Transversus Abdominis Thickness Research Articles

The Association among Physical Activity, Sociodemographic, Trunk Muscles Thickness and Low Back Pain-Related Disability in Amateur Soccer Players: An Observational Study

Abstract Objective Although low back pain (LBP) is one of the most common musculoskeletal disorders, there is limited evidence assessing which factors contribute LBP severity in amateur athletes. We aimed to analyze relationships between sociodemographic, clinical, lifestyle and lumbar multifidus (LM) at L4 and L5 levels, rectus abdominis (RA), external and internal obliques (EO and IO) and transversus abdominis (TrA) muscles thickness assessed with ultrasound imaging (US) variables with lumbar disability in amateur athletes with LBP and lumbar disc herniation. Methods Eighty-two male amateur soccer athletes were analyzed. Demographic data, internal hip rotation, finger-floor distance, pain intensity, number of LBP episodes within the last year, metabolic equivalent of tasks for physical activity, sitting time, muscle thickness and disability caused by LBP were collected. Results Pain intensity showed significant associations with LBP recurrence, disability, sedentarism, trunk and hip flexibility, vigorous physical activity and TrA, EO and RA muscles thickness (p<0.05). Similarly, disability was associated with number of LBP episodes, vigorous activity, sitting time, finger floor distance, and RA, EO and IO muscles thickness (p<0.05). TrA thickness and internal hip rotation were not associated with lumbar disability (p>0.05). Conclusion LBP intensity and pain-related disability were significantly associated with LBP episodes, vigorous activity, sitting time, finger floor distance, and thickness of abdominal muscles were associated with pain intensity and disability. However, lumbar multifidus thickness at rest, ankle dorsiflexion and walking time were not associated with clinical severity.

Surgical Anatomy of Transversus Abdominis Muscle for Transversus Abdominis Release: A CT-Based Study in Three Patient Groups.

The anatomy of the transversus abdominis muscle and its aponeurosis is important in transversus abdominis release surgery. We studied the CT anatomy of the transversus abdominis muscle medial to the linea semilunaris at different levels in the abdomen and measured the thickness of this muscle. In this retrospective study, we analysed 150 abdominal computed tomography at L1, L3, and L5 vertebral levels corresponding to subxiphoid, umbilical, and suprapubic regions, respectively. The patients were divided into three groups based on age and sex: women aged 15-20 years (nulliparous), women aged 30-60 years (multiparous), and men aged 15-60 years, with each group having 50 patients. We compared the thickness of the TA muscle at the L1 level between men and women and between nulliparous and multiparous women. Transversus abdominis muscle was consistently present medial to the linea semilunaris at L1 vertebral level in the subxiphoid region (150/150). At the L3 vertebral level in the mid-abdomen, only eight patients had the transversus abdominis muscle there (8/150, 5%). At the L5 vertebral level in the suprapubic region, no patient had the transversus abdominis muscle medial to the linea semilunaris. The mean thickness of the transversus abdominis muscle at the L1 level was 3.4 mm, and at the L3 level, it was 1.6 mm. There was no statistically significant difference in the transversus abdominis muscle thickness between the men and women; however, a significant difference was found between the nulliparous and multiparous women, with thinner TA muscle in later. There is good transversus abdominis muscle bulk medial to the linea semilunaris for doing transversus abdominis muscle division in the upper abdomen. However, as we move towards the mid-abdomen, we have TA aponeurosis or rarely TA muscle of little bulk.

Comparison of Muscle Activity and Muscle Thickness According to Knee Flexion Angle during Supine Bridge Exercises using the Abdominal Drawing-in Maneuver on an Unstable Surface.

