunteers, with mean age (standard deviation) 20.4 years (1.7 years), height 170.9 cm (4.5 cm), and weight 64.6 kg (8.9 kg). We measured muscular thickness of the LM muscle using US, and measured muscle activity of the erector spinae and LM muscles using surface EMG. We then measured thickness of the LM muscle at rest and during contraction to determine changes. Subjects were measured in the following 3 positions: prone; sitting; and standing. In the 3 postures, differences in mean values of muscle thickness changes and EMG were assessed using a Bonferroni multiple comparisons procedure. Results: Significant differences in each posture were seen between muscle thickness changes and EMG of the LM. LM muscle thickness change was highest in the order of prone, sitting, and standing, and EMG was highest in the order of prone, standing, and sitting. EMG of the erector spinae muscles differed significantly between prone and sitting, and between standing and sitting. Conclusion(s): Muscle thickness changes and EMG activities of LM differed depends on posture. During muscle contraction using US for LM, since posture may not reflect muscle activity, the data need to be interpreted more carefully. Implications: This study provides the groundwork for measurement of LM using US to investigate the assessment of treatment approaches on low back pain.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 101
IS – (Kasai T.; Itoh C.; Wakayama S.) Hirosaki University, Graduate School of Health Sciences, Hirosaki, Japan
PG – eS729
SP – eS729
EP –
AN –
DO – 10.1016/j.physio.2015.03.3588
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72114526
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Cross-sectional area and muscle activity of the lumbar multifidus muscles in varying postures during abdominal draw-in exercises
A1 – Watanabe M.
A1 – Hayashi T.
A1 – Miyazaki Y.
A1 – Miyakawa S.
Y1 – 2015///
PD –
AB – Background: In the prevention of low back pain, the selective training of deep muscles such as the transverse abdominal (TrA) and multifidus (MF) muscles is an important initial stage. Co-contraction of the TrA and MF muscles is important for trunk stability. Therefore, physical therapists train patients to selectively contract the TrA muscles using abdominal draw-in exercises, but studies have shown that TrA muscle activity during draw-in exercises is not affected by posture. To the best of our knowledge, only few studies have reported the correlation between posture and maximum muscle activity during draw-in exercises, but no studies have examined MF muscle activity during draw-in exercises. Purpose: This study was designed to clarify the MF muscle activity during the draw-in exercise performed in four different postures. Differences in muscle activity and crosssectional area among postures were measured using surface electrodes and ultrasonography. Methods: Eleven men (24±2 years) assumed four postures in which they performed the draw-in exercises: sitting pelvic neutral (S-N); sitting pelvic anterior tilt (S-A); sitting pelvic posterior tilt (S-P); and standing position. The MF muscle activity was measured using surface electrodes. To normalize muscle activity, the maximum voluntary contraction (MVC) was measured on both sides, and the root mean square was calculated to determine the muscle activity in each posture. At the same time, using ultrasonography, still images of the MF muscle in the line of the fourth lumbar spinous process were recorded. The cross-sectional area was measured in 0.1-mm units. To compare the muscle activities and crosssectional areas among postures, one-way repeated measures analysis of variance was used. Results: MF muscle activity was significantly higher in the S-A posture (Rt. 24.6% MVC, Lt. 21.3% MVC, p < 0.05) than in the other postures. Furthermore, MF muscle activity was significantly higher in the standing posture than in the S-P posture. No differences in the cross-sectional areas of the MF muscle were seen among postures. Conclusion(s): In this study, draw-in exercises were performed by patients in four different postures to selectively contract the TrA muscle. We found higher MF muscle cocontraction in the standing and S-A postures. However, no changes were seen in the cross-sectional area. Earlier studies have shown that the sacroiliac joint was stabilized by the simultaneous contraction of TrA and MF muscles. The current findings suggest that draw-in exercises in the S-A and standing postures could effectively increase MF muscle activity and consequently trunk stability since cocontraction of the MF and TrA muscles contributes to trunk stability. Visual feedback on the changes in muscle activity during exercise could increase effectiveness; however, in our study, change in MF muscle activity could not be captured by ultrasonography. Hence, imaging modalities that provide visual depiction of muscle activity change are needed. Implications: This study showed clear differences in muscle activity in different postures during exercise involving contraction of the TrA and co-contraction of the MF. These findings could serve as a reference to ensure effective training.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 101
IS – (Miyakawa S.) University of Tsukuba, Graduate School of Comprehensive Human Sciences, Ibaraki, Japan
PG – eS1609
SP – eS1609
EP –
AN –
DO – 10.1016/j.physio.2015.03.1622
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72115646
NS –
N1 – Exclusion reason: 5.- Wrong study design; SAMUEL FERNANDEZ (2018-04-07 02:14:38)(Select): ERROR PAPER;
ER –

TY – JOUR
T1 – Effect of six-week specific stabilization exercise with ultrasound biofeedback for patients with recurrent LBP
A1 – Chen Y.-H.
A1 – Huang Y.-C.
A1 – Tsai Y.-C.
A1 – Chen H.-Y.
A1 – Chang C.-C.
A1 – Liu S.-S.
A1 – Wang S.-F.
Y1 – 2015///
PD –
AB – Background: Chronic LowBack Pain (LBP) is a common musculoskeletal problem with high prevalence and recurrence. Specific stabilization exercises with feedback, which aim to restore the function of deep trunk muscles such as transversus abdominis (TrA), have been suggested to modify motor control deficits but the quantitative effects of such exercises is lacking. Purpose: 1. To examine the performance of the TrA after 6-week ultrasonography (US) biofeedback guided specific stabilization exercises, for patients with recurrent chronic LBP; 2. To examine the effects on TrA contraction, pain and disability. Methods: Subjects with recurrent chronic LBP were included in the study. Real-time ultrasound images were viewed in B-mode with 5-12MHz linear-array transducer (Teroson t3000). Specific stabilization exercise with US biofeedback to confirm the TrA contraction was conducted by physical therapists once a week for six weeks. The architecture of the anterior and posterior sites of the TrA was measured during the abdominal draw-in maneuver (ADIM), prone ipsilateral hip extension (IE) and prone contralateral hip extension (CE). Outcome measurements included pain (current and most pain, VAS), disability (Oswestry disability index, self-efficient score), resting thickness (Thr), contracted thickness (Thc), change of thickness (ΔT) and sliding of the muscle-fascial junctions of the TrA (ΔX). Paired-t test was used to assess the effect of exercise training. Results: Eleven participants (male: 8, age: 40.5±9.4) with recurrent chronic LBP were enrolled in the study. The current pain and self-efficient score were improved (P < 0.05) after 6-week exercise training. ΔT and ΔX of the TrA were all improved after training (P < 0.05). Thc only increased in the abdominal draw-in maneuver and prone ipsilateral hip extension (P < 0.05). Thr was unaltered. Conclusion(s): 6-week specific stabilization exercises with ultrasound biofeedback improve pain, disability and muscle contraction pattern of the TrA in subjects with recurrent chronic LBP. Using this training protocol may helps patients with LBP to contract their core muscle more specifically and accurately, consequently, pain and function improved. Implications: Specific stabilization exercise with US feedback benefited patients with recurrent LBP in both pain and function. US image provided the visual feedback and quantitative measurement to enhance the accurate contraction of deep core muscles.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 101
IS – (Wang S.-F.) National Taiwan University Hospital, Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, Taipei, Taiwan
PG – eS230
SP – eS230
EP –
AN –
DO – 10.1016/j.physio.2015.03.403
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72113899
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The evaluation of lumbar multifidus muscle function via palpation: Reliability and validity of a new clinical test
A1 – Hebert J.J.
A1 – Koppenhaver S.L.
A1 – Teyhen D.S.
A1 – Walker B.F.
A1 – Fritz J.M.
Y1 – 2015///
PD –
AB – Background context The lumbar multifidus muscle provides an important contribution to lumbar spine stability, and the restoration of lumbar multifidus function is a frequent goal of rehabilitation. Currently, there are no reliable and valid physical examination procedures available to assess lumbar multifidus function among patients with low back pain. Purpose To examine the inter-rater reliability and concurrent validity of the multifidus lift test (MLT) to identify lumbar multifidus dysfunction among patients with low back pain. Study design/setting A cross-sectional analysis of reliability and concurrent validity performed in a university outpatient research facility. Patient sample Thirty-two persons aged 18 to 60 years with current low back pain and a minimum modified Oswestry disability score of 20%. Study participants were excluded if they reported a history of lumbar spine surgery, lumbar radiculopathy, medical red flags, osteoporosis, or had recently been treated with spinal manipulation or trunk stabilization exercises. Outcome measures Concurrent measures of lumbar multifidus muscle function at the L4-L5 and L5-S1 levels were obtained with the MLT (index test) and real-time ultrasound imaging (reference standard). Methods The inter-rater reliability of the MLT was examined by measuring the level of agreement between two blinded examiners. Concurrent validity of the MLT was investigated by comparing clinicians’ judgments with real-time ultrasound imaging measures of lumbar multifidus function. Results Inter-rater reliability of the MLT was substantial to excellent (κ=0.75 to 0.81, p≤.01) and free from errors of bias and prevalence. When performed at L4-L5 or L5-S1, the MLT demonstrated evidence of concurrent validity through its relationship with the reference standard results at L4-L5 (r bsubesub =0.59-0.73, p≤.01). The MLT generally failed to demonstrate a relationship with the reference standard results from the L5-S1 level. Conclusions Our results provide preliminary evidence supporting the reliability and validity of the MLT to assess lumbar multifidus function at the L4-L5 spinal level. Additional research examining the measurement properties and utility of this test should be undertaken before confident implementation with patients.
JO – Spine Journal
PB –
CY –
VL – 15
IS – 6
PG – 1196-1202
SP – 1196
EP – 1202
AN –
DO – 10.1016/j.spinee.2013.08.056
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L52898017
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Association of sagittal spinal alignment with thickness and echo intensity of lumbar back muscles in middle-aged and elderly women
A1 – Masaki M.
A1 – Ikezoe T.
A1 – Fukumoto Y.
A1 – Minami S.
A1 – Tsukagoshi R.
A1 – Sakuma K.
A1 – Ibuki S.
A1 – Yamada Y.
A1 – Kimura M.
A1 – Ichihashi N.
Y1 – 2015///
PD –
AB – Objective: Quantitative changes, such as a decrease in muscle mass, and qualitative changes, such as an increase in the amount of intramuscular non-contractile tissue, occur with aging. However, it is unclear whether quantitative or qualitative changes in back muscles are associated with spinal alignment in the standing position. We investigated the association of sagittal spinal alignment with muscle thickness as an index of the mass of lumbar back muscles and muscle echo intensity as an index of the amount of non-contractile tissue within these muscles. Methods: Study participants comprised 36 middle-aged and elderly women. Thickness and echo intensity of erector spinae, psoas major, and lumbar multifidus muscles were measured using an ultrasound imaging device. Standing sagittal spinal alignment, determined from thoracic kyphosis and lumbar lordosis angles, and the sacral anterior inclination angle was measured using the Spinal Mouse. Results: Stepwise regression analysis performed using muscle thickness, echo intensity, and age as independent variables showed that erector spinae muscle thickness was a significant determinant of the thoracic kyphosis angle. Psoas major muscle thickness and echo intensity of the lumbar multifidus muscle were significant determinants of the sacral anterior inclination angle. Conclusion: Our results suggest that an increase in thoracic kyphosis is associated with a decrease in the mass of the erector spinae muscle, and that a decrease in pelvic anterior inclination is associated with a decrease in the mass of the psoas major muscle and an increase in the amount of non-contractile tissue within the lumbar multifidus muscle.
JO – Archives of Gerontology and Geriatrics
PB –
CY –
VL – 61
IS – 2
PG – 197-201
SP – 197
EP – 201
AN –
DO – 10.1016/j.archger.2015.05.010
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L604752068
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Changes in lumbar multifidus muscle function and nociceptive sensitivity in low back pain patient responders versus non-responders after dry needling treatment
A1 – Koppenhaver S.L.
A1 – Walker M.J.
A1 – Su J.
A1 – McGowen J.M.
A1 – Umlauf L.
A1 – Harris K.D.
A1 – Ross M.D.
Y1 – 2015///
PD –
AB – Background: Little is known about the physiologic mechanism of dry needling. While some evidence suggests that dry needling may decrease nocioceptive sensitivity and facilitate muscle function, no studies to date have examined these physiologic changes compared to clinical outcomes. Objective: To examine changes in lumbar multifidus (LM) muscle function and nociceptive sensitivity after dry needling in patients with LBP and to determine if such changes differ in patients that exhibit improved disability (responders) and those that do not (non-responders). Design: Quasi-experimental study. Methods: Sixty-six volunteers with mechanical LBP (38 men, age = 41.3 ± 9.2 years) completed the study. Ultrasound measurements and pain algometry of the LM were taken at baseline and repeated immediately following dry needling treatment to the LM muscles and after one week. The percent change in muscle thickness from rest to contraction was calculated for each time point to represent muscle function. Pressure pain threshold (PPT) was used to measure nociceptive sensitivity. Participants were dichotomized as responders and non-responders based on whether or not they experienced clinical improvement using the modified Oswestry Disability Index after one week. 2 × 3 mixed-model ANOVA were conducted for group (responders vs. non-responders) by time. Results: Patient responders exhibited larger improvements in LM muscle contraction and nociceptive sensitivity 1 week, but not immediately, after dry needling than non-responders. Conclusions: Our results suggest that there may be lasting and clinically relevant sensorimotor changes that occur in LBP patients that improve with dry needling treatment that partially explain the physiologic mechanism of action.
JO – Manual Therapy
PB –
CY –
VL – 20
IS – 6
PG – 769-776
SP – 769
EP – 776
AN –
DO – 10.1016/j.math.2015.03.003
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L603236152
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Measuring lumbar sagittal posture in sewage workers using an ultrasonic device
A1 – Friedrich M.
Y1 – 2002///
PD –
AB – Because the degree and duration of lumbar flexion during sewage work have only been assessed on the basis of subjective reports, the purpose of this study was to investigate the usability of a measurement system for the non-invasive assessment of lumbar sagittal posture during sewage work using ultrasound. The validity of an ultrasonic measurement device was investigated in 16 healthy individuals by comparing the measurements obtained with the device with both Schober and electronic inclinometer measurements. To determine the intra-rater reliability of the ultrasonic device, short-term, medium-term, and long-term test-retest data were collected. Moreover, the percentage of the work time sewage workers spend in each of seven lumbar flexion categories within their individual lumbar flexion range of motion was assessed. Pearson’s correlation coefficients of ≥ 0.88 indicate high validity between the methods. The intraclass correlation coefficients between tests and retests (≥ 0.88) demonstrate high reproducibility of the measurement procedures. Sewage workers spend about 25% of their work day in the most extreme of the seven lumbar posture categories. Also, testing did not interfere with the workers’ normal work routine. The validity and reliability data as well as the trouble-free technical performance of the ultrasonic device support its usability for the continuous measurement of lumbar posture during sewage work.
JO – Journal of Musculoskeletal Research
PB –
CY –
VL – 6
IS – 3-4
PG – 135-145
SP – 135
EP – 145
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L36187547
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Between-day repeatability and symmetry of multifidus cross-sectional area measured using ultrasound imaging
A1 – Pressler J.F.
A1 – Heiss D.G.
A1 – Buford J.A.
A1 – Chidley J.V.
Y1 – 2006///
PD –
AB – Study Design: Prospective test-retest, intrarater reliability study. Objectives: To estimate the intrarater reliability, asymmetry, and associated error with measurement of the cross-sectional area (CSA) of the bilateral S1 multifidi when measured by a physical therapist following a short course of self-directed training in ultrasound imaging. Background: There is increasing interest in the assessment of the lumbar multifidus during the recovery from low back injury. It is important to know the error associated with the CSA measurements obtained by a physical therapist with limited experience in ultrasound imaging when using a portable unit. Methods and Measures: Thirty healthy females (mean ± SD age, 23 ± 2 years; mean ± SD mass, 63.1 ± 9.2 kg; mean ± SD height, 1.63 ± 0.06 m) participated. Fourteen subjects returned within 1 to 4 days for repeated measurements. Results: For all 30 subjects, the average (±SD) CSA of the left S1 multifidus (4.18 ± 0.55 cm2) was larger (P< .05) than the right (4.11 ± 0.57 cm2), with a standard error of the measurement (SEM) of 0.13 cm2 and average ± SD asymmetry of 3.5% ± 3.4%. For a subset of 14 subjects, the between-day intrarater reliability for the right S1 multifidus muscle was ICC3,1 = 0.80 (95% Cl, 0.49-0.93), while the ICC for the left side was 0.72 (95% Cl, 0.34-0.90). The day-to-day average differences for the left and right side were 0.02 cm 2 and 0.04 cm2, respectively. For the most conservative estimate, the between-day SEM was 0.37cm2. Conclusions: A physical therapist, newly trained in ultrasound imaging, obtained reasonable between-day intrarater reliability when imaging the S1 multifidus. A high degree of symmetry was found between the bilateral S1 multifidi in a sample of healthy subjects, which is consistent with previous reports from measurements by skilled ultrasonographers.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 36
IS – 1
PG – 10-18
SP – 10
EP – 18
AN –
DO – 10.2519/jospt.2006.2049
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L43077253
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury
A1 – Hodges P.
A1 – Holm A.K.
A1 – Hansson T.
A1 – Holm S.
Y1 – 2006///
PD –
AB – STUDY DESIGN. Experimental study of muscle changes after lumbar spinal injury. OBJECTIVES. To investigate effects of intervertebral disc and nerve root lesions on cross-sectional area, histology and chemistry of porcine lumbar multifidus. SUMMARY OF BACKGROUND DATA. The multifidus cross-sectional area is reduced in acute and chronic low back pain. Although chronic changes are widespread, acute changes at 1 segment are identified within days of injury. It is uncertain whether changes precede or follow injury, or what is the mechanism. METHODS. The multifidus cross-sectional area was measured in 21 pigs from L1 to S1 with ultrasound before and 3 or 6 days after lesions: incision into L3-L4 disc, medial branch transection of the L3 dorsal ramus, and a sham procedure. Samples from L3 to L5 were studied histologically and chemically. RESULTS. The multifidus cross-sectional area was reduced at L4 ipsilateral to disc lesion but at L4-L6 after nerve lesion. There was no change after sham or on the opposite side. Water and lactate were reduced bilaterally after disc lesion and ipsilateral to nerve lesion. Histology revealed enlargement of adipocytes and clustering of myofibers at multiple levels after disc and nerve lesions. CONCLUSIONS. These data resolve the controversy that the multifidus cross-sectional area reduces rapidly after lumbar injury. Changes after disc lesion affect 1 level with a different distribution to denervation. Such changes may be due to disuse following reflex inhibitory mechanisms. © 2006 Lippincott Williams & Wilkins, Inc.
JO – Spine
PB –
CY –
VL – 31
IS – 25
PG – 2926-2933
SP – 2926
EP – 2933
AN –
DO – 10.1097/01.brs.0000248453.51165.0b
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L44885709
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Measurement of lumbar multifidus muscle contraction with rehabilitative ultrasound imaging
A1 – Kiesel K.B.
A1 – Uhl T.L.
A1 – Underwood F.B.
A1 – Rodd D.W.
A1 – Nitz A.J.
Y1 – 2007///
PD –
AB – Rehabilitative Ultrasound Imaging (RUSI) has been validated as a noninvasive method to measure activation of selected muscles. The purpose of this study was to determine the relationship between muscle thickness change, as measured by ultrasonography, and electromyography (EMG) activity of the lumbar multifidus (LM) muscle in normal subjects. Bipolar fine wire electrodes were inserted into the LM at the L4 level of five subjects. Simultaneous EMG and RUSI data (muscle thickness) were collected while subjects performed increasingly demanding postural response tasks thought to activate the LM muscle. To determine the relationship between muscle thickness change and EMG activity, the normalized EMG data were correlated to normalized RUSI data. To determine if the tasks increased the demand on the LM, the mean EMG data were compared over each of the four tasks. Muscle thickness change as measured by RUSI was highly correlated with EMG activity of LM in asymptomatic subjects (r = . 79,P < . 001 ). Mean EMG data showed increasing levels of activation across tasks (19-34% of maximum voluntary isometric contraction (MVIC)). The results of the repeated measures ANOVA demonstrated theses differences were significant (F3, 12 = 25.39,P < . 001 ). Measurement of muscle thickness change utilizing RUSI is a valid and potentially useful method to measure activation of the LM muscle in a narrow range (19-34% of MVIC) in an asymptomatic population. © 2006 Elsevier Ltd. All rights reserved.
JO – Manual Therapy
PB –
CY –
VL – 12
IS – 2
PG – 161-166
SP – 161
EP – 166
AN –
DO – 10.1016/j.math.2006.06.011
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L46628788
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Reliability and validity of standing back extension test for detecting motor control impairment in subjects with low back pain
A1 – Gondhalekar G.A.
A1 – Kumar S.P.
A1 – Eapen C.
A1 – Mahale A.
Y1 – 2016///
PD –
AB – 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.
JO – Journal of Clinical and Diagnostic Research
PB –
CY –
VL – 10
IS – 1
PG – KC07-KC11
SP – KC07
EP – KC11
AN –
DO – 10.7860/JCDR/2016/14987.7142
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L607579564
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Comparison of psoas major muscle thickness measured by sonography during active straight leg raising in subjects with and without uncontrolled lumbopelvic rotation
A1 – Jeon I.-C.
A1 – Kwon O.-Y.
A1 – Weon J.-H.
A1 – Choung S.-D.
A1 – Hwang U.-J.
Y1 – 2016///
PD –
AB – Background: The psoas major (PM) is important for stabilizing lumbopelvic region during active straight leg raising (ASLR). Uncontrolled lumbopelvic rotation (ULPR) frequently occurs during ASLR in subjects with poor lumbo-pelvic stability and may contribute to asymmetric symptoms including pain in lumbopelvic region. Objects: This study compared the thickness of contralateral PM (cPM) using ultrasound imaging during ASLR in subjects with and without ULPR. Method: Healthy male subjects (18 without ULPR, 19 with ULPR) were recruited. The thickness of the cPM during rest and ASLR without loading and with a 1-kg load was measured by ultrasound imaging. The relative muscle thickness was calculated as the thickness during ASLR/thickness at rest. Two-way mixed-model analysis of variance was used to identify significant differences in the relative thickness of the cPM between groups and within a loading status. The level of statistical significance was set at α = 0.05. Results: The resting thickness of the cPM in subjects without ULPR did not differ from that of subjects with ULPR. The relative thickness of the cPM in subjects without ULPR was significantly greater during ASLR than that in subjects with ULPR both without loading and with a load (p < 0.01). No significant change in thickness of the cPM was evident in those with ULPR. Conclusion: The thickness of the cPM was significantly greater during ASLR in subjects without ULPR than with ULPR. This result indicates that persons with ULPR have less activation of the cPM to stabilize the lumbar spine during ASLR.
JO – Manual Therapy
PB –
CY –
VL – 21
IS – (Weon J.-H., jhweon@joongbu.ac.kr) Department of Physical Therapy, College of Tourism and Health Science, Joongbu University, Geumsan, South Korea
PG – 165-169
SP – 165
EP – 169
AN –
DO – 10.1016/j.math.2015.07.006
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L605390342
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The immediate effect of dry needling on multifidus muscles’ function in healthy individuals
A1 – Dar G.
A1 – Hicks G.E.
Y1 – 2016///
PD –
AB – BACKGROUND: Dry needling of muscles is mainly used for the management of pain in musculoskeletal disorders. Yet, the association between dry needling and motor performance of muscles is still unclear. OBJECTIVE: To investigate the immediate effect of dry needling on lumbar multifidus muscles’ function in healthy subjects. METHODS: Twenty-eight volunteers were divided randomly into: study group (13 subjects) and control group (15 subjects) who underwent no intervention. Study group received dry needling to the lumbar multifidus muscles using a deep insertion technique with 4 needles (2 on each side of the spine). The needles were left in situ for 10 minutes. Ultrasound imaging was used to measure multifidus muscles’ thickness, pre and post-procedure during rest in a prone position and during contralateral active straight leg extension. RESULTS: Significant difference was found in the percentage of change of muscle activation post needling between groups on the right side at level L4-5. A slight increase in the percentage of muscle activity, post procedure was observed in the dry needling group compared with the control group, although not significant in other segments examined. CONCLUSION: An improvement of back muscle function following dry needling procedure in healthy individuals was found. This implies that dry needling might stimulate motor nerve fibers and as such increase muscle activity.
JO – Journal of Back and Musculoskeletal Rehabilitation
PB –
CY –
VL – 29
IS – 2
PG – 273-278
SP – 273
EP – 278
AN –
DO – 10.3233/BMR-150624
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L610582762
NS –
N1 – Exclusion reason: 7.- Wrong patient population;
ER –

