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.
[Purpose] The purpose of this study was to examine the activities of the abdominal
muscles of women who had experienced vaginal delivery in comparison with those who had
experienced Cesarean childbirth. [Subjects and Methods] A total of 14 subjects (7 vaginal
delivery, 7 Cesarean section) performed an active straight leg raise to 20 cm above the
ground, and we measured the activities of the internal oblique abdominal muscle, the
external oblique abdominal muscle, and the rectus abdominal muscle on both sides using
electromyography. The effort required to raise the leg was scored on a Likert scale. Then,
the subjects conducted maximum isometric contraction for hip joint flexion with the leg
raised at 20 cm, and maximum torque and abdominal muscle activities were measured using
electromyography. [Results] During the active straight leg raise, abdominal muscle
activities were higher in the Cesarean section subjects. The Likert scale did not show a
significant difference. The activities of the abdominal muscles and the maximum torque of
the hip joint flexion at maximum isometric contraction were higher in the vaginal delivery
subjects. [Conclusion] The abdominal muscles of Cesarean section subjects showed greater
recruitment for maintaining pelvic stability during the active straight leg raising, but
were relatively weaker when powerful force was required. Therefore, we consider that more
abdominal muscle training is necessary for maintaining pelvic stability of Cesarean
section subjects.
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