Could changes in the ultrasound image of the muscles of the lateral abdominal wall be seen as a sign of muscle activity? A narrative review
DOI:
https://doi.org/10.15584/ejcem.2017.1.9Keywords:
ultrasonography, electromyography, lateral abdominal wall, muscle activity, muscle morphologyAbstract
Aim. Currently, ultrasonography (USG) is used to study changes occurring in the lateral abdominal wall muscles (LAM). Here, the question that naturally arises is whether a change in the thickness of the ultrasound image can be identified with a change in muscle activity. Therefore, the purpose of the present work is to: 1) undertake an analysis of available publications exploring the relationship between electromyography (EMG) and USG; 2) define the USG measurement of each LAM; 3) identify gaps in the literature.
Material and methods. The databases MEDLINE, POL-index and Google Scholar were used to search the literature. We used a combination of terms (in Polish and English) containing the abbreviated and full names of the following expressions: ultrasound, electromyography and external oblique muscle, internal oblique muscle, or transverse abdominal muscle.
Results. Nine publications fulfilled the conditions for inclusion in the analysis. These used different methodologies and test conditions, making it difficult to interpret the results of individual works. The majority demonstrated poor or no correlation between EMG and USG measurements.
Conclusion. Changes in the thickness of the LAM using USG should not be equated with a change in muscle activity. To avoid misinterpretation, one should avoid the term “muscle activity” in evaluating changes in the thickness of the LAM. It is recommended that the terms “thickness change” or “morphological change” be used in the assessment of this phenomenon, which is closely related to real changes in USG imaging, expressing a more complex phenomenon than a mere change in bioelectrical potential.
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References
Gardner-Morse MG, Stokes IA. The effects of abdominal muscle coactivation on lumbar spine stability. Spine (Phila Pa 1976). 1998;23(1):86-91-2.
Richardson CA, Snijders CJ, Hides JA, Damen L, Pas MS, Storm J. The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine (Phila Pa 1976). 2002;27(4):399-405.
Bergmark A. Stability of the lumbar spine. A study in mechanical engineering. Acta Orthop Scand Suppl. 1989;230:1-54.
Cresswell AG, Grundström H, Thorstensson A. Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man. Acta Physiol Scand. 1992;144(4):409-18. doi:10.1111/j.1748-1716.1992.tb09314.x.
Błaszczyk J. Biomechanika Kliniczna. Warszawa: PZWL; 2004.
Pullman SL, Goodin DS, Marquinez AI, Tabbal S, Rubin M. Clinical utility of surface EMG: report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology. Neurology. 2000;55(2):171-7.
Hides J, Wilson S, Stanton W, et al. An MRI investigation into the function of the transversus abdominis muscle during “drawing-in” of the abdominal wall. Spine (Phila Pa 1976). 2006;31(6):175-8. doi:10.1097/01.brs.0000202740.86338.df.
Teyhen D. Rehabilitative Ultrasound Imaging Symposium San Antonio, TX, May 8-10, 2006. J Orthop Sports Phys Ther. 2006;36(8):A1-3.
Wolny T, Linek P. Rehabilitative Ultrasound Imaging - anatomia sonograficzna i sonofeedback w ocenie i kinezyterapii zespołu bocznego przyparcia rzepki. Rehabil w Prakt. 2016;4:28-32.
Wolny T, Linek P, Wróbel Ł. Rehabilitative Ultrasound Imaging - podstawy fizyczne oraz zastosowanie w codziennej pracy fizjoterapeuty. Rehabil w Prakt. 2016;3:30-4.
Wolny T, Linek P, Wróbel L. Rehabilitative Ultrasound Imaging - anatomia sonograficzna i sonofeedback w ocenie i kinezyterapii zespołu ciasnoty podbarkowej. Rehabil w Prakt. 2016;5:28-35.
Linek P. Assessment of the deep abdominal muscles at rest and during the abdominal drawing-in maneuver in adolescents practicing volleyball: A case control study. Isokinet Exerc Sci. 2015;23(4):215-20. doi:10.3233/IES-150596.
Linek P, Saulicz E, Kuszewski M, Wolny T. Ultrasound Assessment of the Abdominal Muscles at Rest and During the ASLR Test Among Adolescents with Scoliosis. Clin spine Surg. June 2016. doi:10.1097/BSD.0000000000000055.