TY – JOUR
T1 – Effects of different verbal instructions on change of lumbar multifidus muscle thickness in asymptomatic adults and in patients with low back pain
A1 – Wang-Price S.
A1 – Zafereo J.
A1 – Brizzolara K.
A1 – Sokolowski L.
A1 – Turner D.
Y1 – 2017///
PD –
AB – Background: Spinal stabilisation exercise has been shown to be effective in the rehabilitation of low back pain (LBP). Due to the isometric nature of spinal stabilisation exercise, manual therapists use various verbal instructions to elicit lumbar multifidus muscle contraction. Objectives: The purpose of this study was to assess whether or not three verbal instructions would alter muscle thickness of the lumbar multifidus muscle differently in asymptomatic individuals and patients with LBP. Methods: Three verbal instructions were selected for this study: (1) swell the muscle underneath the transducer, (2) draw your belly button in towards your spinal column and (3) think about tilting your pelvis but without really doing it. Lumbar multifidus muscle thickness was determined using parasagittal ultrasound (US) imaging. Measurements of muscle thickness were collected at rest and during verbal instructions from 21 asymptomatic adults and 21 patients with LBP. Percent changes of muscle thickness during contraction and at rest were compared between groups and across verbal instructions. Results: ANOVA results showed no significant interaction for both L4-5 and L5-S1, but a significant main effect of verbal instruction (P = 0.049) at L4-5.Post hoc analysis showed a greater increase with verbal instruction #3 than verbal instruction #2 (P = 0.009). There was no significant main effect of group at either segment. Discussion: The results of the study suggest that both groups responded similarly to the three verbal instructions. Verbal instructions may increase lumbar multifidus muscle thickness by different amounts at L4-5, but by the same amount at L5-S1.
JO – Journal of Manual and Manipulative Therapy
PB –
CY –
VL – 25
IS – 1
PG – 22-29
SP – 22
EP – 29
AN –
DO – 10.1179/2042618615Y.0000000021
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L611285826
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The assessment of levator muscle strength: A validation of three ultrasound techniques
A1 – Dietz H.P.
A1 – Jarvis S.K.
A1 – Vancaillie T.G.
Y1 – 2002///
PD –
AB – Levator ani muscle function is traditionally evaluated by palpation or perioneometry. Recently, three different techniques of performing this task by translabial ultrasound have been described. The authors intended to validate these new methods by correlating results with assessments performed by perineometry and palpation. One hundred consecutive women were evaluated prospectively by a physiotherapist and a gynecologist. The physiotherapist undertook an assessment by palpation (Oxford grading) and perineometry (Peritron™). The gynecologist performed translabial ultrasound. Both were blinded against each other’s results. Correlations between ultrasound and palpation were between 0.52 and 0.62, with displacement of the bladder neck agreeing most closely with palpation. As regards perineometry, correlations were 0.38 to 0.52, and again bladder neck displacement agreed best with the physiotherapeutic assessment. All correlations were highly significant. It appears that the assessment of levator function by ultrasound correlates strongly with vaginal palpation of muscle strength and perineometry.
JO – International Urogynecology Journal
PB –
CY –
VL – 13
IS – 3
PG – 156-159
SP – 156
EP – 159
AN –
DO – 10.1007/s192-002-8346-5
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L34812267
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Assessment of pelvic floor movement using transabdominal and transperineal ultrasound
A1 – Thompson J.A.
A1 – O’Sullivan P.B.
A1 – Briffa K.
A1 – Neumann P.
A1 – Court S.
Y1 – 2005///
PD –
AB – The aims of the study were (1) to assess the reliability of transabdominal (TA) and transperineal (TP) ultrasound during a pelvic floor muscle (PFM) contraction and Valsalva manoeuvre and (2) to compare TA ultrasound with TP ultrasound for predicting the direction and magnitude of bladder neck movement in a mixed subject population. A qualified sonographer assessed 120 women using both TA and TP ultrasound. Ten women were tested on two occasions for reliability. The reliability during PFM was excellent for both methods. TP ultrasound was more reliable than TA ultrasound during Valsalva. The percentage agreement between TA and TP ultrasound for assessing the direction of movement was 85% during PFM contraction, 100% during Valsalva. There were significant correlations between the magnitude of the measurements taken using TA and TP ultrasound and significant correlations with PFM strength assessed by digital palpation. © International Urogynecology Journal 2005.
JO – International Urogynecology Journal
PB –
CY –
VL – 16
IS – 4
PG – 285-292
SP – 285
EP – 292
AN –
DO – 10.1007/s00192-005-1308-3
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L41511165
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Effect of test position on pelvic floor muscle assessment
A1 – Frawley H.C.
A1 – Galea M.P.
A1 – Phillips B.A.
A1 – Sherburn M.
A1 – Bø K.
Y1 – 2006///
PD –
AB – The aims of this study were to analyse the effect of different body positions on pelvic floor muscle (PFM) assessment using digital muscle testing, manometry and transabdominal ultrasound. In addition, subject acceptance of each testing position was recorded. Subjects were 20 women’s health physiotherapists. The testing protocol included the best of three maximum voluntary contractions tested in each of four positions (crook lying, supine, sitting and standing). Significant differences in muscle strength and subject acceptance between positions were found with each tool, most often between lying and upright positions. Digital muscle testing and vaginal squeeze-pressure scores were highest in the lying position, and vaginal resting pressure and transabdominal ultrasound scores were highest in the standing position. Subjects preferred the lying positions for internal examinations. The clinical significance of these differences and the reasons for these variations require further investigation. © International Urogynecology Journal 2005.
JO – International Urogynecology Journal
PB –
CY –
VL – 17
IS – 4
PG – 365-371
SP – 365
EP – 371
AN –
DO – 10.1007/s00192-005-0016-3
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L43833805
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – A prospective observational trial of pelvic floor muscle training for female stress urinary incontinence
A1 – Balmforth J.R.
A1 – Mantle J.
A1 – Bidmead J.
A1 – Cardozo L.
Y1 – 2006///
PD –
AB – OBJECTIVE: To assess the impact of pelvic floor muscle training (PFMT) on bladder neck mobility in a prospective observational study, and to correlate any observed changes with objective, standardized outcome measures of the severity of stress urinary incontinence (SUI). PATIENTS AND METHODS: Women with the symptom of SUI were recruited prospectively over a 3-year period from a tertiary referral urogynaecology clinic in a teaching hospital. A group of 97 treatment-naive women complaining of SUI and confirmed as having urodynamic SUI on video-urodynamic assessment agreed to participate. Bladder neck mobility on perineal ultrasonography was assessed immediately before and on completing a 14-week programme of ‘PFM rehabilitation’. Treatment outcome was assessed using a standardized pad-test and a condition-specific, validated quality-of-life questionnaire (King’s Health Questionnaire). Changes in functional anatomy were quantified using transperineal ultrasonography to measure the bladder neck position at rest, maximum PFM contraction and maximum Valsalva manoeuvre. Bladder neck rotational mobility from rest to maximum incursion and maximum excursion was calculated. RESULTS: Treatment with an intensive package of PFMT and behavioural modification resulted in significant elevation of the bladder neck position at all three measured positions. Displacement of the bladder neck on Valsalva (rotational excursion) was reduced after treatment, suggesting increased levator ‘stiffness’. These changes in functional anatomy were associated with a statistically and clinically significant reduction in urine loss and improvement in condition-specific quality of life. CONCLUSION: The present results show that PFMT is an effective treatment for SUI and provide an important new insight into how dynamic pelvic floor anatomy can be modified by this widely used intervention. © 2006 The Authors.
JO – BJU International
PB –
CY –
VL – 98
IS – 4
PG – 811-817
SP – 811
EP – 817
AN –
DO – 10.1111/j.1464-410X.2006.06393.x
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L44368030
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Comparison of transperineal and transabdominal ultrasound in the assessment of voluntary pelvic floor muscle contractions and functional manoeuvres in continent and incontinent women
A1 – Thompson J.A.
A1 – O’Sullivan P.B.
A1 – Briffa N.K.
A1 – Neumann P.
Y1 – 2007///
PD –
AB – Transperineal (TP) and transabdominal (TA) ultrasounds were used to assess bladder neck (TP) and bladder base (TA) movement during voluntary pelvic floor muscle (PFM) contraction and functional tasks. A sonographer assessed 60 asymptomatic (30 nulliparous, 30 parous) and 60 incontinent (30 stress, 30 urge) women with a mean age of 43 (SD=7) years, BMI of 24 (SD=4) kg m2 and a median parity of 2 (range, 0-5), using both ultrasound methods. The mean of three measurements for bladder neck and bladder base (sagittal view) movement for each task was assessed for differences between the groups. There were no differences in bladder neck (p=0.096) or bladder base (p=0.112) movement between the four groups during voluntary PFM contraction but significant differences in bladder neck (p<0.004) and a trend towards differences in bladder base (p=0.068) movement during Valsalva and abdominal curl manoeuvre. During PFM contraction, there was a strong trend for the continent women to have greater bladder neck elevation (p=0.051), but no difference in bladder base movement (p=0.300), when compared to the incontinent women. The incontinent women demonstrated increased bladder neck descent during Valsalva and abdominal curl (p<0.001) and bladder base descent during Valsalva (p=0.021). The differences between the groups were more marked during functional activities, suggesting that comprehensive assessment of the PFM should include functional activities as well as voluntary PFM contractions. TP ultrasound was more reliable and takes measures from a bony landmark when compared to TA ultrasound, which lacks a reference point for measurements. TA ultrasound is less suitable for PFM measures during functional manoeuvres and comparisons between subjects. Few subjects were overweight so the results may not be valid in an obese population. © International Urogynecology Journal 2006.
JO – International Urogynecology Journal
PB –
CY –
VL – 18
IS – 7
PG – 779-786
SP – 779
EP – 786
AN –
DO – 10.1007/s00192-006-0225-4
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47023329
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Rehabilitative ultrasound imaging of pelvic floor muscle function
A1 – Whittaker J.L.
A1 – Thompson J.A.
A1 – Teyhen D.S.
A1 – Hodges P.
Y1 – 2007///
PD –
AB – This commentary provides an overview of the current concepts and evidence related to rehabilitative ultrasound imaging of pelvic floor (levator ani) function. As this is an emerging topic, the goal is to provide a basic understanding of ultrasound imaging applications related to levator ani function: the available quantitative and qualitative information, the limitations, as well as how ultrasound imaging can be incorporated as a form of biofeedback during rehabilitation. Furthermore, as the ability to compile and compare existing evidence depends on the degree of similarity in methodology by investigators, this commentary highlights points of consideration and provides guidelines, as well as an agenda, for future investigation.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 37
IS – 8
PG – 487-498
SP – 487
EP – 498
AN –
DO – 10.2519/jospt.2007.2548
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47257755
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Healthy adults can more easily elevate the pelvic floor in standing than in crook-lying: An experimental study
A1 – Kelly M.
A1 – Tan B.-K.
A1 – Thompson J.
A1 – Carroll S.
A1 – Follington M.
A1 – Arndt A.
A1 – Seet M.
Y1 – 2007///
PD –
AB – Questions: Are there any differences in the displacement and endurance of an elevating voluntary pelvic floor muscle contraction in standing and in crook-lying? Are there any differences in these variables between males and females in either test position? Design: An experimental study. Participants: Forty-five nulliparous female and 20 male participants aged 23 years (SD 3) with no symptoms of urinary incontinence or low back pain. Intervention: Voluntary pelvic floor muscle contraction was measured in both standing and crook-lying. Outcome measures: Transabdominal ultrasound was used to measure the displacement (mm) and endurance (s) of pelvic floor elevation. Results: Displacement was greater in standing than in crook-lying (mean difference 2.6 mm, 95% Cl 1.5 to 3.7). There was no difference between males and females (mean difference 1.3 mm, 95% Cl -0.5 to 3.2). Similarly, endurance of pelvic floor elevation was longer in standing than in crook-lying (mean difference 17.3 s, 95% Cl 12.2 to 22.4). Again there was no difference between males and females (mean difference 0.5 s, 95% Cl -9.3 to 8.3). Conclusion: Standing was found to be a more effective position for achieving and sustaining an elevation of the pelvic floor compared to crook-lying, regardless of sex, and this should be taken into account when assessing and training pelvic floor muscle contraction. © Australian Physiotherapy Association 2007.
JO – Australian Journal of Physiotherapy
PB –
CY –
VL – 53
IS – 3
PG – 187-191
SP – 187
EP – 191
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47491007
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Digital and ultrasonographic evaluation of pelvic floor muscles in women with pelvic organ prolapse-preliminary results
A1 – Stupp L.
A1 – Resende A.
A1 – Bernardes B.
A1 – Oliveira E.
A1 – Castro R.
A1 – Girão M.
A1 – Sartori M.
Y1 – 2009///
PD –
AB – Objective: To evaluate pelvic floor muscles strength by vaginal palpation and ultrasonography. This included the collection of pilot data to test questionnaires, evaluation methods and inform sample size calculations in preparation for undertaking the full trial. Background: The identification of discrete injuries to the muscles and connective tissues that lead to pelvic organ prolapse is needed to improve our understanding of the pathophysiology of pelvic organ prolapse and to develop strategies of prevention (1). Furthermore the evaluation of pelvic floor muscle strength is an important parameter in clinical and scientific issues regarding pelvic floor training (2). Methods: Nine women (55.1±6.2 years-old) with stage II prolapse were recruited at Urogynecologic and Vaginal Surgery Ambulatory of Federal University of São Paulo. A pelvic organ prolapse quantification (POP-Q) (3) examination was performed and used to determine eligibility for inclusion in this study. Women were selected to a standardized physiotherapy evaluation consisting over a two- week period. Initially, a history was taken, anatomy and function of the pelvic floor muscles (PFMs) were taught and types of prolapse explained. Also was applied the P-QOL questionnaire. Women were taught how to correctly contract the muscles previously the digital palpation (Oxford modified scale) was taken. In another inquiry, the cross sectional area (CSA) of levator ani was measured by ultrasonography. Results: (Table presented) Conclusions: Were founded decrease of pelvic floor muscle strength, endurance and quality of life in all evaluated women. Sixty three women will be randomised and advised to do at least 3 sets of exercises daily. Lifestyle advice will also give. Twenty one women will be randomised to the control group (lifestyle advice information sheet only).
JO – International Urogynecology Journal and Pelvic Floor Dysfunction
PB –
CY –
VL – 20
IS – 3
PG – S464-S465
SP – S464
EP – S465
AN –
DO – 10.1007/s00192-009-0982-y
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L70076786
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Methods used by physical therapists to learn pelvic floor muscle examination
A1 – Shelly E.
A1 – Krum L.
Y1 – 2009///
PD –
AB – Hypothesis / aims of study: To investigate current methods by which physical therapists (PTs) in the United States learn how to perform pelvic floor muscle (PFM) examination and the methods they employ in assessing PFM function. Study design, materials and methods: One thousand one hundred and seventy five (N=1,175) women’s health PTs were invited to participate in a 38 question webbased survey that had been validated using four content experts. Subjects were solicited from the APTA Section on Women’s Health, BCIA EMG courses, and personal PT contacts. All students, PTAs and international PTs were excluded from participation. Questions addressed professional (entry-level, post-professional, and continuing) education in PFM dysfunction (hours, types of diagnoses, types of assessments discussed and practiced); and current type of assessments used in physical therapy practice. Descriptive statistics were used to examine the data. Results: Two hundred and three (n=203) PTs completed the survey (17.3% response rate). Seven subjects (7.7%) reported practicing the vaginal palpation of the PFM in their entry level education with 42.7% of subjects reporting some discussion of the topic. The most common method of learning PFM examination is post professional continuing education (96.1%). One hundred and twenty eight (62.1%) of subjects reported more than nine days of continung education in PFM therapy. When learning PFM assessment, most PTs and PT students practice on class mates (84.5%). PT who specialize in PFM dysfunction provided the majority of this edcuation (99%). Respondents reported which PFM examination techniques they received hands-on instruction in and practiced as part of their educational experience (Figure 1). In clinical practice, most PTs used vaginal palpation (73.9%) and perineal observation (68.5%) to examine the PFM. Other examination techniques reported included EMG with vaginal sensor (19.7%) and external sensors (21.2%). In contrast assessment techniques rarely used included real-time imaging ultrasound (3%) and pressure biofeedback (3.4%). Interpretation of results: Treatment of PFM dysfunction is a growing specialty in physical therapy. There is no scientific evidence that identifies the methods by which PTs learn to perform PFM examination. Compared to reports of previous authors [1,2] there appears to be increasing exposure to PFM dysfunction in entry level professional education. Jacobs has studied nursing education in urology. Based on that research, nurses and physical therapists are similar in their use of continuing education (84% and 99% respectively). However they vary greatly in their usage of on the job training (nurses 97% and physical therapists 47%). [3] Most PTs are receiving instruction in PFM examination in post professional continuing education courses. Most PTs are using vaginal palpation to examine the PFM. Currently US PTs are using very little real-time ultrasound to assess PFM. This may be related to financial and reimbursement constraints. Given a recent surge of interest in real-time ultrasound and evidence to support its use in clinical practice, future studies may reflect increased usage of this assessment technique. (Figure Presented) Concluding message: PTs are participating in increasing hours of formalized education and are using a variety of validated examination techniques and tools to perform PFM assessment. Documentation of current US physical therapy practice allows comparision with other profesions in the US and other PTs around the world. In addtion, future studies may show changes in practice patterns and educational methods.
JO – Neurourology and Urodynamics
PB –
CY –
VL – 28
IS – 7
PG – 821-822
SP – 821
EP – 822
AN –
DO – 10.1002/nau.20808
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L70048356
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Assessment of pelvic floor muscle function in women with and without low back pain using transabdominal ultrasound
A1 – Arab A.M.
A1 – Behbahani R.B.
A1 – Lorestani L.
A1 – Azari A.
Y1 – 2010///
PD –
AB – Pelvic floor muscle (PFM) dysfunction has been recently associated with the development of low back pain (LBP). Transabdominal ultrasound imaging has been established as an appropriate method for visualizing and measuring PFM function. No study has directly evaluated PFM function in individuals with and without LBP. The purpose of this study was to investigate the PFM function in women with and without LBP using transabdominal ultrasound. Convenience sample of 40 non-pregnant female participated in the study. Subjects were categorized into two groups: with LBP (n = 20) and without LBP (n = 20). The amount of bladder base movement on ultrasound (normalized to body mass index) was measured in all subjects and considered as an indicator of PFM function. Statistical analysis (Independent t-test) revealed significant difference in transabdominal ultrasound measurements for PFM function between the two groups (P = 0.04, 95% CI of difference: 0.002-0.27).The results of this study indicate PFM dysfunction in individuals with LBP compared to those without LBP. The results could be beneficial to clinicians when assessing and prescribing therapeutic exercises for patients with LBP. © 2009 Elsevier Ltd.
JO – Manual Therapy
PB –
CY –
VL – 15
IS – 3
PG – 235-239
SP – 235
EP – 239
AN –
DO – 10.1016/j.math.2009.12.005
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L50768485
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Can we ‘feel’ with our fingers as well as we ‘see’ with ultrasound?
A1 – Kruger J.
A1 – Dietz P.
A1 – Botelho C.
A1 – Dumoulin C.
Y1 – 2010///
PD –
AB – Hypothesis/aims of study It is becoming increasingly recognized that trauma to the levator ani (LA) (‘avulsion’ injury) is significantly associated with pelvic floor muscle dysfunction (1). Magnetic resonance imaging (MRI) and pelvic floor ultrasound (US) can visualise avulsion whereas manual palpation appears to require substantial training (2). Despite ultrasound being generally more accessible, it is still not available in all clinical settings and is operator dependent, increasing the need for a reliable digital means of assessment. Therefore the aim of this study was to assess the predictive value of the following four digital parameters to identify an avulsion injury: 1. direct palpation of a discontinuity of puborectalis where the muscle attaches to the pubic ramus. 2. palpation of the distance between the two muscle insertion sites, 3. palpation of LA strength, 4. palpation of LA tone. These would then be compared to the results obtained from tomographic ultrasound images of the levator ani complex. Study design, materials and methods Study design: This was an observational study imbedded in a larger quasi-experimental cohort study which characterized and compared the morphology and function of the female pelvic floor in continent and incontinent older women. Transperineal ultrasound using tomographic imaging during a maximum pelvic floor muscle contraction was used to determine the presence or absence of avulsion injury in a cohort of elderly women who had attended, or were going to attend, physiotherapy treatment for urinary incontinence (n=72). All participants were imaged supine after bladder emptying. Slices were obtained at 2.5mm intervals taken from 2.5mm below to 12.5mm above the plane of minimal dimensions as previously described (3), see Figure 1. Imaging was performed using an Acuson Antares TM system (Siemens, USA Inc) with a 5-3MHz curvilinear probe. Post processing analysis was performed using ViewTool V3.1. An avulsion injury was rated positive if a defect could be seen in at least 3 of the central slices (Figure 1). Left and right sided avulsions were graded independently. Digital assessment of LA integrity included: 1. feeling for continuity of the puborectalis muscle at its insertion site on either side of the pubic bone 2. determining the distance between the insertion points of the puborectalis muscle, measured using finger widths (as with diastasis recti), 3. grading of LA strength using the standard Oxford grading scale and 4. grading of tone using a verified scale to assess tone at rest (2). The levator palpation was performed by an experienced physiotherapist who was blinded to the results from the ultrasound examination. All ultrasound images were verified remotely by an expert in ultrasound imaging of the pelvic floor muscles using tomographic ultrasound (PD). Statistical analysis was undertaken using SPSS V 18 (SPSS, Chicago, IL USA). Agreement between methods and ultrasound evaluators was assessed using Cohen’s kappa. Results The mean age of 72 participants was 69 years (range 60-87). 22% of these were nulliparous (n=19), with the median number of vaginal deliveries being 1. Of the 72 women, 2 had invalid ultrasound images and 2 others were unable to be assessed digitally. Thus, 68 datasets were available for analysis, with 136 paired assessments of a right or left defect. As regards analysis of ultrasound volumes, there was agreement between the two assessors in 86% of cases (60/70), k=0.618. Seventeen (25%) women presented with either a partial or complete avulsion of the puborectalis muscle on either side as diagnosed with tomographic ultrasound. Eleven (16%) were complete avulsions, of which 1 was bilateral. Palpation for continuity of the puborectalis muscle at its insertion site agreed moderately well with ultrasound diagnosis of avulsion, k=0.467. Palpating the distance between the two insertion sites at the level of the pubis and using a cut off of ≥ 3.5 fingers was able to predict 73% of complete avulsions (k=0.531). The grading of LA strength using an Oxford grading ≤3, and grading of resting tone ≤2, were less predictive. Agreement between palpation and ultrasound findings is shown in Table 1. Interpretation of results Palpation for continuity of the puborectalis portion of the levator ani has been described as a method for diagnosing avulsion of the levator ani muscle. Our results suggest that the diagnosis of avulsion could be enhanced by using the simple measure of ‘distance in finger widths between muscle insertion points’. This method is not intended to replace, but rather to add to those already in use, as it is unable to distinguish between unilateral and bilateral avulsion. However, ‘distance in finger widths between muscle insertion points’ may be of interest for older women where some muscle and vaginal atrophy is likely and it is often more difficult to palpate muscle insertion. An important limitation of our study is the low prevalence of avulsion amongst our study subjects as most suffered from urinary incontinence rather than prolapse. Further research with larger numbers may allow development of a model to show which combination of parameters will best predict defects using manual palpation. Concluding message Palpating the distance between muscle insertion points at the level of the pubis may enhance our ability to detect avulsion of the levator ani muscle by digital vaginal examination. Further work is needed to confirm these results. (Table Presented).
JO – International Urogynecology Journal and Pelvic Floor Dysfunction
PB –
CY –
VL – 21
IS – (Dietz P.) University of Sydney, Australia
PG – S372-S373
SP – S372
EP – S373
AN –
DO – 10.1007/s00192-010-1192-3
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L71622084
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Comparison of the manner of evaluation of pelvic floor muscle disfunction and to investigate relationship between diasti recti and pelvic floor muscle disfunction
A1 – Yeniel A.O.
A1 – Tosun O.C.
A1 – Turan V.
A1 – Malkoc¸ M.
A1 – Ergenoʇlu A.M.
A1 – Itil I.M.
A1 – Aşkar N.
A1 – Tosun G.
Y1 – 2010///
PD –
AB – Purpose: Aim of this study is to investigate relationship between digital palpation, transabdominal ultrasound (TA-USG) and perineometry in determination of pelvic floor muscle disfunction (PFMD) and to detect relationship between diasti recti and PFMD. Material and method: In our study, 33 patients were included whose ages and physical properties were similar. In the assessment of pelvic floor muscle strength (PFMS) all patients were performed digital palpation through Oxford method and examined by (TA-USG) and perineometry. Evaluation of diasti recti was carried out on supine position. Results: Mean PFMS of cases through digital palpation, TA. USG and perineometry were 2.78+/-3.1, 7.69+/-14mm and 17.11+/-12 cmH20, respectively. In the assessment of PFMS there was a significant relationship between perineometry and digital palpation (p<0.05). We could not revealed significant association between TA USG and perineometry (p>0.05) and digital palpation p>0.05). There was abscens of a significant relationship between evaluation of diasti recti and PFMS. Conclusion: In the evaluation of pelvic floor muscle strength although sonography stand out as non invasive method, it seems to be far from alternative method for digital palpation and perineometry. There was abscens of a relationship between diasti recti and pelvic floor muscle disfunction.
JO – Fizyoterapi Rehabilitasyon
PB –
CY –
VL – 21
IS – 3
PG – 164
SP – 164
EP –
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L70490281
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Comparison of digital palpation against longitudinal and tranverse abdominal sonography practices in the assessment of pelvic floor muscle strength
A1 – Tosun O.C.
A1 – Turan V.
A1 – Malkoc¸ M.
A1 – Ergenoʇlu A.M.
A1 – Yeniel A.O.
A1 – Itil I.M.
A1 – Aşkar N.
A1 – Tosun G.
Y1 – 2010///
PD –
AB – Purpose: Aim of this study is to investigate relationship between digital palpation and two separate sonographic methods in determination of pelvic floor muscle strength. Material and method: In our study, 31 patients were included whose ages and physical properties were similar. In the assessment of pelvic floor muscle strength all patients were carried out digital palpation through Oxford method and examined by transabdominal ultrasonography in longitudinal and transverse axis to represent change of distance in bladder base before and following contractions. Results: Mean pelvic floor muscle strength of cases through digital palpation, TA-USG-L and TA-USG-T were 2.77+/-1.3; 8.62+/-16.25 mm; 7.64±13 mm respectively. We could not revealed significant association between digital palpation and ultrasonography in the assessment of pelvic floor muscle strength. (p>0.05). In the assessment of pelvic floor muscle strength there was a significant relationship between TA-USG-L and TA-USG-T. (P<0.05) Conclusion: In the assessment of pelvic floor muscle strength although sonography stand out as non invasive method, it seems to be far from alternative method for digital palpation.
JO – Fizyoterapi Rehabilitasyon
PB –
CY –
VL – 21
IS – 3
PG – 165
SP – 165
EP –
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L70490282
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – 2D real time ultrasound for pelvic floor muscle assessment.
A1 – Thompson J.
A1 – Sherburn M.
Y1 – 2011///
PD –
AB –
JO – Journal of physiotherapy
PB –
CY –
VL – 57
IS – 1
PG – 59
SP – 59
EP –
AN –
DO – 10.1016/S1836-9553(11)70012-1
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L361560712
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – A comprehensive reliability analysis of 3D/4D transperineal ultrasound imaging in the assessment of levator hiatal dimensions and puborectalis muscle length
A1 – Thibault-Gagnon S.
A1 – Gentilcore-Saulnier E.
A1 – McLean L.
Y1 – 2011///
PD –
AB – Purpose: To investigate between-rater and between-day reliability of three-/four-dimensional (3D/4D) transperineal ultrasound imaging (USI) in the measurement of the dimensions of the levator hiatus (LH) and the length of the puborectalis muscle. Relevance: The dimensions of the LH and the length of the puborectalis muscle obtained using transperineal USI have been used to investigate pelvic floor muscle (PFM) morphology and function in women, and have recently been used to demonstrate the effectiveness of physiotherapy interventions in the treatment of pelvic organ prolapse. Good to very good between-day reliability has been shown for these ultrasound measures, however estimates of minimally important differences (MIDs) in measurements obtained on separate days have not been reported. Furthermore, between-rater reliability has not been investigated when two investigators perform the imaging as well as the analysis independently. Participants: A convenience sample of fourteen healthy nulliparous women aged 22-39 years participated in the study. Methods: In this observational study, two separate investigators performed independent 3D/4D USI assessments and measured the dimensions of the LH (anteroposterior and transverse diameters, area and circumference) and puborectalis muscle length, at rest, during PFM contraction, and during Valsalva. Participants repeated the USI assessment on a separate occasion with a single investigator. Analysis: Intraclass correlation coefficients (ICCs) and regression analyses were used to investigate between-rater and between-day reliability for all measures, coefficients of variation (CVs) were computed to assess variability in the measurements obtained by each rater across three repeated trials of each task (rest, contraction, Valsalva), and standard error of measurement (SEM) and mean absolute difference (MAD) were computed as estimates of MIDs. Results: ICC values demonstrated very good between-rater (ICC, 0.85-0.98) and between-day (ICC, 0.88-0.99) reliability for all measurements of levator hiatal dimensions as well as puborectalis muscle length, at rest, during contraction and during Valsalva. Regression analyses demonstrated high covariance for between-rater and between-day measurements, with little or no systematic bias between-raters. CV values demonstrated very lowvariability in the measurements obtained by both raters (CV, 1.65-6.49%). The SEM and MAD obtained for each measure according to each task suggest that the MIDs needed to demonstrate the effect of an intervention, within a group and within an individual respectively, may be relatively small across all measures. Conclusions: Ultrasound measures of levator hiatal dimensions and puborectalis muscle length are highly reproducible in healthy nulliparous women, when obtained by separate investigators and on separate days. Implications: These results suggest that operator influence may be negligible when investigators use the same methods to obtain measurements of the dimensions of the LH and puborectalis muscle length using 3D/4D US, and these measures may be used to evaluate the effect of an intervention as they are likely to be responsive to change. Future work should aim to investigate the reliability and responsiveness of these measures in symptomatic female populations.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 97
IS – (Thibault-Gagnon S.; Gentilcore-Saulnier E.; McLean L.) Queen’s University, School of Rehabilitation Therapy, Kingston, Canada
PG – eS1227
SP – eS1227
EP –
AN –
DO – 10.1016/j.physio.2011.04.002
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L71883849
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Pelvic floor muscle morphology and function in women with and without provoked vestibulodynia evaluated using 3D/4D transperineal ultrasound imaging
A1 – Thibault-Gagnon S.
A1 – McLean L.
A1 – Pukall C.
A1 – Goldfinger C.
A1 – Chamberlain S.
Y1 – 2011///
PD –
AB – Purpose: To investigate differences in pelvic floor muscle (PFM) morphology and function between women with provoked vestibulodynia (PVD) and women without vulvar pain, using three-dimensional (3D) and four-dimensional (4D) ultrasound imaging (USI). Relevance: PVD, the most common cause of painful sexual intercourse in women, has been linked to PFM dysfunction. Physical therapists play an important role in the treatment of PVD through pelvic floor (PF) rehabilitation. To date there is limited knowledge of the direct effect of PF rehabilitation on the PFMs in women with PVD. 3D/4D USI has been shown to be a valid and reliable method of investigating PFM morphology and function in several female populations; however, no study has been conducted in women with PVD. Participants: A convenience sample of ten women with PVD (mean age = 22.3 years) and 10 women without a history of vulvar pain (mean age = 21.7 years) participated. Methods: In this observational case-control study, 3D/4D transperineal USI was conducted with all participants at rest, during PFM contraction, and during Valsalva. Measurements of the dimensions of the levator hiatus (LH) (anteroposterior and transverse diameters, area, and circumference) and the length of the puborectalis muscle were obtained in all women at rest, during contraction and during Valsalva. Analysis: Separate two-way analyses of variance models including group (PVD and control) and task (rest, contraction, Valsalva) main effects and group by task interactions were performed for each measure (α = 0.05). Results: Asignificant task main effect was found for all measures. In both groups, compared to measures obtained at rest, significant reductions in all measures were seen during contraction, and significant increases were seen during Valsalva. Asignificant group main effect was found for three of the five measurements obtained. The anteroposterior and transverse diameters, and the area of the LH were significantly smaller in the women with PVD as compared to the women in the control group. No group by task interactions were found. Conclusions: These preliminary results suggest that PFM morphology may differ between women with and without PVD; women with PVD appear to have smaller levator hiatuses and shorter puborectalis muscles than their matched control counterparts. It is not possible to ascertain whether these findings are due to morphological differences or behavioral responses in women with PVD. These results also suggest that PFM function during PFM contraction and during Valsalva is similar in both groups. Implications: This study provides the groundwork for using USI to investigate the impact of treatment approaches on the PFMs of women with PVD.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 97
IS – (Chamberlain S.) Queen’s University, Department of Obstetrics and Gynaecology, Kingston, Canada
PG – eS1228
SP – eS1228
EP –
AN –
DO – 10.1016/j.physio.2011.04.002
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L71883850
NS –
N1 – Exclusion reason: 4.- Abstracts from Congress, Symposium…;
ER –

TY – JOUR
T1 – Sonographic evaluation of the levator ani muscle in women with stress urinary incontinence
A1 – Stachowicz N.
A1 – Stachowicz S.
A1 – Smoleń A.
A1 – Morawska D.
A1 – Kotarski J.
Y1 – 2012///
PD –
AB – Three-dimensional sonography has been used for about 15 years, not only to examine the female genital organs, but also the lower urinary tract and pelvic floor. Three-dimensional sonography offers more information than traditional two-dimensional sonography, allowing for a dynamic representation of the examined structures and observation at any angle necessary. Translabial sonography is the best way of a sonographic examination of the lower urinary tract, because it does not affect the mutual relationship of any parts in the lower pelvic area, contrary to the transrectal or transvaginal probes. In order to establish proper treatment of the urinary incontinence symptoms, not only a functional examination of the lower urinary tract, but also a very accurate assessment of the statics of the female genital organs and pelvic floor need to be performed. Background: The aim of the study was to rate the area and diameters of the limbs of the levator ani muscle using a three-dimensional (3D) translabial sonography in women with stress urinary incontinence without the female genital tract prolapse. Material and methods: The study group included 100 patients who were examined with the GE Kretz Voluson 730 (GE, Austria), equipped with 6-9 MHz translabial probe. The first group with stress urinary incontinence consisted of 50 women (mean age 56.22 (±10.43) years) and the second group included 50 women without symptoms (mean age 49.40 (±13.22) years). All cases of urinary stress incontinence in the first group were confirm by means of a urodynamic examination. Women in both groups had similar body weight (kilograms), mean (±SD): 26.88 (±2.02) and 26.20 (±4,14), respectively. Menopausal status in both groups was not statistically significant and amounted to 7.21 (±8.71) in the group of women with stress urinary incontinence and 4.70 (±6.32) in the group without symptoms. Mean (±SD) number of deliveries was significantly higher in the group of women with stress urinary incontinence than in the control group (2.40 (±1.03) and 1.56 (±1.34), respectively). In all cases 3D coronal view of the pelvic diaphragm was obtained and the area and thickness of limbs of the levator ani muscle were measured. All women had about 200 ml urine in the bladder. Results: The results are presented as means±SD. Mean measurements of this area in both groups were 8.54±1.62 cm2 and 10.57±1.29 cm2, respectively. Mean thickness of the limbs in the groups were: 8.72±0.64mm and 10.85±0.89mm on the left side and 8.85±0.67mm and 10.89±0.87mm on right side, respectively. The differences between both groups in all measurements were statistically significant (p<0.001). Conclusions: There are some differences involving measurements of the thickness and the area of the limbs of the levator ani muscle in women with and without stress urinary incontinence and without the genital tract prolapse in both groups. The observed differences could have implications in physiotherapy of the pelvic floor muscles in women without statics abnormalities. © Polskie Towarzys two Ginekologiczne.
JO – Ginekologia Polska
PB –
CY –
VL – 83
IS – 9
PG – 669-673
SP – 669
EP – 673
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L365873253
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Transperineal sonography evaluation of muscles and vascularity in the male pelvic floor
A1 – Roll S.C.
A1 – Kutch J.J.
Y1 – 2013///
PD –
AB – Idiopathic chronic male pelvic pain is difficult to diagnose and treat. Currently, diagnosis relies on subjective symptoms; objective measures of neuromuscular mechanisms have not been investigated. Sonographic imaging has been used to investigate these neuromuscular mechanisms in the female pelvic floor, but neither research nor books describe sonography evaluation of the male pelvic floor. The purpose of this study was to develop and evaluate a perineal sonographic technique for the examination of the male pelvic floor muscles. Anatomic landmarks were identified with images collected from two subjects, one with intermittent reports of pelvic pain and one with no history of pain in the pelvic region. A description of the equipment settings, the examination protocol, and the resulting comparative image analysis is included. A validated protocol such as this may be useful in documenting differences in the soft tissue structures between asymptomatic individuals and patients with chronic pelvic pain to aid in diagnosis and treatment. This is the first known study to report sonographic findings of the individual muscles in the male pelvic floor, and additional research is needed to validate the techniques that have been deemed feasible. © The Author(s) 2013.
JO – Journal of Diagnostic Medical Sonography
PB –
CY –
VL – 29
IS – 1
PG – 3-10
SP – 3
EP – 10
AN –
DO – 10.1177/8756479312472394
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L368122816
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Real time ultrasound as an adjunct to pelvic floor physical therapy muscle retraining: A demonstration of our technique
A1 – Rodriguez P.
A1 – Kambiss S.
Y1 – 2013///
PD –
AB – Objectives: Women’s health physical therapists have been treating pelvic floor dysfunction for nearly 30 years. Various modalities have been utilized to assist the patient in recruitment of the levator plate without the overriding of the abdominals or gluteals. This paradoxical pattern of pelvic descent with attempt to contract/lift the PF appears to be a significant contributing factor for PF prolapse, failed incontinence surgeries, and chronic low back pain. Methods: Over the past 10-15 years, real time ultrasound (RTUS) has worked its way into the realm of musculoskeletal assessment. Outpatient physical therapy women’s health clinics are beginning to utilize RTUS systems available as a diagnostic and treatment modality. The patient and the therapist gain immediate feedback on the PF muscle activity as well as the surrounding structures. Once the PF muscles are recognized, the patient can then begin to consciously lift/hold during functional activities to include cough with minimal pelvic descent. We demonstrate our technique at utilizing this adjunctive modality in the care of our patients with pelvic floor dysfunction. Results: Surface EMG demonstrates objective, measurable changes in muscle activity but specific muscle activity cannot be identified. RTUS gives immediate, specific visual feedback to the patient. This modality makes visible soft tissue deficits at rest but more importantly, can be used functionally to give patients immediate visual feedback of the pelvic floor support structures Conclusions: This technique facilitates immediate awareness of a pelvic floor which was otherwise unresponsive and can lead to improvement of troublesome conditions.
JO – Female Pelvic Medicine and Reconstructive Surgery
PB –
CY –
VL – 19
IS – (Rodriguez P.; Kambiss S.) OB/GYN, San Antonio Military Medical Center, Fort Sam Houston, United States
PG – S102-S103
SP – S102
EP – S103
AN –
DO – 10.1097/SPV.0b013e3182a5ddf0
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72285848
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Why are some women with pelvic floor dysfunction unable to contract their pelvic floor muscles?
A1 – Kim S.
A1 – Wong V.
A1 – Moore K.H.
Y1 – 2013///
PD –
AB – Introduction Many women with pelvic floor dysfunction are unable to voluntarily contract their pelvic floor muscles. This study hypothesised that women who cannot contract their pelvic floor muscles, despite specialised pelvic floor physiotherapy, are likely to have avulsion defect of the levator ani muscle, visible on 3-dimensional ultrasound. Methods Pelvic floor muscle strength was assessed by modified Oxford scale in all women presenting to a tertiary urogynaecology clinic with a main complaint of urinary incontinence ± pelvic organ prolapse. Women who could not contract their pelvic floor muscles (PFM) after having training with a specialised pelvic floor physiotherapist, (modified Oxford score of 0 or 1), were invited to participate in 3-dimensional transperineal ultrasound. Results Of 625 women presenting with urinary incontinence and/or pelvic organ prolapse, 150 (24.0%) were unable to contract their PFM at initial assessment. After specialised pelvic floor physiotherapy, 20 of 150 (15.3%) could not contract and were termed ‘noncontractors’. Of these, 12 agreed to participate in transperineal ultrasound. Levator avulsion defects were detected in 8 of 12 (66.7%). Conclusion Our results show that 67% of women who cannot contract their PFM despite physiotherapy have levator avulsion defects. The mechanism affecting the remaining 33% is yet to be discovered. © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
JO – Australian and New Zealand Journal of Obstetrics and Gynaecology
PB –
CY –
VL – 53
IS – 6
PG – 574-579
SP – 574
EP – 579
AN –
DO – 10.1111/ajo.12133
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L52817731
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Stress urinary incontinence: Impact of self perineal-rehabilitation at home after conventional perineal rehabilitation
A1 – Legendre G.
A1 – Levaillant J.-M.
A1 – Fuchs F.
A1 – Fernandez H.
Y1 – 2014///
PD –
AB – Study Objective: The pelvic floor muscle rehabilitation is the first step of treatment of stress urinary incontinence (SUI). However, patients have to perform self-retraining exercises at home, in order to maintain the benefit of the physiotherapy. The aim of this study is to assess the benefit of a perineal electro-stimulator, during this home-care phase. Design: Longitudinal prospective study (Canadian Task Force classification II-2). Setting: Gynecology department in a teaching hospital. Patients: Ten patients with de novo SUI were included between May 2012 and May 2013. Intervention: All patients benefited from a pelvic floor muscle training followed by a 2-month self-maintenance at home of perineal rehabilitation with the KEAT® Pro system (Codepharma, France). The evaluation of clinical symptoms and quality of life was made using validated questionnaires. The biometrics of levator ani muscle, the measures of the angle and the urogenital hiatus area were assessed by 3D perineal ultrasound at inclusion, after conventional rehabilitation and after self-rehabilitation. Measurements and Main Results: Nine patients (90%) completed the protocol and one patient (10%) was lost to follow-up. Mean age was 48 year (37-59). All patients (100%) showed clinical improvement of SUI. The scores of quality of life were significantly improved at the end of protocol versus inclusion (17.9 vs 10.3, p = 0.02). Elevator Ani muscles were significantly thicker after conventional rehabilitation than at baseline (8.5 mm vs 7.1 mm; p = 0.01) and significantly thicker after selfrehabilitation than after conventional rehabilitation (9.2 vs 8.5 mm; p = 0.01). The perineal angle and the surface of the urogenital hiatus were significantly decreased after self-rehabilitation training compared to measurements performed after conventional rehabilitation (50° vs 52.5°; p = 0.03 and 5.9 vs 4.8 cm2; p = 0.01 respectively). No complications were reported. Conclusion: Conducting a self-rehabilitation in addition to conventional rehabilitation objectively improves perineal muscle building obtained after conventional rehabilitation.
JO – Journal of Minimally Invasive Gynecology
PB –
CY –
VL – 21
IS – 6
PG – S53
SP – S53
EP –
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L71657747
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Relationship among vaginal palpation, vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles
A1 – Pereira V.S.
A1 – Hirakawa H.S.
A1 – Oliveira A.B.
A1 – Driusso P.
Y1 – 2014///
PD –
AB – CONCLUSIONS: This study showed that there was a correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the PFM in nulliparous women. The strong correlation between digital palpation and PFM contraction pressure indicated that perineometry could easily be replaced by PFM digital palpation in the absence of equipment.
JO – Brazilian journal of physical therapy
PB –
CY –
VL – 18
IS – 5
PG – 428-434
SP – 428
EP – 434
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L615102681
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Reliability of Superficial Male Pelvic Floor Structural Measurements Using Linear-Array Transperineal Sonography
A1 – Roll S.C.
A1 – Rana M.
A1 – Sigward S.M.
A1 – Yani M.S.
A1 – Kirages D.J.
A1 – Kutch J.J.
Y1 – 2015///
PD –
AB – This study evaluated reliability of measures for superficial structures of the male pelvic floor (PF) obtained via transperineal sonography. Two embalmed cadavers were dissected to identify positioning of muscles on and around the bulb of the penis and to confirm the PF protocol. Cross-sectional area (CSA) and linear thickness of the bulb of the penis, urethra, bulbospongiosus (BS) muscles, and ischiocavernosus (IC) muscles were measured on 38 transverse images from 20 male patients by three raters with varied study knowledge and sonographic experience. Intra- and inter-rater reliability were calculated with two-way, mixed effects intra-class correlation coefficients. Measures of the bulb of the penis had the best reliability. CSA of all muscles and sagittal thickness of the BS near the central tendon had good reliability. Reliability varied for rater-identified thickest muscle region and measures of the urethra. Our study suggests that structures of the male PF can be reliably evaluated using a transperineal sonographic approach.
JO – Ultrasound in Medicine and Biology
PB –
CY –
VL – 41
IS – 2
PG – 610-617
SP – 610
EP – 617
AN –
DO – 10.1016/j.ultrasmedbio.2014.09.008
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L602221983
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Measurement of pelvic floor muscle activity from transperineal ultrasound imaging in men: A validation study with invasive electromyography
A1 – Stafford R.
A1 – Coughlin G.
A1 – Lutton N.
A1 – Hodges P.
Y1 – 2015///
PD –
AB – Background: The role of rehabilitation of pelvic floor muscle function in management of urinary incontinence after prostatectomy has been debated. A major limitation in research and clinical practice is that most methods used for assessment and feedback of muscle contraction relate to contraction of anal muscles, which have little to do with control of urinary continence. Direct measurement of muscles that impact urethral closure is urgently required. Although transperineal ultrasound imaging (US) is used to visualise movement of pelvic floor structures in women during contraction of pelvic floor muscles, a similar technique has only recently been described for men. Based on anatomy, motions of the urethrovesical junction (UVJ) and anorectal junction (ARJ), mid urethra (MU), and bulb of penis (BP) have been attributed to contraction of the puborectalis (PR), striated urethral sphincter (SUS), and bulbocavernosis (BC) muscles, respectively. A critical step in development of this method is validation of the interpretation of these motions by comparison of ultrasound imaging and direct recordings of each muscle with electromyography (EMG). Purpose: To investigate the relationship between displacement of pelvic floor landmarks observed with transperineal ultrasound imaging and EMG recordings of the muscles proposed to cause the displacements. Methods: Three healthy men participated in this study. Transperineal ultrasound imaging was used to record motion of the pelvic floor landmarks (recorded in video format) in conjunction with recordings made with fine-wire EMG electrodes inserted into the PR and BC muscles and a transurethral catheter electrode (fixated with suction) to record SUS EMG. Intra-abdominal pressure (IAP) was recorded via sensor mounted on a nasogastric tube. Tasks included submaximal and maximal voluntary contractions and Valsalva. EMG and IAP amplitudes were calculated and compared with landmark displacements from the simultaneous US frame by fitting regression lines. Results: Strong, non-linear relationships were identified for each appropriate landmark/muscle pair (e.g. ARJ/PR EMG) for submaximal contractions (R2 = 0.71-0.91). Although the relationships between MU/SUS EMG and BP/BC EMG were strong during MVC (R2 = 0.73-0.94), increased IAP prevented shortening of PR, which resulted in weak relationships between ARJ/PR EMG and UVJ/PR EMG. Increased IAP during valsalva prevented shortening of PR but not SUS or BC. Conclusion(s): Transperineal US provides a valid measure of activation of individual pelvic floor muscles in men during voluntary contractions. Although all muscles can be individually assessed during gentle contractions, the interpretation of PR activation is compromised in tasks that involve elevated IAP. Implications: Transperineal ultrasound imaging is a viable method to assess and provide feedback of pelvic floor muscle function in men. Further work is required to study this relationship after prostatectomy.
JO – Physiotherapy (United Kingdom)
PB –
CY –
VL – 101
IS – (Lutton N.) Princess Alexandra Hospital, Department of Colorectal Surgery, Brisbane, Australia
PG – eS582
SP – eS582
EP –
AN –
DO – 10.1016/j.physio.2015.03.3405
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72114344
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Does pelvic organ support deteriorate in the years following a first birth?
A1 – Wanderley Souto Ferreira C.
A1 – Kamisan Atan I.
A1 – Martin A.
A1 – Shek K.L.
A1 – Dietz H.P.
Y1 – 2015///
PD –
AB – Hypothesis/aims of study The pelvic floor is affected by hormones during pregnancy (1) and suffers distension during vaginal delivery. Both can lead to changes in morphology and function (2). It has been claimed that pelvic organ support may deteriorate over time following vaginal childbirth (the ‘ship in dock hypothesis’) (3), but to date experimental evidence for this hypothesis is lacking. The aim of this study was to observe the development of pelvic organ support over time, following a first birth. Study design, materials and methods This was a retrospective observational study using archived data sets of women seen in the context of two prospective perinatal imaging studies. All subjects had undergone a local standardized interview, a clinical examination and 4D translabial ultrasound (TLUS), with the patient supine and after voiding, at maximum Valsalva, 3 months and 2 – 5 years post-partum. TLUS volume data sets were analysed at a later date, on a PC using a proprietary software by the first author, blinded against all other data. Main outcome measures were bladder neck descent (BND), position of bladder, uterus and rectal ampulla in relation to the pubic symphysis (SP), rectocele depth and levator hiatal area at maximum Valsalva (Figure 1). Means at the two time points were compared using paired Student’s T-test (paired) for normally distributed data. Differences in proportions at the two time points were tested using McNemar’s test. Predictors of change over time in continuous variables were explored using linear modelling methods. Results Of 1148 women originally recruited, 315 have had at least 2 postnatal visits at 3-6 months, 2 years or 5 years postpartum, to date. Fifteen were excluded (missing volume data in 9, intercurrent pregnancy in 6), leaving 300 women for analysis. They were first seen on average 0.39 (SD 0.2, range 0.2-2.1) years after childbirth and again 3.1 (SD 1.5, range 1.4-8) years after the index delivery, at a mean interval of 2.71 (SD 1.5, range 0.7-7.7) years, yielding 813 woman-years of observation. Their first birth had been a normal vaginal delivery (NVD) in 54% (n=162), and a vacuum, forceps and Caesarean section delivery (CS) in 11.7% (n=35), 3.7% (n=11) and 30.7% (n=92), respectively. At the last follow up, 51.3% (n=154) had had at least one subsequent delivery (range, 1 – 3). Mean age at the second visit was 32 (SD 5.7, range 20-48) years with a mean BMI of 26.2 (SD 6.7, range 15.7-56.5) kg/m2. One hundred and ten (36.7%) complained of symptoms of stress urinary incontinence, 39 (13%) of urge incontinence, 20 (6.7%) of symptoms of prolapse, 26 (8.7%) of voiding dysfunction and 60 (20%) of obstructed defecation (Table 1). On univariate analysis, there was significant improvement, i.e., less organ descent on Valsalva, for the anterior and posterior compartments, while there was no change for uterine descent. Hiatal area also decreased between the follow-ups (see Table 2). On multivariate analysis controlling for potential confounders (such as length of follow-up, levator avulsion, birthweight, mode of delivery, second birth), these findings were confirmed. Improvement seemed to be positively associated with follow-up length, but it was less marked (although still significant) in those with evidence of major levator trauma. In women who had given birth by Caesarean Section this improvement was still significant but smaller. Interpretation of results In this study population of 300 women observed for a total of 813 woman-years, pelvic organ support and hiatal distension appeared to improve over time. The degree of improvement was greater at longer follow-up intervals and less marked in women with levator avulsion. This implies ongoing ‘healing’ or regression of delivery- induced changes in functional anatomy, regardless of additional vaginal births. Major trauma may reduce the degree of recovery. Concluding message Our findings do not support the ‘ship in dock hypothesis’, at least not in the time frame investigated in this study. Deterioration of pelvic organ descent after childbirth, if it occurs at all, may follow a very slow time course. (Table Presented).
JO – Neurourology and Urodynamics
PB –
CY –
VL – 34
IS – (Martin A.) NHMRC Clinical Trials Centre, University of Sydney, Australia
PG – S180-S182
SP – S180
EP – S182
AN –
DO – 10.1002/nau.22830
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L71952668
NS –
N1 – Exclusion reason: 4.- Abstracts from Congress, Symposium…;
ER –

