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Published in: BMC Musculoskeletal Disorders 1/2015

Open Access 01-12-2015 | Technical advance

Using ultrasound to assess the thickness of the transversus abdominis in a sling exercise

Authors: Jörn Lükens, Kim J. Boström, Christian Puta, Tobias L. Schulte, Heiko Wagner

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

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Abstract

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, η2 = 0.72], no significant effect of the factor time [F(2.38) = 2.45, p = 0.1, η2 = 0.11], and no significant interaction effect [F(4,76) = 0.315, p = 0.867, η2 = 0.02]. Statistically corrected post-hoc t-tests revealed significant differences in TrA thickness showing that RC < SC (p < 0.001; η2 = 0.19; d = 0.96), SC < APC (p < 0.0001; η2 = 0.23; d = 1.10), RC < APC (p < 0.0001; η2 = 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.
Literature
1.
go back to reference Hodges PW. Is there a role for transversus abdominis in lumbo-pelvic stability? Man Ther. 1999;4(2):74–86.CrossRefPubMed Hodges PW. Is there a role for transversus abdominis in lumbo-pelvic stability? Man Ther. 1999;4(2):74–86.CrossRefPubMed
2.
go back to reference Himes ME, Selkow NM, Gore MA, Hart JM, Saliba SA. Transversus abdominis activation during a side-bridge exercise progression is similar in people with recurrent low back pain and healthy controls. J Strength Cond Res. 2012;26(11):3106–12.CrossRefPubMed Himes ME, Selkow NM, Gore MA, Hart JM, Saliba SA. Transversus abdominis activation during a side-bridge exercise progression is similar in people with recurrent low back pain and healthy controls. J Strength Cond Res. 2012;26(11):3106–12.CrossRefPubMed
3.
go back to reference Reeve A, Dilley A. Effects of posture on the thickness of transversus abdominis in pain-free subjects. Man Ther. 2009;14(6):679–84.CrossRefPubMed Reeve A, Dilley A. Effects of posture on the thickness of transversus abdominis in pain-free subjects. Man Ther. 2009;14(6):679–84.CrossRefPubMed
4.
go back to reference Hodges PW, Pengel LHM, Herbert RD, Gandevia SC. Measurement of muscle contraction with ultrasound imaging. Muscle Nerve. 2003;27(6):682–92.CrossRefPubMed Hodges PW, Pengel LHM, Herbert RD, Gandevia SC. Measurement of muscle contraction with ultrasound imaging. Muscle Nerve. 2003;27(6):682–92.CrossRefPubMed
5.
go back to reference McMeeken JM, Beith ID, Newham DJ, Milligan P, Critchley DJ. The relationship between EMG and change in thickness of transversus abdominis. Clin Biomechanics. 2004;19(4):337–42.CrossRef McMeeken JM, Beith ID, Newham DJ, Milligan P, Critchley DJ. The relationship between EMG and change in thickness of transversus abdominis. Clin Biomechanics. 2004;19(4):337–42.CrossRef
6.
go back to reference Whittaker JL, Teyhen DS, Elliott JM, Cook K, Langevin HM, Dahl HH, et al. Rehabilitative ultrasound imaging: understanding the technology and its applications. J Orthop Sports Phys Ther. 2007;37(8):434–49.CrossRefPubMed Whittaker JL, Teyhen DS, Elliott JM, Cook K, Langevin HM, Dahl HH, et al. Rehabilitative ultrasound imaging: understanding the technology and its applications. J Orthop Sports Phys Ther. 2007;37(8):434–49.CrossRefPubMed
7.
go back to reference Teyhen DS. Rehabilitative ultrasound imaging symposium: overview. J Orthop Sports Phys Ther. 2006;36(8):1–17.CrossRef Teyhen DS. Rehabilitative ultrasound imaging symposium: overview. J Orthop Sports Phys Ther. 2006;36(8):1–17.CrossRef
8.
go back to reference Ljunggren AE, Weber H, Kogstad O, Thom E, Kirkesola G. Effect of Exercise on Sick Leave Due to Low Back Pain. Spine. 1997;14:1610–7.CrossRef Ljunggren AE, Weber H, Kogstad O, Thom E, Kirkesola G. Effect of Exercise on Sick Leave Due to Low Back Pain. Spine. 1997;14:1610–7.CrossRef
9.