This study evaluated changes in deep trunk muscle thickness and lower extremity muscle activities during bridge exercises with the abdominal drawing-in maneuver. Bridge exercises were conducted on an unstable surface at different knee flexion angles (60º, 90º and 120º), with the aim of identifying more effective angles for bridge exercises. This study included 21 healthy adults, aged 20-27 years. Biceps femoris (BF), rectus abdominis, and rectus femoris activity was measured using surface electromyography. The thicknesses of the transverse abdominis (TrA), external oblique (EO) and internal oblique (IO) muscles were measured. BF (p = 0.000, partial η2 = 0.670) activity increased considerably as the knee flexion angle decreased. TrA (p = 0.000, partial η2 = 0.883) and IO (p = 0.000, partial η2 = 0.892) thickness significantly increased, while EO (p = 0.000, partial η2 = 0.893) thickness decreased as the knee flexion angle decreased. When performing bridge exercises using the abdominal drawing-in maneuver on an unstable surface, the knee flexion angles should be at 120º and 60º to increase trunk stability and lower extremity muscle activity, respectively.

Comparison of transversus abdominis activation characteristics between healthy and chronic low back pain population during upright functional movement.

Previous literature suggests that transversus abdominis (TrA) activation is diminished in chronic low back pain (cLBP) subjects compared to healthy subjects in less-functional positions. However, few studies have investigated the effects of upright functional movement on TrA activation in cLBP individuals. This pilot study aimed to compare TrA activation characteristics in healthy and cLBP subjects during the movement of double leg standing (DLS) to single leg standing (SLS) and to a 30∘ single leg quarter squat (QSLS). TrA activation was determined by the percentage change in TrA thickness from DLS to SLS and DLS to QSLS. TrA thickness was measured in 14 healthy and 14 cLBP participants using ultrasound imaging with a probe holder at 20mm and 30mm from the fascia conjunction point. At both measurement points (20 and 30mm), there were no significant main effects of body sides, lower limb movements and the interactions between them on TrA activations between the healthy and cLBP participants even after covariates were adjusted for (all p> 0.05). Results from this study suggest the evaluation of TrA activation during upright functional movements as part of an assessment for cLBP management may not be suggested.

Changes in Transversus Abdominis Muscle Thickness, Low Back Pain, and Standing Balance after Foam Roller Exercise in Female Adults: A Randomized Controlled Trial

Objectives: The purpose of this study was to compare transversus abdominis muscle thickness and exercise performance before and after foam roller exercise (FRex).Methods: This was a randomized controlled trial (RCT). Twenty-four adult female subjects were randomly divided into two groups: (1) an intervention group that underwent FRex, and (2) a control group that remained in the supine position for the same period. Transversus abdominis muscle thickness, modified Star Excursion Balance Test (mSEBT) score, and degree of back pain experienced during daily work were measured before and after the intervention in each group using a visual analog scale (VAS), and a within-group comparison was conducted for each value. The amount of change before and after the intervention was calculated, and the correlation between each measurement item was examined.Results: Pre-intervention and post-intervention comparisons in the intervention group revealed significantly greater values for transversus abdominis lower fiber thickness and mSEBT scores, and significantly lower values for low back pain after the intervention. A moderate negative correlation was found between changes in lower back pain VAS scores and changes in transversus abdominis lower fiber thickness and mSEBT scores. Moreover, a moderate positive correlation was noted between changes in the transversus abdominis lower fiber thickness and mSEBT scores.Conclusions: These results suggest that FRex may be beneficial for preventing low back pain and improving balance.

Lateral abdominal muscle thickness and contractile function in women with and without stress urinary incontinence.

Stress urinary incontinence (SUI) primarily results from the weakness of pelvic floor muscles, working synergistically with the abdominal muscles. The current study aimed to compare thickness and contractile function of lateral abdominal muscles in women with and without SUI. Thirty-nine women with SUI (SUI group; age: 38.87±8.96 years, body mass index (BMI): 24.03 (5.94) kg/m2) and 42 healthy women (control group; age: 36.21±11.46 years, BMI: 23.90 (5.85) kg/m2) were included. Transverse abdominis (TrA) and internal oblique (IO) muscle thickness at rest and during abdominal drawing-in maneuver (ADIM) were measured with ultrasound imaging in B-mode using a Logiq S7/Expert device and a 9-11 MHz linear transducer. Percentage change in thickness and contractile function of these muscles were also calculated. No significant differences in the thickness of TrA and IO muscles at rest and during ADIM between the groups were found (p>0.05). The percent change in thickness and contractile function of both right and left side TrA muscles and the right side IO muscle were lower in SUI group than control group (p<0.05). The percentage change in thickness and the contractile function of the left side IO muscle did not change (p>0.05). Women with SUI had a smaller percentage change in thickness and contractile function of TrA and IO muscle than women without SUI. However, there was no difference in the morphological features of these muscles between the groups. Considering the lateral abdominal muscle, training may be important for management of SUI.

