scholarly journals Reproducibility and Concurrent Validity of Manual Palpation with Rehabilitative Ultrasound Imaging for Assessing Deep Abdominal Muscle Activity: Analysis with Preferential Ratios

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 298
Author(s):  
Irene Valentín-Mazarracin ◽  
Miriam Nogaledo-Martín ◽  
Ibai López-de-Uralde-Villanueva ◽  
César Fernández-de-las-Peñas ◽  
María Stokes ◽  
...  

The abdominal drawing-in maneuver (ADIM) is a clinical tool used for identifying preferential activity of deep abdominal muscles. However, concurrent validity and reproducibility of palpation during the ADIM has not been formally investigated. The aims of this study were (1) to assess intra- and interrater reliability of manual palpation during the ADIM, and (2) to determine the concurrent validity of manual palpation during the ADIM by calculating preferential activation ratio cut-off as assessed with ultrasound imaging (RUSI). Thirty-two subjects (n = 16 patients with nonspecific low back pain and 16 comparable healthy individuals) performed the ADIM in a supine hook-lying position. Two experienced assessors evaluated the presence or absence of preferential contraction of the deep abdominal muscles by palpation during the ADIM on 2 different days. Intrarater (test-retest) and interrater reliability of palpation were calculated using Cohen’s kappa coefficients. Muscle thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles at rest and during the ADIM were also measured. TrA-Contraction Ratio (TrA-CR), TrA-Preferential Activation Ratio (TrA-PAR), and Modified-TrA-PR (M-TrA-PAR) were calculated. The concurrent validity of manual palpation was determined using the correlation between manual palpation and imaging and by calculating ROC curve (operating characteristics curve), Youden index, and sensitivity and specificity. Intra- and interrater reliability of manual palpation during the ADIM was excellent (k: 0.82–1.00) and good to excellent (k: 0.71–1.00), respectively. Interrater reliability for muscle thickness ranged from good to excellent (ICC3,1 0.79–0.91). Manual palpation and TrA ratio showed low to moderate correlations (r: 0.36–0.60). When evaluating the diagnostic accuracy of manual palpation, the best predictive model (ROC value: 0.89; p < 0.001) for correct a preferential contraction of TrA was obtained when the M-TrA-PAR was ≥0.08 (sensitivity: 0.95–1.00; specificity: 0.62). Good to excellent intra- and interrater reliability of manual palpation was found during the ADIM in both patients and healthy groups. Manual palpation showed concurrent validity for identifying the preferential activity of the TrA muscle supporting its use in clinical practice.

2012 ◽  
Vol 21 (2) ◽  
pp. 151-160 ◽  
Author(s):  
Rebecca J. Guthrie ◽  
Terry L. Grindstaff ◽  
Theodore Croy ◽  
Christopher D. Ingersoll ◽  
Susan A. Saliba

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-by-time 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.


Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 702
Author(s):  
Iria Da Cuña-Carrera ◽  
Alejandra Alonso-Calvete ◽  
Mercedes Soto-González ◽  
Eva M. Lantarón-Caeiro

Background and objective: Prior studies have reported an activation of abdominal muscles during hypopressive exercises in women with pelvic floor disfunction. However, no previous research analyzed the effects of hypopressive exercise on abdominal muscles in healthy populations to understand the normal biomechanics of this area. The aim of this study was to examine the thickness of abdominal muscles at rest and during hypopressive exercise in supine and standing positions with ultrasound imaging in healthy adults. Methods: A cross-sectional study was carried out in 99 healthy university students. The thickness of the abdominal muscles at rest and during hypopressive exercise was assessed with ultrasound imaging in supine and standing positions. Results: During hypopressive exercise, there was a significant increase in the muscle thickness of transversus abdominis (p < 0.001) and internal oblique (p < 0.001) in supine and standing positions. External oblique only increased its thickness significantly in the standing position (p < 0.001) and rectus abdominis did not change during the hypopressive exercise in any position (p > 0.05). In conclusion, hypopressive exercises seem to increase the thickness of the deepest and most stabilized muscles such as transversus abdominis and internal oblique. Conclusion: These findings should be considered for future interventions with hypopressive exercises in healthy subjects.