TY – JOUR
T1 – Transabdominal ultrasound to assess pelvic floor muscle performance during abdominal curl in exercising women
A1 – Barton A.
A1 – Serrao C.
A1 – Thompson J.
A1 – Briffa K.
Y1 – 2015///
PD –
AB – Introduction and hypothesis: The aim of this study was to assess pelvic floor muscle (PFM) function using transabdominal ultrasound (TAUS) in women attending group exercise classes. Specific aims were to: (1) identify the ability to perform a correct elevating PFM contraction and (2) assess bladder-base movement during an abdominal curl exercise. Methods: Ninety women participating in group exercise were recruited to complete a survey and TAUS assessment performed by two qualified Continence and Women’s Health physiotherapists with clinical experience in ultrasound scanning. The assessment comprised three attempts of a PFM contraction and an abdominal curl exercise in crook lying. Bladder-base displacement was measured to determine correct or incorrect activation patterns. Results: Twenty-five percent (n = 23) of women were unable to demonstrate an elevating PFM contraction, and all women displayed bladder-base depression on abdominal curl (range 0.33–31.2 mm). Parous women displayed, on average, significantly more bladder-base depression than did nulliparous women [15.5 (7.3) mm vs 11.4 (5.8) mm, p < 0.009). Sixty percent (n = 54) reported stress urinary incontinence (SUI). There was no association between SUI and the inability to perform an elevating PFM contraction (p = 0.278) or the amount of bladder-base depression with abdominal curl [14.1 (7.6) mm SUI vs 14.2 (6.7) mm non-SUI]. Conclusions: TAUS identified that 25 % of women who participated in group exercise were unable to perform a correctly elevating PFM contraction, and all depressed the bladder-base on abdominal curl. Therefore, exercising women may be at risk of PFM dysfunction when performing abdominal curl activities. JO – International Urogynecology Journal PB – CY – VL – 26 IS – 12 PG – 1789-1795 SP – 1789 EP – 1795 AN – DO – 10.1007/s00192-015-2791-9 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L605390141 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Can Abdominal Hypopressive Technique Change Levator Hiatus Area?: A 3-Dimensional Ultrasound Study A1 – Resende A.P.M. A1 – Torelli L. A1 – Zanetti M.R.D. A1 – Petricelli C.D. A1 – Jármy-Di Bella Z.I.K. A1 – Nakamura M.U. A1 – Júnior E.A. A1 – Moron A.F. A1 – Girão M.J.B.C. A1 – Sartori M.G.F. Y1 – 2016/// PD – AB – This study aimed to evaluate the levator hiatus area (LHA) at rest and during the performance of maximal pelvic floor muscle (PFM) contractions, during the abdominal hypopressive technique (AHT), and during the combination of PFM contractions (PFMCs) and the AHT. The study included 17 healthy nulliparous women who had no history of pelvic floor disorders. The LHA was evaluated with the patients in the lithotomy position. After a physiotherapist instructed the patients on the proper performance of the PFM and AHT exercises, 1 gynecologist performed the 3-dimensional translabial ultrasound examinations. The LHA was measured with the patients at rest. The PFMC alone, the AHT alone or the AHT in combination with a PFMC with 30 seconds of rest between the evaluations were performed. Each measurement was performed 2 times, and the mean value was used for statistical analysis. The Wilcoxon test was used to test the differences between the 2 maneuvers. Similar values were observed when comparing the LHA of the PFM at rest (12.2 ± 2.4) cm2 and during the AHT (11.7 ± 2.6) cm2 (P = 0.227). The AHT+ PFMC (10.2 ± 1.9) cm2 demonstrated lower values compared with AHT alone (11.7 ± 2.6) cm2 (P = 0.002). When comparing the PFMC (10.4 ± 2.1) cm2 with the AHT + PFMC (10.2 ± 1.9) cm2, no significant difference (P = 0.551) was observed. During PFMC, the constriction was 1.8 cm2; during the AHT, the constriction was 0.5 cm2; and during the AHT + PFMC, it was 2 cm2. The LHA assessed by 3-dimensional ultrasound did not significantly change with AHT. These results support the theory that AHT does not strengthen PFM. JO – Ultrasound Quarterly PB – CY – VL – 32 IS – 2 PG – 175-179 SP – 175 EP – 179 AN – DO – 10.1097/RUQ.0000000000000181 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L606470215 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Differences in motor learning of pelvic floor muscle contraction between women with and without stress urinary incontinence: Evaluation by transabdominal ultrasonography A1 – Yoshida M. A1 – Murayama R. A1 – Hotta K. A1 – Higuchi Y. A1 – Sanada H. Y1 – 2017/// PD – AB – Aims: To evaluate differences in motor learning of pelvic floor muscle (PFM) contraction between women with and without stress urinary incontinence (SUI) under transabdominal ultrasonography (TAUS)-guided PFM training. Methods: Postpartum women received an intensive 3-month PFM training program from 3 to 6 months postpartum. The program consisted of home exercises and weekly group sessions with individual TAUS-guided training. Motor learning progress of PFM contraction was evaluated with TAUS at each weekly session. We regarded a woman who contracted her PFM correctly more than 9 times out of the 10 repetitions as having achieved the associative stage of motor learning. Women were evaluated before and after a 12-week intervention for PFM and SUI by using transperineal ultrasonography and questionnaire, respectively. Results: Seventy-three women were included: 44 primiparous women (60.3%) and 64 vaginal deliveries (87.7%). Of 73 women, 22 (30.1%) were classified as the SUI group. By the fifth session, the proportion of women who could correctly contract their PFM > 9 out of the 10 repetitions had increased significantly more in the non-SUI group than in the SUI group (90.0% vs. 58.8%, P = 0.011). The proportion of women achieving the associative stage of correct PFM contraction was not different between the two groups after the sixth session. PF morphology and SUI were improved after intervention (P < 0.05). Conclusions: The proportion of women achieving the associative stage in women with SUI was less than that in women without SUI in the early phase of the combination of group and home PFM training with TAUS-guided training. Neurourol. Urodynam. 36:98–103, 2017. © 2015 Wiley Periodicals, Inc. JO – Neurourology and Urodynamics PB – CY – VL – 36 IS – 1 PG – 98-103 SP – 98 EP – 103 AN – DO – 10.1002/nau.22867 UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L605989091 NS – N1 – Exclusion reason: 5.- Wrong study design; ER – TY – JOUR T1 – The relationship between pelvic examination and ultrasound finding in patient with pelvic floor dysfunction A1 – Yang J.-M. Y1 – 2017/// PD – AB – In Pelvic examination, the POPQ system is an objective, site-specific system for describing and staging pelvic organ prolapse (POP) in women to create a “topographic”map of the vagina. Ultrasound is capable of identifying different compartmental defects of the pelvic floor.On ultrasonography, there are three methods for the quantification of POP: determining position by 1 distance and 1 angle (polar coordinate), by 2 distances ( orthogonal coordinate), or by measuring the height of pelvic organ with reference to a horizontal line drawn at the lower border of symphysis pubis. The differences between resting and stress bladder neck angles yield the rotational angle, which represents urethral or bladder neck mobility in a similar way as the Q-tip test. There are no definite values of normal bladder neck descent or urethral mobility. Although the positions of the bladder neck in patients with stress incontinence are lower than those of continent women, there is an overlap between these two groups. Nevertheless, urethral mobility was reported to be related to grade of incontinence. The levatorani muscles play an important role in supporting pelvic organs and maintaining normal pelvic floor function. Palpation through the vagina or rectum helps in assessing pelvic floor squeeze strength and levator muscle thickness. Guidelines have been published by the International Continence Society to assess pelvic floor musculature tone. Women with poor pelvic floor muscle function may benefit from pelvic physical therapy. On ultrasonography, the function of levatorani muscle has been assessed indirectly by the displacement of pelvic structures (e.g. bladder neck or bladder base) on its contractions. The bladder and urethra moves upwards and ventrally during pelvic floor contractions. Correlations between shift of bladder neck and palpation/perineometry have been shown to be good. During straining, the bladder neck maymove in a semicircular fashion with the tip of the symphysis pubis as the center (rotational descent), or move downward along the urethral axis (sliding descent). On ultrasonography, the occurrence of bladder neck funneling suggests poor urethral closure pressure. In addition to stress incontinence, bladder neck funneling may also be found in women with urge incontinence. It does not occur in normal continent women unless the bladder is full. Enteroceles are often difficult to recognize by clinical examination, but are easily detected by perineal or introital ultrasound. The imaging of the cervix and the vaginal apex may be incomplete with the presence of large rectoceles, and the extent of pelvic floor relaxation may be underestimated because of transducer pressure and without the help of sim speculum. Levator avulsion, detachment of puborectalis muscle from its insertion, and hiatal (levator ani compelx) overdistensibility, are two risk factors associated with POP. JO – Ultrasound in Medicine and Biology PB – CY – VL – 43 IS – (Yang J.-M.) Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan PG – S130 SP – S130 EP – AN – DO – UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L619372159 NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Traditional Gymnastic Exercises for the Pelvic Floor Often Lead to Bladder Neck Descent – a Study Using Perineal Ultrasound A1 – Baeßler K. A1 – Junginger B. Y1 – 2017/// PD – AB – Background The aims of physiotherapy in stress incontinent women are to improve pelvic floor function and the continence mechanism including bladder neck support and urethral closure pressure. In Germany, traditional conservative treatment often includes gymnastic exercises with unclear effects on the bladder neck. The aim of this study was to sonographically assess bladder neck movements during selected exercises. Methods Fifteen healthy, continent women without previous vaginal births, who were able to voluntarily contract their pelvic floor muscels performed the shoulder bridge, the abdominal press, tiptoe and the Pilates clam exercises. The first set was performed without any additional instructions. During the second set directions were given to activate the pelvic floor before beginning each exercise and to maintain the contraction throughout the exercise. Bladder neck movement was measured on perineal ultrasound using a validated method with the pubic symphysis as a reference point. Results The median age of participants was 32 years, median BMI was 23. Eight women were nulliparous and seven had given birth to 1?–?2 children via caesarean section. When exercises were performed without voluntary pelvic floor contraction the bladder neck descended on average between 2.3 and 4.4 mm, and with pelvic floor contraction prior to the exercise only between 0.5 and 2.1 mm (p > 0.05 except for abdominal press p = 0.007). The Pilates clam exercise and toe stand stabilised the bladder neck most effectively. Discussion Bladder neck descent often occurs during pelvic floor gymnastic exercises as traditionally performed in Germany, and a voluntary pelvic floor contraction during the exercises does not necessarily prevent this.
JO – Geburtshilfe und Frauenheilkunde
PB –
CY –
VL –
IS – (Baeßler K., kaven.baessler@charite.de; Junginger B.) Campus Benjamin Franklin, Abt. für Gynäkologie, Beckenbodenzentrum Charité, Berlin, Germany
PG –
SP –
EP –
AN –
DO – 10.1055/s-0043-103460
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L616472004
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Association between digital assessment (flexibility and strength) and ultrasound morphometric parameters of the pelvic floor
A1 – Cacciari L.
A1 – Morin M.
A1 – Dumoulin C.
Y1 – 2017///
PD –
AB – Hypothesis/aims of study Pelvic floor muscles (PFM) should have an adequate resting tone, symmetry and the ability to voluntarily and involuntarily contract with constriction and inward (ventro-cephalad) movement of the pelvic openings [1]. Decreases in muscle tone and strength are associated with either reduced contractile activity and/or passive stiffness, which are components of the mechanism related to pelvic organs descent and urinary incontinence (UI). PFM function is commonly assessed by digital palpation scales, with the disadvantage of being a subjective method with limited reproducibility. Transperineal ultrasound (TPUS) has been increasingly used as an objective and non-invasive method to assess both the constriction of the PFM muscle and the inward movement of the pelvic floor structure, however its relation to digital assessments of PFM function in UI women is still unclear. The aim of this study is to explore the relation between PFM digital assessment (flexibility and strength) and morphometric parameters measured by TPUS in women with UI. Study design, materials and methods This is a cohort study with 60 years or older women suffering from UI symptoms. Participants were recruited through communitybased advertising. UI was defined as at least one weekly episode of involuntary urine loss during the preceding 3 months. The participants were asked to empty their bladders, and were positioned in supine. Digital and TPUS assessments of the PFM were conducted by an experienced physiotherapist. The flexibility of the vaginal opening (passive vaginal opening) was measured with the index and, if possible, the middle finger inserted into the distal vagina to the proximal interphalangeal joints and abducted in the 3 and 9 o’clock plane. It was scored from 0 (less than one finger insertion) to 4 (two finger insertion with fingers abducted horizontally ≥2cm) [2]. PFM strength was assessed intra-vaginally with one finger, using the Modified Oxford Scale (MOS) with scores ranging from 1 to 5. PFM morphometry was evaluated using TPUS imaging (Voluson E8 Expert BT10; GE Healthcare) with a 3-/4-dimensional transperineal probe (RM6C next-generation matrix). Images were recorded at rest, during maximum PFM contraction and during cough. Each maneuver was performed twice and the ultrasound volume with the most effective contraction (i.e., most reduced levator hiatus antero-posterior diameter) and cough (i.e., most caudal displacement of the bladder neck (BN)) were considered for analysis. TPUS data was analyzed offline (4D View, Version 10.2; GE Healthcare) by an observer blinded to the digital assessment. Morphometry was assessed by measuring the following parameters in the midsagittal and axial planes (at the level of minimal hiatal dimensions) planes: (1) anorectal height, distance from the apex of the anorectal angle to a horizontal reference line passing by the inferior-posterior margin of the symphysis pubis, BN (2) x-axis and (3) y-axis related to the inferiorposterior margin of the symphysis pubis, (4) levator hiatus area, (5) levator hiatal antero-posterior and (6) transverse diameters. The shift between rest condition and both tasks (cough and contraction) were calculated (rest-task), as well as the percentage of change for each variable ((rest-task)/rest %). BN cranioventral displacement was also calculated for contraction and cough as the hypotenuse of a right-angled triangle (square root: ΔBN-x2+ΔBN-y2). The relationships between digital and TPUS assessments of PFM function were investigated using Pearson correlation coefficient and hierarchical stepwise regression by assessment condition (rest, contraction/couch). This method was used to explore how well digital assessment variances are explained by morphometric parameters of the pelvic floor TPUS evaluation. Results 204 incontinent women were evaluated. Participants were aged between 60 and 84 (68 ± 5.6) years, mean BMI was 27.1 ± 4.6 Kg/m2, parity ranged from 0 to 8 (median 2, interquartile range from 1 to 3) and the mean ICIQ-UI SF score was 12.3 ± 3.3. For the digital assessment, flexibility score ranged from 0.75 to 4 (median 2, interquartile range from 2 to 2.5) and MOS ranged from 0 to 5 (median 3, interquartile range from 3 to 4). Ultrasound morphometric parameters are shown in Table 1. Associations between flexibility and morphometric parameters of the PFM during rest and cough are shown in Table 2. Using hierarchical regression by assessment condition (rest, cough) levator hiatus area at rest explained 10.9% of the variance in flexibility (Beta coefficient in the final model is β= 0.327; p<0.01). When adding variables in the cough condition to the model, BN cranio-ventral shift (β = 0.028; p = 0.700) explained additionally 0.1% of the variance, for a total explained variance of 11%. (Table presented) BN cranio-ventral shift (r= 267, p<0.01); Statistically significant results are highlighted, p<0.05 Associations between strength (MOS) and morphometric parameters of the PFM during rest and contraction are shown in Table 3. Using hierarchical regression by assessment condition (rest, contraction), the anorectal height at rest explained 1.6% of the variance in strength (Beta coefficient in the final model is β= 0.135; p=0.052). When adding variables in the contraction condition to the model, anorectal height percentages of change (β =-0.324; p<0.001), levator hiatus anteroposterior shift (β =-0.726; p = 0.002) and percentages of change (β = 1.198; p<0.001) explained additionally 33.8% of the variance (p<0.001) for a total explained variance of 35.4%. (Table presented) Interpretation of results Higher PFM flexibility (passive vaginal opening) was associated with larger levator hiatus at rest. For the cough task, higher flexibility was related to more dorsally positioned BN and larger displacements of BN and levator hiatus. Levator hiatus area at rest contributed more to predicting PFM flexibility than any other morphometric parameter assessed during rest or cough, although with poor agreement. PFM strength was associated with smaller hiatus area and anteroposterior dimension, with more cranial and ventrally positioned BN and with higher shifts and percentages of change of almost all measured variables during contraction. Anorectal height, levator hiatus dimension shift and percentages of change during contraction were the variables that better contributed to the prediction of PFM strength, with fair agreement. Concluding message In older women with UI, increased flexibility was poorly associated with PFM morphometry during rest and cough. Higher PFM strength was fairly associated with increased constriction of the PFM and inward movement of the PFM structure during contraction.
JO – Neurourology and Urodynamics
PB –
CY –
VL – 36
IS – (Dumoulin C.) Research Center of the Institut Universitaire de Gériatrie de Montréal, University of Montreal, Faculty of Medicine, Montreal, Canada
PG – S551-S552
SP – S551
EP – S552
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L617687166
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The Intervention Effects of Different Treatment for Chronic Low Back Pain as Assessed by the Cross-sectional Area of the Multifidus Muscle.
A1 – Huang, Qiuchen
A1 – Li, Desheng
A1 – Yokotsuka, Noriyo
A1 – Zhang, Yuying
A1 – Ubukata, Hitomi
A1 – Huo, Ming
A1 – Maruyama, Hitoshi
Y1 – 2013///
PD – 07
AB – [Purpose] The purpose of this this study was to examine the immediate effects of intervention of proprioceptive neuromuscular facilitation (PNF), neuromuscular joint facilitation (NJF) and NJF+pelvic floor muscle (PFM) exercise. [Subjects] Thirteen young people (5 males, 8 females) who had chronic low back pain on one side for more than 6 months. [Methods] Subjects were asked to lie on their sides with the painful side uppremost. The subjects received PNF, and NJF, NJF+PFM exercise treatments. The changes in the cross-sectional area of the multifidusmuscle were measured using ultrasonography. [Results] The cross-sectional area of the multifidus muscle of NJF+PFM group showed the largest increases on both the sides with and without pain. [Conclusion] Our results show that chronic low back pain can be improved by a combination of PFM exercise and the NJF pattern.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 25
IS – 7
PG – 811-813
SP – 811
EP – 813
AN – 24259859
DO – 10.1589/jpts.25.811
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=24259859&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Comparison of abdominal muscle thickness with vaginal pressure changes in healthy women.
A1 – Kim, Bo-In
A1 – Hwang-Bo, Gak
A1 – Kim, Ha-Roo
Y1 – 2014///
PD – 03
AB – [Purpose] The purpose of this study was to verify the efficacy of a pelvic floor muscle exercise program by comparing subjects’ muscle thickness with changes in vaginal pressure. [Subjects] Two groups of female participants without a medical history of pelvic floor muscle dysfunction were evaluated. The mean age of Group I was 33.5 years and that of Group II was 49.69 years. [Methods] The participants were instructed to perform a pelvic floor muscle contraction. While measuring the vaginal pressure of the pelvic floor muscle, biofeedback was given on five levels, and the thicknesses of the transversus abdominis, external oblique, and internal oblique muscles were measured with ultrasound. [Results] The thickness of the transversus abdominis muscle was significantly increased at 30 cmH2O in Group I, and at 20 cmH2O in Group II. The thickness of the internal oblique abdominal muscle significantly increased at maximum contraction in Group II. [Conclusion] Different abdominal muscles contracted depending on vaginal pressure. The result may be used to create and implement an exercise program that effectively strengthens the pelvic floor muscles.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 26
IS – 3
PG – 427-430
SP – 427
EP – 430
AN – 24707099
DO – 10.1589/jpts.26.427
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=24707099&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – ULTRASOUND IMAGING AND THE PELVIC FLOOR MUSCLES. (Abstract)
A1 – Thompson, J.A.
A1 – Whitaker, J.L.
Y1 – 2006///
PD – 08//
AB – This abstract overviews the use of ultrasonics with pelvic floor muscles: what is known? what is unknown? and directions for future research. Research is still in its infancy and much more needs to be done.
JO – Journal of Orthopaedic & Sports Physical Therapy
PB –
CY – ;
VL – 36
IS – 8
PG – A-6-a-7
SP – A
EP – 6
AN –
DO –
UR – http://www.apta.org/
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – The Development and Reliability of an Objective Tool for Assessment of Pelvic Floor Muscle Function Using Diagnostic Ultrasound Imaging.
A1 – Abraham-Justice, Karen E.
A1 – Houghton, Melissa
A1 – Hiller, Jaclyn
A1 – Kang, Steven
A1 – Hopson, Scott
A1 – Meck, Bryce
Y1 – 2011///
PD – 01//Jan-Apr2011
AB –
JO – Journal of Women’s Health Physical Therapy
PB – Lippincott Williams & Wilkins
CY – Baltimore, Maryland
VL – 35
IS – 1
PG – 20-21
SP – 20
EP – 21
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104896489&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The clinical application of two-dimensional ultrasound image processing in identifying the response of urogenital structures to voluntary and reflex pelvic floor muscle contractions.
A1 – Jones R
A1 – Peng Q
A1 – Constantinou C
Y1 – 2006///
PD – Spring
AB – Perineal ultrasonography has become a clinical standard as a non-invasive means of evaluating the function of the female pelvic floor. Invariably, a very large amount of dynamic data is contained within the temporal sequence of ultrasound images captured. In particular, the movements of urogenital structures during pelvic floor muscle (PFM) activity contain important clinical information, defining both their anatomy and functional interaction. The present authors describe the analysis of sequences of voluntarily and reflexively generated PFM contractions on the urethra, vagina and rectum. Sequences of observations were taken of perineal ultrasound at an imaging frequency of 3.5 MHz using a curved linear array probe in the sagittal plane, and the video images were captured and stored. An edge extraction algorithm was used to outline the coordinates of the symphysis, urethra and rectum interfaces on a frame-by-frame basis for sequences of 10-30 s. During each PFM contraction, the trajectory of each structure’s boundary was evaluated, colour-coded and overlaid to characterize the sequential history of the ensuing movement. The resulting image analysis was focused to reveal the anatomical displacement of the urogenital structures, enabling the evaluation of their biomechanical parameters in terms of displacement, velocity and acceleration. On the basis of these observations, the mechanism of pelvic floor function response to voluntary contractions or activation of the guarding reflex can be identified. It is concluded that a considerable amount of useful clinical information can be revealed from video recordings of perineal ultrasound using the image analysis approach proposed.
JO – Journal of the Association of Chartered Physiotherapists in Women’s Health
PB – Pelvic Obstetric & Gynaecological Physiotherapy (POGP)
CY –
VL –
IS – 98
PG – 28-35
SP – 28
EP – 35
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106318811&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – The effectiveness of real time ultrasound as a biofeedback tool for muscle retraining.
A1 – Chipchase LS
A1 – Thoirs K
A1 – Jedrzejczak A
Y1 – 2009///
PD – 04//
AB – Background: Real time ultrasound (RTUS) is being used by physiotherapists as a tool for enhancing biofeedback. Aim: The aim of this systematic review was to summarise and evaluate the available literature on the effectiveness of RTUS as a biofeedback tool for muscle retraining. Method: A systematic review of the literature was performed to identify primary research examining the effect of RTUS muscle retraining. Studies were ranked according to the National Health and Medical Research Council hierarchy of evidence. The methodological quality of the randomised controlled trials was systematically assessed using the PEDro rating scale while a modified tool for case series studies was used. Results: Three RCTs, one case series and one case study were included. The methodological quality of the five studies was average to good, ranging from 55 to 82%. The studies used abdominal, multifidus and pelvic floor muscles to demonstrate the effects of RTUS biofeedback. The results varied depending on the purpose of the tool and the muscles re-trained. The effectiveness of RTUS as a teaching tool is moderate for multifidus, modest for abdominal muscles and weak for pelvic floor muscles. There was a paucity of available literature on the long term retention of muscle control following use of RTUS as a biofeedback tool. Conclusion: While research in this field is limited in quantity at the current time, the results warrant further investigation. However, future researchers must make an effort to ensure that their study design is of the highest quality and also demonstrate the long term effects of using RTUS to enhance muscle retraining.
JO – Physical Therapy Reviews
PB – Taylor & Francis Ltd
CY – Philadelphia, Pennsylvania
VL – 14
IS – 2
PG – 124-131
SP – 124
EP – 131
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=105356506&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Ultrasound imaging in rehabilitation: just a fad?
A1 – Hodges, Paul W
Y1 – 2005///
PD – 06
AB –
JO – The Journal Of Orthopaedic And Sports Physical Therapy
PB – Williams And Wilkins
CY – United States
VL – 35
IS – 6
PG – 333-337
SP – 333
EP – 337
AN – 16001904
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=16001904&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Transvaginal ultrasound measurement of bladder wall thickness: a more reliable approach than transperineal and transabdominal approaches.
A1 – Panayi, Demetri C
A1 – Khullar, Vikram
A1 – Fernando, Ruwan
A1 – Tekkis, Paris
Y1 – 2010///
PD – 11
AB – OBJECTIVES To validate transperineal, transabdominal and transvaginal ultrasound (US) techniques to measure bladder wall thickness (BWT). SUBJECTS AND METHODS Women underwent US measurement of BWT at three different anatomical sites: anterior wall, dome and trigone of the bladder by two ‘blinded’ operators using transabdominal, transperineal and transvaginal approaches at separate visits and by a single operator using transabdominal and transperineal techniques. Bland-Altman analysis was used to determine interobserver reliability for all three techniques and intraobserver reliability for transabdominal and transperineal methods. RESULTS In all, 25 women were scanned. The transperineal US had a high interobserver mean difference when measuring the anterior BWT (-0.34) and a high intraobserver mean difference when measuring the anterior (0.54) and dome BWT (0.33). Transabdominal US had a high interobserver mean difference for all measurements of BWT, and a high intraobserver mean difference when measuring the trigonal thickness (0.56). Transvaginal US had a consistent interobserver mean difference for all three measurements. The transperineal and transabominal approaches had the widest intraobserver and interobserver 95% confidence intervals of the mean difference when compared with the transvaginal approach. CONCLUSIONS Transabdominal and transperineal US for measuring BWT did not have good intraobserver and interobserver reliability for measurement of the three anatomical sites to determine mean BWT. Transvaginal US had good interobserver reliability, thus mean BWT is best measured using the transvaginal approach.; © 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.
JO – BJU International
PB – Blackwell Science
CY – England
VL – 106
IS – 10
PG – 1519-1522
SP – 1519
EP – 1522
AN – 20438565
DO – 10.1111/j.1464-410X.2010.09367.x
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=20438565&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Effects of stabilization training on multifidus muscle cross-sectional area among young elite cricketers with low back pain.
A1 – Hides J
A1 – Stanton W
A1 – McMahon S
A1 – Sims K
A1 – Richardson C
Y1 – 2008///
PD – 03//
AB – STUDY DESIGN: A single-blinded, pretreatment-posttreatment assessment. OBJECTIVES: To investigate, using ultrasound imaging, the cross-sectional area (CSA) of the lumbar multifidus muscle at 4 vertebral levels (L2, L3, L4, L5) in elite cricketers with and without low back pain (LBP) and (2) to document the effect of a staged stabilization training program on multifidus muscle CSA. BACKGROUND: Despite high fitness levels and often intensive strength training programs, athletes still suffer LBP. The incidence of LBP among Australian cricketers is 8% and as high as 14% among fast bowlers. Previous researchers have found that the multifidus muscle contributes to segmental stability of the lumbopelvic region; however, the CSA of this muscle has not been previously assessed in elite cricketers. METHODS AND MEASURES: CSAs of the multifidus muscles were assessed at rest on the left and right sides for 4 vertebral levels at the start and completion of a 13-week cricket training camp. Participants who reported current or previous LBP were placed in a rehabilitation group. The stabilization program involved voluntary contraction of the multifidus, transversus abdominis, and pelvic floor muscles, with real-time feedback from rehabilitative ultrasound imaging (RUSI), progressed from non-weight-bearing to weight-bearing positions and movement training. Pain scores (using a visual analogue scale) were also collected from those with LBP. RESULTS: The CSAs of the multifidus muscles at the L5 vertebral level increased for the 7 cricketers with LBP who received the stabilization training, compared with the 14 cricketers without LBP who did not receive rehabilitation (P = .004). In addition, the amount of muscle asymmetry among those with LBP significantly decreased (P = .029) and became comparable to cricketers without LBP. These effects were not evident for the L2, L3, and L4 vertebral levels. There was also a 50% decrease in the mean reported pain level among the cricketers with LBP. CONCLUSION: Multifidus muscle atrophy can exist in highly active, elite athletes with LBP. Specific retraining resulted in an improvement in multifidus muscle CSA and this was concomitant with a decrease in pain. LEVEL OF EVIDENCE: Therapy, level 2b.
JO – Journal of Orthopaedic & Sports Physical Therapy
PB – American Physical Therapy Association, Orthopaedic Section
CY – La Crosse, Wisconsin
VL – 38
IS – 3
PG – 101-108
SP – 101
EP – 108
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=105734609&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Comparison of changes in the mobility of the pelvic floor muscle on during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction.
A1 – Jung, Halim
A1 – Jung, Sangwoo
A1 – Joo, Sunghee
A1 – Song, Changho
Y1 – 2016///
PD – 01
AB – [Purpose] The purpose of this study was to compare changes in the mobility of the pelvic floor muscle during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction. [Subjects] Thirty healthy adults participated in this study (15 men and 15 women). [Methods] All participants performed a bridge exercise and abdominal curl-up during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction. Pelvic floor mobility was evaluated as the distance from the bladder base using ultrasound. [Results] According to exercise method, bridge exercise and abdominal curl-ups led to significantly different pelvic floor mobility. The pelvic floor muscle was elevated during the abdominal drawing-in maneuver and descended during maximal expiration. Finally, pelvic floor muscle mobility was greater during abdominal curl-up than during the bridge exercise. [Conclusion] According to these results, the abdominal drawing-in maneuver induced pelvic floor muscle contraction, and pelvic floor muscle contraction was greater during the abdominal curl-up than during the bridge exercise.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 28
IS – 2
PG – 467-472
SP – 467
EP – 472
AN – 27065532
DO – 10.1589/jpts.28.467
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=27065532&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Pubococcygeal activity on perineal ultrasound in incontinent women.
A1 – de Abreu Etienne, Mara
A1 – de Oliveira, André Lima
A1 – da Silva Carramão, Silvia
A1 – Macea, José Rafael
A1 – Aoki, Tsutomu
A1 – Auge, Antonio Pedro Flores
Y1 – 2011///
PD – 03
AB – Introduction and Hypothesis: The aim of this study was to investigate the applicability and reproducibility of perineal ultrasound (US) in the evaluation of the pubococcygeal muscle (PCM) activity in urinary incontinent women.; Methods: Thirty women were assessed twice by two examiners who measured the angle between the lateral bundles of the PCM. The 2D US on coronal view evaluated the PCM performance during squeezing, straining, and resting.; Results: There was significant correlation (p ≤ 0.001) in all measurements to both examiners, except for the contraction on their second assessment. The images showed asymmetries of muscle volume and activity. Five women (16.7%) had difficulty to rest after squeezing or straining, six (20%) first opened the muscle bundles when asked to squeeze them, and eight (26.7%) had no movement during different moments.; Conclusions: The 2D perineal US on coronal view is useful to evaluate PCM activity. It is easily applicable and reproducible.;
JO – International Urogynecology Journal
PB – Springer
CY – England
VL – 22
IS – 3
PG – 315-320
SP – 315
EP – 320
AN – 20798920
DO – 10.1007/s00192-010-1251-9
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=20798920&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The automatic pelvic floor muscle response to the active straight leg raise in cases with pelvic girdle pain and matched controls.
A1 – Stuge, Britt
A1 – Sætre, Kaja
A1 – Ingeborg Hoff, Brækken
Y1 – 2013///
PD – 08//
AB – Abstract: The active straight leg raise (ASLR) test has been proposed as a clinical test for the assessment of pelvic girdle pain (PGP). Little is known about the activation of the pelvic floor muscles (PFM) during ASLR. The main aim of this study was to examine the automatic PFM contraction during ASLR. Specific aims were to compare automatic contraction to rest and to voluntary contraction, to compare PFM contraction during ASLR with and without compression and to examine whether there were any differences in PFM contraction between women with and without clinically diagnosed PGP during ASLR. Forty-nine pairs of women participated in a cross-sectional study with individual, one-to-one matched cases and controls. PFM was assessed by reliable and valid 3D ultrasound at rest, during voluntary and automatic contraction. Test–retest data for the levator hiatus during ASLR showed good repeatability. Significantly automatic PFM contractions occurred when ASLR tests were performed. There was a strong positive correlation between voluntary and automatic PFM contractions. Manual compression reduced the automatic PFM contraction during ASLR by 62–66%. There were no significant differences between cases and controls in reduction of levator hiatus or muscle length from rest to automatic contractions during ASLR. Interestingly, a significantly smaller levator hiatus was found in women with PGP than in controls, at rest, during an automatic contraction with ASLR and during voluntary contraction. In conclusion, a significant automatic PFM contraction occurred during ASLR, both in cases and in controls. Women with PGP had a significantly smaller levator hiatus than controls.
JO – Manual Therapy
PB – Elsevier B.V.
CY – New York, New York
VL – 18
IS – 4
PG – 327-332
SP – 327
EP – 332
AN –
DO – 10.1016/j.math.2012.12.004
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104194548&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Ultrasound imaging of the pelvic floor: where are we going?
A1 – Tubaro, Andrea
A1 – Koelbl, Heinz
A1 – Laterza, Rosa
A1 – Khullar, Vik
A1 – de Nunzio, Cosimo
Y1 – 2011///
PD – 06
AB – We produced a non systematic review of ultrasound imaging of the pelvic floor in women with urinary incontinence (UI) and/or pelvic organ prolapse (POP). We have searched the PubMed and Embase databases for the following PICO question: women; imaging; urinary incontinence, pelvic organ prolapse, pelvic floor, pelvic floor muscle, pelvic floor muscle training; physical examination, no imaging; diagnosis, prognosis, outcome. The production of a systematic review was deemed impossible based on the type and quality of the published evidence. Clinical research focused on the pathophysiology of the UI and POP looking relation between anatomic abnormalities, childbirth, the risk of UI or POP, the outcome of conservative treatment and reconstructive surgery. Published papers fall into the remits of diagnostic studies but often fail to comply with the recommendations of the STARD initiative. Most published evidence remains the product of a single institution effort and confirmatory studies are rarely found. Imaging studies in patients with UI did not provide evidence of any clinical benefit in the management of patients. In patients with POP, interesting correlations have been identified such as between childbirth, dimension of levator hiatus, avulsion of levator ani and risk of prolapse, but the non clinical benefit of pelvic floor imaging could still not be identified. Research on pelvic floor imaging requires a coordinated, international, multicentre effort to improve internal and external validity of imaging techniques, confirm observations published by single institutions and provide health technology assessment of imaging in the management of UI or POP patients.; Copyright © 2011 Wiley-Liss, Inc.
JO – Neurourology And Urodynamics
PB – Alan R. Liss
CY – United States
VL – 30
IS – 5
PG – 729-734
SP – 729
EP – 734
AN – 21661021
DO – 10.1002/nau.21136
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=21661021&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Novel augmented ADIM training using ultrasound imaging and electromyography in adults with core instability.
A1 – Lee, Nam-Gi
A1 – Jung, Ji-Hee
A1 – You, Joshua (Sung)-H.
A1 – Kang, Sung-Kouk
A1 – Lee, Dong-Ryul
A1 – Kwon, Oh-Yun
A1 – Jeon, Hye-Seon
Y1 – 2011///
PD – 10//
AB – Objective: To determine the effect of novel augmented abdominal drawing-in maneuver (ADIM) training using rehabilitative ultrasound imaging (RUSI) and electromyography (EMG) in adults with core instability. Methods: A convenience sample of 20 young adults with core instability (female =4; mean age ± standard deviation=24.4 ± 2.9 years) was recruited. Core instability was determined by the formal test. All subjects underwent an intensive ADIM that was augmented by comprehensive visual feedback via a pressure biofeedback unit, RUSI, and EMG. The intervention was provided for 20 minutes a day, 7 days a week, over a two-week period. Results: The paired t-test showed that both transverse abdominal (TrA) and internal oblique (IO) muscle thickness during ADIM were significantly greater than at rest (p= 0.000). However, external oblique (EO) muscle thickness remained relatively unchanged. The mean EMG amplitudes of the EO and erector spinae (ES) muscles were significantly decreased after the intervention (p=0.001, p=0.008). The intra-class correlation coefficient (ICC_{1,2}) showed the excellent test-retest reliability for muscle thickness (ranging from 0.90 to 0.98 in the prone position). Conclusion: This is the first evidence to demonstrate that the novel augmented ADIM training can effectively improve the lumbo-pelvic stabilization in adults with core instability. ABSTRACT FROM AUTHOR
JO – Journal of Back & Musculoskeletal Rehabilitation
PB –
CY –
VL – 24
IS – 4
PG – 233-240
SP – 233
EP – 240
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=67655699&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Ultrasound imaging transducer motion during clinical lumbopelvic maneuvers.
A1 – Whittaker JL
A1 – Warner M
A1 – Stoeks MJ
Y1 – ///
PD –
AB –
JO – Physiotherapy Canada
PB – University of Toronto Press
CY – Toronto, Ontario
VL – 61
IS –
PG – 37-37
SP – 37
EP – 37
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=105428253&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 4.- Abstracts from Congress, Symposium…;
ER –

TY – JOUR
T1 – Changes in Lateral Abdominal Muscle Thickness During an Abdominal Drawing-In Maneuver in Individuals With and Without Low Back Pain.
A1 – Beazell, James R.
A1 – Grindstaff, Terry L.
A1 – Hart, Joseph M.
A1 – Magrum, Eric M.
A1 – Cullaty, Martha
A1 – Shen, Francis H.
Y1 – 2011///
PD – 10//Oct-Dec2011
AB – The purpose of this study was to compare lateral abdominal muscle thickness changes in individuals with and without low back pain (LBP) during an abdominal drawing-in maneuver (ADIM) using ultrasound imaging. Twenty individuals (13 females and 7 males, average age 40.1 ± 13.4) with stabilization classification LBP and 19 controls (10 females and 9 males, average age 30.3 ± 8.7) participated in this study. Bilateral measurements were made using ultrasound imaging to determine changes in thickness of the transversus abdominus (TrA) and external and internal oblique (EO+IO) muscles during an ADIM. There were no significant differences in relaxed muscle thickness values or contraction ratios for the TrA or EO+IO between groups or side. Individuals with stabilization classification LBP demonstrated no difference in lateral abdominal muscle thickness during an ADIM when compared with controls without LBP when using a pressure biofeedback device to monitor stability. ABSTRACT FROM PUBLISHER
JO – Research in Sports Medicine
PB –
CY –
VL – 19
IS – 4
PG – 271-282
SP – 271
EP – 282
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=66438593&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Current Perspectives: The Clinical Application of Ultrasound Imaging by Physical Therapists.
A1 – Whittaker, Jackie
Y1 – 2006///
PD – 06//
AB – The author reflects on the clinical application of ultrasound imaging (UI) by physical therapists. He stresses that UI has emerged as a clinical tool to help physical therapists in the detection and treatment of altered motor control. He believes that the uses of UI by physical therapists may vary depending on the jurisdiction, its specific licensing guidelines and professional regulation.
JO – Journal of Manual & Manipulative Therapy (Journal of Manual & Manipulative Therapy)
PB –
CY –
VL – 14
IS – 2
PG – 73-75
SP – 73
EP – 75
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=21645277&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Validity of Estimation of Pelvic Floor Muscle Activity from Transperineal Ultrasound Imaging in Men.
A1 – Stafford, Ryan E
A1 – Coughlin, Geoff
A1 – Lutton, Nicholas J
A1 – Hodges, Paul W
Y1 – 2015///
PD – 12/07
AB – Purpose: To investigate the relationship between displacement of pelvic floor landmarks observed with transperineal ultrasound imaging and electromyography of the muscles hypothesised to cause the displacements.; Materials and Methods: Three healthy men participated in this study, which included ultrasound imaging of the mid-urethra, urethra-vesical junction, ano-rectal junction and bulb of the penis. Fine-wire electromyography electrodes were inserted into the puborectalis and bulbocavernosus muscles and a transurethral catheter electrode recorded striated urethral sphincter electromyography. A nasogastric sensor recorded intra-abdominal pressure. Tasks included submaximal and maximal voluntary contractions, and Valsalva. The relationship between each of the parameters measured from ultrasound images and electromyography or intra-abdominal pressure amplitudes was described with nonlinear regression.; Results: Strong, non-linear relationships were calculated for each predicted landmark/muscle pair for submaximal contractions (R2-0.87-0.95). The relationships between mid-urethral displacement and striated urethral sphincter electromyography, and bulb of the penis displacement and bulbocavernosus electromyography were strong during maximal contractions (R2-0.74-0.88). Increased intra-abdominal pressure prevented shortening of puborectalis, which resulted in weak relationships between electromyography and anorectal and urethravesical junction displacement during all tasks.; Conclusions: Displacement of landmarks in transperineal ultrasound imaging provides meaningful measures of activation of individual pelvic floor muscles in men during voluntary contractions. This method may aid assessment of muscle function or feedback for training.;
JO – Plos One
PB – Public Library of Science
CY – United States
VL – 10
IS – 12
PG – e0144342-e0144342
SP – e0144342
EP – e0144342
AN – 26642347
DO – 10.1371/journal.pone.0144342
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=26642347&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Ultrasound assessment of transversus abdominis muscle contraction ratio during abdominal hollowing: a useful tool to distinguish between patients with chronic low back pain and healthy controls?
A1 – Pulkovski, N
A1 – Mannion, A F
A1 – Caporaso, F
A1 – Toma, V
A1 – Gubler, D
A1 – Helbling, D
A1 – Sprott, H
Y1 – 2012///
PD – 08
AB – Spine stabilisation exercises, in which patients are taught to preferentially activate the transversus abdominus (TrA) during “abdominal hollowing” (AH), are a popular treatment for chronic low back pain (cLBP). The present study investigated whether performance during AH differed between cLBP patients and controls to an extent that would render it useful diagnostic tool. 50 patients with cLBP (46.3 ± 12.5 years) and 50 healthy controls (43.6 ± 12.7 years) participated in this case-control study. They performed AH in hook-lying. Using M-mode ultrasound, thicknesses of TrA, and obliquus internus and externus were determined at rest and during 5 s AH (5 measures each body side). The TrA contraction-ratio (TrA-CR) (TrA contracted/rest) and the ability to sustain the contraction [standard deviation (SD) of TrA thickness during the stable phase of the hold] were investigated. There were no significant group differences for the absolute muscle thicknesses at rest or during AH, or for the SD of TrA thickness. There was a small but significant difference between the groups for TrA-CR: cLBP 1.35 ± 0.14, controls 1.44 ± 0.24 (p < 0.05). However, Receiver Operator Characteristics (ROC) analysis revealed a poor and non-significant ability of TrA-CR to discriminate between cLBP patients and controls on an individual basis (ROC area under the curve, 0.60 [95% CI 0.495; 0.695], p = 0.08). In the patient group, TrA-CR showed a low but significant correlation with Roland Morris score (Spearman Rho = 0.328; p = 0.02). In conclusion, the difference in group mean values for TrA-CR was small and of uncertain clinical relevance. Moreover, TrA-CR showed a poor ability to discriminate between control and cLBP subjects on an individual basis. We conclude that the TrA-CR during abdominal hollowing does not distinguish well between patients with chronic low back pain and healthy controls.;
JO – European Spine Journal: Official Publication Of The European Spine Society, The European Spinal Deformity Society, And The European Section Of The Cervical Spine Research Society
PB – Springer-Verlag
CY – Germany
VL – 21 Suppl 6
IS –
PG – S750-S759
SP – S750
EP – S759
AN – 21451982
DO – 10.1007/s00586-011-1707-8
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=21451982&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Rehabilitative ultrasound imaging; the technology and techniques.
A1 – Whittaker JL
Y1 – ///
PD –
AB –
JO – Physiotherapy Canada
PB – University of Toronto Press
CY – Toronto, Ontario
VL – 61
IS –
PG – 25-26
SP – 25
EP – 26
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=105428202&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 3.- No abstract available or incomplete;
ER –