Transversus Abdominis Ultrasound Thickness during Popular Trunk-Pilates Exercises in Young and Middle-Aged Women.

The transversus abdominis (TrA) is a core muscle that contributes to functional mobility and lumbar stability. This study aimed to compare the changes in TrA thickness during different Pilates exercises, and to identify the exercise that elicited the greatest TrA activation. Forty-four healthy women were divided into two groups: young (25-35 years old) and middle-aged (36-55 years old). TrA thickness was assessed by ultrasound while the participants performed five Pilates exercises: basic position, hundred, hip roll, side plank, and dead bug. A repeated measures analysis of variance revealed that the dead bug exercise induced a significantly higher increase in TrA thickness (relative to rest) than the other exercises (p < 0.05). The young group also showed a significantly higher overall TrA thickness than the middle-aged group (p < 0.05). The findings suggest that the dead bug exercise is the most effective for enhancing TrA activation among the Pilates exercises tested. The basic position and the hundred exercises can be used as warm-up exercises before performing more challenging exercises such as the hip roll, the side plank, and the dead bug. The sequence of exercises can be similar for both young and middle-aged women.

Effect of a Multimodal Supervised Therapeutic Exercise Program on Quality of Life, Pain, and Lumbopelvic Impairments in Women With Endometriosis Unresponsive to Conventional Therapy: A Randomized Controlled Trial

ObjectiveTo evaluate the effectiveness of “Physio-EndEA”, a multimodal nine-week supervised exercise intervention, on quality of life, pain, and lumbopelvic impairments in women with endometriosis unresponsive to conventional therapy. DesignParallel-group randomized controlled trial. Outcomes were measured at baseline, post-intervention, and at 1 year. SettingTwo Public University Hospitals. ParticipantsThis trial included 31 women with endometriosis (N=31) randomly allocated to “Physio-EndEA” group (n=16) or control group (n=15). Four participants dropped out of the study for causes unrelated to the intervention. InterventionsThe “Physio-EndEA” program consisted of a 1-week lumbopelvic stabilization learning phase followed by an 8-week phase of stretching, aerobic, and resistance exercises focused on the lumbopelvic area. It was sequentially instructed and supervised by a trained physiotherapist (with volume and intensity progression) and adapted daily to the potential of each participant. Control group received the usual treatment stipulated by their gynecologist. Main Outcome MeasuresThe primary outcome was quality of life. Secondary outcomes were pain intensity, pressure pain thresholds, pain-related catastrophic thoughts, abdominal and back strength, lumbopelvic stability, and muscle architecture. ResultsAdherence rate was 90.6% and mean (±standard deviation) satisfaction was 9.44±0.73 out of 10. No remarkable health problems were reported during the trial. In comparison with controls, the quality of life was improved post-intervention and at 1 year in the Physio-EndEA group with large effect sizes (d>0.80). This group also evidenced: a reduced intensity of dyspareunia, catastrophic thoughts; an increase in pelvic, lumbar, and distal pressure pain thresholds; increases in abdominal and back strength and lumbopelvic stability; and increased thickness of transversus abdominis (right side) and width of lumbar multifidus (left side). ConclusionA 9-week program of multimodal supervised therapeutic exercise is a feasible and effective intervention to improve QoL in women with endometriosis. This program also offers benefits in terms of pain/sensitization and lumbopelvic impairments.