go back to reference Stuge B, Veierød MB, Lærum E, Vøllestad N. The Efficacy of a Treatment Program Focusing on Specific Stabilizing Exercises for Pelvic Girdle Pain After Pregnancy. Spine. 2004;29:E197–203.CrossRefPubMed Stuge B, Veierød MB, Lærum E, Vøllestad N. The Efficacy of a Treatment Program Focusing on Specific Stabilizing Exercises for Pelvic Girdle Pain After Pregnancy. Spine. 2004;29:E197–203.CrossRefPubMed
10.
go back to reference Vasseljen O, Fladmark AM. Abdominal muscle contraction thickness and function after specific and general exercises: a randomized controlled trial in chronic low back pain patients. Man Ther. 2010;15:482–9.CrossRefPubMed Vasseljen O, Fladmark AM. Abdominal muscle contraction thickness and function after specific and general exercises: a randomized controlled trial in chronic low back pain patients. Man Ther. 2010;15:482–9.CrossRefPubMed
11.
go back to reference Lee J-S, Yang S-H, Koog Y-H, Jun H-J, Kim S-H, Kim K-J. Effectiveness of sling exercise for chronic low back pain: a systematic review. J Phys Ther Sci. 2014;26:1301–6.CrossRefPubMedPubMedCentral Lee J-S, Yang S-H, Koog Y-H, Jun H-J, Kim S-H, Kim K-J. Effectiveness of sling exercise for chronic low back pain: a systematic review. J Phys Ther Sci. 2014;26:1301–6.CrossRefPubMedPubMedCentral
12.
go back to reference Misuri G, Colagrande S, Gorini M, Iandelli I, Mancini M, Duranti R, et al. In vivo ultrasound assessment of respiratory function of abdominal muscles in normal subjects. Eur Respir J. 1997;10:2861–7.CrossRefPubMed Misuri G, Colagrande S, Gorini M, Iandelli I, Mancini M, Duranti R, et al. In vivo ultrasound assessment of respiratory function of abdominal muscles in normal subjects. Eur Respir J. 1997;10:2861–7.CrossRefPubMed
13.
go back to reference Pinto RZ, Ferreira PH, Franco MR, Ferreira MC, Ferreira ML, Teixeira-Salmela LF, et al. The effect of lumbar posture on abdominal muscle thickness during an isometric leg task in people with and without non-specific low back pain. Man Ther. 2011;16(6):578–84.CrossRefPubMed Pinto RZ, Ferreira PH, Franco MR, Ferreira MC, Ferreira ML, Teixeira-Salmela LF, et al. The effect of lumbar posture on abdominal muscle thickness during an isometric leg task in people with and without non-specific low back pain. Man Ther. 2011;16(6):578–84.CrossRefPubMed
14.
go back to reference Koppenhaver SL, Parent EC, Teyhen DS, Herbert JJ, Fritz JM. 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. J Orthop Sports Phys Ther. 2009;39(8):604–11.CrossRefPubMed Koppenhaver SL, Parent EC, Teyhen DS, Herbert JJ, Fritz JM. 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. J Orthop Sports Phys Ther. 2009;39(8):604–11.CrossRefPubMed
15.
go back to reference Dankaerts W, O’Sullivan PB, Burnett AF, Straker LM, Danneels LA. Reliability of EMG measurements for trunk muscles during maximal and sub-maximal voluntary isometric contractions in healthy controls and CLBP patients. J Electromyographie Kinesiology. 2004;14(3):333–42.CrossRef Dankaerts W, O’Sullivan PB, Burnett AF, Straker LM, Danneels LA. Reliability of EMG measurements for trunk muscles during maximal and sub-maximal voluntary isometric contractions in healthy controls and CLBP patients. J Electromyographie Kinesiology. 2004;14(3):333–42.CrossRef
16.
go back to reference Tsao H, Hodges PW. Immediate changes in feedforward postural adjustments following voluntary motor training. Exp Brain Res. 2007;181(4):537–46.CrossRefPubMed Tsao H, Hodges PW. Immediate changes in feedforward postural adjustments following voluntary motor training. Exp Brain Res. 2007;181(4):537–46.CrossRefPubMed
Metadata
Title
Using ultrasound to assess the thickness of the transversus abdominis in a sling exercise
Authors
Jörn Lükens
Kim J. Boström
Christian Puta
Tobias L. Schulte
Heiko Wagner
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-015-0674-3

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