TY – JOUR
T1 – Does Transvaginal Neuromuscular Electrical Stimulation Elicit a Pelvic Floor Muscle Contraction? A Pilot Study Using Ultrasonography in Healthy Women.
A1 – Maher, Ruth M.
A1 – Hayes, Dawn M.
Y1 – 2012///
PD – 05//May-Aug2012
AB –
JO – Journal of Women’s Health Physical Therapy
PB – Lippincott Williams & Wilkins
CY – Baltimore, Maryland
VL – 36
IS – 2
PG – 102-107
SP – 102
EP – 107
AN –
DO – 10.1097/JWH.0b013e318260dd24
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=108144173&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – [Commentary on] Transabdominal ultrasound measurement of pelvic floor muscle activity when activated directly or via a transversus abdominis muscle contraction.
A1 – Hay-Smith J
Y1 – 2004///
PD – 11//
AB –
JO – New Zealand Journal of Physiotherapy
PB – New Zealand Society of Physiotherapists
CY –
VL – 32
IS – 3
PG – 145-146
SP – 145
EP – 146
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106622818&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The association between pelvic floor muscle function and pelvic girdle pain – A matched case control 3D ultrasound study.
A1 – Stuge, Britt
A1 – Sætre, Kaja
A1 – Brækken, Ingeborg Hoff
Y1 – 2012///
PD – 04//
AB – Abstract: There is uncertainty regarding the association between the function of the pelvic floor muscles (PFM) and pelvic girdle pain (PGP), and whether exercises to strengthen the PFM should be recommended for patients with PGP. This one-to-one matched case-control study examined whether there is any difference in voluntary PFM function between women with and without clinically diagnosed PGP. PFM function was assessed by manometry and three-dimensional ultrasound. Images were saved anonymously and analyses were performed offline by one investigator. A special Cox regression model was used to fit a conditional logistic regression procedure for one-to-one matched case-control studies. Forty-nine pairs of women were successfully matched according to age and parity. The study showed no difference in voluntary PFM function measured by palpation, manometry or ultrasound. The size of the levator hiatus area, together with BMI, was significantly associated with PGP. Women with PGP had statistically significantly smaller levator hiatus areas and a tendency for higher vaginal resting pressure compared to the control group. A significantly smaller levator hiatus and a tendency for higher vaginal resting pressure may indicate increased activity of the PFM. Hence, no evidence was found to recommend strengthening exercises for the PFM in patients with PGP. It is important to note that in this study we examined only voluntary contractions and not an automatic response of the PFM to a functional activity.
JO – Manual Therapy
PB – Elsevier B.V.
CY – New York, New York
VL – 17
IS – 2
PG – 150-156
SP – 150
EP – 156
AN –
DO – 10.1016/j.math.2011.12.004
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104522261&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – ACTIVATION OF THE DEEP ABDOMINALS.
A1 – Mew, Rosie
Y1 – 2011///
PD – 07//
AB – This article seeks to answer the question of whether activation of the deep abdominals is more effective in a functional position such as standing or in a more traditional Pilates position of crook lying. The study aimed to determine whether transversus abdominis (TrA) demonstrates greater activity on lower abdominal hollowing (LAH) in standing compared with crook lying, and with greater specificity in relation to the internal oblique (IO) and external oblique (EO). Subjects performed LAH in crook lying and standing. Muscle activity of TrA, IO and EO was measured using real-time ultrasound at rest and during LAH, and compared between the two postures. Changes in thickness due to involuntary postural tone, with the subject at rest, were also compared between the two postures. TrA showed significantly greater activity on LAH in standing compared with crook lying, and with greater specificity in relation to IO and EO. ABSTRACT FROM AUTHOR
JO – SportEX Medicine
PB –
CY –
VL –
IS – 49
PG – 12-18
SP – 12
EP – 18
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=65966324&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Retraining motor control of abdominal muscles among elite cricketers with low back pain Hides et al. Retraining motor control of abdominal muscles.
A1 – Hides, J. A.
A1 – Stanton, W. R.
A1 – Wilson, S. J.
A1 – Freke, M.
A1 – McMahon, S.
A1 – Sims, K.
Y1 – 2010///
PD – 12//
AB – The purpose of this study was to document the effect of a staged stabilization training program on the motor control of the anterolateral abdominal muscles in elite cricketers with and without low back pain (LBP). Changes in the cross-sectional area of the trunk, the thickness of the internal oblique and transversus abdominis (TrA) muscles and the shortening of the TrA muscle in response to an abdominal drawing-in task were measured at the start and completion of a 13-week cricket training camp. Measures were performed using ultrasound imaging and magnetic resonance imaging. Participants from the group with LBP underwent a stabilization training program that involved performing voluntary contractions of the multifidus, TrA and pelvic floor muscles, while receiving feedback from ultrasound imaging. By the end of the training camp, the motor control of cricketers with LBP who received the stabilization training improved and was similar to that of the cricketers without LBP. ABSTRACT FROM AUTHOR
JO – Scandinavian Journal of Medicine & Science in Sports
PB –
CY –
VL – 20
IS – 6
PG – 834-842
SP – 834
EP – 842
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=54503164&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Guest editorial. Current perspectives: the clinical application of ultrasound imaging by physical therapists.
A1 – Whittaker J
Y1 – 2006///
PD – 06//
AB –
JO – Journal of Manual & Manipulative Therapy (Journal of Manual & Manipulative Therapy)
PB – Journal of Manual & Manipulative Therapy
CY – Forest Grove, Oregon
VL – 14
IS – 2
PG – 73-75
SP – 73
EP – 75
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106369456&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Interobserver agreement of multicompartment ultrasound in the assessment of pelvic floor anatomy.
A1 – Lone, Farah
A1 – Sultan, Abdul H
A1 – Stankiewicz, Aleksandra
A1 – Thakar, Ranee
Y1 – 2016///
PD –
AB – Objective: To assess the interobserver agreement of pelvic floor anatomical measurements using multicompartment pelvic floor ultrasound.; Methods: Females were recruited from the urogynaecology/gynaecology clinics between July and October 2009 and underwent multicompartment pelvic floor ultrasonography (PFUS) using two-dimensional (2D) transperineal ultrasound (TPUS), high-frequency 2D/three-dimensional (3D) endovaginal ultrasound (EVUS) using a biplane probe with linear and transverse arrays and a 360° rotational 3D-EVUS. PFUS measurements were independently analysed by two clinicians.; Results: 158 females had PFUS assessment. Good-to-excellent interobserver agreement was observed for bladder-symphysis distance at rest and valsalva, urethral thickness, urethral length, urethral volume, levator hiatus area and width, anteroposterior diameter and anorectal angle. Lins Correlation was used to calculate the interobserver agreement and Bland-Altman plots were created to demonstrate the agreement between the researchers. There was also a good-to-excellent agreement between the two clinicians for the assessment of pelvic organ prolapse (POP) in the anterior, middle and posterior compartment.; Conclusion: Multicompartment PFUS is a reliable tool in the anatomical assessment of pelvic floor measurements and POP.; Advances in Knowledge: We found a good-to-excellent agreement between the two assessors in the assessment of pelvic floor measurements for all three pelvic floor compartments and suggest that multicompartment PFUS could be considered as a systematic integrated approach to assess the pelvic floor.;
JO – The British Journal Of Radiology
PB – British Institute of Radiology
CY – England
VL – 89
IS – 1059
PG – 20150704-20150704
SP – 20150704
EP – 20150704
AN – 26800394
DO – 10.1259/bjr.20150704
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=26800394&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Abdominal ultrasound imaging of pelvic floor muscle function in individuals with low back pain.
A1 – Whittaker J
Y1 – 2004///
PD – 03//
AB – Research reveals that the primary impairment of the muscular system in individuals with low back pain is not one of strength or functional capacity but rather one of motor control of the deep muscles of the trunk. These deep muscles include the transversus abdominis, the deep segmental fibers of lumbar multifidus, the pelvic floor, and the diaphragm. Advances in knowledge regarding load transfer in the lumbopelvic region have provided the orthopaedic manual therapist with the necessary tools to assess most components of lumbopelvic dysfunction with the exclusion of an evaluation technique for pelvic floor motor control. The use of ultrasound imaging to observe the real-time contraction of muscles is a valuable tool, specifically when the muscles of interest are deep and not readily observable. The author proposes a novel abdominal ultrasound imaging method to assess voluntary pelvic floor motor control and discusses the rationale for its application in a population with lumbopelvic dysfunction.
JO – Journal of Manual & Manipulative Therapy (Journal of Manual & Manipulative Therapy)
PB – Journal of Manual & Manipulative Therapy
CY – Forest Grove, Oregon
VL – 12
IS – 1
PG – 44-49
SP – 44
EP – 49
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106756050&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – DANCE, BALANCE AND CORE MUSCLE PERFORMANCE MEASURES ARE IMPROVED FOLLOWING A 9-WEEK CORE STABILIZATION TRAINING PROGRAM AMONG COMPETITIVE COLLEGIATE DANCERS.
A1 – Watson, Todd
A1 – Graning, Jessica
A1 – McPherson, Sue
A1 – Carter, Elizabeth
A1 – Edwards, Joshuah
A1 – Melcher, Isaac
A1 – Burgess, Taylor
Y1 – 2017///
PD – 02//
AB – Background: Dance performance requires not only lower extremity muscle strength and endurance, but also sufficient core stabilization during dynamic dance movements. While previous studies have identified a link between core muscle performance and lower extremity injury risk, what has not been determined is if an extended core stabilization training program will improve specific measures of dance performance. Hypothesis/Purpose: This study examined the impact of a nine-week core stabilization program on indices of dance performance, balance measures, and core muscle performance in competitive collegiate dancers. Study Design: Within-subject repeated measures design. Methods: A convenience sample of 24 female collegiate dance team members (age = 19.7 ± 1.1 years, height = 164.3 ± 5.3 cm, weight 60.3 ± 6.2 kg, BMI = 22.5 ± 3.0) participated. The intervention consisted of a supervised and non-supervised core (trunk musculature) exercise training program designed specifically for dance team participants performed three days/week for nine weeks in addition to routine dance practice. Prior to the program implementation and following initial testing, transversus abdominis (TrA) activation training was completed using the abdominal draw-in maneuver (ADIM) including ultrasound imaging (USI) verification and instructor feedback. Paired t tests were conducted regarding the nine-week core stabilization program on dance performance and balance measures (pirouettes, single leg balance in passe’ releve position, and star excursion balance test [SEBT]) and on tests of muscle performance. A repeated measures (RM) ANOVA examined four TrA instruction conditions of activation: resting baseline, self-selected activation, immediately following ADIM training and four days after completion of the core stabilization training program. Alpha was set at 0.05 for all analysis. Results: Statistically significant improvements were seen on single leg balance in passe’ releve and bilateral anterior reach for the SEBT (both p ≤ 0.01), number of pirouettes (p = 0.011), and all measures of strength (p ≤ 0.05) except single leg heel raise. The RM ANOVA on mean percentage of change in TrA was significant; post hoc paired t tests demonstrated significant improvements in dancers’ TrA activations across the four instruction conditions Conclusion: This core stabilization training program improves pirouette ability, balance (static and dynamic), and measures of muscle performance. Additionally, ADIM training resulted in immediate and short-term (nine-week) improvements in TrA activation in a functional dance position. Level of Evidence: 2b ABSTRACT FROM AUTHOR
JO – International Journal of Sports Physical Therapy
PB –
CY –
VL – 12
IS – 1
PG – 25-41
SP – 25
EP – 41
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=121527736&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The reliability of measuring the inter-recti distance using highresolution and low-resolution ultrasound imaging comparing a novice to an experienced sonographer…ML Roberts Prize Winner
A1 – Iwan, Tom
A1 – Garton, Briar
A1 – Ellis, Richard
Y1 – 2014///
PD – 11//
AB –
JO – New Zealand Journal of Physiotherapy
PB – New Zealand Society of Physiotherapists
CY –
VL – 42
IS – 3
PG – 154-162
SP – 154
EP – 162
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=103920558&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Assessment of pelvic floor muscle contraction ability in healthy males following brief verbal instruction.
A1 – Scott, Olivia M
A1 – G Osmotherly, Peter
A1 – E Chiarelli, Pauline
Y1 – 2013///
PD – 03//
AB – This study assessed the ability of healthy men to contract their pelvic floor muscles on request, following standardised, brief, verbal instruction. Associations between self-reported lower urinary tract symptoms and the ability to contract the pelvic floor muscles on request were explored since there is currently no available data related to these topics. The study group, 52 healthy men (mean age of 22.6 years, SD 4.42), received brief, standardised instructions. Each man’s starting position was randomised to standing or crook lying. Bladder base elevation was observed and recorded using real-time transabdominal ultrasound imaging to determine muscle activation. Participants then completed a questionnaire recording age, body mass index, presence of chronic respiratory conditions, acute lower back pain and any lower urinary tract symptoms. Univariate logistic regression was applied to assess associations between ability to contract the pelvic floor muscles in each position, participant characteristics and study variables likely to impact upon lower urinary tract symptoms. Six participants (11.5%) were unable to perform the muscle contraction in either standing or crook lying, 17 (32.7%) men could not contract the muscles in crook lying and 14 (26.9%) could not contract the muscles when standing. While results suggest there is no optimal starting position in which to achieve pelvic floor muscle contraction in men, no assumptions should be made that an ability to contract those muscles is present or effective in young, asymptomatic men. This may have implications for interventions aimed at pelvic floor muscle rehabilitation following treatment for management of prostate cancer.
JO – Australian & New Zealand Continence Journal
PB – Cambridge Publishing
CY –
VL – 19
IS – 1
PG – 12-17
SP – 12
EP – 17
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104253932&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Reliability of real-time ultrasound for the assessment of transversus abdominis function.
A1 – Kidd, Adrian W
A1 – Magee, Scott
A1 – Richardson, Carolyn A
Y1 – 2002///
PD – 07
AB – Unlabelled: Transversus abdominis (TrA) has now been established as a key muscle for the stabilization of the lumbar spine and sacroiliac joints. Significantly, dysfunction of this muscle has also been implicated in low back pain. Real-time ultrasound (US) is a non-invasive procedure that has the potential to evaluate objectively the function of TrA.; Objective: To investigate M-mode US as a reliable method of assessing TrA function.; Method: M-mode US was used to measure the width of TrA as subjects drew in their lower abdominal wall at a controlled speed to a target depth. Eleven subjects were imaged.; Results: the measures of TrA width were reliable and ranged between 3.14mm relaxed and 6.35mm contracted. The standard error of measurement ranged between 0.18mm and 0.57mm.; Conclusion: M-mode US provides a reliable non-invasive measure of a controlled contraction of TrA.;
JO – Journal Of Gravitational Physiology: A Journal Of The International Society For Gravitational Physiology
PB – Galileo Foundation
CY – United States
VL – 9
IS – 1
PG – P131-P132
SP – P131
EP – P132
AN – 15002516
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=15002516&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Color Doppler ultrasonography of lumbar artery blood flow in patients with low back pain.
A1 – Espahbodi, Shima
A1 – Doré, Caroline J
A1 – Humphries, Keith N
A1 – Hughes, Sean P F
Y1 – 2013///
PD – 02/15/
AB – Study Design: Prospective, clinical, noninvasive imaging study.Objective: To quantify normal lumbar artery hemodynamics and develop a reference range and lumbar artery hemodynamics in patients with low back pain.Summary Of Background Data: Blood supply to the lumbar spinal tissues, intraosseous capillary circulation, and avascular intervertebral discs derives directly from the lumbar arteries. Pathology may affect this blood supply, impact nutrient delivery and contribute to low back pain and disc degeneration. However knowledge of hemodynamic characteristics of lumbar arteries is lacking. This could improve understanding into pathological tissue function and its relation to lumbar spine circulation in back disorders.Methods: Sixty-four patients with low back pain and 30 normal controls underwent lumbar spine imaging investigations with color Doppler ultrasonography. Doppler data on blood flow was obtained from arteries at S1 through to L1 bilaterally and angle-corrected peak systolic blood flow velocity (PSV) measured in all vessels. Aortic PSV was used to derive the normalized lumbar artery: Aortic PSV ratio (PSVR) for all subjects’ levels L1 to S1 bilaterally.Results: In both the control and low back pain (LBP) groups blood flow PSV in the lumbar arteries increased incrementally from levels L1 to L4, declined to its lowest values at L5 and rose again at S1. Normalized lumbar artery blood flow PSVR in the LBP group is consistently higher at all levels (L1-S1) than in controls (P < 0.001). At level L5, lumbar artery blood flow PSVR was 46% higher in the LBP group than in controls.Conclusion: Color Doppler ultrasonography can reliably be used as a clinical tool to visualize and quantify blood flow in lumbar arteries of patients with low back disorders. Findings of increased blood flow PSVR in patients are consistent with the well-documented Doppler changes that occur during inflammatory hyperemia.Level Of Evidence: 3.
JO – Spine (03622436)
PB – Lippincott Williams & Wilkins
CY – Baltimore, Maryland
VL – 38
IS – 4
PG – E230-6
SP – E230
EP – 6
AN –
DO – 10.1097/BRS.0b013e31827ecd6e
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=108031705&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Rehabilitative ultrasound imaging of the lumbar multifidus muscle: the parasagittal view.
A1 – Kiesel K
A1 – Underwood F
A1 – Nitz A
Y1 – ///
PD –
AB –
JO – Journal of Orthopaedic & Sports Physical Therapy
PB – American Physical Therapy Association, Orthopaedic Section
CY – La Crosse, Wisconsin
VL – 36
IS – 8
PG – A-11
SP – A
EP – 11
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106349200&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 4.- Abstracts from Congress, Symposium…;
ER –

TY – JOUR
T1 – Rehabilitative ultrasound imaging of the lumbar multifidus muscle: biofeedback training, clinical and research applications.
A1 – Hides JA
Y1 – ///
PD –
AB –
JO – Journal of Orthopaedic & Sports Physical Therapy
PB – American Physical Therapy Association, Orthopaedic Section
CY – La Crosse, Wisconsin
VL – 36
IS – 8
PG – A-12
SP – A
EP – 12
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106349202&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain.
A1 – Hides JA
A1 – Stokes MJ
A1 – Saide M
A1 – Jull GA
A1 – Cooper DH
A1 – Hides, J A
A1 – Stokes, M J
A1 – Saide, M
A1 – Jull, G A
A1 – Cooper, D H
Y1 – ///
PD –
AB – The effect of low back pain on the size of the lumbar multifidus muscle was examined using real-time ultrasound imaging. Bilateral scans were performed in 26 patients with acute unilateral low back pain (LBP) symptoms (aged 17-46 years) and 51 normal subjects (aged 19-32 years). In all patients, multifidus cross-sectional area (CSA) was measured from the 2nd to the 5th lumbar vertebrae (L2-5) and in six patients, that of S1 was also measured. In all normal subjects, CSA was measured at L4 and in 10 subjects measurements were made from L2-5. Marked asymmetry of multifidus CSA was seen in patients with the smaller muscle being on the side ipsilateral to symptoms (between-side difference 31 +/- 8%), but this was confined to one vertebral level. Above and below this level of wasting, mean CSA differences were < 6%. In normal subjects, the mean differences were < 5% at all vertebral levels. The site of wasting in patients corresponded to the clinically determined level of symptoms in 24 of the 26 patients, but there was no correlation between the degree of asymmetry and severity of symptoms. Patients had rounder muscles than normal subjects (measured by a shape ratio index), perhaps indicating muscle spasm. Linear measurements of multifidus cross-section were highly correlated with CSA in normal muscles but less so in wasted muscles, so CSA measurements are more accurate than linear dimensions. The fact that reduced CSA, i.e., wasting, was unilateral and isolated to one level suggests that the mechanism of wasting was not generalized disuse atrophy or spinal reflex inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)
JO – Spine (03622436)
PB – Lippincott Williams & Wilkins
CY – Baltimore, Maryland
VL – 19
IS – 2
PG – 165-172
SP – 165
EP – 172
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=107441401&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The effect of resistance exercise direction for hip joint stabilization on lateral abdominal muscle thickness.
A1 – Jung, Ju-Hyeon
A1 – Lee, Sang-Yeol
Y1 – 2016///
PD – 10/31
AB – 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.;
JO – Journal Of Exercise Rehabilitation
PB – Korean Society of Exercise Rehabilitation
CY – Korea (South)
VL – 12
IS – 5
PG – 424-428
SP – 424
EP – 428
AN – 27807520
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=27807520&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 7.- Wrong patient population;
ER –

TY – JOUR
T1 – Fine-wire EMG is more sensitive than rehabilitative ultrasound imaging for detecting changes in lumbar multifidus activity in persons with low back pain.
A1 – Givens DL
A1 – Briggs MS
A1 – Navalgund A
A1 – Young G
Y1 – ///
PD –
AB –
JO – Journal of Orthopaedic & Sports Physical Therapy
PB – American Physical Therapy Association, Orthopaedic Section
CY – La Crosse, Wisconsin
VL – 39
IS – 1
PG – A94-A94
SP – A94
EP – A94
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=105637350&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 3.- No abstract available or incomplete;
ER –