Reliability of transversus abdominis and internal oblique muscle thickness measurement using B-mode ultrasound imaging in standing and single leg standing positions

Background: The thickness of the transversus abdominis (TrA) and internal oblique (IO) muscles are measured with high reliability by musculoskeletal ultrasound imaging (MSUSI) in the supine hook-lying and walking position. However, the reliability of the procedure to measure the TrA and IO muscle thickness measurement in the functional positions such as standing and single leg standing positions have not been well established. Objectives: To examine the reliability of MSUSI for the TrA and IO muscles thickness measurement during standing and single leg standing positions in healthy participants. Materials and methods: Ten healthy participants (aged 24.10±2.47 years) were recruited to perform MSUSI measurement of TrA and IO muscle thickness during the resting and abdominal drawing in maneuver (ADIM) in the standing and single leg standing positions. The intra-tester reliability of MSUSI measurement was performed by the same investigator in 2 different times (24 to 72 hours apart), while the inter-tester reliability was performed by 2 investigators within the same day. The intraclass correlation coefficient (ICC) whereby ICC3,3 was used to determine the intra-tester and ICC 2,3 was used to determine the inter-tester reliability of TrA and IO muscles thickness measurement using MSUSI. The standard error of measurement (SEM) and coefficient of variation (CV) were calculated. Results: The MSUSI measurements for TrA and IO muscles thickness showed high reliability in both standing and single leg standing positions (ICC3,3 and ICC2,3 &gt;0.9). Moreover, the values of SEM ranged between 0.055 to 0.662 mm, MDC ranged between 0.152 to 1.834 mm and CV ranged between 0.543 to 14.001%. Conclusion: The MSUSI measurement of TrA and IO muscles thickness could be performed with high intra and inter-tester reliability in standing and single leg standing positions among healthy individuals. The study findings on the MSUSI procedure to measure muscle thickness of TrA and IO would be useful for practice guidance in various research and clinical settings.

Effects of 3D Postural Correction and Abdominal Muscle Contraction on the Symmetry of the Transverse Abdominis and Spinal Alignment in Patients with Idiopathic Scoliosis

This study aimed to investigate the effectiveness of 3D postural correction (3DPC) using corrective cushions (CCs) and abdominal muscle contraction (AMC) on the thickness symmetry of the transversus abdominis (TrA) and spinal alignment in patients with idiopathic scoliosis (IS). In the first experiment, ultrasound measurements were taken of the TrA thickness on both the convex and concave sides of the lumbar curve in the supine position during AMC and non-AMC without 3DPC, and during AMC and non-AMC with 3DPC using CCs, in 11 IS patients. In the second experiment, 37 IS patients participated in a four-week 3DPC exercise program that aimed to maintain TrA thickness symmetry based on the results of the first experiment. The study found that TrA thickness symmetry significantly increased after 3DPC using CCs and combined with AMC (p < 0.05). Additionally, the Cobb angles and trunk rotation angles showed significant decreases, and trunk expansion showed a significant increase (p < 0.05). These results indicate that the simultaneous application of 3DPC and AMC is the most effective way to achieve TrA thickness symmetry in IS patients. Therefore, 3DPC and AMC should be considered as crucial elements in exercise interventions for IS patients.

The effects of Pilates training on abdominal muscle thickness and core endurance in patients with Parkinson's disease: a single-blind controlled clinical study.

This study aims at examining the effects of Pilates training on the transversus abdominis (TrA) and internal obliques (IO) muscle thickness and core endurance in different positions in patients with Parkinson's Disease. Patients were divided into 2 groups as Pilates training (n = 13) and control (n = 10) groups. Pilates training was performed twice a week for 6 weeks. The participants' muscle thickness and core endurance were measured at the beginning of the study (pretraining), and the effectiveness of Pilates training was then assessed in the 6th week (posttraining) and in the 12th-week follow-up. The thickness of the TrA and IO muscles was measured with a two-dimensional ultrasonography device. Core endurance was assessed with prone bridge and sit-ups tests. The assessments of the Pilates training group after the 6-week showed a statistically significant increase in the prone bridge and sit-ups test performances, and an increase in the thickness of the IO muscle [during resting in the supine position and abdominal drawing-in maneuver (ADIM) in standing position] and the TrA muscle (during ADIM in the standing position) (p < 0.05). Pilates exercises were also shown to have improved core muscle endurance and thickness (IO thickness during ADIM in the standing position and TrA thickness during resting in the supine position, ADIM in the supine and standing position) in the Pilates training group after a period of 18 weeks (p < 0.05). Pilates training has a favorable effect on the core endurance, and the TrA and IO muscle thickness of patients with Parkinson's disease and this effect can be maintained until three months after the training.