Linek P, Saulicz E, Wolny T, Myśliwiec A, Gogola A. Ultrasound evaluation of the symmetry of abdominal muscles in mild adolescent idiopathic scoliosis. J Phys Ther Sci. 2015;27(2):465-8. doi:10.1589/jpts.27.465.
Linek P, Saulicz E, Wolny T, Myśliwiec A, Kokosz M. Lateral abdominal muscle size at rest and during abdominal drawing-in manoeuvre in healthy adolescents. Man Ther. 2015;20(1):117-23. doi:10.1016/j.math.2014.07.009.
Linek P, Saulicz E, Wolny T, Myśliwiec A. Assessment of the abdominal muscles at rest and during abdominal drawing-in manoeuvre in adolescent physically active girls: A case–control study. J Sport Heal Sci. 2015. doi:10.1016/j.jshs.2015.10.002.
Gray J, Aginsky KD, Derman W, Vaughan CL, Hodges PW. Symmetry, not asymmetry, of abdominal muscle morphology is associated with low back pain in cricket fast bowlers. J Sci Med Sport. 2016;19(3):222-6.
Tayashiki K, Maeo S, Usui S, Miyamoto N, Kanehisa H. Effect of abdominal bracing training on strength and power of trunk and lower limb muscles. Eur J Appl Physiol. 2016;116(9):1703-13. doi:10.1007/s00421-016-3424-9.
Noormohammadpour P, Hosseini Khezri A, Linek P, et al. Comparison of lateral abdominal muscle thickness and cross sectional area of multifidus in adolescent soccer players with and without low back pain: a case control study. Asian J Sports Med. 2016. doi:10.5812/asjsm.38318.
Rankin G, Stokes M, Newham DJ. Abdominal muscle size and symmetry in normal subjects. Muscle Nerve. 2006;34(3):320-6. doi:10.1002/mus.20589.
Myśliwiec A, Kuszewski M, Saulicz E, et al. Assessment of transverse abdominal muscle symmetry by ultrasonography | Ocena symetrii mięśnia poprzecznego brzucha w badaniu ultrasonograficznym. Ortop Traumatol Rehabil. 2014;16(4):427-34. doi:10.5604/15093492.1119620.
Rasouli O, Arab AM, Amiri M, Jaberzadeh S. Ultrasound measurement of deep abdominal muscle activity in sitting positions with different stability levels in subjects with and without chronic low back pain. Man Ther. 2011;16(4):388-93. doi:10.1016/j.math.2011.01.009.
Manshadi FD, Parnianpour M, Sarrafzadeh J, et al. Abdominal hollowing and lateral abdominal wall muscles’ activity in both healthy men & women: An ultrasonic assessment in supine and standing positions. J Bodyw Mov Ther. 2011;15(1):108-13. doi:10.1016/j.jbmt.2009.10.004.
Critchley DJ, Pierson Z, Battersby G. Effect of pilates mat exercises and conventional exercise programmes on transversus abdominis and obliquus internus abdominis activity: pilot randomised trial. Man Ther. 2011;16(2):183-89. doi:10.1016/j.math.2010.10.007.
Linek P, Saulicz E, Wolny T, Myśliwiec A. Intra-rater reliability of B-mode ultrasound imaging of the abdominal muscles in healthy adolescents during the active straight leg raise test. PM R. 2015;7(1):53-9. doi:10.1016/j.pmrj.2014.07.007.
Do Y-C, Yoo W-G. Comparison of the thicknesses of the transversus abdominis and internal abdominal obliques during plank exercises on different support surfaces. J Phys Ther Sci. 2015;27(1):169-70. doi:10.1589/jpts.27.169.
Miura T, Yamanaka M, Ukishiro K, et al. Individuals with chronic low back pain do not modulate the level of transversus abdominis muscle contraction across different postures. Man Ther. 2014;19(6):534-40. doi:10.1016/j.math.2014.05.010.
Costa LOP, Maher CG, Latimer J, Smeets RJEM. Reproducibility of rehabilitative ultrasound imaging for the measurement of abdominal muscle activity: a systematic review. Phys Ther. 2009;89(8):756-69. doi:10.2522/ptj.20080331.
Blanchard TW, Smith C, Grenier SG. 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. J Electromyogr Kinesiol. 2016;28:99-103. doi:10.1016/j.jelekin.2016.03.006.
