Transversus Abdominis Function Research Articles

Does transversus abdominis function correlate with prone plank and bench bridge holding time in club cricket players?

Bridge and plank holding times are used to evaluate core stability. Transversus abdominis (TA) muscle function is assessed using ultrasound and also provides input on an individual's core stability. A correlation study comparing TA muscle function with bridge and plank holding time in club cricketers. Seventeen male, premier league cricketers (age: 22.1 ± 3.3 years) participated in this study. Ultrasound was used to measure bilateral TA, internal oblique (OI) and external oblique (OE) muscle thickness at rest and during abdominal hollowing. Muscle function was measured by means of a Pearson's correlation as the change in muscle thickness from rest to abdominal hollowing and compared to holding time of the bench bridge and prone plank (seconds). TA muscle thickness was preferentially recruited bilaterally (p=0.00001) during abdominal hollowing. No significant correlations were found between TA muscle function and holding time for the bench bridge (dominant (D): r = 0.03 [95% CI:-0.46-0.50]; non-dominant (ND): r = -0.02 [95% CI:-0.50-0.47]) or prone plank (D: r = -0.16 [95% CI:-0.60-0.34]; ND: r = -0.13 [95% CI:-0.57-0.38]). Prone plank and bench bridge holding times are not correlated with TA muscle function during abdominal hollowing. Core stability cannot rely on a single test to evaluate its effectiveness. In particular, the contribution of the local and global muscle system to 'core stability' needs to be evaluated independently. Therefore these tests are not sensitive enough to evaluate the contribution of the local muscle system to the global muscle system in a healthy, pain free, sporting population.

Extended field-of-view ultrasound imaging is reliable for measuring Transversus Abdominis muscle size at rest and during contraction

BackgroundThe strength and size of core muscles, including the abdominal muscles, are crucial to proper function in most activities. Therefore, it is important to reliably assess these characteristics. Our primary objective was to determine if the length, thickness and cross-sectional area of the transversus abdominis (TrA) can be visualized independently from the internal and external abdominal oblique muscles using extended field of view ultrasound imaging at rest and with contraction and to establish its intra- and inter-tester reliability.MethodsTwenty-six individuals were recruited to participate in the study (20 F, 6 M), average age 24.0 years (SD 9.4), height 170.7 cm (SD 8.6) and weight 63.9 kg (SD 9.0). From this total number of participants, two groups of 16 randomly selected participants were assessed to determine intra- and inter-tester reliability respectively. Extended field of view ultrasound images were obtained at three vertebral levels during rest and contraction in the side lying position for both the right and left sides of the trunk.ResultsExcellent intra-tester and inter-tester reliability was seen (ICC range of 0.972 to 0.984). The overall average percent standard error of the measurement for all measurements and locations was approximately 4%. The overall average minimal difference for the thickness measurement for the resting and contraction conditions combined were as follows: intratester 0.056 (0.014) cm and intertester 0.054 (0.017) cm, for area intratester 0.287 (0.086) cm2 and intertester 0.289 (0.101) cm2 and for length intratester 0.519 (0.097) cm and intertester 0.507 (0.085) cm.ConclusionsExtended field of view ultrasound imaging is an effective method of reliably capturing clear images of the TrA during rest and contraction. It provides an efficient mechanism for the analysis of muscle morphology by being able to measure the cross-sectional area, thickness, and length on one image. This methodology is recommended for studies investigating TrA function and training.

Changes in thickness of the transversus abdominis during the abdominal drawing-in manoeuvre and expiratory muscle training in elderly people.

[Purpose] It has been reported that exercises focusing upon the transversus abdominis (TrA) ameliorate low back pain (LBP). We investigated whether expiratory muscle training (EMT) can promote activity of the TrA to the same degree as the abdominal drawing-in manoeuvre (ADIM) in elderly individuals. [Subjects and Methods] Twenty-one elderly subjects (9 males, 12 females; mean age, 84.9 ± 6.6 years) without LBP symptoms were included. Using ultrasound imaging we measured changes in thickness of the lateral abdominal muscles, TrA, internal oblique muscle (IO), and external oblique muscle (EO) during ADIM and EMT. The load in EMT was set to 15% of maximal expiratory pressure. [Results] TrA showed a significant increase in muscle thickness during ADIM and EMT compared with at rest. A significant increase in muscle thickness was noted for EMT in comparison with ADIM. No significant differences were found for IO and EO. [Conclusion] In elderly people, EMT may be an effective alternative to ADIM for promoting activity of the TrA and can be used as an exercise to maintain TrA function.