2020 ◽  
Vol 63 (12) ◽  
pp. 3974-3981
Author(s):  
Ashwini Joshi ◽  
Isha Baheti ◽  
Vrushali Angadi

Aim The purpose of this study was to develop and assess the reliability of a Hindi version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). Reliability was assessed by comparing Hindi CAPE-V ratings with English CAPE-V ratings and by the Grade, Roughness, Breathiness, Asthenia and Strain (GRBAS) scale. Method Hindi sentences were created to match the phonemic load of the corresponding English CAPE-V sentences. The Hindi sentences were adapted for linguistic content. The original English and adapted Hindi CAPE-V and GRBAS were completed for 33 bilingual individuals with normal voice quality. Additionally, the Hindi CAPE-V and GRBAS were completed for 13 Hindi speakers with disordered voice quality. The agreement of CAPE-V ratings was assessed between language versions, GRBAS ratings, and two rater pairs (three raters in total). Pearson product–moment correlation was completed for all comparisons. Results A strong correlation ( r > .8, p < .01) was found between the Hindi CAPE-V scores and the English CAPE-V scores for most variables in normal voice participants. A weak correlation was found for the variable of strain ( r < .2, p = .400) in the normative group. A strong correlation ( r > .6, p < .01) was found between the overall severity/grade, roughness, and breathiness scores in the GRBAS scale and the CAPE-V scale in normal and disordered voice samples. Significant interrater reliability ( r > .75) was present in overall severity and breathiness. Conclusions The Hindi version of the CAPE-V demonstrates good interrater reliability and concurrent validity with the English CAPE-V and the GRBAS. The Hindi CAPE-V can be used for the auditory-perceptual voice assessment of Hindi speakers.


Author(s):  
Blanca De-la-Cruz-Torres ◽  
Emmanuel Navarro-Flores ◽  
Daniel López-López ◽  
Carlos Romero-Morales

Background: the aim of this study was to compare the echotexture of patients with soleus muscle injury and age matched controls. Methods: a sample of 62 athletes was recruited at the private clinic and was divided in two group: a healthy group (n = 31) and a soleus pathology group whose athletes had soleus muscle injury, located in the central tendon (n = 31). The muscle thickness (MTh), echointensity (EI) and echovariation (EV) were analyzed. An intra-rater reliability test (Intraclass Correlation Coefficient-ICC) was performed in order to analyze the reliability of the values of the measurements. Results: Sociodemographic variables did not show statistically significant differences (p > 0.05). Ultrasound imaging measurements who reported statistically significant differences were EI (p = 0.001) and standard deviation (SD) (p = 0.001). MTh and EV variables did not show statistically significant differences (p = 0.381 and p = 0.364, respectively). Moreover, reliability values for the MTh (ICC = 0.911), EI (ICC = 0.982), SD (ICC = 0.955) and EV (ICC = 0.963). Based on these results the intra-rater reliability was considered excellent. Conclusion: Athletes with a central tendon injury of soleus muscle showed a lower EI when they were compared to healthy athletes. The echogenicity showed by the quantitative ultrasound imaging measurement may be a more objective parameter for the diagnosis and follow-up the soleus muscle injuries.


2021 ◽  
pp. 1-10
Author(s):  
Ryo Miyachi ◽  
Nana Koike ◽  
Suzu Kodama ◽  
Junya Miyazaki

BACKGROUND: Although trunk muscles are involved in many important functions, evaluating trunk muscle strength is not an easy task. If trunk muscle mass and thickness could be used as indicators of trunk muscle strength, the burden of measurement would be reduced, but the relationship between trunk muscle strength and trunk muscle mass and thickness has not been clarified. OBJECTIVE: The purpose of this study was to clarify the relationship between trunk muscle strength and trunk muscle mass by bioelectrical impedance analysis and trunk muscle thickness by ultrasound imaging in healthy adults. METHODS: One hundred and twenty-one healthy university students were included in this study. Trunk flexion/extension muscle strength and trunk muscle mass by bioelectrical impedance analysis, and trunk muscle thickness by ultrasound imaging were measured. RESULTS: Both trunk flexion strength and trunk extension strength were significantly correlated with trunk muscle mass and oblique and rectus abdominis muscle thickness. Multiple regression analysis showed that trunk extension muscle strength had an independent relationship with trunk muscle mass. CONCLUSIONS: This study demonstrated that trunk muscle mass or trunk muscle thickness can be used as an alternative means for evaluating trunk muscle strength, making the evaluation of trunk muscles less burdensome.