TY – JOUR
T1 – The Evaluation of Chronic Low Back Pain by Determining the Ratio of the Lumbar Multifidus Muscle Cross-sectional Areas of the Unaffected and Affected Sides.
A1 – Huang, Qiuchen
A1 – Zhang, Yuying
A1 – Li, Desheng
A1 – Yang, Degang
A1 – Huo, Ming
A1 – Maruyama, Hitoshi
Y1 – 2014///
PD – 10
AB – [Purpose] The primary purpose of this study was to evaluate chronic low back pain by determining the ratio of the cross-sectional areas of the lumbar multifidus of the unaffected and affected sides at the L5 level using the ultrasound imaging. [Subjects and Methods] The subjects were 24 young people (10 males, 14 females) with chronic low back pain lasting for more than 6 months on one side. The visual analog scale (VAS) value of pain was assessed and the cross-sectional areas of the bilateral multifidus muscle were measured with the subjects in a supine position in a resting state using ultrasound imaging. Correlation and linear regression analysis were performed on the VAS and the ratio of the cross-sectional areas of the lumbar multifidus of the unaffected and affected sides. [Results] The VAS and the ratio of the cross-sectional areas of the lumbar multifidus were linearly correlated. [Conclusion] The results of this research indicate that when the ratio of the cross-sectional areas of the lumbar multifidus of the unaffected and affected sides increases, the symptom of chronic low back pain deteriorates.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 26
IS – 10
PG – 1613-1614
SP – 1613
EP – 1614
AN – 25364126
DO – 10.1589/jpts.26.1613
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=25364126&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – REHABILITATIVE ULTRASOUND IMAGING OF THE LUMBAR MULTIFIDUS MUSCLE: MEASURING MORPHOLOGY. (Abstract)
A1 – Stokes, M.
Y1 – 2006///
PD – 08//
AB – This abstract discusses how physical therapists can use rehabilitative ultrasound imaging of the lumbar multifidus to measure spinal morphology: waht is known, what is unknown; and, future directions and priorities.
JO – Journal of Orthopaedic & Sports Physical Therapy
PB –
CY – ;
VL – 36
IS – 8
PG – A-10-a-11
SP – A
EP – 10
AN –
DO –
UR – http://www.apta.org/
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – LATERAL ABDOMINAL MUSCLE SYMMETRY IN COLLEGIATE SINGLE-SIDED ROWERS.
A1 – Gill, Norman W.
A1 – Mason, Beth E.
A1 – Gerber, J. Parry
Y1 – 2012///
PD – 02//
AB – Purpose/Background: Although side to side symmetry of lateral abdominal muscle thickness has been established in healthy individuals, it is unknown whether abdominal muscle symmetry exists in athletes with asymmetrical physiological demands, such as those of single-sided rowers. The purpose of this study was to examine the oarside versus the non-oarside lateral abdominal musculature thickness in collegiate single-sided rowers, as measured by ultrasound imaging (USI). Methods: The study was a prospective, cross-sectional, observational design. Thirty collegiate crew team members (17 males, 13 females, age 19.8±1.2 years) characterized as single-sided rowers participated. Resting muscle thickness measurements of the transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles were obtained via USI. Comparisons of absolute and relative muscle thickness between oarside and non-oarside were performed using paired t-tests. Potential differences based on gender, rowing experience, and history of low back pain were investigated using mixed model analysis of variance. Results: There were no clinically significant differences in absolute or relative thickness of the TrA, IO or EO on the oarside versus the non-oarside. There were no significant side to side differences in the relative muscle thickness of the TrA, IO or EO based on gender, rowing experience, or history of low back pain. Conclusions: In this sample of single-sided rowing athletes, no clinically significant side to side differences in lateral abdominal muscle thickness were observed. Despite the asymmetrical functional demands of single- sided rowers in this study, thickness of the lateral abdominal muscles was symmetric. Level of Evidence: 4 ABSTRACT FROM AUTHOR
JO – International Journal of Sports Physical Therapy
PB –
CY –
VL – 7
IS – 1
PG – 13-19
SP – 13
EP – 19
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=74547236&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The Differences of the Abdominal Muscles at Rest between the Lying Position and Lying on a Stretch Pole.
A1 – Fuse, Yoko
A1 – Yazaki, Takaaki
A1 – Fukui, Tsutomu
Y1 – 2012///
PD – 02//
AB – [Purpose] We investigated methods for strengthening the transverse abdominis. [Subjects] Twelve healthy subjects participated in this research. [Method] The thicknesses of the external oblique, internal oblique and transverse abdominis were measured on both the right and left sides using ultrasonography. The position of the measurements were as follows: A) the supine position, B) lying on a stretch pole (with upper limb support), C) lying on a stretch pole (without upper limb support). [Results] The thicknesses of the transverse abdominis showed significant difference among the positions, but there was no significant difference in the external oblique and internal oblique muscles. The transverse abdominis showed a significant difference between A and B, and A and C. [Conclusion] A stretch pole was effective for exercising the transverse abdominis. ABSTRACT FROM AUTHOR
JO – Rigakuryoho Kagaku
PB –
CY –
VL – 27
IS – 1
PG – 77-80
SP – 77
EP – 80
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=71939750&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Correlation between architectural variables and torque in the erector spinae muscle during maximal isometric contraction.
A1 – Cuesta-Vargas, Antonio
A1 – González-Sánchez, Manuel
Y1 – 2014///
PD – 11/15/
AB – This study analysed whether a significant relationship exists between the torque and muscle thickness and pennation angle of the erector spinae muscle during a maximal isometric lumbar extension with the lumbar spine in neutral position. This was a cross-sectional study in which 46 healthy adults performed three repetitions for 5 s of maximal isometric lumbar extension with rests of 90 s. During the lumbar extensions, bilateral ultrasound images of the erector spinae muscle (to measure pennation angle and muscle thickness) and torque were acquired. Reliability test analysis calculating the internal consistency (Cronbach’s alpha) of the measure, correlation between pennation angle, muscle thickness and torque extensions were examined. Through a linear regression the contribution of each independent variable (muscle thickness and pennation angle) to the variation of the dependent variable (torque) was calculated. The results of the reliability test were: 0.976–0.979 (pennation angle), 0.980–0.980 (muscle thickness) and 0.994 (torque). The results show that pennation angle and muscle thickness were significantly related to each other with a range between 0.295 and 0.762. In addition, multiple regression analysis showed that the two variables considered in this study explained 68% of the variance in the torque. Pennation angle and muscle thickness have a moderate impact on the variance exerted on the torque during a maximal isometric lumbar extension with the lumbar spine in neutral position. ABSTRACT FROM AUTHOR
JO – Journal of Sports Sciences
PB –
CY –
VL – 32
IS – 19
PG – 1797-1804
SP – 1797
EP – 1804
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=97834396&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The effects of transcutaneous neuromuscular electrical stimulation on the activation of deep lumbar stabilizing muscles of patients with lumbar degenerative kyphosis.
A1 – Kim, So Yeon
A1 – Kim, Jin Hyun
A1 – Jung, Gil Su
A1 – Baek, Seung Ok
A1 – Jones, Rodney
A1 – Ahn, Sang Ho
Y1 – 2016///
PD – 01
AB – [Purpose] To investigate the effectiveness of three different neuromuscular electrical stimulation (NMES) protocols for the deep lumbar stabilizing muscles of patients with lumbar degenerative kyphosis (LDK). [Subjects and Methods] Twenty patients with LDK were recruited. Three stimulation protocols were investigated: stimulation of the abdominal muscles (protocol A); stimulation of the lumbar muscles (protocol B); and simultaneous stimulation of the abdominal and lumbar muscles (protocol A+B). Images of the obliquus externus (OE), obliquus internus (OI), transversus abdominis (TrA), and lumbar multifidus (LM) muscles were captured by real-time ultrasound imaging (RUSI). [Results] The thickness of LM was significantly greater during stimulation than at rest for all three protocols. Thicknesses of the abdominal muscles (TrA, OI, and OE) were significantly greater during stimulation than at rest for protocols A and A+B. Thickness increases in LM were significantly greater during protocols B and A+B, but not during protocol A. Thickness increases in the abdominal muscles (TrA, OI, and OE) were significantly greater during protocols A and A+B, but not during protocol B. [Conclusion] NMES can significantly activate the deep lumbar stabilizing muscles of patients with LDK. Protocol A+B of NMES is recommended to aid postural correction and low back pain (LBP) in patients with LDK.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 28
IS – 2
PG – 399-406
SP – 399
EP – 406
AN – 27064323
DO – 10.1589/jpts.28.399
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=27064323&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The effects of visual biofeedback using ultrasonograpy on deep trunk muscle activation.
A1 – Cha, Hyun-Gyu
A1 – Kim, Myoung-Kwon
A1 – Shin, Young-Jun
Y1 – 2016///
PD – 12
AB – [Purpose] The objective of this study is to investigate the effect of visual biofeedback using ulatrasonography on the functional improvement of deep trunk muscle. [Subjects and Methods] This study selected ten healthy people without orthopedic history and information on the study. The average ages, heights, and weights were 22.70 ± 2.06 years old, 171.15 ± 9.18 cm, and 66.86 ± 8.88 kg in the experimental group, respectively. The abdominal drawing-in maneuver were executed for subjects through monitoring the status of muscle contraction using ultrasonic waves. And motor control exercises were performed during 6 weeks, 20 minutes/day and three times/week. We collected the data using electromyography MP150 system (BIOPAC system Inc., CA, USA) in order to measure trunk muscle activation. [Results] The subjects showed significant improvements in Internal oblique abdominis and lumbar multifidus muscle after intervention. [Conclusion] Visual biofeedback training using ultrasonography might be effective in improving function of the deep trunk muscle.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 28
IS – 12
PG – 3310-3312
SP – 3310
EP – 3312
AN – 28174441
DO – 10.1589/jpts.28.3310
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=28174441&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – A Comparison of the Contribution of the Transversus Abdominis to Trunk Rotation in Normal Subjects and Subjects with Chronic Low Back Pain.
A1 – TAKUYA MIURA
A1 – MASANORI YAMANAKA
A1 – HARUKAZU TOHYAMA
A1 – HIROSHI SAITO
A1 – MINA SAMUKAWA
A1 – TAKUMI KOBAYASHI
A1 – NAOKI TAKEDA
Y1 – 2014///
PD – 04//
AB – [Purpose] To study the activities of the deep abdominal muscles during trunk rotation using ultrasound imaging. [Subjects] The subjects were 10 healthy persons with no lower limb or trunk disorders, and 6 chronic low back pain (LBP) patients. [Methods] In the sitting position, trunk rotation was performed voluntarily, and passively with a device. The thickness changes in the transversus abdominis (TrA) during performance of the task were compared between the healthy subjects and LBP patients. [Results] We found that the TrA thickness increased unilaterally in trunk rotational movement of the healthy subjects, but not in the LBP patients. [Conclusion] The difference observed in the TrA activities of healthy subjects and LBP patients suggests TrA contributes to trunk rotation, and TrA functionality is one aspect of the difference between healthy subjects and LBP patients. ABSTRACT FROM AUTHOR
JO – Rigakuryoho Kagaku
PB –
CY –
VL – 29
IS – 2
PG – 207-212
SP – 207
EP – 212
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=96240726&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Comparison of curvilinear and linear ultrasound imaging probes for measuring cross-sectional area and linear dimensions.
A1 – Warner, M B
A1 – Cotton, A M
A1 – Stokes, M J
Y1 – 2008///
PD – Nov-Dec
AB – The aim of the study was to determine whether different ultrasound probe/transducer configurations produce the same measurements. Two investigators undertook 10 scans of a general purpose semi-solid multi-tissue ultrasound phantom (phantom A) using two ultrasound scanners with a linear and curvilinear probe. From those 10 scans, two measurements of cross-sectional area (CSA), width and thickness were made. These measurements were then repeated with an open-top fluid-filled phantom, with 10% ethanol solution (phantom B). Intra- and inter-rater reliability were examined using Bland and Altman plots. Agreement between measurements made with the two probe types was also assessed using Bland and Altman plots. An independent samples t-test was used to compare statistical differences between probe type configuration. There was a significant difference (p < 0.05) and a tendency for increased measurements in CSA and width, and decreased measurements in thickness when using a curvilinear probe on phantom A, and these differences were not scanner specific. When imaging phantom B there were no significant differences in measurements between probe configurations; however there was a small bias for smaller CSA measurements with a curvilinear probe. In conclusion there are small differences in measurements obtained from different ultrasound probe configurations using a semi-solid phantom, but their clinical significance is unknown.; JO – Journal Of Medical Engineering & Technology PB – Informa Healthcare CY – England VL – 32 IS – 6 PG – 498-504 SP – 498 EP – 504 AN – 19005964 DO – 10.1080/03091900701695533 UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=19005964&lang=es&site=eds-live NS – N1 – Exclusion reason: 5.- Wrong study design; ER – TY – JOUR T1 – Comparison of clinical test and real time ultrasound evaluation of muscle contraction in normals and patients with low back pain. A1 – Beazell JR A1 – Grindstaff TL A1 – Magrum EM A1 – Cullaty M A1 – Hart JM A1 – Shen FH Y1 – 2006/// PD – 09// AB – JO – Journal of Manual & Manipulative Therapy (Journal of Manual & Manipulative Therapy) PB – Journal of Manual & Manipulative Therapy CY – Forest Grove, Oregon VL – 14 IS – 3 PG – 168-169 SP – 168 EP – 169 AN – DO – UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106270910&lang=es&site=eds-live NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Rehabilitative ultrasound imaging. A1 – Teyhen, Deydre A1 – Koppenhaver, Shane Y1 – 2011/// PD – AB – Unlabelled: Neuromuscular deficits have been linked with chronic musculoskeletal conditions. The use of ultrasound imaging(USI) to aid rehabilitation of neuromusculoskeletal disorders has been called rehabilitative ultrasound imaging (RUSI)and defined as ‘a procedure used by physical therapists to evaluate muscle and related soft tissue morphology and function during exercise and physical tasks. RUSI is used to assist in the application of therapeutic interventions,providing feedback to the patient and physical therapist (Teyhen 2006). Brightness mode (b-mode) USI is the most common form used by physical therapists and will be the focus of this summary.; Clinical Utility: USI can distinguish between healthy adults and those with low back pain (LBP). Those with LBP have decreased muscle thickness, side-to-side asymmetry,and decreased ability to thicken the muscles during a contraction (Teyhen et al 2009). Moreover, when measured by USI, lumbar multifidus muscle asymmetry appears to be predictive of future episode of LBP up to three years later(Hides et al 2001). Finally, USI can distinguish between changes in muscle thickness during common LBP exercises when performed by healthy adults (Teyhen et al 2008) and is preliminarily supported as a biofeedback tool to enhance exercise effectiveness (Henry and Teyhan 2007). CRITERION-RELATED VALIDITY: In a recent systematic review Koppenhaver et al (2009a) concluded that b-mode USI when applied in a rehabilitative setting is a valid tool to measure trunk muscle size and muscle activation during most submaximal contracted states. When comparing muscle thickness obtained by magnetic resonance imaging and USI, researchers have demonstrated substantial agreement(ICC 0.84 to –0.95) with only minimal differences between the modalities (0.03 to 0.21 cm2) (Hides et al 1995, 2006). Although comparisons between electromyography and change in muscle thickness obtained by USI have most often demonstrated a curvilinear relationship (Hodges et al 2003), the ability of USI to measure muscle activation is likely context-dependent and is based on the muscle being measured, the task performed, and the intensity of the contraction (Koppenhaver et al 2009a). RESPONSIVENESS TO CHANGE: Motor control training has been demonstrated to increase multifidus cross sectional area (p = 0.004), decrease side-to-side asymmetry, and was associated with a 50% reduction in pain (Hides et al 2008b).Additionally, recent evidence suggests increased contracted thickness of the lumbar multifidus one week after a spinal manipulation was predictive of larger improvements in low back pain-related disability (Koppenhaver et al 2011).The minimal amount of change associated with clinical improvement has yet to be determined.; Reliability: In a recent systematic review Hebert et al (2009)concluded that the majority of high quality studies indicated that RUSI has good intrarater and inter-rater reliability (ICC> 0.90). The standard error of measurement was decreased by nearly 25% when using a mean of two measures and by 50% when using a mean of three measures (Koppenhaver et al 2009b). Novice raters, when properly trained, can assess the trunk muscles reliably (ICC 0.86 to 0.94) (Teyhen et al 2011). INFLUENCE OF SEX AND BODY MASS INDEX: Muscle thickness and cross sectional area is greater in males than females and is associated with increased body mass index (Teyhenet al 2007).;
JO – Journal Of Physiotherapy
PB – Elsevier
CY – Netherlands
VL – 57
IS – 3
PG – 196-196
SP – 196
EP – 196
AN – 21843838
DO – 10.1016/S1836-9553(11)70044-3
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=21843838&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – ORIGINAL ARTICLE: Ultrasound imaging in rehabilitation
A1 – Hides, Julie
A1 – Richardson, Carolyn
A1 – Jull, Gwendolen
A1 – Davies, Susan
Y1 – 1995///
PD – 1/1/1995///
AB – Real-time ultrasound imaging is currently used extensively in medicine. It provides a safe, cost-effective and readily accessible method of examination of various organs and tissues. Furthermore, real-time ultrasound imaging has the potential to be of considerable benefit in rehabilitation. Possible applications in physiotherapy practice and research relate to measurement of muscle size and observation and monitoring of muscle contraction while it actually occurs. This may be useful for muscle rehabilitation and re-education, especially in the case of deep muscles, which are often difficult to assess.
JO – Australian Journal of Physiotherapy
PB – Elsevier B.V.
CY –
VL – 41
IS –
PG – 187-193
SP – 187
EP – 193
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S0004951414604293&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Self-Managed Exercises, Fitness and Strength Training, and Multifidus Muscle Size in Elite Footballers.
A1 – Hides, Julie A.
A1 – Walsh, Jazmin C.
A1 – Smith, Melinda M. Franettovich
A1 – Mendis, M. Dilani
Y1 – 2017///
PD – 07//
AB – Context: Low back pain (LBP) and lower limb injuries are common among Australian Football League (AFL) players. Smaller size of 1 key trunk muscle, the lumbar multifidus (MF), has been associated with LBP and injuries in footballers. The size of the MF muscle has been shown to be modifiable with supervised motor-control training programs. Among AFL players, supervised motor-control training has also been shown to reduce the incidence of lower limb injuries and was associated with increased player availability for games. However, the effectiveness of a self-managed MF exercise program is unknown. Objective: To investigate the effect of self-managed exercises and fitness and strength training on MF muscle size in AFL players with or without current LBP. Design: Cross-sectional study. Setting: Professional AFL context. Patients or Other Participants: Complete data were available for 242 players from 6 elite AFL clubs. Intervention(s): Information related to the presence of LBP and history of injury was collected at the start of the preseason. At the end of the preseason, data were collected regarding performance of MF exercises as well as fitness and strength training. Ultrasound imaging of the MF muscle was conducted at the start and end of the preseason. Main Outcome Measure(s): Size of the MF muscles. Results: An interaction effect was found between performance of MF exercises and time (F = 13.89, P ≤ .001). Retention of MF muscle size was greatest in players who practiced the MF exercises during the preseason (F = 4.77, P = .03). Increased adherence to fitness and strength training was associated with retained MF muscle size over the preseason (F = 5.35, P = .02). Conclusions: Increased adherence to a self-administered MF exercise program and to fitness and strength training was effective in maintaining the size of the MF muscle in the preseason. ABSTRACT FROM AUTHOR
JO – Journal of Athletic Training (Allen Press)
PB –
CY –
VL – 52
IS – 7
PG – 649-655
SP – 649
EP – 655
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=124259553&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The Reliability of Rehabilitative Ultrasound Imaging of the Cross-sectional Area of the Lumbar Multifidus Muscles in the PNF Pattern.
A1 – Huang, Qiuchen
A1 – Li, Desheng
A1 – Zhang, Yuying
A1 – Hu, Anming
A1 – Huo, Ming
A1 – Maruyama, Hitoshi
Y1 – 2014///
PD – 10
AB – [Purpose] The primary purpose of this study was to evaluate the intraclass correlation coefficient (ICC) in obtaining the cross-sectional area of the lumbar multifidus muscles in patients with chronic low back pain (LBP) at rest and during contractions facilitated by PNF patterns by ultrasound imaging. [Subjects] The subjects were 15 (4 males, 11 females) who had chronic LBP on one side for more than 6 months. [Methods] Subjects were asked to lie on their sides with the painful side facing up. They then rested or received a front or backward lower pelvic pattern of PNF treatment. The cross-sectional area of the multifidus muscle was measured twice using ultrasonography. [Results] The intraclass correlation coefficient of the cross-sectional area of the multifidus muscle measured by ultrasonography was excellent. [Conclusion] Our results show that measurement with ultrasound imaging can be used in the treatment of LBP as an objective assessment.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 26
IS – 10
PG – 1539-1541
SP – 1539
EP – 1541
AN – 25364106
DO – 10.1589/jpts.26.1539
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=25364106&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Original article: Abdominal muscle recruitment during a range of voluntary exercises
A1 – Urquhart, Donna M.
A1 – Hodges, Paul W.
A1 – Allen, Trevor J.
A1 – Story, Ian H.
Y1 – 2005///
PD – 1/1/2005///
AB – Various exercises are used to retrain the abdominal muscles in the management of low back pain and other musculoskeletal disorders. However, few studies have directly investigated the activity of all the abdominal muscles or the recruitment of regions of the abdominal muscles during these manoeuvres. This study examined the activity of different regions of transversus abdominis (TrA), obliquus internus (OI) and externus abdominis (OE), and rectus abdominis (RA), and movement of the lumbar spine, pelvis and abdomen during inward movement of the lower abdominal wall, abdominal bracing, pelvic tilting, and inward movement of the lower and upper abdominal wall. Inward movement of the lower abdominal wall in supine produced greater activity of TrA compared to OI, OE and RA. During posterior pelvic tilting, middle OI was most active and with abdominal bracing, OE was predominately recruited. Regions of TrA were recruited differentially and an inverse relationship between lumbopelvic motion and TrA electromyography (EMG) was found. This study indicates that inward movement of the lower abdominal wall in supine produces the most independent activity of TrA relative to the other abdominal muscles, recruitment varies between regions of TrA, and observation of abdominal and lumbopelvic motion may assist in evaluation of exercise performance.
JO – Manual Therapy
PB – Elsevier Ltd
CY –
VL – 10
IS –
PG – 144-153
SP – 144
EP – 153
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1356689X04000864&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Diagnostic paraspinal musculoskeletal ultrasonography.
A1 – Robert G. Schwartz
A1 – James Rohan
A1 – Frank Hayden
Y1 – 1999///
PD – 01//
AB – Debate has developed with respect to the use of diagnostic musculoskeletal ultrasound for inflammatory disorders of the nerve root or spinal facets. This discussion has shifted the focus from less controversial aspects of spinal diagnostic ultrasonography including measurement of spinal canal diameter, paraspinal muscle evaluation, and monitoring of intraoperative spinal decompression. This paper will review the literature with respect to the above, and present a supporting argument for the use of diagnostic musculoskeletal ultrasonography in the evaluation of paraspinal conditions involving ligamentous or muscular strain. A clinical study will be presented where images are correlated to magnetic resonance imaging (MRI), and a case report will be presented. ABSTRACT FROM AUTHOR
JO – Journal of Back & Musculoskeletal Rehabilitation
PB –
CY –
VL – 12
IS – 1
PG – 25
SP – 25
EP –
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=5031766&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – The effects of pelvic diagonal movements and resistance on the lumbar multifidus.
A1 – Lee, Ji-Yeon
A1 – Lee, Dong-Yeop
A1 – Hong, Ji-Heon
A1 – Yu, Jae-Ho
A1 – Kim, Jin Seop
Y1 – 2017///
PD – 03
AB – [Purpose] The purpose of this study was to compare the effects of pelvic diagonal movements, made with and without resistance, on the thickness of lumbar multifidus muscles. [Subjects and Methods] Participants in this study were healthy subjects who had no musculoskeletal disorders or lumbar-related pain. Participants were positioned on their side and instructed to lie with their hip flexor at 40 degrees. Ultrasonography was used for measurement, and the values of two calculations were averaged. [Results] The thickness of ipsilateral lumbar multifidus muscles showed a significant difference following the exercise of pelvic diagonal movements. The results of anterior elevation movements and posterior depression movements also demonstrated significant difference. There was no significant difference in lumbar multifidus muscles thickness between movements made with and without resistance. [Conclusion] These findings suggest that pelvic diagonal movements can be an effective method to promote muscular activation of the ipsilateral multifidus. Furthermore, researchers have concluded that resistance is not required during pelvic diagonal movements to selectively activate the core muscles.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 29
IS – 3
PG – 539-542
SP – 539
EP – 542
AN – 28356650
DO – 10.1589/jpts.29.539
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=28356650&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Original article: The response of the transverse abdominis and internal oblique muscles to different postures
A1 – Ainscough-Potts, Anne-Marie
A1 – Morrissey, Matthew C
A1 – Critchley, Duncan
Y1 – 2006///
PD – 1/1/2006///
AB – The purpose of this study was to consider how the deep abdominal muscles responded to alterations in seated stability. The thickness of the right transverse abdominis (TrA) and internal oblique (IO) muscles were measured with ultrasound imaging in 30 healthy human subjects (mean age 27.7, years 22 females) in supine lying, relaxed sitting on a chair with both feet on the ground, relaxed sitting on a gym ball with both feet on the ground and sitting on a gym ball lifting the left foot off the floor. Measurements were taken at the end of both inspiration and expiration. The results showed that muscle thickness expressed as a percentage of the actual muscle thickness in supine lying did not differ between relaxed sitting on a chair and sitting on a gym ball for either muscle (P=0.012–0.054) where Bonferroni corrected P-value for significance=0.002. Raising the foot off the floor produced a significant increase in thickness for TrA and IO, when compared with the other seated postures (P<0.001). It was also found that both muscles were thicker at the end of expiration (P<0.001) which has also been established by other authors. These findings suggest that both deep abdominal muscles respond in the same way to postural changes. It also demonstrates that these muscles are automatically targeted by significantly decreasing the base of support, but in normal subjects sitting on a gym ball is not sufficient to increase their activity. JO – Manual Therapy PB – Elsevier Ltd CY – VL – 11 IS – PG – 54-60 SP – 54 EP – 60 AN – DO – UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1356689X05000391&lang=es&site=eds-live NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Ultrasound transducer shape has no effect on measurements of lumbar multifidus muscle size. A1 – Worsley, Peter R. A1 – Smith, Nicholas A1 – Warner, Martin B. A1 – Stokes, Maria Y1 – 2012/// PD – 04// AB – Abstract: Objective: Evidence is currently lacking for guidance on ultrasound transducer configuration (shape) when imaging muscle to measure its size. This study compared measurements made of lumbar multifidus on images obtained using curvilinear and linear transducers. Method: Fifteen asymptomatic males (aged 21–32 years) had their right lumbar multifidus imaged at L3. Two transverse images were taken with two transducers (5 MHz curvilinear and 6 MHz linear), and linear and cross-sectional area (CSA) measurements were made off-line. Reliability of image interpretation was shown using intra-class correlation coefficients (0.78–0.99). Muscle measurements were compared between transducers using Bland and Altman plots and paired t-tests. Relationships between CSA and linear measurements were examined using Pearson”s Correlation Coefficients. Results: There were no significant differences (p > 0.05) in the measurements of the two transducers. Thickness and CSA measurements had small differences between transducers, with mean differences of 0.01 cm (SDdiff = 0.21 cm) and 0.03 cm2 (SDdiff = 0.58 cm2) respectively. Width measures had a mean difference of 0.14 cm, with the linear transducer giving larger measures. Significant correlations (p < 0.001) were found between all linear measures and CSA, with both transducers (r = 0.78–0.89). Conclusion: Measurements of multifidus at L3 were not influenced by the configuration of transducers of similar frequency. For the purposes of image interpretation, the curvilinear transducer produced better definition of the lateral muscle border, suggesting it as the preferable transducer for imaging lumbar multifidus.
JO – Manual Therapy
PB – Elsevier B.V.
CY – New York, New York
VL – 17
IS – 2
PG – 187-191
SP – 187
EP – 191
AN –
DO – 10.1016/j.math.2011.07.001
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104522268&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Diaphragm breathing movement measurement using ultrasound and radiographic imaging: a concurrent validity.
A1 – Noh, Dong K
A1 – Lee, Jae J
A1 – You, Joshua H
Y1 – 2014///
PD –
AB – Recent ultrasound imaging evidence asserts that the diaphragm is an important multifunctional muscle to control breathing as well as stabilize the core and posture in humans. However, the validity and accuracy of ultrasound for the measurement of dynamic diaphragm movements during breathing and functional core activities have not been determined. The specific aim of this study was to validate the accuracy of ultrasound imaging measurements of diaphragm movements by concurrently comparing these measurements to the gold standard of radiographic imaging measurements. A total of 14 asymptomatic adults (9 males, 5 females; mean age =28.4 ± 3.0 years) were recruited to participate in the study. Ultrasound and radiographic images were used concurrently to determine diaphragm movement (inspiration, expiration, and excursion) during tidal breathing. Pearson correlation analysis showed strong correlations, ranging from r=0.78 to r=0.83, between ultrasound and radiographic imaging measurements of the diaphragm during inhalation, exhalation, and excursion. These findings suggest that ultrasound imaging measurement is useful to accurately evaluate diaphragm movements during tidal breathing. Clinically, ultrasound imaging measurements can be used to diagnose and treat diaphragm movement impairments in individuals with neuromuscular disorders including spinal cord injuries, stroke, and multiple sclerosis.;
JO – Bio-Medical Materials And Engineering
PB – IOS Press
CY – Netherlands
VL – 24
IS – 1
PG – 947-952
SP – 947
EP – 952
AN – 24211983
DO – 10.3233/BME-130889
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=24211983&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Effects of core stability exercises on multifidus muscles in healthy women and women with chronic low-back pain.
A1 – Kliziene, Irina
A1 – Sipaviciene, Saule
A1 – Klizas, Sarunas
A1 – Imbrasiene, Daiva
Y1 – 2015///
PD – 10//
AB – The article presents a study that investigates the effects of core stabilization exercises on multifidus muscles in healthy women and women with chronic low-back pain (LPB). It notes that decreased lumbar multifidus muscle cross-sectional area (CSA) is maybe related to LPB which was measured by ultrasonography. It is suggested that lumbar stabilization training is beneficial to both women.
JO – Journal of Back & Musculoskeletal Rehabilitation
PB –
CY –
VL – 28
IS – 4
PG – 841-847
SP – 841
EP – 847
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=111946901&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Research report: Abdominal Muscle Function in Chronic Low Back Pain Patients. Measurement with real-time ultrasound scanning
A1 – Critchley, Duncan J
A1 – Coutts, Fiona J
Y1 – 2002///
PD – 1/1/2002///
AB – Conclusion Real-time ultrasound scanning is potentially a practical means of quantifying transversus abdominis performance. A transversus abdominis dysfunction may occur in many chronic low back pain patients and its assessment and rehabilitation should be considered in these people. The validity of using thickness change as a measure of muscle function, the correlation of transversus abdominis dysfunction with other clinical features and the effect of specific retraining all require further investigation.
JO – Physiotherapy
PB – Elsevier Ltd
CY –
VL – 88
IS –
PG – 322-332
SP – 322
EP – 332
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S0031940605607456&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Original research: The relationship between the piriformis muscle, low back pain, lower limb injuries and motor control training among elite football players
A1 – Leung, Felix T.
A1 – Mendis, M. Dilani
A1 – Stanton, Warren R.
A1 – Hides, Julie A.
Y1 – 2015///
PD – //
AB – Conclusions Piriformis muscle size increases across the season in elite AFL players and is affected by the presence of LBP and lower limb injury. Motor control training positively affects piriformis muscle size in players with LBP.
JO – Journal of Science and Medicine in Sport
PB – Elsevier Ltd
CY –
VL – 18
IS –
PG – 407-411
SP – 407
EP – 411
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1440244014001224&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – EFFECT OF CORE STABILITY EXERCISE ON CROSS-SECTIONAL AREA OF LUMBAR MULTIFIDUS MUSCLE AND PHYSICAL CAPACITY. / STUBURO STABILIZAVIMO PRATIMŲ POVEIKIS DAUGINIO RAUMENS SKERSPJŪVIO PLOTO IR FIZINIO PAJĖGUMO KAITAI.
A1 – Klizienė, Irina
A1 – Sipavičienė, Saulė
A1 – Imbrasienė, Daiva
A1 – Klizas, Šarūnas
A1 – Inokaitis, Hermanas
Y1 – 2011///
PD – 11//
AB – Research background and hypothesis. Our research novelty was the validation of the use of the method of Ultrasound Imaging to measure the changes in the size of the cross-sectional area (CSA) of the multifidus muscle, performing exercises for lumbar stability. Stabilization exercises have been designed in order to enhance the neuromuscular control system correct the dysfunction. Research aim. The purpose of this study was to establish the effect of core stability exercise for cross-sectional area of lumbar multifidus muscle and physical capacity for elderly women. Research methods. The elderly women (n = 22) were in occupations involving light or no manual work and did not take part in sports. CSA of the multifidus muscle was measured from L2 to L5 vertebral segments. These measures were taken with ultrasound „TITAN™™” (SonoSite, USA). For the assessment of physical capacity we estimated the women’s static strength endurance of back muscles and dynamic strength endurance of abdominal muscles. The tests were done three times: the first testing occurred before exercises for training lumbar stability, the second – after four months, and the third – after eight months of applying exercises for training lumbar stability. Research results. The results of study showed that after eight months of stability exercises, the subjects had significantly larger right side multifidus CSA than before practice – 9.01 ± 1.1, the left side of the lumbar multifidus muscle was 8.23 ± 0.9 (p < 0.05). After the evaluation of physical capacity we revealed that after eight moths it was 97.6 ± 2.8 s (very good), compared to the values before the research (25.4 ± 9.2) (p < 0.05). Discussion and conclusions. After the core stabilization exercise program multifidus CSA values were significantly larger than before practice, multifidus muscle asymmetry decreased. Physical activity programs adapted to the elderly women increased their physical capacities. ABSTRACT FROM AUTHOR
JO – Education. Physical Training. Sport
PB –
CY –
VL – 83
IS – 4
PG – 9-15
SP – 9
EP – 15
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=69691346&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Using ultrasound to assess the thickness of the transversus abdominis in a sling exercise.
A1 – Lükens, Jörn
A1 – Boström, Kim J
A1 – Puta, Christian
A1 – Schulte, Tobias L
A1 – Wagner, Heiko
Y1 – 2015///
PD – 08/19
AB – Background: Activation of the deep stabilizing trunk muscle transversus abdominis (TrA) is important for trunk stabilization and spine stability. Sling exercises are used for the activation of trunk muscles, therefore we determined the thickness of the TrA in a standardized sling exercise in comparison to rest and abdominal press. Furthermore we propose a standardized measurement method, which can be used to compare relative muscle thickness levels in different exercises.; Methods: The main objective of the study was to assess and to compare the thickness of the TrA during different conditions; resting condition, sling exercise condition (non-voluntary contraction), and abdominal press condition (voluntary contraction) using a non-invasive ultrasound-based measurement method. Ultrasound measurement (USM; 8.9 MHz, B-mode) was employed to measure the thickness of the TrA in twenty healthy volunteers (13 m, 7 f), each one measured three times with breaks of 48 h. On each measurement day, the subjects were measured on three different conditions: resting condition (RC), sling condition (SC), and abdominal press condition (APC). The USM images were analyzed using a custom-made MatLab script, to determine the thickness of the TrA.; Results: A two-way repeated-measurements ANOVA was performed with a significant effect of the factor condition [F(2,38) = 47.82, p < 0.0001, η(2) = 0.72], no significant effect of the factor time [F(2.38) = 2.45, p = 0.1, η(2) = 0.11], and no significant interaction effect [F(4,76) = 0.315, p = 0.867, η(2) = 0.02]. Statistically corrected post-hoc t-tests revealed significant differences in TrA thickness showing that RC < SC (p < 0.001; η(2) = 0.19; d = 0.96), SC < APC (p < 0.0001; η(2) = 0.23; d = 1.10), RC < APC (p < 0.0001; η(2) = 0.53; d = 2.11). As for the test-retest reliability the intra-class correlation coefficient (ICC) yielded a value of 0.71, 0.54, and 0.29, on the conditions RC, SC, and APC, respectively.; Conclusions: We showed that the investigated sling exercise can be used to significantly increase the TrA thickness, and that the TrA thickness was significantly different on the three conditions (RC, SC, APC) using the ultrasound-based method.;
JO – BMC Musculoskeletal Disorders
PB – BioMed Central
CY – England
VL – 16
IS –
PG – 203-203
SP – 203
EP – 203
AN – 26286595
DO – 10.1186/s12891-015-0674-3
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=26286595&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Original Article: Effects of posture on the thickness of transversus abdominis in pain-free subjects
A1 – Reeve, Angelica
A1 – Dilley, Andrew
Y1 – 2009///
PD – 1/1/2009///
AB – The role of transversus abdominis (TrA) on spinal stability may be important in low back pain (LBP). To date, there have not been any investigations into the influence of lumbo-pelvic neutral posture on TrA activity. The present study therefore examines whether posture influences TrA thickness. A normative within-subjects single-group study was carried out. Twenty healthy adults were recruited and taught five postures: (1) supine lying; (2) erect sitting (lumbo-pelvic neutral); (3) slouched sitting; (4) erect standing (lumbo-pelvic neutral); (5) sway-back standing. In each position, TrA thickness was measured (as an indirect measure of muscle activity) using ultrasound. In erect standing, TrA (mean TrA thickness: 4.63±1.35mm) was significantly thicker than in sway-back standing (mean TrA thickness: 3.32±0.95mm) (p=00001). Similarly, in erect sitting TrA (mean thickness=4.30mm±1.58mm) was found to be significantly thicker than in slouched sitting (mean thickness=3.46mm±1.13mm) (p=0002). In conclusion, lumbo-pelvic neutral postures may have a positive influence on spinal stability compared to equivalent poor postures (slouched sitting and sway-back standing) through the recruitment of TrA. Therefore, posture may be important for rehabilitation in patients with LBP.
JO – Manual Therapy
PB – Elsevier Ltd
CY –
VL – 14
IS –
PG – 679-684
SP – 679
EP – 684
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1356689X09000460&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Relationship of moderate and low isometric lumbar extension through architectural and muscular activity variables: a cross sectional study.
A1 – Cuesta-Vargas, Antonio I
A1 – Gonzalez-Sanchez, Manuel
Y1 – 2013///
PD – 11/19
AB – Background: No study relating the changes obtained in the architecture of erector spinae (ES) muscle were registered with ultrasound and different intensities of muscle contraction recorded by surface EMG (electromyography) on the ES muscle was found. The aim of this study was analyse the relationship in the response of the ES muscle during isometric moderate and light lumbar isometric extension considering architecture and functional muscle variables.; Methods: Cross-sectional study. 46 subjects (52% men) with a group mean age of 30.4 (±7.78). The participants developed isometric lumbar extension while performing moderate and low isometric trunk and hip extension in a sitting position with hips flexed 90 degrees and the lumbar spine in neutral position. During these measurements, electromyography recordings and ultrasound images were taken bilaterally. Bilaterally pennation angle, muscle thickness, torque and muscle activation were measured. This study was developed at the human movement analysis laboratory of the Health Science Faculty of the University of Malaga (Spain).; Results: Strong and moderate correlations were found at moderate and low intensities contraction between the variable of the same intensity, with correlation values ranging from 0.726 (Torque Moderate – EMG Left Moderate) to 0.923 (Angle Left Light – Angle Right Light) (p < 0.001). This correlation is observed between the variables that describe the same intensity of contraction, showing a poor correlation between variables of different intensities.; Conclusion: There is a strong relationship between architecture and function variables of ES muscle when describe an isometric lumbar extension at light or moderate intensity.;
JO – BMC Medical Imaging
PB – BioMed Central
CY – England
VL – 13
IS –
PG – 38-38
SP – 38
EP – 38
AN – 24252273
DO – 10.1186/1471-2342-13-38
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=24252273&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – ULTRASOUND IMAGING MEASUREMENT OF THE TRANSVERSUS ABDOMINIS IN SUPINE, STANDING, AND UNDER LOADING: A RELIABILITY STUDY OF NOVICE EXAMINERS.
A1 – Hoppes, Carrie W.
A1 – Sperier, Aubrey D.
A1 – Hopkins, Colleen F.
A1 – Griffiths, Bridgette D.
A1 – Principe, Molly F.
A1 – Schnall, Barri L.
A1 – Bell, Johanna C.
A1 – Koppenhaver, Shane L.
Y1 – 2015///
PD – 11//
AB – Background: Military personnel and first responders (police and firefighters) often carry large amounts of gear. This increased load can negatively affect posture and lead to back pain. The ability to quantitatively measure muscle thickness under loading would be valuable to clinicians to assess the effectiveness of core stabilization treatment programs and could aid in return to work decisions. Ultrasound imaging (USI) has the potential to provide such a measure, but to be useful it must be reliable. Purpose: To assess the intrarater and interrater reliability of measurements of transversus abdominis (TrA) and internal oblique (IO) muscle thickness conducted by novice examiners using USI in supine, standing, and with an axial load. Study Design: Prospective, test-retest study Methods: Healthy, active duty military (N = 33) personnel were examined by two physical therapy doctoral students (primary and secondary ultrasound technicians) without prior experience in USI. Thickness measurements of the TrA and IO muscles were performed at rest and during a contraction to preferentially activate the TrA in three positions (hook-lying, standing, and standing with body armor). Percent thickness changes and intraclass correlation coefficients (ICC) were calculated. Results: Using the mean of three measurements for each of the three positions in resting and contracted muscle states, the intrarater ICC (3,3) values ranged from 0.90 to 0.98. The interrater ICC (2,1) values ranged from 0.39 to 0.79. The ICC values of percent thickness changes were lower than the individual ICC values for all positions and muscle states. Conclusion: There is excellent intrarater reliability of novice ultrasound technicians measuring abdominal muscle thickness using USI in three positions during the resting and contracted muscle states. However, interrater reliability of two novice technicians was poor to fair, so additional training and experience may be necessary to improve reliability. ABSTRACT FROM AUTHOR
JO – International Journal of Sports Physical Therapy
PB –
CY –
VL – 10
IS – 6
PG – 910-917
SP – 910
EP – 917
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=119252102&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Original article: Quantification of Dry Needling and Posture Effects on Myofascial Trigger Points Using Ultrasound Shear-Wave Elastography
A1 – Maher, Ruth M.
A1 – Hayes, Dawn M.
A1 – Shinohara, Minoru
Y1 – 2013///
PD – //
AB – Conclusions The shear modulus measured with ultrasound SWE reduced after DN and in the prone position compared with sitting, in agreement with reductions in palpable stiffness. These findings suggest that DN and posture have significant effects on the shear modulus of MTrPs, and that shear modulus measurement with ultrasound SWE may be sensitive enough to detect these effects.
JO – Archives of Physical Medicine and Rehabilitation
PB – Elsevier Inc.
CY –
VL – 94
IS –
PG – 2146-2150
SP – 2146
EP – 2150
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S000399931300364X&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Changes in multifidus and abdominal muscle size in response to microgravity: possible implications for low back pain research.
A1 – Hides, J A
A1 – Lambrecht, G
A1 – Stanton, W R
A1 – Damann, V
Y1 – 2016///
PD – 05
AB – Purpose: In microgravity, muscle atrophy occurs in the intrinsic muscles of the spine, with changes also observed in the abdominal muscles. Exercises are undertaken on the International Space Station and on Earth following space flight to remediate these effects. Similar effects have been seen on Earth in prolonged bed rest studies and in people with low back pain (LBP). The aim of this case report was to examine the effects of microgravity, exercise in microgravity and post-flight rehabilitation on the size of the multifidus and antero-lateral abdominal muscles.; Methods: Ultrasound imaging was used to assess size of the multifidus, transversus abdominis and internal oblique muscles at four time points: pre-flight and after daily rehabilitation on day one (R + 1), day 8 (R + 8) and day 14 (R + 14) after return to Earth (following 6 months in microgravity).; Results: Exercises in microgravity maintained multifidus size at L2-L4, however, after spaceflight, size of the multifidus muscle at L5 was reduced, size of the internal oblique muscle was increased and size of transversus abdominis was reduced. Rehabilitation post-space flight resulted in hypertrophy of the multifidus muscle to pre-mission size at the L5 vertebral level and restoration of antero-lateral abdominal muscle size.; Conclusions: Exercise in space can prevent loss of spinal intrinsic muscle size. For the multifidus muscles, effectiveness varied at different levels of the spine. Post-mission rehabilitation targeting specific motor control restored muscle balance between the antero-lateral abdominal and multifidus muscles, similar to results from intervention trials for people with LBP. A limitation of the current investigation is that only one astronaut was studied, however, the microgravity model could be valuable as predictable effects on trunk muscles can be induced and interventions evaluated. Level of Evidence Case series.;
JO – European Spine Journal: Official Publication Of The European Spine Society, The European Spinal Deformity Society, And The European Section Of The Cervical Spine Research Society
PB – Springer-Verlag
CY – Germany
VL – 25 Suppl 1
IS –
PG – 175-182
SP – 175
EP – 182
AN – 26582165
DO – 10.1007/s00586-015-4311-5
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=26582165&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – 超音波画像診断装置を用いた姿勢別体幹筋筋厚の変化. / Changes in Muscle Thicknesses of the Trunk Muscles with Posture.
A1 – 遠藤 佳章
A1 – 小野田 公
A1 – 久保 晃
Y1 – 2017///
PD – 08//
AB – [Purpose] The purpose of this study was to examine how multiple local muscles work in different postures. [Subjects and Methods] The subjects were 28 healthy young men (mean age: 22.4±1.9 years old). Muscle thicknesses of the right side of the second and fifth lumbar multifidus [LM(L2), LM(L5)], erector spinae (ES), transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles were evaluated in different postures using an ultrasound imaging system. [Results] The muscle thickness of LM(L2) significantly increased, the most in the recumbent position and the least in the standing position. The muscle thickness of LM(L5) significantly increased, the most in the standing position. The muscle thicknesses of ES, TrA, and IO significantly increased, more in the sitting and standing positions than in the recumbent position. However, there were no significant changes in the muscle thickness of EO. [Conclusions] The results suggest that each trunk muscle has individual characteristics of trunk muscle thickness variation with changes in posture. ABSTRACT FROM AUTHOR
JO – Rigakuryoho Kagaku
PB –
CY –
VL – 32
IS – 4
PG – 527-530
SP – 527
EP – 530
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=124845709&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects
A1 – Hides, Julie
A1 – Gilmore, Craig
A1 – Stanton, Warren
A1 – Bohlscheid, Emma
Y1 – 2008///
PD – 1/1/2008///
AB – Previous studies have provided evidence of multifidus muscle atrophy in people with low back pain (LBP). In cases of acute LBP, these studies have shown that the pattern of atrophy is both vertebral level and side specific. For chronic LBP, there are conflicting reports about the extent and location of muscle atrophy. The purpose of this study was to compare chronic LBP patients and asymptomatic subjects on measures of multifidus size (cross-sectional area; CSA) and symmetry (proportional difference of relatively larger side to smaller side). Data were obtained from 40 asymptomatic subjects without a prior history of LBP (13 females, 27 males), and a retrospective audit was undertaken of records from 50 chronic low back pain patients (27 females, 23 males) presenting to a back pain clinic. Results of the analysis showed that chronic LBP patients had significantly smaller multifidus CSAs than asymptomatic subjects at the lowest two vertebral levels. Males were found to have significantly larger multifidus CSAs than females at all vertebral levels except L5, the most common symptomatic level as determined by manual examination. The greatest asymmetry between sides was seen at the L5 vertebral level in patients with unilateral pain presentations. The smaller multifidus CSA was ipsilateral to the reported side of pain in all cases. The results of this study support previous findings that the pattern of multifidus muscle atrophy in chronic LBP patients is localized rather than generalized. Furthermore, between side asymmetry may be seen in chronic LBP patients presenting with a unilateral pain distribution.
JO – Manual Therapy
PB – Elsevier Ltd
CY –
VL – 13
IS –
PG – 43-49
SP – 43
EP – 49
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1356689X06001317&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Original research: Reproducibility of Ultrasound Measurement of Transversus Abdominis During Loaded, Functional Tasks in Asymptomatic Young Adults
A1 – McPherson, Sue L.
A1 – Watson, Todd
Y1 – 2012///
PD – //
AB – Conclusions This study produced acceptable reproducibility of USI measures of TrA during loaded functional activities.
JO – PM&R
PB – Elsevier Inc.
CY –
VL – 4
IS –
PG – 402-412
SP – 402
EP – 412
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1934148212000792&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Original article: The Relationship of Transversus Abdominis and Lumbar Multifidus Activation and Prognostic Factors for Clinical Success With a Stabilization Exercise Program: A Cross-Sectional Study
A1 – Hebert, Jeffrey J.
A1 – Koppenhaver, Shane L.
A1 – Magel, John S.
A1 – Fritz, Julie M.
Y1 – 2010///
PD – 1/1/2010///
AB – Conclusions Decreased LM muscle activation, but not TrA muscle activation, is associated with the presence of factors predictive of clinical success with a stabilization exercise program. Our findings provide researchers and clinicians with evidence regarding the construct validity of the prognostic factors examined in this study, as well as the potential clinical importance of the LM muscle as a target for stabilization exercises.
JO – Archives of Physical Medicine and Rehabilitation
PB – Elsevier Inc.
CY –
VL – 91
IS –
PG – 78-85
SP – 78
EP – 85
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S0003999309007540&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Original article: Ultrasound imaging of lumbar multifidus muscle: normal reference ranges for measurements and practical guidance on the technique
A1 – Stokes, M.
A1 – Rankin, G.
A1 – Newham, D.J.
Y1 – 2005///
PD – 1/1/2005///
AB – This cross-sectional, prospective study aimed to produce normal reference data for measurements of the lumbar multifidus muscle. A total of 120 subjects, 68 females (aged 20–64 years) and 52 males (20–69 years) were studied. Bilateral transverse ultrasound images were made of multifidus at the fourth and fifth lumbar vertebrae (L4 & L5). Cross-sectional area (CSA, cm2) and linear dimensions (AP, anteroposterior; Lat, lateral) were measured and the latter expressed as a ratio (AP/Lat) to reflect shape. Relationships between CSA and anthropometric measures were examined. Multifidus CSA was larger in males (P<0.001) and age had no effect. The CSA was larger at L5 than L4 (P<0.001) and highly correlated between the two levels (males r=0.82, females 0.80). Differences in muscle shape were observed for gender, age and vertebral level. Between-side symmetry was high for size but not shape (CSA <10% difference). Linear measurements multiplied (AP×Lat) correlated highly with CSA (all groups r⩾0.94, P<0.0001). The AP dimension was also acceptably predictive of CSA at L4 (r⩾0.79). There were no clinically useful correlations between CSA and anthropometric measures. These findings provide normal references ranges for objective assessment of lumbar multifidus. This paper also addresses specific practical issues when scanning multifidus. JO – Manual Therapy PB – Elsevier Ltd CY – VL – 10 IS – PG – 116-126 SP – 116 EP – 126 AN – DO – UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1356689X04000839&lang=es&site=eds-live NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Original research: Multifidus muscle size and symmetry among elite weightlifters A1 – Sitilertpisan, Patraporn A1 – Hides, Julie A1 – Stanton, Warren A1 – Paungmali, Aatit A1 – Pirunsan, Ubon Y1 – 2012/// PD – 1/1/2012/// AB – Conclusion This study provides new information on resting CSA for the LM muscle in elite weightlifters. Future studies could investigate other aspects of neuromotor control of the LM muscle to determine if there are impairments which could be addressed in an attempt to decrease the high prevalence of LBP in this population. JO – Physical Therapy in Sport PB – Elsevier Ltd CY – VL – 13 IS – PG – 11-15 SP – 11 EP – 15 AN – DO – UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1466853X11000411&lang=es&site=eds-live NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Reliability of Rehabilitative Ultrasound Imaging of the Lumbar Multifidus. A1 – Abiko, Teppei A1 – Takei, Hitoshi A1 – Shimamura, Ryota A1 – Abiko, Yoko A1 – Yamamoto, Junichiro A1 – Sakasai, Takayuki A1 – Soma, Masayuki A1 – Ogawa, Daisuke A1 – Yamaguchi, Toru A1 – Hata, Masafumi Y1 – 2011/// PD – 12// AB – [Purpose] The purpose of this study was to evaluate the intra-examiner reliability of rehabilitative ultrasound imaging (RUSI) in obtaining thickness measurements of the lumbar multifidus (LM) with intraclass correlation coefficients (ICC) and minimum detectable change (MDC). [Subjects] Ten healthy volunteers participated in the study. [Method] We measured thickness measurements of LM at 3 angles of pelvic tilt (moderate anterior-tilt, neutral position and moderate posterior-tilt) and different percentages of voluntary isometric contraction. The task was static muscle contraction of LM during pelvic anterior-tilt with nutation of the sacrum in a prone position on the edge of the bed and hanging subject’s legs. Thickness measurements of left LM were obtained by using RUSI during 2 sessions, 1 to 4 weeks apart. ICC and measurement error by 95% confidence intervals of MDC (MDC95) were used to estimate reliability. [Result] Intra-examiner reliability estimates ranged from 0.73-0.96 for same-day comparisons and from 0.67-0.93 for between-day comparisons, except for maximum effort in the neutral pelvic position. MDC95 of thickness measurements were 0.8-2.7 mm for same-day and 1.5-3.0 mm for between-day measurements. [Conclusion] We suggest that RUSI thickness measurements of LM are highly reliable at the 3 angles of pelvic tilt and different percentages of voluntary isometric contraction. ABSTRACT FROM AUTHOR JO – Rigakuryoho Kagaku PB – CY – VL – 26 IS – 5 PG – 693-697 SP – 693 EP – 697 AN – DO – UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=71939716&lang=es&site=eds-live NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – Original article: Use of ultrasound imaging by physiotherapists: A pilot study to survey use, skills and training A1 – Potter, Catherine L. A1 – Cairns, Mindy C. A1 – Stokes, Maria Y1 – 2012/// PD – 1/1/2012/// AB – Conclusions The development and piloting of the questionnaire provides a starting point for a more extensive evaluation of how USI is being used, the training needs of physiotherapists and benefits as a biofeedback tool. Refinement is needed and replication in a larger sample. Results could assist the development of a structured formal training framework encompassing key skills. JO – Manual Therapy PB – Elsevier Ltd CY – VL – 17 IS – PG – 39-46 SP – 39 EP – 46 AN – DO – UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1356689X11001482&lang=es&site=eds-live NS – N1 – Exclusion reason: 5.- Wrong study design; ER – TY – JOUR T1 – Immediate Changes in Resting and Contracted Thickness of Transversus Abdominis After Dry Needling of Lumbar Multifidus in Healthy Participants: A Randomized Controlled Crossover Trial A1 – Puentedura, Emilio J. A1 – Buckingham, Sarah J. A1 – Morton, Daniella A1 – Montoya, Crystal A1 – Fernandez de las Penas, Cesar Y1 – 2017/// PD – 6/20/// AB – Conclusion This study suggests that application of DN to LM was accompanied by a decreased resting thickness and an increased contraction thickness of the TrA in asymptomatic participants. JO – Journal of Manipulative and Physiological Therapeutics PB – Elsevier Inc. CY – VL – IS – PG – SP – EP – AN – DO – UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S0161475416302019&lang=es&site=eds-live NS – N1 – Exclusion reason: 7.- Wrong patient population; SAMUEL FERNANDEZ (2017-12-20 10:31:27)(Screen): The purpose of this study was to investigate changes in resting and/or contraction thickness of the transversus abdominis (TrA) muscle after dry needling (DN) of the lumbar multifidus (LM) in asymptomatic participants. METHODS: A randomized controlled laboratory trial with crossover design was performed. Forty-seven healthy individuals who had not experienced low back pain in the previous 6 months were randomly assigned to receive DN to the LM or a sham-DN intervention. Participants received both interventions separated at least 7 days apart. They were instructed on how to perform a concentric contraction of TrA. Resting and contraction thicknesses of the TrA were obtained through real-time ultrasound measurements before and immediately after each intervention by an assessor blinded to the intervention received. Data from 4 individuals had to be excluded because of poor image quality. RESULTS: Two-way analysis of variance revealed a significant contraction with treatment interaction (F[1,42] = 11.489; P = .002). Simple main effects using paired-samples t tests and a Bonferroni post hoc analysis revealed differences in contracted states of the TrA for DN vs sham-DN (P = .009) and between contracted and resting states for the DN group (P = .001): after DN, TrA thickness at rest exhibited a mean decrease of 0.03 cm and a mean increase of 0.05 cm during contraction. CONCLUSION: This study suggests that application of DN to LM was accompanied by a decreased resting thickness and an increased contraction thickness of the TrA in asymptomatic participants. ; ER – TY – JOUR T1 – Original Research: Ultrasound Measurement of Abdominal Muscle Thickness With and Without Transducer Fixation During Standing Postural Tasks in Participants With and Without Chronic Low Back Pain: Intrasession and Intersession Reliability A1 – Ehsani, Fatemeh A1 – Arab, Amir Massoud A1 – Salavati, Mahyar A1 – Jaberzadeh, Shapour A1 – Hajihasani, Abdolhamid Y1 – 2016/// PD – // AB – Level of Evidence III JO – PM&R PB – Elsevier Inc. CY – VL – 8 IS – PG – 1159-1167 SP – 1159 EP – 1167 AN – DO – UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1934148216301472&lang=es&site=eds-live NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – The effects of an 8-week stabilization exercise program on lumbar multifidus muscle thickness and activation as measured with ultrasound imaging in patients with low back pain: An exploratory study A1 – Larivière, Christian A1 – Gagnon, Dany H. A1 – Henry, Sharon M. A1 – Preuss, Richard A1 – Dumas, Jean-Pierre Y1 – 2017/// PD – 10/21/// AB – Conclusions Patients showed less muscle activation than controls at baseline (L5-S1 level), but the LSEP did not normalize this impairment. The links between RUSI measures and the change in clinical outcomes during LSEP should be further explored. JO – PM&R PB – Elsevier Inc. CY – VL – IS – PG – SP – EP – AN – DO – UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1934148216312874&lang=es&site=eds-live NS – N1 – Exclusion reason: 1.- Not randomised studies.; ER – TY – JOUR T1 – ULTRASOUND IMAGING OF THE DEEP ABDOMINAL MUSCLES DURING CORE STABILIZATION EXERCISES. (Abstract) A1 – Teyhen, D. A1 – Rieger, J. A1 – Westrick, R. A1 – Miller, A. A1 – Molloy, J. A1 – Wainner, R. A1 – Childs, J. Y1 – 2006/// PD – 01// AB – JO – Journal of Orthopaedic & Sports Physical Therapy PB – CY – ; VL – 36 IS – 1 PG – A16-A16 SP – A16 EP – A16 AN – DO – UR – http://www.apta.org/ NS – N1 – Exclusion reason: 4.- Abstracts from Congress, Symposium…; ER – TY – JOUR T1 – Effects of a core stability intervention programme on abdominal and lumbar muscle symmetry in elite high school cricketers. A1 – Aginsky K A1 – Lambert M A1 – Gray J A1 – Derman W Y1 – 2008/// PD – 06// AB – JO – British Journal of Sports Medicine PB – BMJ Publishing Group CY – VL – 42 IS – 6 PG – 492-492 SP – 492 EP – 492 AN – DO – UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=105662570&lang=es&site=eds-live NS – N1 – Exclusion reason: 4.- Abstracts from Congress, Symposium…; ER – TY – JOUR T1 – Deep abdominal muscle thickness measured under sitting conditions during different stability tasks. A1 – Nagai, Hideyuki A1 – Akasaka, Kiyokazu A1 – Otsudo, Takahiro A1 – Sawada, Yutaka A1 – Okubo, Yu Y1 – 2016/// PD – 03 AB – [Purpose] This study was conducted to investigate ultrasonically determined changes in the thickness of the transversus abdominis and internal oblique muscles during different sitting conditions. [Subjects and Methods] Twenty healthy men volunteered to participate in this study. Four different sitting conditions including (A) sitting, (B) sitting with left hip flexion, (C) sitting with an abdominal hollowing maneuver (AHM), and (D) sitting with an AHM and left hip flexion, were used. Subjective exercise difficulty was evaluated. [Results] Transversus abdominis and internal oblique muscle thicknesses significantly differed between conditions, with significantly greater thickness between positions from (A) to (D). Stability of the surface when sitting had no effect on the muscle thickness of the transversus abdominis. By contrast, sitting on an unstable surface caused an increase in muscle thickness of the internal oblique in each condition. The subjects reported progressively increasing difficulty in performing each exercise in a stable position from (A) to (D), while the difficulty in an unstable position was significantly different between (A) and (B), and between (C) and (D). [Conclusion] Our findings suggest that task (B) on a stable surface should be chosen for maximal activation of transversus abdominis without inducing overactivation of the internal oblique muscle.; JO – Journal Of Physical Therapy Science PB – Society of Physical Therapy Science CY – Japan VL – 28 IS – 3 PG – 900-905 SP – 900 EP – 905 AN – 27134381 DO – 10.1589/jpts.28.900 UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=27134381&lang=es&site=eds-live NS – N1 – Exclusion reason: 5.- Wrong study design; ER – TY – JOUR T1 – Is activation of transversus abdominis and obliquus internus abdominis associated with long-term changes in chronic low back pain? A prospective study with 1-year follow-up. A1 – Unsgaard-Tøndel M A1 – Lund Nilsen TI A1 – Magnussen J A1 – Vasseljen O Y1 – 2012/// PD – 08// AB – Objective To investigate associations between deep abdominal muscle activation and long-term pain outcome in chronic non-specific low back pain (LBP). Methods Recruitment of transversus abdominis and obliquus internus abdominis during the abdominal drawing-in manoeuvre was recorded by B-mode ultrasound and anticipatory onset of deep abdominal muscle activity with M-mode ultrasound. Recordings were done before and after 8 weeks with guided exercises for 109 patients with chronic non-specific LBP. Pain was assessed with a numeric rating scale (0-10) before and 1 year after intervention. Associations between muscle activation and long-term pain were examined by multiple linear and logistic regression methods. Results Participants with a combination of low baseline lateral slide in transversus abdominis and increased slide after intervention had better odds for long-term clinically important pain reduction (>=2 points on the numeric rating scale) compared with participants with small baseline slide and no improvement in slide (OR 14.70, 95% CI 2.41 to 89.56). There were no associations between contraction thickness ratios in transversus abdominis or obliquus internus abdominis and pain at 1-year follow-up. Transversus abdominis lateral slide before intervention was marginally associated with a lower OR for clinically important improvement in pain at 1-year follow-up (OR 0.76, 95% CI 0.62 to 0.93). Delayed onset of the abdominal muscles after the intervention period was weakly associated with higher long-term pain. Conclusion Improved transversus abdominis lateral slide among participants with low baseline slide was associated with clinically important long-term pain reduction. High baseline slide and delayed onset of abdominal muscles after the intervention period were weakly associated with higher pain at 1-year follow-up. Clinical Trial Registration number The study was preregistered in ClinicalTrials.gov with identifier NCT00201513.
JO – British Journal of Sports Medicine
PB – BMJ Publishing Group
CY –
VL – 46
IS – 10
PG – 729-734
SP – 729
EP – 734
AN –
DO – 10.1136/bjsm.2011.085506
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104359735&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Correlation between Peak Expiratory Flow and Abdominal Muscle Thickness.
A1 – Ishida, Hiroshi
A1 – Kobara, Kenichi
A1 – Osaka, Hiroshi
A1 – Suehiro, Tadanobu
A1 – Ito, Tomotaka
A1 – Kurozumi, Chiharu
A1 – Watanabe, Susumu
Y1 – 2014///
PD – 11
AB – [Purpose] The purpose of this study was to determine whether forced expiration is correlated with abdominal muscle thickness. [Subjects] Twenty-three healthy male volunteers participated in this study. [Methods] The peak expiratory flow (PEF) was obtained using a peak flow meter with subjects in the sitting position. The thicknesses of the right rectus abdominis, external oblique, internal oblique, and transverse abdominis muscles were measured using B-mode ultrasonography at the end of a relaxed expiration in the supine position. [Results] Among the abdominal muscles, only the thickness of the external oblique muscle displayed a significant correlation with PEF. [Conclusion] It appears that the thickness of the external oblique muscle might be associated with PEF during forced expiration.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 26
IS – 11
PG – 1791-1793
SP – 1791
EP – 1793
AN – 25435702
DO – 10.1589/jpts.26.1791
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=25435702&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Use of rehabilitative ultrasound imaging as biofeedback tool to facilitate performance of the abdominal-hollowing exercise.
A1 – Henry SM
Y1 – ///
PD –
AB –
JO – Journal of Orthopaedic & Sports Physical Therapy
PB – American Physical Therapy Association, Orthopaedic Section
CY – La Crosse, Wisconsin
VL – 36
IS – 8
PG – A-9
SP – A
EP – 9
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106349195&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Effects of different types of contraction in abdominal bracing on the asymmetry of left and right abdominal muscles.
A1 – Park, Sung-Hyun
A1 – Song, Min-Young
A1 – Park, Hyeon-Ji
A1 – Park, Ji-Hyun
A1 – Bae, Hyun-Young
A1 – Lim, Da-Som
Y1 – 2014///
PD – 12
AB – [Purpose] The purpose of this study was to investigate the effective strength levels of abdominal muscle contraction using the bracing contraction method. [Subjects] The experiment was conducted with 31 healthy male (M=15) and female (F=16) adults attending D University in Busan; all participants had less than obesity level BMI (BMI<30). [Methods] Bracing contraction was performed by the subjects in the hook-lying position at maximum and minimum pressure levels, five times each, using a Pressure Biofeedback Unit (PBU), and the mean measurement value was calculated. The maximum pressure level was set at 100% and the half maximum pressure level was set at 50%. Each subject’s left and right abdominal muscle thicknesses were then measured by ultrasound imaging in each state: at rest, 100% contraction, and 50% contraction. [Results] No significant differences were found between the left and right sides of the transversus abdominis (TrA) at rest, 50%, or 100% contraction. The external oblique abdominis (EO) and internal oblique abdominis (IO) showed no significant difference at rest or at the 50% contraction. However, a significant difference was noted at 100% contraction for the EO and IO. [Conclusion] Application of abdominal contraction using bracing can achieve symmetry in the left and right abdominal muscles at less than the maximum contractile strength. The occurrence of asymmetry in the left and right abdominal muscles at the maximum contractile strength suggests that the most suitable contractile strength in this exercise is less than the maximum contractile strength.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 26
IS – 12
PG – 1843-1845
SP – 1843
EP – 1845
AN – 25540478
DO – 10.1589/jpts.26.1843
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=25540478&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Effects of selective exercise for the deep abdominal muscles and lumbar stabilization exercise on the thickness of the transversus abdominis and postural maintenance.
A1 – Lee, Jung-Seok
A1 – Kim, Tae-Ho
A1 – Kim, Da-Yeon
A1 – Shim, Jae-Ho
A1 – Lim, Jin-Yong
Y1 – 2015///
PD – 02
AB – [Purpose] The purpose of this study was to examine the effects of selective exercise for the deep abdominal muscles (SEDA) and lumbar stabilization exercise (LSE) on the thickness of the transversus abdominis and postural maintenance on an unstable base of support. [Subjects and Methods] The subjects of this study were 20 male and 10 female adults in their 20s without lumbar pain. They were equally and randomly assigned to a SEDA group and a LSE group. The thickness of the transversus abdominis was measured using ultrasound imaging during rest and drawing-in. The thickness of the transversus abdominis was measured when subjects raised their right and left legs while lying on a Swiss ball. [Results] Initially, there were no differences between the two groups. After the intervention, significant differences were observed in all parameters. A significant interaction between group and period was not found for any parameters. [Conclusion] In conclusion, both SEDA and LSE thickened the transversus abdominis, which is a deep abdominal muscle, thereby adjusting posture, and stabilizing the trunk. These exercises increased the thickness of the deep abdominal muscles. They are important exercises for improving the stability of athletes or patients who need postural adjustment.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 27
IS – 2
PG – 367-370
SP – 367
EP – 370
AN – 25729169
DO – 10.1589/jpts.27.367
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=25729169&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 7.- Wrong patient population;
ER –