The Relationship between Transversus Abdominis and Internal Oblique Thickness and Disease-Related Characteristics in Parkinson's Disease

Background and Aim: The core muscles are essential for spinal stability during functional activities. Trunk muscle function is affected by specific neurodegenerative processes of Parkinson's disease (PD). This study aimed to investigate whether changes in transversus abdominis (TrA) and internal oblique (IO) thickness during the abdominal drawing-in maneuver (ADIM) were associated with clinical manifestations, core endurance, and functional mobility in patients with PD. Materials and Methods: We included patients with a modified Hoehn and Yahr staging of 3 or lower. TrA and IO muscle thickness were measured using ultrasound both at rest and during ADIM, and the percent change (%) was calculated to assess TrA and IO activation. Patients performed core endurance (prone bridge and sit-ups) and functional mobility tests (timed “up and go” [TUG] and five times sit-to-stand [FTSTS]). All assessments were conducted during the “on” phase. Results: Five female and 17 male patients were included in this study. We found a statistically significant correlation between ultrasound parameters of IO and the clinical manifestations of PD (P &lt; 0.05). Correlations were observed between TrA percent change and prone bridge, sit-ups, TUG, and FTSTS (P &lt; 0.05). Conclusion: To the best of our knowledge, this is the first ultrasound imaging-based study to demonstrate the relationship between TrA and IO muscle thickness and clinical outcomes, and functional performance in patients with PD. Percentage changes in IO were associated with the clinical manifestations of PD. Increased activation of TrA during ADIM was associated with improved core endurance and mobility. The results suggest that a trunk-specific exercise program may be the cornerstone in the treatment of PD-related changes.

Validity of the Transverse Abdominis Thickness Change for Abdominal Draw-in Maneuver Using Biofeedback Sensor

Background Transverse abdominis (TrA) is an important local muscle that plays an essential role in the core. Ultrasound imaging is a reliable and valid technique for analyzing TrA muscle thickness. However, this method requires skilled operators. Biofeedback devices have achieved similar clinical outcomes to ultrasound. Even so, few studies have examined the validity of this biofeedback. Objectives This study aimed to assess whether changes in waist circumference, as determined by changes in the thickness of TrA detected with a stretch sensor made with a biofeedback device, produce results similar to those obtained through ultrasound. Methods Nineteen healthy participants were recruited for this study. Ultrasound measurement of the thickness of TrA was compared with the simultaneous measurement of the stretch sensor biofeedback device. Results Acceptable validity was found between the thickness of the TrA and the stretch sensor displayed on-screen waist circumference (Pearson correlation = -0.69, p = 0.03). Conclusions The study confirmed that changes in the grape bar on the screen of the stretch sensor application could be employed as a suitable indicator for assessing the changes to the thickness of the TrA muscle.

Effect of Progressive Postural Control Exercise Versus Core Stability Exercise in Young Adults with Chronic Low Back Pain: A Randomized Controlled Trial.

This study aimed to investigate the effects of progressive postural control exercise (PPCE) vs core stability exercise (CSE) in patients with chronic low back pain (CLBP). A total of 34 young-adult participants with CLBP were randomly assigned to two groups (the PPCE group and the CSE group). They received instructions for two different exercise training regimens persisting over 8weeks. Before, after, and at 6months after the intervention, the participants were evaluated on the basis of pain intensity (VAS), degree of dysfunction (ODI and RMDQ), contractility of transversus abdominis (TrA) and lumbar multifidus (MF), as well as the ability to control static posture. There was no significant difference between the results of the PPCE group and the CSE group. At the 6-month follow-up after the 8-week treatment, the scores of VAS, ODI, and RMDQ in the two groups decreased significantly compared to before (p < 0.05). The percentage change in thickness of bilateral TrA and left MF (p < 0.05) was elevated and the sway area of center of pressure during static stance tasks with eyes opened (p < 0.05) was decreased in both groups. In the short term, PPCE provides positive effects similar to those of core stability exercise in patients with CLBP. The effective mechanism of PPCE might be the consequence of neuromuscular plasticity and adaptation adjustments. PPCE enriches the choices of treatment for CLBP. The trial was registered at www.chictr.org.cn , identifier ChiCTR2100043113.

