Ultrasound Characteristics of the Deep Abdominal Muscles During the Active Straight Leg Raise Test

Teyhen, Deydre S.; Williamson, Jared; Carlson, Nathan H.; Suttles, Sean T.; O'Laughlin, Shaun J.; Whittaker, Jackie L.; Goffar, Stephen L.; Childs, John D.

doi:10.1016/j.apmr.2008.11.011

Cited by 101 publications

(104 citation statements)

References 31 publications

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“…This is comparable to the results of Critchley and Coutts [27], who recorded thickness change of 49.71% in pain-free controls, however, disagrees with values reported by Koppenhaver et al [21] who found thickness change of about 80% in symptomatic subjects performing voluntary contraction of the TrA. Since evidence suggest that it is unlikely that patients would activate their muscles 'better' than asymptomatic subjects [27,28], we can speculate that it was positioning of the subject what determined observed differences. In the study of Koppenhaver et al [21], the largest TrA thickness change occurred in hook-lying while in supine position it ranged only from 13.1 to 17.9%.…”

Section: Discussioncontrasting

confidence: 37%

Reliability of real-time ultrasound measurement of transversus abdominis thickness in healthy trained subjects

Gnat¹,

Saulicz²,

Miądowicz³

2012

Eur Spine J

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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.

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Section: Discussioncontrasting

confidence: 37%

Reliability of real-time ultrasound measurement of transversus abdominis thickness in healthy trained subjects

Gnat¹,

Saulicz²,

Miądowicz³

2012

Eur Spine J

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“…However, the assessment of AH in positions that better challenge lumbar stability [42] or employ more functional positions such as standing [28] might be better equipped to reveal any impairment in TrA dysfunction. Nonetheless, though sub-group analyses were not part of her main study design, Mew [28] failed to see any notable difference in performance in individuals with a history of LBP compared with controls, whether tested in 4-point kneeling or in standing, and neither were group differences seen in supine lying or 4-point kneeling positions in the recently published study of Gorbet et al [12].…”

Section: Discussionmentioning

confidence: 99%

“…The use of indices expressing the thickness ratio of the relaxed and contracted TrA has further contributed to the quantification of TrA function [41], and such indices have been shown to yield reliable between-day measures in both control subjects and in patients with cLBP [25]. To measure muscle dimensions, bright (B)-Mode ultrasound is usually used, with muscle thickness being measured using on-screen callipers [7,21,22,29,41,42]. However, by applying moving (M)-Mode ultrasound, a depth versus time chart can be displayed, permitting the measurement of thickness changes over time [5].…”

Section: Introductionmentioning

confidence: 99%

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?

et al. 2011

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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.

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“…The feet were positioned 20 cm apart prior to the subject being asked to raise the lower extremity 5 cm off the plinth without bending the knee 8) . Ten seconds after lifting the right leg about 5 cm from the plinth, the bilateral deep abdominal muscles were measured in the same manner as for ADIM 7) . For both postures, the transducer was placed 25 mm form the side between the 12 th rib and the iliac crest for measurement.…”

Section: Methodsmentioning

confidence: 99%

“…It has been reported to have clinical diagnostic value and validity in the assessment of the motor control deficits of patients with unilateral lumbopelvic pain 7) . The ASLR is easier to understand than ADIM, and it is considered to be a method that is easy to perform.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Abdominal Muscle Thicknesses Measured by Ultrasonography between the Abdominal Drawing-in and Straight Leg Raise Maneuvers

Lee

Seo

2012

J Phys Ther Sci

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Abstract. [Purpose] This study compared and analyzed the ultrasonograms of deep abdominal muscles (transverse abdominis muscle, internus oblique abdominal muscle, external oblique abdominal muscle) in the Active Straight Leg Raise (ASLR) and Abdominal Drawing-In Maneuver (ADIM) to identify more effective clinical diagnosis methods. [Subjects and Methods] The study was conducted by performing ASLR and ADIM movement in sequence. The subjects were 37 healthy subjects and we measured the thicknesses of deep abdominal muscles (transverse abdominis muscle, internus oblique abdominal muscle, external oblique abdominal muscle) on ultrasonograms taken during ASLR and ADIM for comparison and analysis. In order to assess the relations among the deep abdominal muscles on the same side as measured during ASLR and ADIM, a correlation analysis was carried out. The independent t-test was conducted to identify the differences in thicknesses of same side muscles as measured during ASLR and ADIM.[Results] The results show that each muscle on the same side during ASLR and ADIM had high level of correlations except during ASLR and ADIM the right EO. Also, for the muscle thickness of the same side muscles, only the right EO showed a significant differences.[Conclusion] ADIM is a complicated and difficult movement to measure. ASLR also enables the measurement of deep abdominal muscles; therefore, it could be used to elevate the efficiency of clinical diagnosis. We anticipate that ASLR will be used more for the measurement of deep abdominal muscles.

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Ultrasound Characteristics of the Deep Abdominal Muscles During the Active Straight Leg Raise Test

Cited by 101 publications

References 31 publications

Reliability of real-time ultrasound measurement of transversus abdominis thickness in healthy trained subjects

Reliability of real-time ultrasound measurement of transversus abdominis thickness in healthy trained subjects

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?

A Comparison of Abdominal Muscle Thicknesses Measured by Ultrasonography between the Abdominal Drawing-in and Straight Leg Raise Maneuvers

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