TY – JOUR
T1 – Reliability of ultrasound in combination with surface electromyogram for evaluating the activity of abdominal muscles in individuals with and without low back pain.
A1 – Yang, Kyung-Hye
A1 – Park, Du-Jin
Y1 – 2014///
PD – 08/31
AB – This study investigated the reliability of ultrasound in combination with surface electromyogram (EMG) for evaluating the activity of the abdominal muscles in individuals with and without low back pain during the abdominal drawing-in maneuver (ADIM). The study recruited ten individuals with or without low back pain, respectively. While the participants were performing the ADIM, the activities of the transversus abdominis (TrA) and the internal oblique (IO) were measured using ultra-sound, while the activities of the external oblique (EO) and the rectus abdominis (RA) were measured using surface EMG. Intra-class correlation coefficients (ICC) were used to verify the inter-rater reliability of ultrasound in combination with surface EMG at rest and during the ADIM, and Bland-Altman plots were used to verify intra-rater reliability. The inter-rater reliability for the two groups at rest and during the ADIM was excellent (ICC2,1 = 0.77-0.95). In the Bland-Altman plots, the mean differences and 95% limits of agreement in the abdominal muscles of the two groups at rest were -0.03∼0.03 mm (-0.66 to 0.60 mm) and -0.12∼ -0.05 (-0.58 to 0.48% MVIC), respectively. The mean differences and 95% limits of agreement in the abdominal muscles of the two groups during the ADIM were -0.04∼0.02 mm (-0.73 to 0.65 mm) and -0.19∼0.05% MVIC (-1.24 to 1.34% MVIC), respectively. The ultrasound in combination with surface EMG showed excellent inter-rater and intra-rater reliability at rest and during the ADIM.;
JO – Journal Of Exercise Rehabilitation
PB – Korean Society of Exercise Rehabilitation
CY – Korea (South)
VL – 10
IS – 4
PG – 230-235
SP – 230
EP – 235
AN – 25210698
DO – 10.12965/jer.140113
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=25210698&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Increased sliding of transverse abdominis during contraction after myofascial release in patients with chronic low back pain.
A1 – Chen, Yen-Hua
A1 – Chai, Huei-Ming
A1 – Shau, Yio-Wha
A1 – Wang, Chung-Li
A1 – Wang, Shwu-Fen
Y1 – 2016///
PD – 06
AB – Purpose: Recent evidence suggested the significance of integrity of the tension balance of the muscle-fascia corset system in spinal stability, particularly the posterior musculofascial junction which is adjacent to dorsal located paraspinal muscles joining each other at lateral raphe (LR). The purpose of this study was to compare the contraction of the transversus abdominis (TrA) at both anterior and posterior musculofascial muscle-fascia junctions in patients with low back pain (LBP) and asymptomatic participants before and immediately after a sustained manual pressure to LR.; Methods: The present observational cohort study used a single-instance, test-retest design. The outcome variables included the resting thickness (Tr), the thickness during contraction (Tc), change in thickness (ΔT), sliding of musculofascial junction (ΔX), muscle length at rest (L) and displacement pattern (ΔD) of the TrA using ultrasonography. Vertical tolerable pressure at the LR was applied manual for 1 min. Tr, Tc, ΔT, and ΔX were analyzed by three-way ANOVA (musculofascial junction sites*group* pre-post manual release). ΔL and ΔD were analyzed by two-way ANOVA (group* pre-post manual release).; Results: Participants with LBP revealed less Tc, ΔT and ΔX at both sites (p < 0.005). After myofascial release, LBP group demonstrated a positive ΔD of the musculofascial junctions at both end (p < 0.001). Nevertheless, both groups increased the ΔT and ΔX at both sites (p < 0.001 and 0.001, respectively).; Conclusion: The result indicated immediately effect of sustained manual pressure on musculofascial junction of TrA and supported the concept that the possible imbalanced tension of the myofascia corset of TrA in patients with LBP.; Copyright © 2015 Elsevier Ltd. All rights reserved.
JO – Manual Therapy
PB – Elsevier
CY – Scotland
VL – 23
IS –
PG – 69-75
SP – 69
EP – 75
AN – 26642754
DO – 10.1016/j.math.2015.10.004
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=26642754&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Comparison of the Thickness of Abdominal Muscles between Subjects With and Without Lumbar Pain Using Ultrasound Images.
A1 – Murakami, Takashi
A1 – Sakuraba, Keishoku
A1 – Nagai, Koichi
Y1 – 2010///
PD – 12/15/
AB – [Purpose] This study was performed to examine the correlation between lumbar pain and abdominal muscle thickness. [Subjects] The subjects were 64 males. [Methods] The subjects were divided into 3 groups based on the results of an interview about lumbar pain. Images of the transversus abdominis, internal abdominal oblique muscle, and external abdominal oblique muscle at rest were obtained using ultrasonography. [Results] The thickness of the transversus abdominis in the group of subjects who had visited a hospital for lumbar pain was less than other groups. [Conclusion] It was suggested that the experience of lumbar pain was related to a decrease in the thickness of the transversus abdominis at rest due to reduced muscular activity and an increase in the thickness of the internal and external abdominal oblique muscles at rest due to excessive muscular activity. ABSTRACT FROM AUTHOR
JO – Rigakuryoho Kagaku
PB –
CY –
VL – 25
IS – 6
PG – 893-897
SP – 893
EP – 897
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=60164355&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Individuals with chronic low back pain do not modulate the level of transversus abdominis muscle contraction across different postures.
A1 – Miura, Takuya
A1 – Yamanaka, Masanori
A1 – Ukishiro, Kengo
A1 – Tohyama, Harukazu
A1 – Saito, Hiroshi
A1 – Samukawa, Mina
A1 – Kobayashi, Takumi
A1 – Ino, Takumi
A1 – Takeda, Naoki
Y1 – 2014///
PD – 12
AB – The aim of this study was to evaluate the thickness of the transversus abdominis (TrA) muscle in three basic postures in subjects with and without chronic low back pain. Subjects were classified into a chronic low back pain group (n = 27) and a healthy control group (n = 23). The thickness of the TrA muscle was measured at rest and during the abdominal drawing-in manoeuvre (ADIM) in supine, sitting and standing postures using B-mode ultrasound imaging. Contraction ratio (TrA thickness during the ADIM/TrA thickness at rest) was calculated for each posture. At rest, the TrA thickness in the sitting and standing postures was significantly greater than in the supine posture (p < 0.017) in the control group, but similar in all three postures in the low back pain group. TrA thickness was similar in the low back pain and control group in all three postures. During the ADIM, TrA thickness was significantly greater in the control group than in the chronic low back pain group in all three postures. The contraction ratio was also significantly higher in the control group than in the chronic low back pain group in all three postures. These results indicate that the automatic postural contraction of the TrA observed in the control subjects in the sitting and standing postures was not demonstrated in subjects with chronic low back pain. The present study revealed the one aspect of different response of the TrA muscle to changing posture between two groups.; Copyright © 2014 Elsevier Ltd. All rights reserved.
JO – Manual Therapy
PB – Elsevier
CY – Scotland
VL – 19
IS – 6
PG – 534-540
SP – 534
EP – 540
AN – 25009124
DO – 10.1016/j.math.2014.05.010
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=25009124&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – The use of real-time ultrasound feedback in teaching abdominal hollowing exercises to healthy subjects.
A1 – Henry SM
A1 – Westervelt KC
Y1 – 2005///
PD – Jun
AB – STUDY DESIGN: Randomized controlled trial. OBJECTIVES: To determine if supplementing typical clinical instruction with real-time ultrasound feedback facilitates performance and retention of the abdominal hollowing exercise (AHE). BACKGROUND: Increasingly clinicians are using real-time ultrasound imaging as a form of feedback when teaching patients trunk stabilization exercises; however, there has been no justification for this practice. METHODS AND MEASURES: Forty-eight subjects were divided randomly into 3 groups that received different types of feedback: group 1 received minimal verbal feedback, group 2 received verbal and palpatory feedback, and group 3 received real-time ultrasound, verbal, and palpatory feedback. If the subject performed 3 consecutive correct AHEs during the initial session, she/he returned for a retention test. The performance of 3 consecutive, correct AHEs was the criterion measure; the number of trials to criterion was also recorded during the initial and retention test sessions. RESULTS: The ability to perform the AHE differed among groups (P<.001). During the initial session, 12.5% of subjects in group 1, 50.0% of subjects in group 2, and 87.5% of subjects in group 3 were able to perform 3 consecutive AHEs. Group 3 subjects achieved the criterion in fewer trials than the other 2 groups (P = .0006). No differences among groups were found for the retention testing; however, low power due to fewer subjects precluded a strong interpretation of this finding. CONCLUSION: Real-time ultrasound feedback can decrease the number of trials needed to consistently perform the AHE; however, the data are inconclusive with regard to retention of this skill.
JO – Journal of Orthopaedic & Sports Physical Therapy
PB – American Physical Therapy Association, Orthopaedic Section
CY – La Crosse, Wisconsin
VL – 35
IS – 6
PG – 338-345
SP – 338
EP – 345
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106497514&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 7.- Wrong patient population;
ER –

TY – JOUR
T1 – Applicability of ultrasonography for evaluating trunk muscle size: a pilot study.
A1 – Wachi, Michio
A1 – Suga, Tadashi
A1 – Higuchi, Takatoshi
A1 – Misaki, Jun
A1 – Tsuchikane, Ryo
A1 – Tanaka, Daichi
A1 – Miyake, Yuto
A1 – Isaka, Tadao
Y1 – 2017///
PD – 02
AB – [Purpose] Ultrasonography (US) is widely applied to measure the muscle size in the limbs, as it has relatively high portability and is associated with low costs compared with large clinical devices such as magnetic resonance imaging (MRI). However, the applicability of US for evaluating trunk muscle size is poorly understood. This study aimed to examine whether US-measured muscle thickness (MT) in the trunk abdominal and back muscles correlated with MT and muscle cross-sectional area (MCSA) measured by MRI. [Subjects and Methods] Twenty-four healthy young males participated in this study. The MT and MCSA in the subjects were measured by US and MRI in a total of 10 sites, including the bilateral sides of the rectus abdominis (upper, central, and lower parts), abdominal wall, and multifidus lumborum. [Results] The interclass correlation coefficients of US-measured MT on the total 10 sites showed excellent values (n=12, 0.919 to 0.970). The US-measured MT significantly correlated with the MRI-measured MT (r=0.753 to 0.963) and MCSA (r=0.634 to 0.821). [Conclusion] US-measured MT could represent a surrogate for muscle size measured by MRI. The application of US for evaluating trunk muscle size may be a useful tool in the clinical setting.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 29
IS – 2
PG – 245-249
SP – 245
EP – 249
AN – 28265150
DO – 10.1589/jpts.29.245
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=28265150&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Comparison of changes in the contraction of the lateral abdominal muscles between the abdominal drawing-in maneuver and breathe held at the maximum expiratory level.
A1 – Ishida, Hiroshi
A1 – Hirose, Ryohei
A1 – Watanabe, Susumu
Y1 – 2012///
PD – 10//
AB – Abstract: The abdominal drawing-in maneuver (ADIM) is commonly used as a fundamental component of lumbar stabilization training programs. One potential limitation of lumbar stabilization programs is that it can be difficult and time consuming to train people to perform the ADIM. The transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles are the most powerful muscles involved in expiration. However, little is known about the differences in the recruitment of the abdominal muscles between the ADIM and breathe held at maximum expiratory level (maximum expiration). The thickness of the TrA and IO muscles was measured by ultrasound imaging, and the activity of the EO muscle was measured by electromyography (EMG) in 33 healthy male performing the ADIM and maximum expiration. Maximum expiration produced a significant increase in the thickness of the TrA and IO muscles compared to the ADIM (p < 0.001). The EMG activity of the EO muscle was significantly higher during maximum expiration than during the ADIM (p < 0.001). The intensity of the EMG activity of the EO muscle was approximately 30% of the maximal voluntary contraction during maximum expiration. Thus, maximum expiration may be an effective method for training of co-activation of the lateral abdominal muscles.
JO – Manual Therapy
PB – Elsevier B.V.
CY – New York, New York
VL – 17
IS – 5
PG – 427-431
SP – 427
EP – 431
AN –
DO – 10.1016/j.math.2012.04.006
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104494955&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Comparison of changes in abdominal muscle thickness between standing and crook lying during active abdominal hollowing using ultrasound imaging.
A1 – Mew R
Y1 – 2009///
PD – 12//
AB – To determine if transversus abdominis (TrA) demonstrates a greater increase in thickness on lower abdominal hollowing (LAH) in standing compared to crook lying.Muscle thickness measurements of TrA, addition of internal obliques (IO) and external obliques (EO) were measured using ultrasound imaging at rest and during LAH on 28 healthy controls (14 female, 14 male) in crook lying and standing.TrA demonstrated greater thickness changes on LAH in standing (+0.88 mm+/-0.12 mm). IO and EO demonstrated greater thickness changes on LAH in crook lying (+0.59 mm+/-0.08 mm and -0.87 mm+/-0.12 mm, respectively). These differences were all significant (p<0.001). Increased resting thickness was noted in standing in TrA (20.7%), IO (10.3%) and EO (1.2%). This increase was only significantly different between TrA and EO (P=0.004).TrA showed significantly greater increases in thickness on LAH in standing compared to crook lying, and with greater specificity in relation to IO and maybe EO. If muscle thickness can be an indicator of muscle function or activity, then this suggests that TrA rehabilitation should be facilitated in positions of greater function, such as standing.
JO – Manual Therapy
PB – Elsevier B.V.
CY – New York, New York
VL – 14
IS – 6
PG – 690-695
SP – 690
EP – 695
AN –
DO – 10.1016/j.math.2009.05.003
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=105267670&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Reliability of ultrasound imaging to measure muscle thickness of the lateral abdominal muscles.
A1 – Teyhen DS
Y1 – ///
PD –
AB –
JO – Journal of Orthopaedic & Sports Physical Therapy
PB – American Physical Therapy Association, Orthopaedic Section
CY – La Crosse, Wisconsin
VL – 36
IS – 8
PG – A-8
SP – A
EP – 8
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106349194&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 3.- No abstract available or incomplete;
ER –

TY – JOUR
T1 – Ultrasound imaging of the lateral abdominal muscles: validation of ultrasound imaging by comparison with magnetic resonance imaging.
A1 – Hides JA
Y1 – ///
PD –
AB –
JO – Journal of Orthopaedic & Sports Physical Therapy
PB – American Physical Therapy Association, Orthopaedic Section
CY – La Crosse, Wisconsin
VL – 36
IS – 8
PG – A-7
SP – A
EP – 7
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106349191&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Influence of Posture on Lateral Abdominal Muscles’ Thicknesses.
A1 – Kaneko, Hideo
A1 – Sato, Hironori
A1 – Maruyama, Hitoshi
Y1 – 2006///
PD – 08//
AB – The article presents a study to clarify the influence of posture on lateral abdominal muscles thickness by using ultrasonography. Twelve male subjects go through muscle measurement and compared their muscle thickness in five postures: supine, sitting and standing postures with neutral pelvic tilt, anterior and posterior pelvic postures in sitting. The study suggests that the measuring lateral abdominal muscles thickness influenced by the pelvic tilt consideration and antigravity posture.
JO – Rigakuryoho Kagaku
PB –
CY –
VL – 21
IS – 3
PG – 255-259
SP – 255
EP – 259
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=22785148&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – The Effect of the Abdominal Drawing-in Manoeuvre during Forward Steps.
A1 – Madokoro, Sachiko
A1 – Miaki, Hiroichi
A1 – Yamazaki, Toshiaki
Y1 – 2014///
PD – 06
AB – [Purpose] A decrease in hip extension has been reported to be a factor in short step width and slow walking speed. Hip motion is related to pelvic and spinal motion, and transversus abdominis (TrA) activation is important for stabilising the pelvis and spine. The abdominal drawing-in manoeuvre (ADIM) can be performed to activate the TrA. The purpose of this study was to examine the influence of the ADIM on forward steps as a gait exercise. [Subjects] The subjects were 20 healthy men (mean age, 20.8 ± 2.4 years). [Methods] Thicknesses of the lateral abdominal muscles during forward step posture with and without ADIM were measured using ultrasound, and kinematics of the hip and pelvis were examined using a three-dimensional motion capture system. [Results] Thicknesses of the TrA and internal oblique increased during forward steps with ADIM. In addition, hip extension increased and pelvic rotation and oblique angles decreased during forward step with ADIM. [Conclusion] We believe that ADIM activates the so-called corset muscles, which consequently stabilise the pelvis and spine and increase hip extension. Our results suggest that an ADIM could increase hip extension during gait exercise.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 26
IS – 6
PG – 889-893
SP – 889
EP – 893
AN – 25013290
DO – 10.1589/jpts.26.889
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=25013290&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – The effect of abdominal stabilization contractions on posteroanterior spinal stiffness.
A1 – Stanton T
A1 – Kawchuk G
Y1 – 2008///
PD – 03/15/
AB – STUDY DESIGN: Intrasubject controls with randomized intervention order. OBJECTIVE: To quantify the immediate change in posteroanterior (PA) spinal stiffness produced by different combinations of trunk muscle contraction. SUMMARY OF BACKGROUND DATA: The abdominal hollow and the abdominal brace are 2 different combinations of trunk muscle contractions that are commonly prescribed to increase spinal stability. Unfortunately, the immediate effect of these different contractions on spinal stiffness (one indicator of spinal stability) has not yet been quantified directly. METHODS: Twenty-eight asymptomatic subjects were taught abdominal hollow and brace contractions then performed them in a randomized order framed by periods of rest. Surface electromyography and B-mode ultrasound confirmed that all contractions were performed appropriately. During each test condition (hollow, brace, and rest), a noninvasive indentation technique was used to quantify PA spinal stiffness. A repeated measures analysis of variance was used to assess the significance of changes in the PA spinal stiffness between test conditions. RESULTS: Both the abdominal hollow and abdominal brace contractions increased PA spinal stiffness significantly when compared with the rest condition (P < 0.001). When the abdominal hollow and brace contractions were compared with each other, the abdominal brace contraction produced significantly greater PA spinal stiffness (P < 0.05). CONCLUSION: In asymptomatic subjects, the abdominal brace contraction provided an immediate PA stiffening effect that was significantly greater in magnitude when compared with conditions of rest and abdominal hollowing. These findings may allow clinicians to better match commonly prescribed contraction-based interventions with specific patient needs. Future work is required to assess the long-term effect of repeated abdominal brace and hollow contractions on PA spinal stiffness and low back pain.
JO – Spine (03622436)
PB – Lippincott Williams & Wilkins
CY – Baltimore, Maryland
VL – 33
IS – 6
PG – 694-701
SP – 694
EP – 701
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=105748175&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Influence of Sitting Posture on Thicknesses and Activities of the Lateral Abdominal Muscles.
A1 – OSANAI, MASAHIRO
A1 – TACHIKAWA, YASUHIDE
A1 – TAMURA, MAMIKO
A1 – SHIMIZU, YAYOI
A1 – ARAI, MISA
A1 – WATANABE, YUUSUKE
A1 – HUKUYAMA, KATHUHIKO
A1 – AKIYAMA, SUMIKAZU
Y1 – 2010///
PD – 02//
AB – [Purpose] We investigated the changes due to posture in activities of the lateral abdominal muscles by ultra-sound sonography and electromyography. [Subjects] The subjects were 9 healthy adults. [Method] After measuring the muscle thicknesses and activities in quiet breathing and maximum expiration in the supine position, we measured them again in 6 sitting positions: with the trunk upright (U), forward (F)- and backward (B)-tilted with both the spine curved (C) and extended (E). [Results] At maximum expiration, electomyograms showed significant differences only for the internal oblique muscles between UE and FC, UC and BC. In quiet breathing, we found significant differences in muscle thickness of the internal oblique muscles between UE and FC, FE and BC. [Conclusion] We consider that upright sitting with the trunk extended is a posture in which the internal oblique muscles are not active in postural maintenance. From the electromyograms at maximum expiration, we consider this posture is one in which it is easy to show the function of the internal oblique muscles as respiratory muscles. ABSTRACT FROM AUTHOR
JO – Rigakuryoho Kagaku
PB –
CY –
VL – 25
IS – 1
PG – 91-94
SP – 91
EP – 94
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=60164302&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Differences in Transversus Abdominis Muscle Function between Chronic Low Back Pain Patients and Healthy Subjects at Maximum Expiration: Measurement with Real-time Ultrasonography.
A1 – Kim, Kang Hoon
A1 – Cho, Sung-Hak
A1 – Goo, Bong-Oh
A1 – Baek, Il-Hun
Y1 – 2013///
PD – 07
AB – The purpose of the present study was to compare the contraction ability at maximum expiration of the transversus abdominis (TrA) in patients with chronic low-back pain (CLBP) with that of healthy individuals. [Subjects] We studied 15 patients with CLBP and 15 healthy subjects. The subjects were informed of the study’s aim and methods, and the experiment was performed after obtaining the consent of the subjects. [Methods] The thickness of the abdominal muscles was measured using a LOGIQ Book XP (GE, USA). The main outcome variable was the ratio of TrA thickness at maximum expiration versus in the relaxed position (TrA activation ratio). [Results] There was a difference between the healthy subjects and the back pain subjects with regard to the thickness of the TrA at rest and the thickness of the muscle during contraction. However, there was no difference in the rate of change in the muscle activity. [Conclusion] In conclusion, CLBP patients exhibited atrophy of the TrA muscle, but voluntary TrA muscle activation was similar to that of the normal subjects.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 25
IS – 7
PG – 861-863
SP – 861
EP – 863
AN – 24259871
DO – 10.1589/jpts.25.861
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=24259871&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – RELIABILITY OF ULTRASOUND IMAGING TO MEASURE MUSCLE THICKNESS OF THE LATERAL ABDOMINAL MUSCLES. (Abstract)
A1 – Teyhen, D.S.
Y1 – 2006///
PD – 08//
AB – This abstract reviews reliability of ultrasound imaging with regards to muscle thickness measurement of the lateral abdominal muscles: what is known, what is unknown, and future directions and research priorities.
JO – Journal of Orthopaedic & Sports Physical Therapy
PB –
CY – ;
VL – 36
IS – 8
PG – A-8-a-9
SP – A
EP – 8
AN –
DO –
UR – http://www.apta.org/
NS –
N1 – Exclusion reason: 4.- Abstracts from Congress, Symposium…;
ER –

TY – JOUR
T1 – The relationship of abdominal muscles balance and body balance.
A1 – Seo, Dong-Kwon
A1 – Kim, Ji-Seon
A1 – Lee, Dong-Yeop
A1 – Kwon, Oh-Sung
A1 – Lee, Sang-Sook
A1 – Kim, Jee-Hee
Y1 – 2013///
PD – 07
AB – This study aimed to identify what impact the thickness differences between the leftside and rightside transversus abdominis (TrA), internal obliquus (IO) and external obliquus (EO) have on balance ability in the abdominal drawing-in maneuver (ADIM) and resting postures. [Subjects and Methods] In this study, 41 young adults were asked to adopt a resting posture and to perform ADIM. The thicknesses of the abdominal muscles (TrA, IO, EO) were measured using ultrasound imaging, Then balance ability was measured, so that a comparative analysis could be carried out. [Results] According to the results, the thicknesses of TrA and IO very significantly increased when ADIM was performed. The changes in thickness of the muscles on the left and right sides showed no significant correlations with balance ability. [Conclusion] According to the study results, the difference in thickness between the left and right side muscles in a normal person is small (symmetric), and the differences in the thickness of TrA and IO on the left and right side reduced when the ADIM, which is a re-education method for abdominal muscles was performed. Therefore, we consider that the ADIM should be used in future clinical trials to induce symmetric contraction of the abdominal muscles. Also, the correlation results of muscle balance and body balance can be used as empirical data.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 25
IS – 7
PG – 765-767
SP – 765
EP – 767
AN – 24259848
DO – 10.1589/jpts.25.765
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=24259848&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – ULTRASOUND IMAGING OF THE LATERAL ABDOMINAL MUSCLES: VALIDATION OF ULTRASOUND IMAGING BY COMPARISON WITH MAGNETIC RESONANCE IMAGING. (Abstract)
A1 – Hides, J.A.
Y1 – 2006///
PD – 08//
AB – This abstract looks at the difference between ultrasound therapy and magnetic resonance imaging when treating the abdominal muscles: what is known, what is unknown, and what are the future directions and research priorities.
JO – Journal of Orthopaedic & Sports Physical Therapy
PB –
CY – ;
VL – 36
IS – 8
PG – A-7-a-8
SP – A
EP – 7
AN –
DO –
UR – http://www.apta.org/
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Predictors of web-based follow-up response in the Prevention Of Low Back Pain In The Military Trial (POLM).
A1 – Childs, John D
A1 – Teyhen, Deydre S
A1 – Van Wyngaarden, Joshua J
A1 – Dougherty, Brett F
A1 – Ladislas, Bryan J
A1 – Helton, Gary L
A1 – Robinson, Michael E
A1 – Wu, Samuel S
A1 – George, Steven Z
Y1 – 2011///
PD – 06/13
AB – Background: Achieving adequate follow-up in clinical trials is essential to establish the validity of the findings. Achieving adequate response rates reduces bias and increases probability that the findings can be generalized to the population of interest. Therefore, the purpose of this study was to determine the influence of attention, demographic, psychological, and health status factors on web-based response rates in the ongoing Prevention of Low Back Pain in the Military (POLM) trial.; Methods: Twenty companies of Soldiers (n = 4,325) were cluster randomized to complete a traditional exercise program including sit-ups (TEP) with or without a psychosocial educational program (PSEP) or a core stabilization exercise program (CSEP) with or without PSEP. A subgroup of Soldiers (n = 371) was randomized to receive an additional physical and ultrasound imaging (USI) examination of key trunk musculature. As part of the surveillance program, all Soldiers were encouraged to complete monthly surveys via email during the first year. Descriptive statistics of the predictor variables were obtained and compared between responders and non-responders using two sample t-tests or chi-square test, as appropriate. Generalized linear mixed models were subsequently fitted for the dichotomous outcomes to estimate the effects of the predictor variables. The significance level was set at .05 a priori.; Results: The overall response rate was 18.9% (811 subjects) for the first year. Responders were more likely to be older, Caucasian, have higher levels of education and income, reservist military status, non smoker, lower BMI, and have received individualized attention via the physical/USI examination (p < .05). Age, race/ethnicity, education, military status, smoking history, BMI, and whether a Soldier received the physical/USI examination remained statistically significant (p < .05) when considered in a full multivariate model.; Conclusion: The overall web based response rate during the first year of the POLM trial was consistent with studies that used similar methodology, but lower when compared to rates expected for standard clinical trials. One year response rate was significantly associated with demographic characteristics, health status, and individualized attention via additional testing. These data may assist for planning of future trials that use web based response systems.; Trial Registration: This study has been registered at reports at http://clinicaltrials.gov (NCT00373009).;
JO – BMC Musculoskeletal Disorders
PB – BioMed Central
CY – England
VL – 12
IS –
PG – 132-132
SP – 132
EP – 132
AN – 21668961
DO – 10.1186/1471-2474-12-132
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=21668961&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 6.- Wrong setting;
ER –

TY – JOUR
T1 – The effects of dynamic exercise utilizing PNF patterns on abdominal muscle thickness in healthy adults.
A1 – Gong, Wontae
Y1 – 2015///
PD – 06
AB – [Purpose] The purpose of this study is to examine the effects of dynamic exercise utilizing the PNF (proprioceptor neuromuscular facilitation) patterns accompanied by abdominal drawing-in exercises on abdominal muscle thickness in healthy adults. [Subjects] The total number of subjects was 30;15 were randomly placed in the training group (TG), and the remaining 15 made up the control group (CG). [Methods] The subjects in the TG conducted 3-5 sets of dynamic exercises utilizing the PNF patterns each day, 3 times a week for 6 weeks. The thickness of the abdominal muscles was measured by ultrasonography. [Results] When the TG’s abdominal muscle thickness pre-test and post-test were compared in this study, there was a statistical significance in all of the external obliquus abdominis (Eo), the internal obliquus abdominis (Io), and the transversus abdominis (Tra). [Conclusion] Dynamic exercise utilizing the PNF patterns increased the thickness of the abdominal muscles that are the basis of trunk stabilization.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 27
IS – 6
PG – 1933-1936
SP – 1933
EP – 1936
AN – 26180351
DO – 10.1589/jpts.27.1933
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=26180351&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 7.- Wrong patient population;
ER –

