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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-47875

Pulkovski, N; Mannion, A F; Caporaso, F; Toma, V; Gubler, D; Helbling, D; Sprott, H (2012). 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? European Spine Journal, 21(S6):750-759.

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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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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Rheumatology Clinic and Institute of Physical Medicine
Dewey Decimal Classification:610 Medicine & health
Deposited On:07 Apr 2011 10:23
Last Modified:05 Apr 2016 14:54
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:10.1007/s00586-011-1707-8

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