2021 ◽  
Vol 10 (23) ◽  
pp. 5699
Author(s):  
Samuel Fernández-Carnero ◽  
Carlos Martin-Saborido ◽  
Alexander Achalandabaso Ochoa-Ruiz de Mendoza ◽  
Alejandro Ferragut-Garcias ◽  
Juan Nicolás Cuenca-Zaldivar ◽  
...  

Rehabilitative ultrasound imaging (RUSI) technique seems to be a valid and reliable tool for diagnosis and treatment in physiotherapy and has been widely studied in the lumbopelvic region the last three decades. The aims for this utility in clinical settings must be review through a systematic review, meta-analysis and meta-regression. A systematic review was designed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with PROSPERO registration and per review in all phases of the process using COVIDENCE, analysis of risk of bias and meta-analysis using REVMAN, and meta-regression calculation using STATA. Database screening provided 6544 references, out of which 321 reported narrative synthesis, and 21 reported quantitative synthesis, while only 7 of them provided comparable data to meta-analyze the variables pain and muscle thickness. In most cases, the forest plots showed considerable I2 heterogeneity indexes for multifidus muscle thickness (I2 = 95%), low back pain (I2 = 92%) and abdominal pain (I2 = 95%), not important for transversus abdominis muscle thickness (I2 = 22%), significant heterogenity (I2 = 69%) depending on the subgroup and not important internal oblique muscle thickness (I2 = 0%) and external oblique muscle thickness (I2 = 0%). Meta-regression did not provide significant data for the correlations between the variables analyzed and the intervention, age, and BMI (Body Mass Index). This review reveals that RUSI could contribute to a high reliability of the measurements in the lumbopelvic region with validity and reliability for the assessments, as well as showing promising results for diagnosis and intervention assessment in physiotherapy compared to the traditional model, allowing for future lines of research in this area.


Author(s):  
Bartlomiej Burzynski ◽  
Tomasz Jurys ◽  
Michalina Knapik ◽  
Kamil Burzynski ◽  
Paweł Rzymski ◽  
...  

IntroductionThis study is designed to assess the percentage share of musculus obliquus externus abdominis, musculus obliquus internus abdominis and musculus transversus abdominis activity among women with stress urinary incontinence using ultrasonography.Material and methodsMaterial and methods: The study is a retrospective analysis of prospective collected data of 84 women aged 23-62 years old. In the study group are women suffering from grade 1 or 2 stress urinary incontinence according to the Stamey classification, the control group consists of women with no micturition disorders. The abdominal muscles activity was measured by using the ultrasound imaging with assessment of muscle thickness.ResultsThe analysis of musculus obliquus externus abdominis in anterolateral abdominal wall activity shows a statistically significant difference between study and control group concerning isometric tension of abdominal muscles (p=0,012) and lower part of abdomen tension (p=0,004). Women with stress urinary incontinence present a higher activity of the musculus obliquus externus abdominis than controls. In the case of the musculus obliquus internus abdominis, statistically significant differences were shown during tension of the lower part of the abdomen (p=0,024). Comparison of activity of the musculus transversus abdominis between study and control groups shows a statistically significant difference during isometric tension of abdominal muscles (p=0,018).ConclusionsThe pattern of activity of the assessed muscles differs between the study group and the control group. In the study group, the activity pattern is concerning the higher activity of the musculus obliquus externus abdominis and the lower activity of the musculus obliquus internus abdominis and musculus transversus abdominis.


2018 ◽  
Vol 32 ◽  
pp. 109-114 ◽  
Author(s):  
Hwang-Jae Lee ◽  
Hyun-Geun Ha ◽  
Joohee Hahn ◽  
Seungyeop Lim ◽  
Wan-hee Lee

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