In a dynamic lifting task, the relationship between cross-sectional abdominal muscle thickness and the corresponding muscle activity is affected by the combined use of a weightlifting belt and the Valsalva maneuver

It has been shown that under isometric conditions, as the activity of the abdominal muscles increases, the thicknesses of the muscles also increase. The purpose of this experiment was to determine whether change in muscle thickness could be used as a measure of muscle activity during a deadlift as well as determining the effect of a weightlifting belt and/or the Valsalva maneuver on the muscle thicknesses. The Transversus Abdominis (TrA) and Internal Obliques (IO) muscles were analyzed at rest and during a deadlift. Muscle thickness was measured using ultrasound imaging and muscle activity was simultaneously recorded using electromyography. Each subject performed deadlift under normal conditions, while performing the Valsalva maneuver, while wearing a weightlifting belt and while both utilizing the belt and the Valsalva maneuver. There was no relationship between change in muscle thickness and muscle activity for both the TrA and IO (R2<0.13 for all conditions). However it was found that the Valsalva maneuver increased abdominal muscle thickness whereas the belt limited muscle expansion; each with an increase in activity. These results indicate that ultrasound cannot be used to measure muscle activity for a deadlift and that the belt affects how the IO and TrA function together.

The effect of transversus abdominis activation on exercise-related transient abdominal pain

Exercise-related transient abdominal pain (ETAP) affects 40-60% of the physically active population, is detrimental to performance but of unknown aetiology. Excessive movement of abdominal peritoneum is one proposed mechanism. Transversus abdominis (TrA) function may play a role reducing in the incidence of Exercise-related transient abdominal pain via the tensioning of the thoracolumbar fascia or increasing intra-abdominal pressure. The aim of this study is to identify any relationship between transversus abdominis function and exercise-related transient abdominal pain, hypothesing that those with stronger transversus abdominis will have lower incidence of exercise-related transient abdominal pain. Observational study design. Trunk muscle strength was measured clinically using the functional Sahrmann test. Contraction of transversus abdominis was measured by ultrasound imaging of resting muscle size and calculating the change in thickness with a voluntary contraction. Participants completed questionnaires describing any exercise-related transient abdominal pain symptoms, and were divided into four groups dependent upon frequency of any symptoms (never, yearly, monthly and weekly). Between group differences were analysed using analysis of covariance, with Bonferroni correction adjusting for age and training of participants using STATA. Poisson regression determined incident rate ratios for relevant variables. Data was obtained from fifty runners (28 male, 25.8 ± 7.0 years). Sahrmann test score and frequency of Exercise-related transient abdominal pain were significantly different between groups (p=0.002) with asymptomatic runners having significantly higher Sahrmann test scores (stronger muscles) than weekly and yearly Exercise-related transient abdominal pain groups (p=0.001, p=0.02). There were significant between group differences for resting transversus abdominis thickness (p=0.034) but not for transversus abdominis thickness change (p=0.555). Participants who had stronger trunk muscles and larger resting Transversus abdominis size experienced Exercise-related transient abdominal pain less.

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

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. 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. Case-control study. Local orthopaedic clinic and research laboratory. 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. 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. 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. 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 < .05). Group differences in peak and mean EMG amplitudes and onset time values for TrA/IO and TA were achieved (P < .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). 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.

Effect of 2 Lumbar Spine Postures on Transversus Abdominis Muscle Thickness During a Voluntary Contraction in People With and Without Low Back Pain

Objective The present study investigated the effect of 2 different lumbar spine postures, neutral and flexed lumbar postures, on transversus abdominis (TrA) muscle function during a voluntary contraction (hollowing and draw-in maneuver) in people with and without low back pain (LBP). Methods Thirty participants with LBP and 30 healthy participants were recruited for this cross-sectional study. Transversus abdominis muscle function was measured as a change in thickness with ultrasound imaging. Participants performed voluntary TrA contraction in a supine lying position with the lumbar spine in neutral and flexed postures. Data were analyzed using a 2-way (groups, postures) analysis of variance. Results Lumbar posture influenced TrA function during a voluntary contraction in people with and without LBP. There was a significant main effect of posture (F 1,58 = 16.140, P < .001). Neutral lumbar posture improved participants' ability to recruit TrA in both group (mean difference, 7.5%; 95% confidence interval, 3.8%-11.3%). No significant differences were found between healthy subjects and those with LBP. Conclusions The results of the present study showed that, in subjects performing a voluntary TrA contraction, the neutral lumbar posture improves the ability to increase change in TrA thickness. This study found no significant difference in TrA thickness change between healthy subjects and those with nonspecific LBP.

