McPherson Sue L, Watson Todd
Motor Behavior, Department of Physical Therapy, 242 HHS Building, Western Carolina University, Cullowhee, NC 28723(∗).
Orthopedics, Department of Physical Therapy, Western Carolina University, Cullowhee, NC(†).
PM R. 2014 Jul;6(7):612-23. doi: 10.1016/j.pmrj.2013.11.014. Epub 2013 Dec 4.
To determine whether healthy adults successfully completing transversus abdominis (TrA) muscle activation training in the supine position with clinician and ultrasound (US) imaging feedback increase their TrA activation during lifting and reaching tasks performed in the standing position.
Prospective longitudinal within-subject, repeated-measures (RM) study.
University laboratory.
A total of 19 of 24 asymptomatic adult volunteers met inclusion criteria.
Each adult performed 3 trials of 5 functional tasks before receiving any training. They were then briefed on the abdominal draw-in maneuver via educational materials. Next, each adult received individualized TrA activation training while in the supine position with clinician and US feedback of TrA activation. At 5 minutes after TrA activation training, each adult who met the criterion during training performed 3 trials of these same 5 functional tasks. Tasks were randomized during these test sessions. Adults who returned 5 months later (n = 10) were tested again on 3 trials of 3 of these tasks. No feedback was provided during test sessions. Recorded cine loop images were obtained via US per trial and masked for TrA measurement.
Resting state (minimum thickness) and contraction state (maximum thickness) of TrA were measured per recorded trial by a clinician who was shown to have high reliability. The percentage of change in TrA thickness {[(thicknessmax - thicknessmin)/ thicknessmin] × (100)} was the primary outcome measure. Trial averages were formed per measure per task per test session per adult.
A 2-test sessions (pretraining, 5-minutes post-training) × 5 tasks RM analysis of variance (N = 19) indicated a significant and large effect for test sessions (P < .001, η(2) = 0.808) and moderate effect for tasks (P = .011; η(2) = 0.164). Likewise, a 3-test sessions (pretraining, 5-minutes posttraining, 5 months post-training) × 3 tasks RM analysis of variance (n = 10) indicated a significant and large test sessions effect (P < .001, η(2) = 0.57) and no task effect. Overall, the percent change in TrA thickness increased after the TrA activation training program and was maintained at 5 months; similar patterns of improvement were noted across test sessions and tasks.
Asymptomatic adults successfully completing a short session of TrA activation training in the supine position with US feedback of TrA activation were able to increase their TrA activation during loaded lifting and reaching tasks for at least 5 months.
确定在临床医生和超声（US）成像反馈下，于仰卧位成功完成腹横肌（TrA）激活训练的健康成年人，在站立位进行提起和够取任务时，其TrA激活是否增加。
前瞻性纵向受试者内重复测量（RM）研究。
大学实验室。
24名无症状成年志愿者中有19名符合纳入标准。
每位成年人在接受任何训练前，对5项功能任务各进行3次试验。然后通过教育材料向他们介绍收腹动作。接下来，每位成年人在仰卧位接受个性化的TrA激活训练，同时临床医生和US对TrA激活进行反馈。在TrA激活训练后5分钟，训练期间达标的每位成年人对这相同的5项功能任务各进行3次试验。在这些测试环节中，任务是随机安排的。5个月后返回的成年人（n = 10）对其中3项任务各进行3次试验，再次接受测试。测试环节不提供反馈。每次试验通过US获取记录的动态循环图像，并进行屏蔽以测量TrA。
由显示具有高可靠性的临床医生，在每次记录的试验中测量TrA的静息状态（最小厚度）和收缩状态（最大厚度）。TrA厚度变化百分比{[（最大厚度 - 最小厚度）/最小厚度]×100}是主要观察指标。为每位成年人在每个测试环节的每项任务的每个测量指标形成试验平均值。
一项2测试环节（训练前、训练后5分钟）×5项任务的RM方差分析（N = 19）表明，测试环节有显著且较大的效应（P <.001，η(2)= 0.808），任务有中等效应（P =.011；η(2)= 0.164）。同样，一项3测试环节（训练前、训练后5分钟、训练后5个月）×3项任务的RM方差分析（n = 10）表明，测试环节有显著且较大的效应（P <.001，η(2)= 0.57），且无任务效应。总体而言，TrA激活训练计划后TrA厚度变化百分比增加，并在第5个月保持；在各测试环节和任务中均观察到类似的改善模式。
在仰卧位接受TrA激活训练短疗程且有US对TrA激活进行反馈的无症状成年人，在负重提起和够取任务期间能够增加其TrA激活，且至少持续5个月。