Rabello LM, Gagnon D, da Silva RA, Paquette P, Larivière C. External abdominal oblique muscle ultrasonographic thickness changes is not an appropriate surrogate measure of electromyographic activity during isometric trunk contractions. J Back Musculoskelet Rehabil. 2015;28(2):229-38. doi:10.3233/BMR-140508.
Whittaker JL, McLean L, Hodder J, Warner MB, Stokes MJ. Association between changes in electromyographic signal amplitude and abdominal muscle thickness in individuals with and without lumbopelvic pain. J Orthop Sports Phys Ther. 2013;43(7):466-77. doi:10.2519/jospt.2013.4440.
Tahan N, Arab AM, Arzani P, Rahimi F. Relationship between ultrasonography and electromyography measurement of abdominal muscles when activated with and without pelvis floor muscles contraction. Minerva Med. 2013;104(6):625-30.
Ferreira PH, Ferreira ML, Nascimento DP, Pinto RZ, Franco MR, Hodges PW. Discriminative and reliability analyses of ultrasound measurement of abdominal muscles recruitment. Man Ther. 2011;16(5):463-9. doi:10.1016/j.math.2011.02.010.
Brown SHM, McGill SM. A comparison of ultrasound and electromyography measures of force and activation to examine the mechanics of abdominal wall contraction. Clin Biomech (Bristol, Avon). 2010;25(2):115-23. doi:10.1016/j.clinbiomech.2009.10.001.
John EK, Beith ID. Can activity within the external abdominal oblique be measured using real-time ultrasound imaging? Clin Biomech (Bristol, Avon). 2007;22(9):972-9. doi:10.1016/j.clinbiomech.2007.07.005.
McMeeken JM, Beith ID, Newham DJ, Milligan P, Critchley DJ. The relationship between EMG and change in thickness of transversus abdominis. Clin Biomech (Bristol, Avon). 2004;19(4):337-42. doi:10.1016/j.clinbiomech.2004.01.007.
Hodges PW, Pengel LHM, Herbert RD, Gandevia SC. Measurement of muscle contraction with ultrasound imaging. Muscle Nerve. 2003;27(6):682-92. doi:10.1002/mus.10375.
Koppenhaver SL, Hebert JJ, Parent EC, Fritz JM. Rehabilitative ultrasound imaging is a valid measure of trunk muscle size and activation during most isometric sub-maximal contractions: a systematic review. Aust J Physiother. 2009;55(3):153-69.
Urquhart DM, Barker PJ, Hodges PW, Story IH, Briggs CA. Regional morphology of the transversus abdominis and obliquus internus and externus abdominis muscles. Clin Biomech (Bristol, Avon). 2005;20(3):233-41. doi:10.1016/j.clinbiomech.2004.11.007.
Okubo Y, Kaneoka K, Imai a, et al. Comparison of the activities of the deep trunk muscles measured using intramuscular and surface electromyography. J Mech Med Biol. 2010;10(4):611-20. Doi:10.1142/s0219519410003599.
Marshall P, Murphy B. The validity and reliability of surface EMG to assess the neuromuscular response of the abdominal muscles to rapid limb movement. J Electromyogr Kinesiol. 2003;13(5):477-89.
McGill S, Juker D, Kropf P. Appropriately placed surface EMG electrodes reflect deep muscle activity (psoas, quadratus lumborum, abdominal wall) in the lumbar spine. J Biomech. 1996;29(11):1503-7.
Whittaker JL, Stokes M. Ultrasound imaging and muscle function. J Orthop Sports Phys Ther. 2011;41(8):572-80. doi:10.2519/jospt.2011.3682.
Peschers UM, Gingelmaier A, Jundt K, Leib B, Dimpfl T. Evaluation of Pelvic Floor Muscle Strength Using Four Different Techniques. Int Urogynecol J. 2001;1(12):27-30.
Delaney S, Worsley P, Warner M, Taylor M, Stokes M. Assessing contractile ability of the quadriceps muscle using ultrasound imaging. Muscle Nerve. 2010;42(4):530-8. doi:10.1002/mus.21725.
Cresswell AG, Thorstensson A. The role of the abdominal musculature in the elevation of the intra-abdominal pressure during specified tasks. Ergonomics. 1989;32(10):1237-46. doi:10.1080/00140138908966893.
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