TY – JOUR
T1 – The importance of body mass normalisation for ultrasound measurements of the morphology of oblique abdominis muscles: the effect of age, gender, and sport practice.
A1 – Linek, Pawel
Y1 – 2017///
PD – 06/27
AB – Some studies have not considered body mass as a confounder in analysis of oblique abdominis muscles (OAM) (including the oblique externus [OE] and oblique internus [OI]), which may have led to improper interpretation of results. To assess the differences in the effect of age, gender, and physical activity between normalised for body mass and actual values of the OAM as well as to establish the effect of age, gender, and physical activity on normalised for body mass OAM thicknesses in adolescents. A real-time ultrasound was used to obtain images of the OAM. Body mass normalisation for OAM thicknesses was performed with allometric scaling and the following equations: Allometric-scaled OE=OE thickness/body mass0.88; Allometric-scaled OI=OI thickness/body mass0.72. Analysis showed that boys have significantly thicker OAM than girls, and those who practise sports have thicker OAM than non-active individuals. For allometric-scaled OAM, there was only a significant gender effect, where boys have thicker allometric-scaled OAM than girls. There was a significant correlation between participants’ age and the actual value of the OAM. The correlations between age and allometric-scaled OAM were insignificant. An analysis of OAM without body mass normalisation can lead to improper interpretation of study results. Thus, future studies should analyse OE and OI thickness measurements after normalisation rather than actual values. In the adolescent population, there is no effect of age and physical activity on allometric-scaled OAM; males have thicker allometric-scaled OAM than females.;
JO – Folia Morphologica
PB – Via Medica
CY – Poland
VL –
IS –
PG –
SP –
EP –
AN – 28653303
DO – 10.5603/FM.a2017.0059
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=28653303&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Applicability of ultrasonography for evaluating trunk muscles size in athletes: a study focused on baseball batters.
A1 – Wachi, Michio
A1 – Suga, Tadashi
A1 – Higuchi, Takatoshi
A1 – Misaki, Jun
A1 – Tsuchikane, Ryo
A1 – Tanaka, Daichi
A1 – Miyake, Yuto
A1 – Kanazawa, Nobuhiko
A1 – Isaka, Tadao
Y1 – 2017///
PD – 09
AB – [Purpose] Recently, we demonstrated that the thicknesses of trunk muscles measured using ultrasonography were correlated strongly with the cross-sectional areas measured using magnetic resonance imaging in untrained subjects. To further explore the applicability of ultrasonography in the clinical setting, the present study examined the correlation between ultrasonography-measured thicknesses and magnetic resonance imaging-measured cross-sectional areas of trunk muscles in athletes with trained trunk muscles. [Subjects and Methods] The thicknesses and cross-sectional areas at total 10 sites of the bilateral sides of the upper, central, and lower parts of the rectus abdominis, abdominal wall, and multifidus lumborum in 30 male baseball batters were measured. [Results] Overall thicknesses and cross-sectional areas of the trunk muscles in baseball batters were higher than those in untrained subjects who participated in our previous study. The ultrasonography-measured thicknesses at all 10 sites of the trunk muscles correlated highly with the magnetic resonance imaging-measured cross-sectional areas in baseball batters. [Conclusion] These results suggest that the thicknesses of the trunk muscles measured using ultrasonography can be used as a surrogate marker for the cross-sectional area measured using magnetic resonance imaging, in athletes who have larger trunk muscles than that of untrained subjects.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 29
IS – 9
PG – 1534-1538
SP – 1534
EP – 1538
AN – 28931982
DO – 10.1589/jpts.29.1534
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=28931982&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Intraclass Correlation Coefficient and Minimal Clinically Important Difference of Lateral Abdominal Muscle Thickness in the Resting State Measured Using Ultrasound Scanning.
A1 – HIDEYUKI ITO
A1 – NORIKO MOROI
A1 – MASAHITO HIDAKA
A1 – MASASI KOSE
Y1 – 2012///
PD – 09//
AB – [Purpose] The present study was conducted to determine the number of measurements required to establish the intra- and inter-class reliabilities of measurement of the thickness of the lateral abdominal muscles using ultrasound scanning equipment. [Subjects] Thes subjects were 15 healthy males. [Methods] To assess intraclass reliability, the measurement was conducted twice by the same examiner, and once, for interclass reliability, by three different examiners. The number of measurements required to establish a high level of reliability was determined using the intraclass correlation coefficient, standard errors of measurement, and minimal clinically important difference. [Results] The interclass correlation coefficient was smaller than the intraclass correlation coefficient. Measurement errors of 0.57 to 0.77 mm were noted between the examiners, suggesting that changes of 1.59 mm for the external abdominal oblique muscle, 2.15 mm for the internal abdominal oblique muscle, and 1.77 mm for the transverse abdominal muscle or more should not be considered as measurement errors. The appropriate number of measurements was one: k=1.0. [Conclusion] The level of reliability was the highest when measurement of the thickness of the lateral abdominal muscles was performed once by the same examiner. ABSTRACT FROM AUTHOR
JO – Rigakuryoho Kagaku
PB –
CY –
VL – 27
IS – 5
PG – 559-563
SP – 559
EP – 563
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=89389743&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Relationships Among Lateral Abdominal Muscles, Gender, Body Mass Index, and and Dominance.
A1 – Springer, Barbara A.
A1 – Mielcarek, Billie J.
A1 – Nesfield, Tiffany K.
A1 – Teyhen, Deydre S.
Y1 – 2006///
PD – 05//
AB – Study Design: Exploratory. Objectives: To explore whether hand dominance, gender, and body mass index (BMI) influence the thickness of the lateral abdominal muscles as measured by ultrasound imaging. To document the extent of improvement in response stability when an average of multiple measures was utilized. Background: Ultrasound imaging is a relatively new tool used to assess the lateral abdominal muscles. A better understanding of how these muscles contract in a healthy population can provide a reference for comparison to patients with low back pain (LBP). Methods and Measures: Thirty-two healthy participants (17 males, 15 females) aged 18 to 45 years (mean +/- SD, 31.9 +/- 7.8 years) were studied. Measurements of muscular thickness of the lateral abdominal muscles were obtained bilaterally while the subjects were at rest, and while they performed the abdominal drawing-in maneuver. To determine the possible influence of hand dominance and gender on muscle thickness, t tests were used. Correlation coefficients were used to assess the relationship between BMI and muscle thickness. Standard error of the measurement was used to assess response stability of the ultrasound imaging technique. Results: No differences in the thicknesses of the transversus abdominis (TrA) muscle were measured during rest or while contracted, based on hand dominance (P is greater than or equal to .73). Men had greater muscular thickness (P < .01), while the TrA in women represented a greater proportion of the total lateral abdominal muscles (P < .01). BMI was positively associated with muscle thickness (r is greater than or equal to .66). Compared to a singular measurement, response stability improved by greater than 50 % when an average of 3 measurements was used. Conclusions: Future researchers should assess the need to control for gender and BMI as potential covariates in ultrasound imaging studies of the lateral abdominal muscles. Asymmetry in the lateral abdominal muscles in those with LBP would be in direct contrast to the bilateral symmetry measured in those without LBP. [ABSTRACT FROM AUTHOR]
JO – Journal of Orthopaedic & Sports Physical Therapy
PB –
CY – ;
VL – 36
IS – 5
PG – 289-297
SP – 289
EP – 297
AN –
DO –
UR – http://www.apta.org/
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Changes in Abdominal Muscle Thickness in Standing and Seated Positions, with and without an Abdominal Belt, in Healthy Subjects.
A1 – MATSUDA, TADAMITSU
A1 – TAKANASHI, AKIRA
A1 – SHIOTA, KOTOMI
A1 – MIYAJIMA, SHIGEKI
A1 – NOGITA, YOSHIHARU
A1 – KAWADA, KYOHEI
A1 – HOSODA, MASATAKA
A1 – KAWAGUCHI, SACHIKO
Y1 – 2010///
PD – 05//
AB – [Purpose] The aim of the present study was to investigate changes in the thickness of abdominal muscles with different states of contraction and postures in healthy subjects. [Subjects] The subjects were fifteen healthy male university students (18-20 yrs) with no history of neurological or orthopedic disease. [Method] Ultrasound equipment was used to measure the change in abdominal muscle thickness upon contraction and relaxation with and without a belt and in the standing and seated positions. [Results] Significant differences were found in the thicknesses of the internal oblique and the transverse abdominis muscles upon contraction and relaxation regardless of the belt condition (with or without) and the two postures. The comparison of the change upon contraction found a significant increase in the thickness of the external oblique when using the belt and a decrease in that of the transverse abdominis. [Conclusion] These results suggest that wearing an abdominal belt artificially increases abdominal pressure and tends to increase external abdominis activity, but that the effect on the transverse abdominis is limited. ABSTRACT FROM AUTHOR
JO – Rigakuryoho Kagaku
PB –
CY –
VL – 25
IS – 2
PG – 265-269
SP – 265
EP – 269
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=52042021&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – A comparison of ultrasound and electromyography measures of force and activation to examine the mechanics of abdominal wall contraction.
A1 – Brown SHM
A1 – McGill SM
Y1 – 2010///
PD – 02//
AB – BACKGROUND: Ultrasound imaging is a valuable tool which, when applied appropriately, has the potential to provide information regarding the mechanics of abdominal muscle contraction. Typically, changes in muscle thickness are obtained and interpreted. However, the link between ultrasound measures of muscle thickening and EMG measures of activation is not clear. METHODS: Five healthy males performed a series of abdominal muscle contractions while surface EMG and trunk posture were monitored and ultrasound images of the internal oblique and external oblique were captured both at relaxation and upon contraction. Ramped isometric flexor and extensor moment contractions were also assessed and compared between EMG and ultrasound. FINDINGS: No definitive relationship between increases in muscle activation and corresponding measures of thickening was observed. Correlations between the two measures, across all contraction types, were 0.14 for internal oblique and -0.22 for external oblique. INTERPRETATION: The lack of clear association between abdominal muscle activation and thickening may be due to the composite laminate-like structure of the abdominal wall, with force being transmitted between obliquely oriented muscle layers. Thus, ultrasound alone may not be a valid measure of muscle activation or force in the unique architecture of the abdominal wall.
JO – Clinical Biomechanics
PB – Elsevier B.V.
CY – New York, New York
VL – 25
IS – 2
PG – 115-123
SP – 115
EP – 123
AN –
DO – 10.1016/j.clinbiomech.2009.10.001
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=105121115&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – 正常歩行時の側腹筋群の動態 ――超音波画像診断装置を用いて――. / Sonographic Observation of the Dynamics of the Lateral Abdominal Region Muscles during Walking.
A1 – Mitsuhashi Kana
A1 – Maezawa Tomomi
A1 – Kawamura Kazuyuki
A1 – Kudō Shintarō
Y1 – 2015///
PD – 12//
AB – [Purpose] Sonography was used to observe the dynamics of the lateral abdominal region muscles during walking. [Subjects] The lateral abdominal region muscles of the 30 male healthy volunteers who participated in this study. [Methods] The linear probe (12 MHz) of the sonograph was positioned over the lateral abdominal region muscle so that the rectus abdominis at the umbilical level, the muscle bellies of the external and internal oblique muscles, and the transversus abdominis could be seen. Walking was recorded in the sagittal plane using a digital video camera which was synchronized with the sonograph. The thickness and deviation of the anterior border of the four lateral abdominal region muscles during walking were calculated. [Results] All of the muscles moved ventrally from mid stance to terminal stance, and they moved dorsally during the swing phase. The thickness ratio of the transversus abdominis was significantly greater than that of the external oblique muscle. [Conclusion] It is possible to conduct stabilization training for the trunk during walking, since the lateral abdominal muscles show small thickness changes and deviations, the internal oblique muscle has higher activity, and the muscle contract-relax of the transversus abdominis is clearly evident. ABSTRACT FROM AUTHOR
JO – Rigakuryoho Kagaku
PB –
CY –
VL – 30
IS – 6
PG – 861-865
SP – 861
EP – 865
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=112247833&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Tissue Deformation Index as a Reliable Measure of Lateral Abdominal Muscle Activation on M-Mode Sonography.
A1 – Biały, Maciej
A1 – Adamczyk, Wacław
A1 – Gnat, Rafael
A1 – Stranc, Tomasz
Y1 – 2017///
PD – 07
AB – The aim of this article is to present a novel method of evaluating the activity of lateral abdominal muscles using M-mode sonography. The method leads to calculation of the tissue deformation index, representing the percent change in lateral abdominal muscle thickness over time. The objectives of this study were as follows: (1) to establish the mean tissue deformation index values for individual lateral abdominal muscles; and (2) to establish the reliability of the tissue deformation index. In a group of 34 healthy young volunteers (mean age, 24.03 years; body mass, 68.89 kg; body height, 174.25 cm), the reflex response of the lateral abdominal muscles to postural perturbation in the form of rapid arm abduction was recorded in 2 series, with 6 repetitions each, and the tissue deformation index was calculated. The mean tissue deformation index values formed a gradient, increasing from deep to superficial lateral abdominal muscles: 0.06%/ms for transversus abdominis, 0.11%/ms for oblique internal, and 0.16 for oblique external muscles. The tissue deformation index values differed significantly among individual lateral abdominal muscles (all paired comparisons, P < .001). Three repeated measurements are sufficient to achieve good intra-rater reliability of the tissue deformation index (intraclass correlation coefficient, > 0.8).; © 2017 by the American Institute of Ultrasound in Medicine.
JO – Journal Of Ultrasound In Medicine: Official Journal Of The American Institute Of Ultrasound In Medicine
PB – John Wiley and Sons
CY – England
VL – 36
IS – 7
PG – 1461-1467
SP – 1461
EP – 1467
AN – 28339131
DO – 10.7863/ultra.16.07045
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=28339131&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – ドローイン歩行の身体反応. / Physical Response to Gait with Abdominal Draw-in.
A1 – 屋嘉比 章紘
A1 – 久保 晃
Y1 – 2017///
PD – 04//
AB – [Purpose] This study assessed the thickness of the transverse abdominal muscle while walking, and before and after draw-in (D). The physical responses during walking and while being aware of draw-in were also evaluated. [Subjects and Methods] We measured the thickness of the transverse abdominal muscle using ultrasonography while walking before and after draw-in. Furthermore, the measurements were performed on a treadmill (4 km/h) under three different conditions: natural walk (N), draw-in walk (D), and exercise walk (E). The three conditions were randomized. Subjects were asked to perform two tasks: task 1 was performed by 10 subjects and task 2 was performed by 20 subjects. [Results] In task 1, thickness of the transverse abdominal muscles measured before and after D were 6.1 ± 1.0 mm and 6.4 ± 1.5 mm, respectively. The difference in thickness was not significant between before and after D, implying that contraction of the transverse abdominal muscle was sustained. In task 2 the rate of consumption of oxygen (VO2) expressed relative to the body weight under the N, D, and E conditions were 11.2 ± 1.2 ml/mln · kg, 13.0 ± 2.7 ml/mln · kg, and 14.5 ± 2.2 ml/mln · kg, respectively. The VO2 significantly increased under the D and E conditions compared with N, and under the E condition compared with D. [Conclusion] The results indicated that the transverse abdominal muscle thickness were not significantly different between before and after D. This implies that contraction of the transverse abdominal muscle is sustained. Moreover, the results suggest draw-in is more effective for energy metabolism than natural walking. ABSTRACT FROM AUTHOR
JO – Rigakuryoho Kagaku
PB –
CY –
VL – 32
IS – 2
PG – 307-311
SP – 307
EP – 311
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=123945235&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Changes in lateral abdominal muscles’ thickness immediately after the abdominal drawing-in maneuver and maximum expiration.
A1 – Ishida, Hiroshi
A1 – Watanabe, Susumu
Y1 – 2013///
PD – 04//
AB – Summary: All lateral abdominal muscles contract more strongly during maximum expiration than during the abdominal drawing-in maneuver (ADIM). However, little is known about which of the lateral abdominal muscles is activated during maximum expiration. Thus, the purpose of this study is to quantify changes in the thickness of the lateral abdominal muscles immediately after the ADIM and maximum expiration. The thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles was measured by ultrasound imaging in 30 healthy men before and after the ADIM and maximum expiration. After the ADIM, there was no significant change in the thickness of the lateral abdominal muscles. After maximum expiration, the thickness of the TrA muscle significantly increased, and there was no significant change in the thickness of the IO and EO muscles. Thus, maximum expiration may be an effective method for TrA, rather than IO and EO, muscle training.
JO – Journal of Bodywork & Movement Therapies
PB – Churchill Livingstone, Inc.
CY –
VL – 17
IS – 2
PG – 254-258
SP – 254
EP – 258
AN –
DO – 10.1016/j.jbmt.2012.12.002
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104266579&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Inter-Rectus Distance Measurement Using Ultrasound Imaging: Does the Rater Matter?
A1 – Keshwani, Nadia
A1 – Hills, Nicole
A1 – McLean, Linda
Y1 – 2016///
PD –
AB – Purpose: To investigate the interrater reliability of inter-rectus distance (IRD) measured from ultrasound images acquired at rest and during a head-lift task in parous women and to establish the standard error of measurement (SEM) and minimal detectable change (MDC) between two raters. Methods: Two physiotherapists independently acquired ultrasound images of the anterior abdominal wall from 17 parous women and measured IRD at four locations along the linea alba: at the superior border of the umbilicus, at 3 cm and 5 cm above the superior border of the umbilicus, and at 3 cm below the inferior border of the umbilicus. The interrater reliability of the IRD measurements was determined using intra-class correlation coefficients (ICCs). Bland-Altman analyses were used to detect bias between the raters, and SEM and MDC values were established for each measurement site. Results: When the two raters performed their own image acquisition and processing, ICCs(3,5) ranged from 0.72 to 0.91 at rest and from 0.63 to 0.96 during head lift, depending on the anatomical measurement site. Bland-Altman analyses revealed no systematic bias between the raters. SEM values ranged from 0.23 cm to 0.71 cm, and MDC values ranged from 0.64 cm to 1.97 cm. Conclusion: When using ultrasound imaging to measure IRD in women, it is acceptable for different therapists to compare IRDs between patients and within patients over time if IRD is measured above or below the umbilicus. Interrater reliability of IRD measurement is poorest at the level of the superior border of the umbilicus.;
JO – Physiotherapy Canada. Physiotherapie Canada
PB – University of Toronto Press
CY – Canada
VL – 68
IS – 3
PG – 223-229
SP – 223
EP – 229
AN – 27909371
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=27909371&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Postpartum characteristics of rectus abdominis on ultrasound imaging.
A1 – Coldron Y
A1 – Stokes MJ
A1 – Newham DJ
A1 – Cook K
Y1 – 2008///
PD – 04//
AB – This cross-sectional and partial longitudinal study aimed to characterize changes in rectus abdominis (RA) and provide reference ranges for the first year postpartum. Ultrasound scanning was used at four stages postnatally to measure cross-sectional area (CSA), thickness, width (indirectly using a shape value) and inter-recti distance (IRD). One hundred and fifteen postnatal women (though some postnatal subjects appeared in more than one postnatal group thus giving a total of 183 data points) and 69 age-matched nulliparous female controls were recruited. Postnatal subjects were studied at Day 1 (PN1; n=63) and at 2 (PN2; n=55), 6 (PN3; n=39) and 12 (PN4; n=26) months postpartum. Longitudinal data were analysed for CSA, thickness, shape (indirect width measurement) (df=67) and IRD (df=62). The mean CSA of the PN1 group was significantly larger (P<0.001) than in controls and decreased (P<0.0021) by 12 months. In all postnatal groups, RA was significantly thinner (P<0.0001, PN1-PN3; P<0.0478, PN4), wider (P<0.0001, PN1-PN3; P=0.0326, PN4) and the IRD was significantly larger (P<0.0001, PN1-PN4) than in controls. Over 2 months postpartum, RA became thicker (P=0.0003) and the width and IRD decreased (P<0.0001 and P=0.0002, respectively) but did not return to control values by 12 months. These results have implications for strength of RA postpartum and anterior abdominal wall stiffness, which together with other muscle characteristics could inform development of effective postnatal exercise programmes.
JO – Manual Therapy
PB – Elsevier B.V.
CY – New York, New York
VL – 13
IS – 2
PG – 112-121
SP – 112
EP – 121
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=105766812&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Abdominal draw-in maneuver combined with simulated weight bearing increases transversus abdominis and internal oblique thickness.
A1 – Kim, Jeong-Soo
A1 – Seok, Cynn-Heon
A1 – Jeon, Hye-Seon
Y1 – 2017///
PD – 12
AB – The abdominal draw-in maneuver (ADIM) is a method commonly used to reestablish neuromuscular control of the deep spine muscles among individuals with musculoskeletal problems. The purpose of this study was to evaluate the effect of ADIM combined with simulated weight-bearing (SWB) activities in the facilitation of the deep spine muscles. The subjects were 30 young healthy individuals. Ultrasound images were used to measure the relative changes in transverse abdominal (TrA), internal oblique (IO) and external oblique (EO) muscle thickness during a simulated weight-bearing ADIM (SWB-ADIM). A paired t-test was used to determine the differences between the ADIM and SWB-ADIM conditions. The results showed that the thickness of the TrA and IO muscles in the SWB-ADIM condition was significantly higher than in the ADIM-alone condition. Our findings suggest that SWB-ADIM is more effective than ADIM alone for improving the deep spine muscles in real-life situations.;
JO – Physiotherapy Theory And Practice
PB – Informa Healthcare
CY – England
VL – 33
IS – 12
PG – 954-958
SP – 954
EP – 958
AN – 28876160
DO – 10.1080/09593985.2017.1359866
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=28876160&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – The relationship between EMG and change in thickness of transversus abdominis
A1 – McMeeken, J.M.
A1 – Beith, I.D.
A1 – Newham, D.J.
A1 – Milligan, P.
A1 – Critchley, D.J.
Y1 – 2004///
PD – 1/1/2004///
AB – Objective. To investigate the relationship between changes in thickness and EMG activity in the transversus abdominis muscle of healthy subjects and the reliability of ultrasound measurements using different modes and transducers. Design. Convenience sampling. Background. Chronic low back pain is associated with transversus abdominis dysfunction but EMG studies of this muscle are restricted to invasive techniques. Since the thickness of transversus abdominis changes with activity, such changes measured from ultrasound images might provide insight into this muscle’s function non-invasively. In addition, little is known about the comparability of ultrasound measurements from different modes and transducers, nor the reliability of transversus abdominis measurements. Methods. In 9 healthy subjects (aged 29–52 years, four male) transversus abdominis was studied at rest and during activity (5–80% max) with simultaneous EMG and ultrasound (M mode, 5 MHz curvilinear transducer) measurements. Intra-rater reliability for thickness measurements was studied on 13 subjects using 7.5 MHz linear and 5 MHz curvilinear transducers in B and M modes. Results. Muscle thickness changes correlated well with EMG activity (P<0.001, R2=0.87) and there were no significant differences between subjects (P>0.05). Using 7.5 MHz head, the ICC for B mode was 0.989 and for M mode was 0.981 for between days reliability. The ICC for between transducer reliability was 0.817. Conclusions. Changes in thickness of transversus abdominis can be used to indicate changes in the electrical activity in this muscle.Relevance Ultrasound scanning can be used in the clinical setting to provide objective information about transversus abdominis function.
JO – Clinical Biomechanics
PB – Elsevier Ltd
CY –
VL – 19
IS –
PG – 337-342
SP – 337
EP – 342
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S0268003304000208&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – 腹部引き込み運動および呼気筋運動時の姿勢別における腹横筋の筋厚変化 / Changes in the Thickness of Transversus Abdominis Muscle during “ Drawing-in” of the Abdominal Wall and Expiratory Threshold Loading According to Posture.
A1 – Sugimoto Takamune
A1 – Yokogawa Masami
A1 – Miaki Hiroichi
A1 – Nakagawa Takao
Y1 – 2015///
PD – 07//7/1/15
AB – [Purpose] The purpose of this study was to compare the thicknesses of the lateral abdominal muscles among the supine, sitting and standing postures during performance of the abdominal drawing-in manoeuvre (ADIM) or expiratory muscle training (EMT). [Subjects] Eighteen healthy men. [Methods] The subjects were measured at rest, then they performed ADIM or EMT in each of the postures in a random order. EMT was performed using the Threshold™ PEP, and the expiratory threshold was set at 15% of each subject’s maximal expiratory mouth pressure. The thicknesses of the transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) muscles were measured by ultrasonography. [Results] Compared to rest, there were significant increases in TrA thickness during ADIM and EMT in the supine and standing positions, but not in the sitting position. [Conclusion] The result suggests that EMT and ADIM in the supine and standing positions are similarly effective at activating TrA. ABSTRACT FROM AUTHOR
JO – Rigakuryoho Kagaku
PB –
CY –
VL – 30
IS – 3
PG – 385-388
SP – 385
EP – 388
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=108714019&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Real-Time Ultrasound Imaging in Physiotherapy Evaluation and Treatment of Transversus Abdominus and Multifidus Muscles in Individuals with Low-Back Pain.
A1 – Cheng, Clementine
A1 – MacIntyre, Norma J
Y1 – 2010///
PD – 01//
AB – Clinical diagnosis and treatment of low back pain may be enhanced through the use of imaging modalities. This study investigates the use of rehabilitative ultrasound imaging in the physiotherapy management of low back pain associated with dysfunction of the transversus abdominis and multifidus muscles. Although encouraging, current evidence for integrating rehabilitative ultrasound imaging into clinical practice is weak and several knowledge gaps have been identified. In particular, the impact on clinical outcomes needs to be determined and well-designed randomized controlled trials investigating effectiveness for improving physical therapy assessment and treatment are required before endorsing translation of rehabilitative ultrasound imaging into clinical practice.
JO – Critical Reviews in Physical & Rehabilitation Medicine
PB – Begell House Incorporated
CY – New York, New York
VL – 22
IS – 1-4
PG – 279-300
SP – 279
EP – 300
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=108073287&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – Technical and measurement report: Reliability of the inter-rectus distance measured by palpation. Comparison of palpation and ultrasound measurements
A1 – Mota, Patrícia
A1 – Pascoal, Augusto Gil
A1 – Sancho, Fátima
A1 – Carita, Ana Isabel
A1 – Bø, Kari
Y1 – 2013///
PD – //
AB – An increased inter-rectus distance (IRD) is a common condition in late pregnancy and in the postnatal period. The condition is difficult to assess. Palpation is the most commonly used method to assess IRD. To date there is scant knowledge of intra and inter-tester reliability of palpation to measure IRD and how palpation compares with ultrasound measurements. The aims of this study were: 1) evaluate intra and inter-rater reliability of abdominal palpation; 2) validate abdominal palpation of IRD measurements using ultrasound imaging as a reference. Two physiotherapists (PTs) conducted the palpation study in random order, blinded to each other’s assessments. IRD was measured as finger widths between the two rectus abdominis (RA) muscles. Ultrasound images were recorded at the same locations as the palpation test. A blinded investigator measured the IRD offline. Palpation showed good intra-rater reliability between days expressed by a weighted Kappa (wK) higher than 0.7 for both physiotherapists, and moderate inter-rater reliability (wK = 0.534). Ultrasound was found to be more responsive for differences in IRD compared with values obtained by palpation. The intra-rater reliability was higher than the inter-rater reliability. Besides the difference in experience with palpation testing between the PTs, this result may be due to differences in finger width and/or the subjective interpretation of abdominal soft-tissues pressure. Ultrasound measures are highly sensitive to changes of IRD, which is not possible to replicate by palpation assessment using a finger width scale. Palpation has sufficient reliability to be used in clinical practice. However, ultrasound is a more accurate and valid method and is recommended in future research of IRD.
JO – Manual Therapy
PB – Elsevier Ltd
CY –
VL – 18
IS –
PG – 294-298
SP – 294
EP – 298
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1356689X12002421&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 5.- Wrong study design;
ER –

TY – JOUR
T1 – Relationship between therapeutic alliance and deep abdominal muscle recruitment in nonspecific low back pain sufferers / Relação entre aliança terapêutica e recrutamento dos músculos abdominais profundos em pacientes com dor lombar não específica / Relación entre alianza terapéutica y reclutamiento de los músculos abdominales profundos en pacientes con dolor de la región lumbar no específico
A1 – Paulo Roberto Carvalho do, Nascimento
A1 – Paulo Henrique, Ferreira
A1 – Fábio Mícolis de, Azevedo
A1 – Rúben de Faria, Negrão Filho
Y1 – 2014///
PD – //
AB – Chronic low back pain is a difficult condition to be treated. As some patients respond positively to treatment and others do not present any improvements, one can think there are others conditional factors that need to be elucidated. By means of this study, we sought to investigate the association between the occurrence of the formation of a positive relationship between patient and therapist, assessed by the therapeutic alliance inventory, and the adequate recruitment of the deep abdominal muscles, as well as to verify the effect of a protocol intervention based on motor control exercises on levels of pain and disability. The recruitment of the transverse abdominal and internal oblique muscles was examined by ultrasound imaging in 12 subjects with nonspecific chronic low back pain before and after implementation of a protocol for motor control exercises, with subsequent application of the therapeutic alliance inventory questionnaire. No association was found between the level of therapist/patient alliance and muscle recruitment. The proposed protocol was effective in reducing the levels of pain and disability; however, recruitment of transverse abdominal and internal oblique muscles showed no significant changes in the end of the intervention. Based on these findings, we verified that the therapeutic alliance has no association with muscle recruitment in the short term. However, although there were no changes in muscle recruitment after the intervention program, the level of pain and disability was reduced. / A dor lombar crônica é uma condição difícil de ser tratada. Como alguns pacientes respondem de forma positiva ao tratamento e outros não apresentam melhora, pode-se pensar na existência de outros fatores condicionantes que precisam ser elucidados. Por meio deste estudo, buscou-se averiguar a ocorrência de uma associação entre a formação de um vínculo positivo entre paciente e terapeuta, avaliada por meio do inventário de aliança terapêutica, e o recrutamento adequado dos músculos abdominais profundos, além de verificar o efeito de um protocolo de intervenção baseado em exercícios de controle motor sobre os níveis de dor e incapacidade. O recrutamento muscular do transverso abdominal e oblíquo interno foi analisado por meio da ultrassonografia de imagem, em 12 sujeitos com dor lombar crônica não específica, antes e após a aplicação de um protocolo de exercícios de controle motor, com uso subsequente do questionário de aliança terapêutica. Não foi encontrada relação entre nível de aliança terapeuta/paciente e recrutamento muscular. O protocolo proposto foi eficaz na redução dos níveis de dor e incapacidade; no entanto, o recrutamento dos músculos transverso abdominal e oblíquo interno não apresentou nenhuma alteração significativa ao final da intervenção. Baseando-se nestes achados, verificou-se que a aliança terapêutica não tem relação com o recrutamento muscular a curto prazo. Entretanto, embora não tenham sido observadas mudanças no recrutamento muscular após o programa de intervenção, o nível de dor e incapacidade foi reduzido.
JO – Fisioterapia e Pesquisa
PB – Universidade de São Paulo
CY – São Paulo
VL –
IS – 4
PG – 320
SP – 320
EP –
AN –
DO – 10.590/1809-2950/11880021042014
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edssci&AN=edssci.S1809.29502014000400320&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The effect of pelvic compression on deep abdominal muscle thickness during the active straight leg raise test.
A1 – Brizzolara, Kelli
A1 – Wang-Price, Sharon
A1 – Roddey, Toni
A1 – Wilson, Iseult
Y1 – 2015///
PD – 02//
AB – Background/Aims: The estimated prevalence of sacroiliac joint (SIJ) pain is 13–30% in patients with non-specific low back pain. One common presentation is pain at or near the SIJ, and common physical therapy interventions include lumbopelvic stabilisation programmes and pelvic compression belts. The aim of this study was to: i) assess how compression of the SIJ affects the thickness of the deep abdominal muscles during the active straight leg raise (ASLR); ii) determine between-day intra-tester reliability of ultrasound imaging to assess percentage change in thickness of the deep abdominal muscles. Methods: Participants (n=15) with unilateral symptoms near the SIJ and age-matched and sex-matched controls (n=15) were recruited for this study. Ultrasound imaging was used to obtain the thickness of the transverse abdominis (TrA) and internal oblique (IO) muscles. Measurements were taken at rest and during the ASLR, with and without pelvic compression. Results: Two separate two-way (group×pelvic compression) analysis of variance (ANOVA) designs with repeated measures were used to analyse the thickness of the TrA and IO muscles; interactions were not significant for percentage change in the TrA (p=0.57) or IO (p=0.10) muscles. Intra-tester reliability was higher when testing with pelvic compression and in the control group (ICC: 0.85–0.89 vs 0.70–0.76). Conclusions: Pelvic compression did not immediately affect the muscular response of the TrA or IO muscles during the ASLR. Pelvic compression belts may be used to address the passive systems of the pelvis by increasing stability; however, specific localised exercises may be needed to improve the percentage change in thickness of the deep abdominal muscles during the ASLR.
JO – International Journal of Therapy & Rehabilitation
PB – Mark Allen Holdings Limited
CY –
VL – 22
IS – 2
PG – 60-67
SP – 60
EP – 67
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=103752753&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – ORIGINAL: Respuesta muscular durante un ejercicio hipopresivo tras tratamiento de fisioterapia pelviperineal: valoración con ecografía transabdominal
A1 – Navarro Brazález, B.
A1 – Torres Lacomba, M.
A1 – Arranz Martín, B.
A1 – Sánchez Méndez, O.
Y1 – 2017///
PD – //
AB – Conclusions Hypopressive exercises achieved elevation of pelvic floor muscles without a direct contraction command. Deep abdominal muscles also contracted during a hypopressive exercise.
JO – Fisioterapia
PB – Elsevier España, S.L.U.
CY –
VL – 39
IS –
PG – 187-194
SP – 187
EP – 194
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S021156381730041X&lang=es&site=eds-live
NS –
N1 – Exclusion reason: 1.- Not randomised studies.;
ER –