The Effect of the Contraction Pressure of the Hip Adductor Muscles on Thickness of Transversus Abdominis: A Randomized Controlled Trial

The Effect of the Contraction Pressure of the Hip Adductor Muscles on Thickness of Transversus Abdominis: A Randomized Controlled Trial

Effects of External Focus and Motor Control Training in Comparison with Motor Control Training Alone on Pain, Thickness of Trunk Muscles and Function of Patients with Recurrent Low Back Pain: A Single Blinded, Randomized Controlled Trial.

Recurrent low back pain (RLBP) affects different structures in the lumbar spine. Exercise therapy is highly recommended as one of the first-line treatments. One crucial variable introduced to enhance RLBP is the external focus. The present study aimed to investigate the effects of external focus training on pain, the thickness of transverse abdominis (TrA), internal oblique (IO), external oblique (EO), and lumbar multifidus (LM) muscles, kinesiophobia, fear-avoidance beliefs, and disability of people with RLBP. This randomized-controlled trial consisted of 38 RLBP patients. Patients were randomly divided into two groups the treatment group (n=19) that received external focus training in addition to motor control training and the control group (n=19) that received motor control training alone. The primary outcome was pain intensity, and secondary outcomes were the thickness of TrA, IO, EO, LM muscles, kinesiophobia, fear-avoidance beliefs, and disability that were measured at the baseline and after 16 sessions of interventions. The interventions were performed three sessions weekly. Reduction in pain intensity was more significant in the intervention group than in the control group (P<0.001, Cohen's d=-1.47). The thickness of TrA muscle in the contraction condition of the intervention group was significantly more on the left side (P<0.001, Cohen's d=1.05) than on the right side (P=0.03, Cohen's d=0.44). Other outcomes showed no significant differences. However, the Cohen's d effect size for the left IO (Cohen's d=0.57) and TKS (Cohen's d=-0.53) were moderate. In RLBP patients, external focus and motor control training could effectively reduce the pain. Although this intervention could increase the thickness of the TrA muscle of RLBP, it has no significant effect on the thickness of IO, EO, and LM muscles. In addition, the obtained results indicated that this intervention has no significant effect on kinesiophobia, fear-avoidance beliefs, and disability..

Lateral abdominal muscles of adults with hypermobility may be partially impaired during contraction

BackgroundMuscle function may be impaired in people with generalised hypermobility, yet prior studies have primarily focused on muscles within the extremities. We aimed to examine changes in lateral abdominal muscle...

The effect of activation of thoracolumbar fascia on the thickness of abdominal muscles: An ultrasonographic study.

Objectives This study aims to evaluate the changes in the ultrasonographic thickness of transversus abdominis and internal oblique muscles during bridge with arm extension compared to bridge and abdominal hollowing. Patients and methods Between March 1st, 2019 and March 29th, 2019, a total of 30 healthy individuals (15 males, 15 females; mean age: 28.8±8.1 years; range, 21 to 52 years) among hospital staff were included. Thickness of transversus abdominis, internal, and external oblique muscles of the participants were evaluated using ultrasound during four positions (rest, abdominal hollowing, bridge, and bridge with arm extension). Results The mean body mass index was 23.8±4.1 kg/m2. The thickness of transversus abdominis and internal oblique muscles increased during all positions (p<0.001), compared to rest. The thickness during bridge with arm extension was greater than abdominal hollowing and bridge. Conclusion Co-activation of latissimus dorsi and gluteus maximus muscles during abdominal contraction increases the thickness of internal oblique and transversus abdominis muscles greater than abdominal contraction alone or co-activation of gluteus maximus alone. Simultaneous isometric contraction of latissimus dorsi muscle may enhance abdominal muscle function.

