Abstract
BackgroundActivation 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.MethodsThe 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.ResultsA 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.ConclusionsWe 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.
Highlights
Activation of the deep stabilizing trunk muscle transversus abdominis (TrA) is important for trunk stabilization and spine stability
The present study aimed to investigate the thickness of the M. transversus abdominis (TrA) as a measure for the muscle activation on three measurement conditions: resting condition (RC), sling condition (SC), and abdominal press condition (APC), using an ultrasound-based measurement method (USM)
While it is relatively easy to place the transducer at the right spot on the abdomen when the subject is at rest, it is more difficult to place the transducer when the subject is suspended in the sling system, and when the subject contracts his abdominal muscles with maximum voluntary contraction, so that the abdomen is deformed
Summary
Activation of the deep stabilizing trunk muscle transversus abdominis (TrA) is important for trunk stabilization and spine stability. We propose a standardized measurement method, which can be used to compare relative muscle thickness levels in different exercises. The transversus abdominis (TrA) is one of the most important muscles for the stability of the lumbo-pelvic area, and is considered to be of central importance for the treatment of low back pain [1,2,3]. The patients underwent general physiotherapy, subsequently they carried out a sling exercise training at home with a compliance of 83 %. This intervention led to a decrease of absenteeism by 75-83 % as compared to the year before. Stuge et al [9] find a positive effect for the treatment of low back pain after
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