TY – JOUR
T1 – The use of ultrasound imaging of the abdominal drawing-in maneuver in subjects with low back pain
A1 – Teyhen D.S.
A1 – Miltenberger C.E.
A1 – Deiters H.M.
A1 – Del Toro Y.M.
A1 – Pulliam J.N.
A1 – Childs J.D.
A1 – Boyles R.E.
A1 – Flynn T.W.
Y1 – 2005///
PD –
AB – Study Design: Randomized controlled trial among patients with low back pain (LBP). Objectives: (1) Determine the reliability of real-time ultrasound imaging for assessing activation of the lateral abdominal muscles; (2) characterize the extent to which the abdominal dravving-in maneuver (ADIM) results in preferential activation of the transverse abdominis (TrA); and (3) determine if ultrasound biofeedback improves short-term performance of the ADIM in patients with LBP. Background: Ultrasound imaging is reportedly useful for measuring and training patients to preferentially activate the TrA muscle. However, research to support these claims is limited. Methods and Measures: Thirty patients with LBP referred for lumbar stabilization training were randomized to receive either traditional training (n = 15) or traditional training with biofeedback (n = 15). Ultrasound imaging was used to measure changes in thickness of the lateral abdominal muscles. Differences in preferential changes in muscle thickness of the TrA between groups and across time were assessed using analysis of variance. Results: Intrarater reliability measuring lateral abdominal muscle thickness exceeded 0.93. On average, patients in both groups demonstrated a 2-fold increase in the thickness of the TrA during the ADIM. Performance of the ADIM did not differ between the groups. Conclusion: These data provide construct validity for the notion that the ADIM results in preferential activation of the TrA in patients with LBP. Although, the addition of biofeedback did not enhance the ability to perform the ADIM at a short-term follow-up, our data suggest a possible ceiling effect or an insufficient training stimulus. Further research is necessary to determine if there is a subgroup of patients with LBP who may benefit from biofeedback.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 35
IS – 6
PG – 346-355
SP – 346
EP – 355
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L40770930
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TY – JOUR
T1 – Effect of the abdominal draw-in manoeuvre in combination with ankle dorsiflexion in strengthening the transverse abdominal muscle in healthy young adults: A preliminary, randomised, controlled study
A1 – Chon S.-C.
A1 – Chang K.-Y.
A1 – You J.H.
Y1 – 2010///
PD –
AB – Objectives: To compare the effect of the abdominal draw-in manoeuvre with the abdominal draw-in manoeuvre in combination with ankle dorsiflexion on changes in muscle thickness and associated muscle activity in abdominal muscles. Design: A preliminary, randomised, controlled study. Setting: University laboratory. Participants: Forty healthy adults (18 males, 22 females) were allocated at random to the experimental group [mean age (SD) 24 (1.6) years, n=20] or the control group [mean age (SD) 24 (1.9) years, n=20]. The experimental group performed the abdominal draw-in manoeuvre in combination with ankle dorsiflexion, and the control group performed the abdominal draw-in manoeuvre alone, five times a day. Main outcome measures: Ultrasonography and electromyography were used to determine the intervention-related changes in muscle activity and the thickness of abdominal muscles during the abdominal draw-in manoeuvre or the abdominal draw-in manoeuvre in combination with ankle dorsiflexion. Results: A significant difference was found in the thickness of the transverse abdominal muscle between the groups [mean difference 0.24cm, 95% confidence interval (CI) 0.08 to 0.40, P=0.005. On electromyography, a significant difference was demonstrated in the amplitude of the transverse abdominal muscle contraction between the two techniques in the experimental group (mean difference 68.76mV, 95% CI 53.16 to 84.36, P=0.000. The intra-class correlation coefficient (ICC2,1) showed excellent test-retest reliability of ultrasound measurement of the abdominal muscles: 0.96 (95% CI 0.85 to 0.99) for the transverse abdominal muscle, 0.87 (95% CI 0.62 to 0.98) for the internal oblique muscle and 0.77 (95% CI 0.44 to 0.96) for the external oblique muscle. Conclusions: This is the first study to demonstrate the additive effect of ankle dorsiflexion on deep core muscle thickness and activity, thus contributing to existing knowledge about therapeutic exercise for the effective management of low back pain. © 2009 Chartered Society of Physiotherapy.
JO – Physiotherapy
PB –
CY –
VL – 96
IS – 2
PG – 130-136
SP – 130
EP – 136
AN –
DO – 10.1016/j.physio.2009.09.007
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L50699145
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TY – JOUR
T1 – Changes in recruitment of transversus abdominis correlate with disability in people with chronic low back pain.
A1 – Ferreira P.H.
A1 – Ferreira M.L.
A1 – Maher C.G.
A1 – Refshauge K.
A1 – Herbert R.D.
A1 – Hodges P.W.
Y1 – 2010///
PD –
AB – Although motor control exercises have been shown to be effective in the management of low back pain (LBP) the mechanism of action is unclear. The current study investigated the relationship between the ability to recruit transversus abdominis and clinical outcomes of participants in a clinical trial. Ultrasonography was used to assess the ability to recruit transversus abdominis in a nested design: a sample of 34 participants with chronic LBP was recruited from participants in a randomised controlled trial comparing the efficacy of motor control exercise, general exercise and spinal manipulative therapy. Perceived recovery, function, disability and pain were also assessed. Participants with chronic LBP receiving motor control exercise had a greater improvement in recruitment of transversus abdominis (7.8%) than participants receiving general exercise (4.9% reduction) or spinal manipulative therapy (3.7% reduction). The effect of motor control exercise on pain reduction was greater in participants who had a poor ability to recruit transversus abdominis at baseline. There was a significant, moderate correlation between improved recruitment of transversus abdominis and a reduction in disability (r = -0.35; 95% CI 0.02 to 0.62). These data provide some support for the hypothesised mechanism of action of motor control exercise and suggest that the treatment may be more effective in those with a poor ability to recruit transversus abdominis.
JO – British journal of sports medicine
PB –
CY –
VL – 44
IS – 16
PG – 1166-1172
SP – 1166
EP – 1172
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L360304636
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TY – JOUR
T1 – The effects of running in place in a limited area with abdominal drawing-in maneuvers on abdominal muscle thickness in chronic low back pain patients
A1 – Gong W.
Y1 – 2016///
PD –
AB – BACKGROUND: Based on previous studies indicating that core stabilization exercises accompanied by abdominal drawing-in maneuvers increase the thickness of the transversus abdominis muscle. OBJECTIVE: The purpose of this study was to compare the measurements of abdominal muscle thicknesses during running in place in a limited area with the abdominal drawing-in maneuver. METHODS: The study classified the subjects into two experimental groups: the training group (M = 2, F = 13), and the control group (M = 2, F = 13). The training group performed three sets of running in place in a limited area with abdominal drawing-in maneuvers each time, three times a week for six weeks. The abdominal muscle thicknesses of the subjects were measured using ultrasonography. RESULTS: Comparing the training group’s abdominal muscle thickness before and after this study, there was a statistical significance in all of the external obliquus abdominis, the internal obliquus abdominis, and the transversus abdominis. In particular, thicknesses of external obliquus abdominis and internal obliquus increased remarkably. CONCLUSIONS: Running in place in a limited area accompanied by abdominal drawing-in maneuvers increased the thickness of the deep abdominal muscles that are the basis of trunk stabilization.
JO – Journal of Back and Musculoskeletal Rehabilitation
PB –
CY –
VL – 29
IS – 4
PG – 757-762
SP – 757
EP – 762
AN –
DO – 10.3233/BMR-160686
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L613536225
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TY – JOUR
T1 – The effect of core stability and general exercise on abdominal muscle thickness in non-specific chronic low back pain using ultrasound imaging
A1 – Shamsi M.
A1 – Sarrafzadeh J.
A1 – Jamshidi A.
A1 – Zarabi V.
A1 – Pourahmadi M.R.
Y1 – 2016///
PD –
AB – CONCLUSIONS: The present results provided evidence that only GE increased right and left rectus muscle thickness. The only significant difference between CSE and GE groups was the right rectus thickness. As rectus is a global muscle, the effect of GE on strength improvement (one side stronger than the other) may have a negative effect on motor control of lumbopelvic muscles and possibly increase the risk of back pain occurring or becoming worse, though this was not observed in the present study.
JO – Physiotherapy theory and practice
PB –
CY –
VL – 32
IS – 4
PG – 277-283
SP – 277
EP – 283
AN –
DO – 10.3109/09593985.2016.1138559
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L615388825
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TY – JOUR
T1 – A Randomized Controlled Trial Comparing the McKenzie Method to Motor Control Exercises in People With Chronic Low Back Pain and a Directional Preference
A1 – Halliday M.H.
A1 – Pappas E.
A1 – Hancock M.J.
A1 – Clare H.A.
A1 – Pinto R.Z.
A1 – Robertson G.
A1 – Ferreira P.H.
Y1 – 2016///
PD –
AB – Study Design Randomized clinical trial. Background Motor control exercises are believed to improve coordination of the trunk muscles. It is unclear whether increases in trunk muscle thickness can be facilitated by approaches such as the McKenzie method. Furthermore, it is unclear which approach may have superior clinical outcomes. Objectives The primary aim was to compare the effects of the McKenzie method and motor control exercises on trunk muscle recruitment in people with chronic low back pain classified with a directional preference. The secondary aim was to conduct a between-group comparison of outcomes for pain, function, and global perceived effect. Methods Seventy people with chronic low back pain who demonstrated a directional preference using the McKenzie assessment were randomized to receive 12 treatments over 8 weeks with the McKenzie method or with motor control approaches. All outcomes were collected at baseline and at 8-week follow-up by blinded assessors. Results No significant between-group difference was found for trunk muscle thickness of the transversus abdominis (-5.8%; 95% confidence interval [CI]: -15.2%, 3.7%), obliquus internus (-0.7%; 95% CI: -6.6%, 5.2%), and obliquus externus (1.2%; 95% CI: -4.3%, 6.8%). Perceived recovery was slightly superior in the McKenzie group (-0.8; 95% CI: -1.5, -0.1) on a -5 to +5 scale. No significant between-group differences were found for pain or function (P = .99 and P = .26, respectively). Conclusion We found no significant effect of treatment group for trunk muscle thickness. Participants reported a slightly greater sense of perceived recovery with the McKenzie method than with the motor control approach. Level of Evidence Therapy, level 1b-. Registered September 7, 2011 at www.anzctr.org.au (ACTRN12611000971932). J Orthop Sports Phys Ther 2016;46(7):514-522. Epub 12 May 2016. doi:10.2519/jospt.2016.6379.
JO – The Journal of orthopaedic and sports physical therapy
PB –
CY –
VL – 46
IS – 7
PG – 514-522
SP – 514
EP – 522
AN –
DO – 10.2519/jospt.2016.6379
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L617357288
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TY – JOUR
T1 – Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain
A1 – Hides J.A.
A1 – Richardson C.A.
A1 – Jull G.A.
Y1 – 1996///
PD –
AB – Study Design. A clinical study was conducted on 39 patients with acute, first-episode, unilateral low back pain and unilateral, segmental inhibition of the multifidus muscle. Patients were allocated randomly to a control or treatment group. Objectives. To document the natural course of lumbar multifidus recovery and to evaluate the effectiveness of specific, localized, exercise therapy on muscle recovery. Summery of Background Data. Acute low back pain usually resolves spontaneously, but the recurrence rate is high. Inhibition of multifidus occurs with acute, first-episode, low back pain, and pathologic changes in this muscle have been linked with poor outcome and recurrence of symptoms. Methods. Patients in group 1 received medical treatment only. Patients in group 2 received medical treatment and specific, localized, exercise therapy. Outcome measures for both groups included 4 weekly assessments of pain, disability, range of motion, and size of the multifidus cross-sectional area. Independent examiners were blinded to group allocation. Patients were reassessed at a 10-week follow-up examination. Results. Multifidus muscle recovery was not spontaneous on remission of painful symptoms in patients in group 1. Muscle recovery was more rapid and more complete in patients in group 2 who received exercise therapy (P = 0.0001). Other outcome measurements were similar for the two groups at the 4- week examination. Although they resumed normal levels of activity, patients in group 1 still had decreased multifidus muscle size at the 10-week follow- up examination. Conclusions. Multifidus muscle recovery is not spontaneous on remission of painful symptoms. Lack of localized, muscle support may be one reason for the high recurrence rate of low back pain following the initial episode.
JO – Spine
PB –
CY –
VL – 21
IS – 23
PG – 2763-2769
SP – 2763
EP – 2769
AN –
DO – 10.1097/00007632-199612010-00011
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L26427740
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TY – JOUR
T1 – The effect of motor control exercise versus general exercise on lumbar local stabilizing muscles thickness: Randomized controlled trial of patients with chronic low back pain
A1 – Akbari A.
A1 – Khorashadizadeh S.
A1 – Abdi G.
Y1 – 2008///
PD –
AB – Background: The specific training of lumbar local stabilizing muscles is one of the recent focuses in management of patients with chronic LBP. Enhanced stability of the lumbar spine segments is the mechanism for pain relief with this specific exercise. Objective: The aim of this study was to compare the effect of motor control exercises with general exercises on the lumbar local stabilizing muscles thickness, activity limitation and pain in patients with chronic low back pain (LBP). Design: A double-blind, randomized controlled trial. Methods: Forty-nine patients with chronic LBP were randomly assigned to either a motor control (n = 25) or a general exercises group (n = 24). Before and after intervention, we assessed the lumbar multifidus (LM) and Transversus abdominis (TA) muscles thickness (mm) using a 7.5 MHz B-mode transducer ultrasound, pain through visual analog scale and activity limitation through Back Performance Scale (Ordinal). A 16 session’s exercise program which lasted 8 weeks, twice per week, and 30 minutes per session was performed for both groups. Results: The mean TA thickness increased from 1.87 ± 0.63 mm to 2.39 ± 0.63 mm in the motor control group and from 1.93 ± 0.49 mm to 2.22 ± 0.47 mm in the general exercise group (P < 0.0001). The mean LM thickness increased from 8.63 ± 2.37 mm to 9.69 ± 2.49 mm in the motor control group and from 8.83 ± 1.53 mm to 9.26 ± 1.56 mm in the general exercise group (P < 0.0001). The mean activity limitation decreased from 8.83 ± 3.38 to 5.42 ± 2.43 in the motor control group and from 10.67 ± 2.81 to 7.25 ± 2.73 in the general exercise group (P < 0.0001). After treatment, there was no significant difference between two groups, with the exception of pain (P > 0.05). Conclusion: The motor control and general exercises decreased pain and increased TA and LM muscles thickness and lumbar mobility in patients with chronic LBP without any signs of spinal instability. Although, the motor control exercises were more effective than general exercises in pain decreasing. © 2008 IOS Press. All rights reserved.
JO – Journal of Back and Musculoskeletal Rehabilitation
PB –
CY –
VL – 21
IS – 2
PG – 105-112
SP – 105
EP – 112
AN –
DO –
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L352044231
NS –
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TY – JOUR
T1 – Early multimodal rehabilitation following lumbar disc surgery: a randomised clinical trial comparing the effects of two exercise programmes on clinical outcome and lumbar multifidus muscle function
A1 – Hebert J.J.
A1 – Fritz J.M.
A1 – Thackeray A.
A1 – Koppenhaver S.L.
A1 – Teyhen D.
Y1 – 2015///
PD –
AB – CONCLUSIONS: Following lumbar discectomy, multimodal rehabilitation programmes comprising specific or general trunk exercises have similar effects on clinical and muscle function outcomes. Local factors such as the individual patient characteristics identified by specific assessment findings, clinician expertise and patient preferences should direct therapy selection when considering the types of exercises tested in this trial for inclusion in rehabilitation programmes following lumbar disc surgery.
JO – British journal of sports medicine
PB –
CY –
VL – 49
IS – 2
PG – 100-106
SP – 100
EP – 106
AN –
DO – 10.1136/bjsports-2013-092402
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L606007345
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TY – JOUR
T1 – The use of real-time ultrasound imaging for biofeedback of lumbar multifidus muscle contraction in healthy subjects
A1 – Van K.
A1 – Hides J.A.
A1 – Richardson C.A.
Y1 – 2006///
PD –
AB – Study Design: Randomized controlled trial. Objective: To determine if the provision of visual biofeedback using real-time ultrasound imaging enhances the ability to activate the multifidus muscle. Background: Increasingly clinicians are using real-time ultrasound as a form of biofeedback when re-educating muscle activation. The effectiveness of this form of biofeedback for the multifidus muscle has not been reported. Methods and Measures: Healthy subjects were randomly divided into groups that received different forms of biofeedback. All subjects received clinical instruction on how to activate the multifidus muscle isometrically prior to testing and verbal feedback regarding the amount of multifidus contraction, which occurred during 10 repetitions (acquisition phase). In addition, 1 group received visual biofeedback (watched the multifidus muscle contract) using real-time ultrasound imaging. All subjects were reassessed a week later (retention phase). Results: Subjects from both groups improved their voluntary contraction of the multifidus muscle in the acquisition phase (P<.001) and the ability to recruit the multifidus muscle differed between groups (P<.05), with subjects in the group that received visual ultrasound biofeedback achieving greater improvements. In addition, the group that received visual ultrasound biofeedback retained their improvement in performance from week 1 to week 2 (P>.90), whereas the performance of the other group decreased (P<.05). Conclusion: Real-time ultrasound imaging can be used to provide visual biofeedback and improve performance and retention in the ability to activate the multifidus muscle in healthy subjects.
JO – Journal of Orthopaedic and Sports Physical Therapy
PB –
CY –
VL – 36
IS – 12
PG – 920-925
SP – 920
EP – 925
AN –
DO – 10.2519/jospt.2006.2304
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L44912683
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N1 –
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TY – JOUR
T1 – The Effect of 2 Different Exercise Programs on Pain Intensity and Muscle Dimensions in Patients With Chronic Low Back Pain: A Randomized Controlled Trial
A1 – Nabavi N.
A1 – Mohseni Bandpei M.A.
A1 – Mosallanezhad Z.
A1 – Rahgozar M.
A1 – Jaberzadeh S.
Y1 – 2017///
PD –
AB – Objectives: The purpose of this study was to compare the effect of 2 exercise programs combined with electrotherapy on pain intensity and lumbar stabilizer muscles dimensions in patients with nonspecific chronic low back pain. Methods: A randomized controlled clinical trial was performed with 41 patients with chronic LBP. Participants were randomly allocated into 2 groups: an experimental group (n = 20) received stabilization exercises plus electrotherapy, and a control group (n = 21) received routine exercises plus electrotherapy. Pain intensity, using a visual analog scale, and muscle dimensions of both right and left transverse abdominis and lumbar multifidus muscles, using rehabilitative ultrasonography, were assessed before and immediately after 4 weeks of intervention. Results: Significant improvement was identified after interventions on pain intensity and muscle size measurements in both groups (P < .01 in all instances). The only exception was the right-side lumbar multifidus cross-sectional area of the control group, which was not statistically significant (P = .081). No significant differences were found between the 2 exercise groups on pain intensity and muscle dimensions (P > .05 in all instances). Conclusions: The results of this study suggest that a combination of electrotherapy with either routine or stabilization exercise programs may improve pain intensity and muscle dimensions in patients with nonspecific chronic low back pain.
JO – Journal of Manipulative and Physiological Therapeutics
PB –
CY –
VL –
IS – (Jaberzadeh S.) Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
PG –
SP –
EP –
AN –
DO – 10.1016/j.jmpt.2017.03.011
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L617478066
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TY – JOUR
T1 – Effects of Low-Load Motor Control Exercises and a High-Load Lifting Exercise on Lumbar Multifidus Thickness
A1 – Berglund L.
A1 – Aasa B.
A1 – Michaelson P.
A1 – Aasa U.
Y1 – 2017///
PD –
AB – Study Design. Randomized controlled trial. Objective. The aim of this study was to compare the effects of low-load motor control (LMC) exercises and a high-load lifting (HLL) exercise, on lumbar multifidus (LM) thickness on either side of the spine and whether the effects were affected by pain intensity or change in pain intensity. Summary of Background Data. There is evidence that patients with low back pain (LBP) may have a decreased size of the LM muscles with an asymmetry between sides in the lower back. It has also been shown that LMC training can affect this asymmetry. It is, however, not known whether a high-load exercise has the same effect. Methods. Sixty-five participants diagnosed with nociceptive mechanical LBP were included and randomized into LMC exercises or a HLL exercise, the deadlift. The LM thickness was measured using rehabilitative ultrasound imaging (RUSI), at baseline and after a 2-month training period. Results. There were no differences between interventions regarding effect on LM muscle thickness. However, the analysis showed a significant effect for asymmetry. The thickness of the LM muscle on the small side increased significantly compared with the large side in both intervention groups, without influence of pain at baseline, or change in pain intensity. Conclusion. At baseline, there was a difference in thickness of the LM muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the LM muscles on the small side, irrespective of exercise load. The increase in LM thickness does not appear to be mediated by either current pain intensity or the magnitude of change in pain intensity.
JO – Spine
PB –
CY –
VL – 42
IS – 15
PG – E876-E882
SP – E876
EP – E882
AN –
DO – 10.1097/BRS.0000000000001989
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L613409260
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TY – JOUR
T1 – Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: Randomized controlled trial
A1 – Bernardes B.T.
A1 – Resende A.P.M.
A1 – Stüpp L.
A1 – Oliveira E.
A1 – Castro R.A.
A1 – di Bella Z.I.K.J.
A1 – Girão M.J.B.C.
A1 – Sartori M.G.F.
Y1 – 2012///
PD –
AB – CONTEXT AND OBJECTIVE: Previous studies have shown that women with pelvic floor dysfunctions present decreased cross-sectional area (CSA) of the levator ani muscle. One way to assess the effects of training programs is to measure the CSA of the muscle, using ultrasonography. The aim here was to evaluate the efficacy of pelvic floor muscle training and hypopressive exercises for increasing the CSA of the levator ani muscle in women with pelvic organ prolapse. DESIGN AND SETTING: Prospective randomized controlled trial at the Urogynecology outpatient clinic of Universidade Federal de São Paulo. METHODS: Fifty-eight women with stage II pelvic organ prolapse were divided into three groups for physiotherapy: a pelvic floor muscle training group (GI); a hypopressive exercise group (GII); and a control group (GIII). The patients underwent transperineal ultrasonographic evaluation using a transducer of frequency 4-9 MHz. The (CSA) of the levator ani muscle was measured before physiotherapy and after 12 weeks of treatment. RESULTS: The groups were homogeneous regarding age, number of pregnancies, number of vaginal deliveries, body mass index and hormonal status. Statistically significant differences in CSA were found in GI and GII from before to after the treatment (P < 0.001), but not in relation to GIII (P = 0.816). CONCLUSIONS: The CSA of the levator ani muscle increased significantly with physiotherapy among the women with pelvic organ prolapse. Pelvic floor muscle training and hypopressive exercises produced similar improvements in the CSA of the levator ani muscle.
JO – Sao Paulo Medical Journal
PB –
CY –
VL – 130
IS – 1
PG – 5-9
SP – 5
EP – 9
AN –
DO – 10.1590/S1516-31802012000100002
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L364330429
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TY – JOUR
T1 – Pelvic floor muscle training in women with stress urinary incontinence causes hypertrophy of the urethral sphincters and reduces bladder neck mobility during coughing
A1 – McLean L.
A1 – Varette K.
A1 – Gentilcore-Saulnier E.
A1 – Harvey M.-A.
A1 – Baker K.
A1 – Sauerbrei E.
Y1 – 2013///
PD –
AB – Aims The purpose of this study was to determine the effect of a 12-week pelvic floor muscle (PFM) training program on urethral morphology and mobility in women with stress urinary incontinence (SUI). Methods Forty women with SUI were randomly assigned to one of two groups: the treatment group received 12 weekly physiotherapy sessions during which they learned how to properly contract their pelvic floor muscles (PFMs) and a home exercise program was prescribed, reviewed, and progressed; the control group received no treatment. Before and after the 12-week study period, ultrasound imaging was used to evaluate bladder neck position and mobility during coughing and Valsalva maneuver in supine and in standing, as well as urethral morphology. Secondary outcome measures included a 3-day bladder diary, 30-min pad test, the Incontinence Impact Questionnaire (IIQ-7) and the Urogenital Distress Inventory (UDI-6). Results The women in the treatment group demonstrated reduced bladder neck mobility during coughing and increased cross-sectional area of their urethra after as compared to before the training. These changes were not evident in the control group. No differences in the resting position of the bladder neck or in bladder neck excursion during Valsalva maneuver were noted in either group. Concomitantly the women in the treatment group demonstrated significant improvements in the 3-day bladder diary and IIQ-7 after the PFM training and improved significantly more than the control group. Conclusion Physiotherapist-supervised PFM training reduces bladder neck motion during coughing, and results in hypertrophy of the urethral sphincter in women who present with SUI. © 2013 Wiley Periodicals, Inc.
JO – Neurourology and Urodynamics
PB –
CY –
VL – 32
IS – 8
PG – 1096-1102
SP – 1096
EP – 1102
AN –
DO – 10.1002/nau.22343
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L52689358
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TY – JOUR
T1 – Do pelvic floor muscle exercises reduce postpartum anal incontinence? A randomised controlled trial
A1 – Johannessen H.H.
A1 – Wibe A.
A1 – Stordahl A.
A1 – Sandvik L.
A1 – Mørkved S.
Y1 – 2017///
PD –
AB – Objective: To evaluate the effect of pelvic floor muscle exercises (PFME) for postpartum anal incontinence (AI). Design: A parallel two-armed randomised controlled trial stratified on obstetrical anal sphincter injury with primary sphincter repair and hospital affinity. Setting: Ano-rectal specialist out-patient clinics at two hospitals in Norway. Population: One hundred and nine postpartum women with AI at baseline. Methods: The intervention group received 6 months of individual physiotherapy-led PFME and the control group written information on PFME. Changes in St. Mark’s scores and predictors of post-intervention AI were assessed by independent samples t-tests and multiple linear regression analyses, respectively. The study was not blind. Main outcome measures: The primary outcome measure was change in AI symptoms on the St. Mark’s score from baseline to post-intervention. Secondary outcome measures were manometry measures of anal sphincter length and strength, endoanal ultrasound (EAUS) defect score and voluntary pelvic floor muscle contraction. Results: There was a significant difference in the reduction of St. Mark’s scores from baseline to post-intervention in favour of the PFME group (−2.1 versus −0.8 points, P = 0.040). No differences in secondary outcome measures were found between groups. Baseline St. Mark’s, PFME group affinity and EAUS defect score predicted post-intervention St. Mark’s score in the imputed intention-to-treat analyses. The analysis on un-imputed data showed that women performing weekly PFME improved their AI scores more than women in the control group did. Conclusions: Our results indicate that individually adapted PFME reduces postpartum AI symptoms. Tweetable abstract: Performing regular pelvic floor muscle exercises may be an effective treatment for postpartum anal incontinence.
JO – BJOG: An International Journal of Obstetrics and Gynaecology
PB –
CY –
VL – 124
IS – 4
PG – 686-694
SP – 686
EP – 694
AN –
DO – 10.1111/1471-0528.14145
UR – http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L610761062
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TY – JOUR
T1 – Effects of Co-contraction of Both Transverse Abdominal Muscle and Pelvic Floor Muscle Exercises for Stress Urinary Incontinence: A Randomized Controlled Trial.
A1 – Tajiri, Kimiko
A1 – Huo, Ming
A1 – Maruyama, Hitoshi
Y1 – 2014///
PD – 08
AB – [Purpose] The purpose of this study was to devise a new urinary incontinence exercise using co-contraction of both the transverse abdominal muscle (TA) and pelvic floor muscle (PFM) and examine the intervention effect in middle-aged women with stress urinary incontinence (SUI). [Subjects] The subjects were fifteen women with SUI who were divided into two groups: the TA and PFM co-contraction exercise group (n=9) and the control group (n=6). [Methods] Participants in the exercise group performed TA and PFM co-contraction exercise. The thickness of the TA was measured before and after 8 weeks of exercise using ultrasound. The thickness of the TA was measured under 4 conditions: (1) at rest, (2) maximal contraction of the TA, (3) maximal contraction of the PFM, and (4) maximal co-contraction of both the TA and PFM. [Results] There were no significant differences among the results of the control group. In the exercise group, the cure rate of SUI was 88.9% after the intervention. There were significant differences in the thickness of the TA during maximal co-contraction of both the TA and PFM after the intervention. [Conclusion] The TA and PFM co-contraction exercise intervention increases the thickness of the TA and may be recommended to improve SUI in middle-aged women.;
JO – Journal Of Physical Therapy Science
PB – Society of Physical Therapy Science
CY – Japan
VL – 26
IS – 8
PG – 1161-1163
SP – 1161
EP – 1163
AN – 25202173
DO – 10.1589/jpts.26.1161
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=25202173&lang=es&site=eds-live
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TY – JOUR
T1 – An investigation of the reproducibility of ultrasound measures of abdominal muscle activation in patients with chronic non-specific low back pain.
A1 – Costa, Leonardo Oliveira Pena
A1 – Maher, Chris G
A1 – Latimer, Jane
A1 – Hodges, Paul W
A1 – Shirley, Debra
Y1 – 2009///
PD – 07
AB – Ultrasound (US) measures are used by clinicians and researchers to evaluate improvements in activity of the abdominal muscles in patients with low back pain. Studies evaluating the reproducibility of these US measures provide some information; however, little is known about the reproducibility of these US measures over time in patients with low back pain. The objectives of this study were to estimate the reproducibility of ultrasound measurements of automatic activation of the lateral abdominal wall muscles using a leg force task in patients with chronic low back pain. Thirty-five participants from an existing randomised, blinded, placebo-controlled trial participated in the study. A reproducibility analysis was undertaken from all patients using data collected at baseline and after treatment. The reproducibility of measurements of thickness, muscle activation (thickness changes) and muscle improvement/deterioration after intervention (differences in thickness changes from single images made before and after treatment) was analysed. The reproducibility of static images (thickness) was excellent (ICC(2,1) = 0.97, 95% CI = 0.96-0.97, standard error of the measurement (SEM) = 0.04 cm, smallest detectable change (SDC) = 0.11 cm), the reproducibility of thickness changes was moderate (ICC(2,1) = 0.72, 95% CI 0.65-0.76, SEM = 15%, SDC 41%), while the reproducibility of differences in thickness changes from single images with statistical adjustment for duplicate measures was poor (ICC(2,1) = 0.44, 95% CI 0.33-0.58, SEM = 21%, SDC = 66.5%). Improvements in the testing protocol must be performed in order to enhance reproducibility of US as an outcome measure for abdominal muscle activation.;
JO – European Spine Journal: Official Publication Of The European Spine Society, The European Spinal Deformity Society, And The European Section Of The Cervical Spine Research Society
PB – Springer-Verlag
CY – Germany
VL – 18
IS – 7
PG – 1059-1065
SP – 1059
EP – 1065
AN – 19415347
DO – 10.1007/s00586-009-1018-5
UR – http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=19415347&lang=es&site=eds-live
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TY – JOUR
T1 – THE EFFICACY OF AN EIGHT-WEEK CORE STABILIZATION PROGRAM ON CORE MUSCLE FUNCTION AND ENDURANCE: A RANDOMIZED TRIAL.
A1 – Hoppes, Carrie W.
A1 – Sperier, Aubrey D.
A1 – Hopkins, Colleen F.
A1 – Griffiths, Bridgette D.
A1 – Principe, Molly F.
A1 – Schnall, Barri L.
A1 – Bell, Johanna C.
A1 – Koppenhaver, Shane L.
Y1 – 2016///
PD – 08//
AB – Background: Body armor is credited with increased survival rates in soldiers but the additional axial load may negatively impact the biomechanics of the spine resulting in low back pain. Multiple studies have found that lumbar stabilization programs are superior to generalized programs for patients with chronic low back pain. It is not known if such programs produce objective changes in trunk muscle function with wear of body armor. Hypothesis/Purpose: An eight-week core stability exercise program would result in a larger improvement in physical endurance and abdominal muscle thickness than a control intervention. The purpose of this study was to assess the effectiveness of an eight-week core stability exercise program on physical endurance and abdominal muscle thickness with and without wear of body armor. Study Design: Randomized controlled trial Methods: Participants (N = 33) were randomized into either the core strengthening exercise group or the control group. Testing included ultrasound imaging of abdominal muscle thickness in hook-lying and standing with and without body armor and timed measures of endurance. Results There were statistically significant group by time interactions for transversus abdominis muscle contraction thickness during standing, both with (p = 0.018) and without body armor (p = 0.038). The main effect for hold-time during the horizontal side-support (p = 0.016) indicated improvement over time regardless of group. There was a significant group by time interaction (p = 0.014) for horizontal side-support hold-time when compliance with the exercise protocol was set at 85%, indicating more improvement in the core stabilization group than in the control group. Conclusion: Performing an eight-week core stabilization exercise program significantly improves transversus abdominis muscle activation in standing and standing with body armor. When compliant with the exercises, such a program may increase trunk strength and muscle endurance. ABSTRACT FROM AUTHOR
JO – International Journal of Sports Physical Therapy
PB –
CY –
VL – 11
IS – 4
PG – 507-515
SP – 507
EP – 515
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=117409331&lang=es&site=eds-live
NS –
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TY – JOUR
T1 – Real-time ultrasound feedback and abdominal hollowing exercises for people with low back pain.
A1 – Worth SGA
A1 – Henry SM
A1 – Bunn JY
Y1 – 2007///
PD – 03//
AB – Purpose: This study examined whether or not supplementing typical clinical instruction with visual feedback from real-time ultrasound images of the anterolateral abdominal wall facilitates performance of the abdominal hollowing exercise for people with low back pain,Methods: Nineteen patients with low back pain were randomly divided into two feedback groups. Group 1 received typical clinical instruction whilst attempting the abdominal hollowing exercise, whereas Group 2 additionally received visual feedback from the ultrasound image. A retention test was performed on each patient within for days of the initial testing session. Three consecutive correct repetitions out of ten attempts within each 20-minute session were defined as successful learning.Results: During the initial testing session, significantly more patients in Group 2 reached the criteria for consistency of performance compared to Group 1 (p = 0.01), and Group 2 had fewer trials to performance criteria compared to Group 1 (p=0.0002). During retention testing there was no significant difference (p=0.09) in the number of patients who reached the criteria for consistency of performance; however Group 2 reached performance criteria in fewer number of trials (p = 0.05).Conclusion: Visual feedback provided by ultrasound imaging can enhance the learning of the abdominal hollowing exercise in patients with low back pain, making it a useful clinical teaching tool for physiotherapists.
JO – New Zealand Journal of Physiotherapy
PB – New Zealand Society of Physiotherapists
CY –
VL – 35
IS – 1
PG – 4-11
SP – 4
EP – 11
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=106293278&lang=es&site=eds-live
NS –
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TY – JOUR
T1 – The Effect of Traditional Bridging or Suspension-Exercise Bridging on Lateral Abdominal Thickness in Individuals With Low Back Pain.
A1 – Guthrie, Rebecca J.
A1 – Grindstaff, Terry L.
A1 – Croy, Theodore
A1 – Ingersoll, Christopher D.
A1 – Saliba, Susan A.
Y1 – 2012///
PD – 05//
AB – Context: Individuals with low back pain (LBP) are thought to benefit from interventions that improve motor control of the lumbopelvic region. It is unknown if therapeutic exercise can acutely facilitate activation of lateral abdominal musculature. Objective: To investigate the ability of 2 types of bridging-exercise progressions to facilitate lateral abdominal muscles during an abdominal drawing-in maneuver (ADIM) in individuals with LBP. Design: Randomized control trial. Setting: University research laboratory. Participants: 51 adults (mean ± SD age 23.1 ± 6.0 y, height 173.6 ± 10.5 cm, mass 74.7 ± 14.5 kg, and 64.7% female) with LBP. All participants met 3 of 4 criteria for stabilization-classification LBP or at least 6 best-fit criteria for stabilization classification. Interventions: Participants were randomly assigned to either traditional-bridge progression or suspension-exercise-bridge progression, each with 4 levels of progressive difficulty. They performed 5 repetitions at each level and were progressed based on specific criteria. Main Outcome Measures: Muscle thickness of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) was measured during an ADIM using ultrasound imaging preintervention and postintervention. A contraction ratio (contracted thickness:resting thickness) of the EO, IO, and TrA was used to quantify changes in muscle thickness. Results: There was not a significant increase in EO (F1,47 = 0.44, P = .51) or IO (F1,47 = .30, P = .59) contraction ratios after the exercise progression. There was a significant (F1,47 = 4.05, P = .05) group-bytime interaction wherein the traditional-bridge progression (pre = 1.55 ± 0.22; post = 1.65 ± 0.21) resulted in greater (P = .03) TrA contraction ratio after exercise than the suspension-exercise-bridge progression (pre = 1.61 ± 0.31; post = 1.58 ± 0.28). Conclusion: A single exercise progression did not acutely improve muscle thickness of the EO and IO. The magnitude of change in TrA muscle thickness after the traditional-bridging progression was less than the minimal detectable change, thus not clinically significant. ABSTRACT FROM AUTHOR
JO – Journal of Sport Rehabilitation
PB –
CY –
VL – 21
IS – 2
PG – 151-160
SP – 151
EP – 160
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=74703597&lang=es&site=eds-live
NS –
N1 –
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TY – JOUR
T1 – Original article: Abdominal and pelvic floor muscle function in women with and without long lasting pelvic girdle pain
A1 – Stuge, Britt
A1 – Mørkved, Siv
A1 – Haug Dahl, Haldis
A1 – Vøllestad, Nina
Y1 – 2006///
PD – 1/1/2006///
AB – Approximately 5–20% of postpartum women suffer from long-lasting pelvic girdle pain (PGP). The etiology and pathogenesis of PGP are still unclear. The aim of this study was to examine whether subjects with and without persisting PGP and disability differed with respect to their ability to voluntarily contract the deep abdominals (TrA and IO) and to the strength of the pelvic floor muscles (PFM). Twenty subjects (12 with persisting PGP, 8 recovered from PGP) were examined. Contractions of the deep abdominal muscles (TrA and IO) were imaged by real-time ultrasound. Vaginal palpation and observation were used to assess the women’s ability to perform correct a PFM contraction. PFM strength was measured by a vaginal balloon catheter connected to a pressure transducer. The active straight leg raise test was used to assess the ability of load transfer. The results showed no statistical significant difference between the groups in increase of muscle thickness of the deep abdominal muscles (TrA; P=0.87 and IO; P=0.51) or regarding PFM strength (P=0.94). The ability to voluntarily contract the deep abdominal muscles and the strength of the PFMs are apparently not associated to PGP. However, the results are based on a small sample and additional studies are needed.
JO – Manual Therapy
PB – Elsevier Ltd
CY –
VL – 11
IS –
PG – 287-296
SP – 287
EP – 296
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1356689X05001128&lang=es&site=eds-live
NS –
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TY – JOUR
T1 – Comparison of real-time ultrasound imaging and pressure biofeedback training for performing abdominal drawing-in maneuver in low back pain.
A1 – Bajaj S
A1 – Chitra K
A1 – Shallu S
Y1 – 2010///
PD – Apr-Jun
AB –
JO – Indian Journal of Physiotherapy & Occupational Therapy
PB – Institute of Medico-legal publications Pvt Ltd
CY –
VL – 4
IS – 2
PG – 61-65
SP – 61
EP – 65
AN –
DO –
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=105037742&lang=es&site=eds-live
NS –
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TY – JOUR
T1 – Abdominal muscle contraction thickness and function after specific and general exercises: A randomized controlled trial in chronic low back pain patients.
A1 – Vasseljen O
A1 – Fladmark AM
Y1 – 2010///
PD – 10//
AB – Abstract: The aim of this study was to assess changes in deep abdominal muscle function after 8 weeks of exercise in chronic low back pain patients. Patients (n = 109) were randomized to specific ultrasound guided, sling or general exercises. Contraction thickness ratio in transversus abdominis (TrA), obliquus internus (OI) and externus (OE), and TrA lateral slide were assessed during the abdominal drawing-in maneuver by b-mode ultrasound. Changes in abdominal muscle function were also regressed on changes in pain. Only modest effects in deep abdominal muscle function were observed, mainly due to reduced activation of OI (contraction thickness ratio: 1.42–1.22, p = 0.01) and reduced TrA lateral slide (1.26–1.01 cm, p = 0.02) in the ultrasound group on the left side. Reduced pain was associated with increased TrA and reduced OI contraction ratio (R 2 = 0.18). It is concluded that 6–8 treatments with specific or general exercises for chronic low back patients attained only marginal changes in contraction thickness and slide in deep abdominal muscles, and could only to a limited extent account for reductions in pain.
JO – Manual Therapy
PB – Elsevier B.V.
CY – New York, New York
VL – 15
IS – 5
PG – 482-489
SP – 482
EP – 489
AN –
DO – 10.1016/j.math.2010.04.004
UR – http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104919034&lang=es&site=eds-live
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TY – JOUR
T1 – Efeito do pilates sobre a flexibilidade do tronco e as medidas ultrassonográficas dos músculos abdominais / Effect of pilates on trunk flexibility and ultrasound measures of abdominal muscles / Efecto del pilates en la flexibilidad del torso y las medidas de los músculos abdominales por ultrasonido
A1 – Gisela Rocha de, Siqueira
A1 – Geisa Guimarães de, Alencar
A1 – Érika da Cruz de Melo, Oliveira
A1 – Vanessa Queiroz Melo, Teixeira
Y1 – 2015///
PD – //
AB – INTRODUÇÃO: a Pilates consiste em um método de treinamento físico e mental que trabalha a flexibilidade e a força muscular. Esse método prioriza fortalecer o conjunto de músculos responsável pelo controle de tronco, chamado de Powerhouse e, consequentemente, aumentar o trofismo dos músculos abdominais reto do abdome, oblíquo interno e externo, transverso do abdome, glúteos, músculos do períneo e paravertebrais lombares. OBJETIVO: avaliar o efeito do método Pilates sobre o trofismo do grupamento abdominal e na flexibilidade do tronco, comparado à aplicação de uma técnica tradicional de fortalecimento dos músculos abdominais e alongamentos estáticos em mulheres saudáveis. MÉTODOS: treze mulheres sedentárias e saudáveis na faixa etária entre 18 e 25 anos foram submetidas a 10 sessões de Pilates grupo Pilates, n = 6 e 10 sessões de alongamento e fortalecimento tradicionais grupo controle, n = 7. Antes e após as intervenções, o trofismo da musculatura abdominal das voluntárias foi avaliado através do ultrassom e a flexibilidade do tronco através do flexímetro. RESULTADOS: no grupo Pilates, após a intervenção, houve um aumento significativo das medidas ultrassonográficas do reto do abdome, da amplitude da rotação para direita e esquerda e da inclinação da coluna vertebral para a esquerda. No grupo controle, observou-se melhora apenas na rotação para a esquerda. CONCLUSÃO: o número de sessões pode ter sido insuficiente para que ocorresse aumento do trofismo de todos os músculos avaliados e da flexibilidade do tronco. É importante investir em pesquisas sobre Pilates, especialmente com a utilização de métodos de imagem mais acurados. / INTRODUCTION: Pilates is a method of physical and mental training that works on flexibility and muscle strength. This method prioritizes strengthening the set of muscles responsible for trunk control, called Powerhouse, and thereby increase the trophysm of the abdominal muscles rectus abdominis, internal and external oblique, transversus abdominis, gluteus, perineal and lumbar paraspinal muscles. OBJECTIVE: to evaluate the effect of the Pilates method on the trophysm of abdominal and trunk flexibility compared to the application of a traditional technique to strengthen the abdominal muscles and static stretching in healthy women. METHODS: thirteen healthy sedentary women, aged between 18 and 25 years underwent 10 sessions of Pilates Pilates group, n=6 and 10 sessions of traditional stretching and strengthening control group, n=7. Before and after the intervention, the trophysm of the abdominal muscles of the volunteers was assessed using ultrasound, and trunk flexibility was evaluated through the fleximeter. RESULTS: after the intervention, there was a significant increase in ultrasound measures of the rectus abdominis muscle, the range of the rotation to right and left, and tilt of the spine to the left in the Pilates group. In the control group, improvement was observed only in the rotation to the left. CONCLUSION: the number of sessions may have been insufficient for the increase in the trophysm of all muscles tested and the flexibility of the trunk to occur. It is important to invest in research on Pilates, especially with the use of more accurate imaging methods.
JO – Revista Brasileira de Medicina do Esporte
PB – Sociedade Brasileira de Medicina do Exercício e do Esporte
CY – São Paulo
VL –
IS – 2
PG – 139
SP – 139
EP –
AN –
DO – 10.1590/1517-86922015210202180
UR – http://search.ebscohost.com/login.aspx?direct=true&db=edssci&AN=edssci.S1517.86922015000200139&lang=es&site=eds-live
NS –
N1 –
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Samuel Fernández Carnero

Grado en Fisioterapia en la Universidad Pontificia de Comillas. Escuela de Enfermería y Fisioterapia. Ecografista Musculo Esquelético Nivel II acreditado mediante examen teórico y práctico por la Universidad Complutense de Madrid. Master Universitario en Neurocontrol Motor en la Universidad Rey Juan Carlos (Madrid). Master en Neurocontrol Motor y Doctor en BioMedicina y Ciencias de la Salud …. (VER MÁS)

Introducción del curso

En España no se conoce el término RUSI: acrónimo anglo sajón: Rehabilitative Ultrasound Imaging.

Este término describe el conjunto de técnicas desarrolladas por investigadores de diversos países (Australia, Canadá, USA ó Reino Unido) para evidenciar trastornos en la función y la morfología de la musculatura del suelo pélvico, región lumbar y faja abdominal y la manera de intervenir de manera efectiva.

Las principales características de esta técnica de exploración residen en el estudio de la forma, y comportamiento de los tejidos musculo esqueléticos durante el desarrollo de su función.

También resulta interesante hacer una valoración en estático, será en la primera opción, que junto con la dinámica donde nos resultarán desde el punto de vista clínico muy relevantes.

Resulta de vital importancia el estudio, difusión y aprendizaje de esta técnica en tanto es una forma de evidenciar los trastornos a nivel funcional que en muchos casos no tienen una base diagnóstica basada en la evidencia. Los profesionales de la salud que rabajamos con pacientes que padecen patología del aparato locomotor lejos de ser empíricos hacen actos de fe, puesto que en muchas ocasiones no se da una explicación basada en datos, hechos, medidas… y aquello que no puedes evidenciar solo lo crees.

Curso de ecografía rusi para profesionales formados en ecografía. Este curso introduce al asistente en la técnica rusi para diagnóstico morfológico y funcional de las alteraciones musculoesqueléticas y tratamiento con biofeedback.

Objetivos del curso

Objetivos del curso de Ecografía para Fisioterapeutas

El uso de los ecógrafos en España hasta la fecha se ha basado en el análisis de los tejidos para la detección de alteraciones de tipo traumático, degenerativo…en definitiva patológico a nivel histológico. Esta materia es competencia de los Radiólogos y este curso nada tiene que ver con esto. A diferencia del uso de ecografía para la detección de los trastornos mencionados, este curso centrará el uso del ecógrafo para la detección de problemas de actividad muscular, por lo que nos capacitará para determinar el correcto funcionamiento de esos músculos y de este modo realizaremos una valoración concienzuda, exhaustiva y precisa de la musculatura que trataremos. Para fijar el hilo conductor del método señalamos el diagrama que la Dra. Stokes nos facilitó al objeto de diferenciar el uso del ecógrafo con fines de diagnóstico clínico-patológico o USI (Ultrasound Imaging) y el uso del ecógrafo con fines de diagnóstico morfológico y funcional o RUSI (Rehabilitative Ultrasound Imaging) Entendemos que es de gran calado en la profesión ya que el tratamiento del tejido musculo esquelético es la materia prima con la que trabajamos debiendo ser capaces de visualizar la actividad para poder determinar un tratamiento más acertado que el basado en test funcionales o intuición.

Programa Nivel RUSI - 18 h.

1. Objetivos.

2. Introducción.

  • a. Historia de la ecografía y de la técnica RUSI.
  • b. Existencia de SEEFi en España. Apoyo Internacional de la SEEFi.
  • c. USI vs RUSI.

3. Región Abdomino-Lumbopélvica.

  • a. Valoración Cualitativa y Cuantitativa.
    • 1. Abdomen.
      • 1. Descripción anatómica relacionada con ecografía.
      • 2. Abordajes anterior, lateral y posterior.
      • 3. Test dinámicos.
    • 2. Lumbar.
      • 1. Descripción anatómica relacionada con ecografía.
      • 2. Abordaje dorsal transversal y sagital.
      • 3. Test dinámicos.
    • 3. Suelo Pélvico.
      • 1. Descripción anatómica relacionada con ecografía.
      • 2. Abordaje Transabdominal y Transperineal.
      • 3. Test dinámicos.
    • 4. Diafragma.
      • 1. Descripción anatómica relacionada con ecografía.
      • 2. Abordaje transabdominal y transcostal.
      • 3. Test dinámicos.
  • b. Uso a nivel investigador.
    • 1. Uso de herramientas de medición.
    • 2. Puntos validados de evaluación y medición.
    • 3. Variables de interés.

4. Integración de los abordajes para la disfunción lumbopélvica:

  • a. Evaluación de la unidad funcional del “CORE”.
  • b. Reeducación en distintas posiciones.
Curso avalado por:

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