Diaphragm thickness, thickness change, and excursion in subjects with and without nonspecific low back pain using B-mode and M-mode ultrasonography

2021 ◽  
pp. 1-11
Author(s):  
Maryam Ziaeifar ◽  
Javad Sarrafzadeh ◽  
Shohreh Noorizadeh Dehkordi ◽  
Amir Massoud Arab ◽  
Hamidreza Haghighatkhah ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Diaphragm Thickness ◽  
Thickness Change

scholarly journals Exploring Neuromuscular Electrical Stimulation Intensity Effects on Multifidus Muscle Activity in Adults With Chronic Low Back Pain: An Ultrasound Imaging–Informed Investigation

2019 ◽  
Vol 12 ◽  
pp. 117954411984957 ◽  
Author(s):  
Jaclyn Megan Sions ◽  
DeJ’a Chyanna Crippen ◽  
Gregory Evan Hicks ◽  
Abdulmohsen Meshari Alroumi ◽  
Tara Jo Manal ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Muscle Activity ◽  
Neuromuscular Electrical Stimulation ◽  
Low Back ◽  
High Tolerance ◽  
Multifidus Muscle ◽  
Thickness Change

Study design: Cross-sectional study. Background: Neuromuscular electrical stimulation (NMES) is an effective tool for stimulating multifidus muscle contractions. Ultrasound imaging (USI) is valid and reliable for quantifying multifidus activity represented by percent thickness change from a resting to contracted state. Thus, USI may be used to help determine optimal NMES intensity. Objectives: To explore NMES intensity effects on multifidus thickening in adults with chronic low back pain (CLBP). Methods: Sixty patients with CLBP participated. L4/5 multifidus ultrasound images were obtained and percent thickness change from a resting to a contracted state was determined at baseline with a limb lift and during NMES application. During NMES, the examiner recorded the intensity, in milliampere, when the multifidus first started to thicken as observed with USI. The examiner also recorded the NMES intensity that resulted in no further multifidus thickening (ie, high-tolerance group) or, in cases where maximal thickening was not observed, the NMES intensity of the submaximal contraction (ie, low-tolerance group). Differences between participants with high versus low NMES tolerance were evaluated. Results: During NMES, the multifidus began thickening at a higher intensity for the high-tolerance group (n = 39), that is, 34 mA, compared with the low-tolerance group (n = 21), that is, 32 mA ( P = .001). A greater mean intensity in the high-tolerance group, that is, 62 mA, as compared to 45 mA in the low-tolerance group, resulted in a larger percent thickness change, that is, 30.89% compared to 20.60%, respectively ( P < .001). Conclusions: Results provide clinicians with NMES intensity targets to facilitate multifidus muscle thickening, which provides insight into muscle activity.

scholarly journals Cocontraction of Ankle Dorsiflexors and Transversus Abdominis Function in Patients With Low Back Pain

2012 ◽  
Vol 47 (4) ◽  
pp. 379-389 ◽  
Author(s):  
Seung-Chul Chon ◽  
Joshua H. You ◽  
Susan A. Saliba
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Onset Time ◽  
Muscle Thickness ◽  
Transversus Abdominis ◽  
Low Back ◽  
Control Groups ◽  
Thickness Change ◽  
And Control ◽  
Ankle Dorsiflexors

Context: The abdominal draw-in maneuver (ADIM) with cocontraction has been shown to be a more effective method of activating the transversus abdominis (TrA) in healthy adults than the ADIM alone. Whether such an augmented core stabilization exercise is effective in managing low back pain (LBP) remains uncertain. Objective: To determine the effect of 2 weeks of ADIM and cocontraction training on abdominal muscle thickness and activation timing and to monitor pain and function in patients with LBP. Design: Case-control study. Setting: Local orthopaedic clinic and research laboratory. Patients or Other Participants: Twenty patients with mechanical LBP (age = 27.20 ± 6.46 years, height = 166.25 ± 8.70 cm, mass = 58.10 ± 11.81 kg) and 20 healthy, age-matched people (age = 24.25 ± 1.59 years, height = 168.00 ± 8.89 cm, mass = 60.65 ± 11.99 kg) volunteered for the study. Intervention(s): Both the LBP and control groups received ten 30-minute sessions of ADIM and cocontraction training of the tibialis anterior (TA) and rectus femoris (RF) muscles over a 2-week period. Main Outcome Measure(s): A separate, mixed-model analysis of variance was computed for the thicknesses of the TrA, internal oblique (IO), and external oblique muscles. The differences in mean and peak electromyographic (EMG) amplitudes, onset time, and latency were compared between the groups. The visual analog pain scale, Pain Disability Index, and LBP rating scale were used to assess pain in the LBP group before and after the intervention. Results: We found an interaction between the LBP and control groups and a main effect from pretest to posttest for only TrA muscle thickness change (F1,38 = 6.57, P = .01). Reductions in all pain measures were observed after training (P &lt; .05). Group differences in peak and mean EMG amplitudes and onset time values for TrA/IO and TA were achieved (P &lt; .05). The RF peak (t38 = −3.12, P = .003) and mean (t38 = −4.12, P = .001) EMG amplitudes were different, but no group difference was observed in RF onset time (t38 = 1.63, P = .11) or the cocontracted TrA/IO peak (t38 = −1.90, P = .07) and mean (t38 = −1.81, P = .08). The test-retest reliability for the muscle thickness measure revealed excellent correlations (intraclass correlation coefficient range, 0.95–0.99). Conclusions: We are the first to demonstrate that a cocontraction of the ankle dorsiflexors with ADIM training might result in a thickness change in the TrA muscle and associated pain management in patients with chronic LBP.