Automated ultrasound measurements of lateral abdominal muscles under controlled breathing phases

Background and objectivesA breathing phase during ultrasound measurements of the lateral abdominal muscles (LAMs) are usually indirectly controlled by visual inspection of the position of the transversus abdominis (TrA) muscle. This is due to the lack of devices to directly control airflow that are connected to the ultrasound in order to automatically and simultaneously freeze ultrasound images at the programmed breathing phase. Such indirect control may be related with potential measurement error because LAMs are respiratory muscles. Thus, the aim of this study was to present a newly developed and automatic measurement procedure to directly control airflow and at the same time automatically collect ultrasound images at the programed breathing phase. Additionally, it was decided to compare LAMs measurements obtained manually by the examiner and with an external device controlling the peak phase of tidal inspiration and expiration and compare the elasticity and thickness measurements between tidal inspiration and expiration in young participants. MethodsThe study was carried out on 10 healthy youth. The thickness and shear modulus were measured by an Aixplorer ultrasound scanner. The measurements were obtained manually by the examiner and with a newly developed external device controlling the peak phases of tidal inspiration and expiration. ResultsA significant difference in external/internal oblique thickness between the expiration and inspiration phases depended on the measurement procedure. The TrA thickness was similar during inspiration and expiration. During inspiration, the TrA shear modulus was higher than during expiration, and the TrA shear modulus depended on the measurement procedure. ConclusionAlthough the raw LAMs thickness and external/internal oblique thickness/shear modulus data were similar, the measurement procedure may affect the interpretation of the results. The TrA shear modulus is the most vulnerable to errors related to the measurement procedure. Construction of this study device controlling airflow and automatically collecting ultrasound images at the selected breathing phase seems to be promising in future studies considering measurements of respiratory muscles in a strictly defined breathing phase.

Evaluation of Abdominal Expiratory Muscle Thickness Pattern, Diaphragmatic Excursion, and Lung Ultrasound Score in Critically Ill Patients and Their Association with Weaning Patterns: A Prospective Observational Study.

IntroductionThe expiratory muscles are an indispensable component of respiratory function in critically ill patients, yet is often overlooked. We evaluated the association of abdominal expiratory muscles thickness pattern with weaning.Materials and methodsThis was a single-center, prospective observational study done on 81 adult mechanically ventilated patients who underwent the weaning process.ResultsSixteen patients had simple weaning and 65 patients had either difficult or prolonged weaning. The mean and standard deviation (SD) of the thickness of expiratory abdominal muscles—rectus abdominis (RA), internal oblique (IO), external oblique (EO), and transversus abdominis (TA) were significantly more in patients with simple weaning than those with difficult or prolonged weaning. The receiver operating curve (ROC) of expiratory muscles showed RA, IO, EO, TA cut-offs 0.638, 0.492, 0.315, and 0.253 cm, respectively, to predict simple weaning. The pattern of expiratory muscle thickness RA > IO > EO > TA was maintained in both simple and difficult/prolonged weaning groups (p = 0.362). The ROC of diaphragmatic excursion (DE) for predicting simple weaning had cut-off 1.79 cm. The lung ultrasound score (LUS) was 5.75 ± 3.32 in the simple weaning group, compared to 9.71 ± 5.18 in the difficult/prolonged weaning group (p = 0.005).ConclusionAbdominal expiratory muscles were significantly thicker in patients with simple weaning compared to those with difficult or prolonged weaning. The pattern of expiratory muscle thickness followed the pattern of RA > IO > EO > TA in both simple weaning and difficult or prolonged weaning groups. DE >1.79 cm predicted simple weaning and LUS was significantly lesser in patients with simple weaning (CTRI/2020/11/028895).How to cite this articleAmara V, Vishwas P, Maddani SS, Natarajan S, Chaudhuri S. Evaluation of Abdominal Expiratory Muscle Thickness Pattern, Diaphragmatic Excursion, and Lung Ultrasound Score in Critically Ill Patients and Their Association with Weaning Patterns: A Prospective Observational Study. Indian J Crit Care Med 2022;26(3):307–313.