Transversus Abdominis Function: A Reliability Study Using Ultrasound Imaging to Measure Changes in Muscle Thickness

Background: Transversus Abdominis (TrA) has an important role in spinal stability contributing to both intraabdominal pressure and the formation of a muscular corset around the spine. Transversus Abdominis has been shown to be dysfunctional in patients with low back pain (LBP) and ultrasound (US) imaging is seen to have an increasing role in the assessment and management of these patients. This study assessed the intrarater reliability of a novice operator to measure the thickness of transversus abdominis when using brightness (B) mode ultrasound imaging. Method: Twenty normal subjects participated in an operator blinded study to assess the intra-rater reliability of US in measuring the thickness of TrA when contracted using the abdominal hollowing exercise (AHE). Brightness (B) mode US was used to image the TrA at the end of expiration. Subjects were then re-imaged in the standardized position. Results: An intraclass correlation coefficient of 0.96 with 95% confidence intervals of 0.93- 0.98 were obtained indicating excellent reliability. However, limits of agreement were ‐ 1.52 mm to +1.35mm (range 2.87mm) suggesting that clinically meaningful measurements may not reliably be measured by a novice operator. Conclusion: This study indicates that additional training is required to achieve clinically meaningful results. It also highlights the importance of using more than one method of establishing reliability.

Evaluation of Transversus Abdominis Function in Physically Active and Pilates Trained Subjects

Evaluation of Transversus Abdominis Function in Physically Active and Pilates Trained Subjects

The relationship between EMG and change in thickness of transversus abdominis

Objective. To investigate the relationship between changes in thickness and EMG activity in the transversus abdominis muscle of healthy subjects and the reliability of ultrasound measurements using different modes and transducers. Design. Convenience sampling. Background. Chronic low back pain is associated with transversus abdominis dysfunction but EMG studies of this muscle are restricted to invasive techniques. Since the thickness of transversus abdominis changes with activity, such changes measured from ultrasound images might provide insight into this muscle's function non-invasively. In addition, little is known about the comparability of ultrasound measurements from different modes and transducers, nor the reliability of transversus abdominis measurements. Methods. In 9 healthy subjects (aged 29–52 years, four male) transversus abdominis was studied at rest and during activity (5–80% max) with simultaneous EMG and ultrasound (M mode, 5 MHz curvilinear transducer) measurements. Intra-rater reliability for thickness measurements was studied on 13 subjects using 7.5 MHz linear and 5 MHz curvilinear transducers in B and M modes. Results. Muscle thickness changes correlated well with EMG activity ( P<0.001, R 2=0.87) and there were no significant differences between subjects ( P>0.05). Using 7.5 MHz head, the ICC for B mode was 0.989 and for M mode was 0.981 for between days reliability. The ICC for between transducer reliability was 0.817. Conclusions. Changes in thickness of transversus abdominis can be used to indicate changes in the electrical activity in this muscle. Relevance Ultrasound scanning can be used in the clinical setting to provide objective information about transversus abdominis function.

Measurement of abdominal muscle thickness using M-mode ultrasound imaging during functional activities

Ultrasound imaging has been previously utilized in the measurement of muscle thickness and cross-sectional area in research studies, and advocated as a clinical biofeedback tool in the rehabilitation of transversus abdominis function following episodes of low back pain. This paper describes how the thickness of the abdominal muscles can be quantified with a new measurement technique using M-mode ultrasound. The technique uses a custom-made transducer holder that facilitates measurement of muscle thickness changes during functional activity. Limitations of the technique and potential future applications are discussed. The M-mode ultrasound technique may provide an effective method for the non-invasive measurement of abdominal muscle thickness during functional activities.