scholarly journals Reproducibility of Rehabilitative Ultrasound Imaging for the Measurement of Abdominal Muscle Activity: A Systematic Review

2009 ◽  
Vol 89 (8) ◽  
pp. 756-769 ◽  
Author(s):  
Leonardo Oliveira Pena Costa ◽  
Chris G. Maher ◽  
Jane Latimer ◽  
Rob J.E.M. Smeets
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Abdominal Wall ◽  
Ultrasound Imaging ◽  
Muscle Activity ◽  
Abdominal Muscle ◽  
Current Evidence ◽  
Low Back ◽  
Critical Question ◽  
Thickness Change

BackgroundRehabilitative ultrasound imaging (RUSI) measures of abdominal wall muscles are used to indirectly measure muscle activity. These measures are used to identify suitable patients and to monitor progress of motor control exercise treatment of people with low back pain.PurposeThe purpose of this study was to systematically review reproducibility studies of RUSI for measuring thickness of abdominal wall muscles.Data SourcesEligible studies were identified via searches of MEDLINE, EMBASE, and CINAHL. The authors also searched personal files and tracked references of the retrieved studies via the Web of Science Index.Study SelectionStudies involving any type of reliability and or agreement of any type of ultrasound measurements (B or M mode) for any of the abdominal wall muscles were selected.Data ExtractionTwo independent reviewers extracted data and assessed methodological quality.Data SynthesisDue to heterogeneity of the studies’ designs, pooling the data for a meta-analysis was not possible. Twenty-one studies were included, and these studies were typically of low quality and studied subjects who were healthy rather than people seeking care for low back pain. The studies reported good to excellent reliability for single measures of thickness and poor to good reliability for measures of thickness change (reflecting the muscle activity). Interestingly, no studies checked reliability of measures of the difference in thickness changes over time (representing improvement or deterioration in muscle activity).ConclusionsThe current evidence of the reproducibility of RUSI for measuring abdominal muscle activity is based mainly on studies with suboptimal designs and the study of people who were healthy. The critical question of whether RUSI provides reliable measures of improvement in abdominal muscle activity remains to be evaluated.

scholarly journals The Main Role of Diaphragm Muscle as a Mechanism of Hypopressive Abdominal Gymnastics to Improve Non-Specific Chronic Low Back Pain: A Randomized Controlled Trial

2021 ◽  
Vol 10 (21) ◽  
pp. 4983
Author(s):  
Davinia Vicente-Campos ◽  
Sandra Sanchez-Jorge ◽  
Pablo Terrón-Manrique ◽  
Marion Guisard ◽  
Marion Collin ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Chronic Low Back Pain ◽  
Central Sensitization ◽  
Diaphragm Muscle ◽  
Control Group ◽  
Low Back ◽  
Diaphragm Thickness ◽  
Left And Right

Background: Chronic low back pain (LBP) has been stated as one of the main health concerns in the XXI century due to its high incidence. Objective: The objective of this study was to determine the effects of an 8-week program of hypopressive abdominal gymnastics (HAG) on inspiratory muscle strength, diaphragm thickness, disability and pain in patients suffering from non-specific chronic LBP. Methods: A total of 40 patients with chronic LBP were randomly divided into two groups. The experimental group carried out an 8-week supervised program of HAG (two sessions/week), whereas the control group did not receive any treatment. Outcomes were measured before and after the intervention, comprising diaphragm thickness during relaxed respiratory activity, maximal inspiratory pressure (PImax), pain intensity (NRS), pressure pain threshold and responses to four questionnaires: Physical Activity Questionnaire (PAQ), Roland–Morris Disability Questionnaire (RMQ), Central Sensitization Inventory (CSI) and Tampa Scale of Kinesiophobia-11 Items (TSK-11). Results: Statistically significant differences (p < 0.05) were observed for greater thickness of the left and right hemi-diaphragms at inspiration, as well as higher PImax and decreased NRS, CSI and RMQ scores in the intervention group. After treatment, the increases in the thickness of the left and right hemi-diaphragms at inspiration and PImax, as well as the decrease in the NRS and RMQ scores, were only predicted by the proposed intervention (R2 = 0.118–0.552). Conclusions: An 8-week HAG intervention seemed to show beneficial effects and predicted an increase in diaphragm thickness and strength during inspiration, as well as a reduction in pain intensity, central sensitization and disability, in patients suffering from chronic non-specific LBP with respect to non-intervention.

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