Spine & Joint Centre, Rotterdam, the Netherlands; Department of Neuroscience-Anatomy, Erasmus University Medical Center, Rotterdam, the Netherlands.
Spine & Joint Centre, Rotterdam, the Netherlands.
J Bodyw Mov Ther. 2020 Jan;24(1):147-153. doi: 10.1016/j.jbmt.2019.10.015. Epub 2019 Oct 28.
This study explores the anatomical relation of the rectus abdominis muscles with the anterior and posterior rectus sheaths. The elastic behavior of these fascial sheets is also assessed. Both of these analyses form an anatomic-biomechanical basis for diagnosis and treatment, especially in relation to diastasis recti abdominis (DRA).
Fundamental observational, biomechanical study. Seven post-mortem, embalmed human specimens were dissected. The abdominal muscles and the fascial sheets of the abdominal wall were dissected. 4 × 4 cm samples of the anterior and posterior rectus sheaths were loaded in longitudinal and transverse direction, while recording elongation by means of a displacement sensor. The main outcome measures were anatomical descriptions and elongation of fascia samples in mm (mean and standard ± deviation).
In longitudinal direction the posterior rectus sheath samples stretched over 1.67 ± 0.48 mm, while in transverse direction the mean stretch was 0.29 ± 0.18 mm (p = 0.001). In contrast, no significant difference between longitudinal (0.78 ± 0.43 mm) and transversal displacement (0.50 ± 0.23 mm) was observed in the anterior rectus sheath (p = 0.56).
The posterior rectus sheath is functionally more related to the transverse abdominis muscle than to the rectus abdominis muscle. From this connection, in combination with the specific stiffness of the posterior fascia in the lateral direction, it is assumed that the transverse abdominis muscles play an important role in the etiology but also in reduction of DRA. The transverse abdominis and rectus abdominis muscles collaborate in support of the abdominal wall.
本研究探讨了腹直肌与前、后腹直肌鞘的解剖关系。还评估了这些筋膜片的弹性行为。这两种分析为诊断和治疗提供了解剖-生物力学基础，特别是与腹直肌分离（DRA）有关时。
基础观察、生物力学研究。对 7 具防腐的尸体标本进行解剖。解剖腹部肌肉和腹壁筋膜。对前、后腹直肌鞘的 4×4cm 样本进行纵向和横向加载，同时通过位移传感器记录伸长量。主要观察指标为解剖描述和筋膜样本的伸长量（mm，平均值和标准偏差±）。
在纵向方向，后腹直肌鞘样本拉伸 1.67±0.48mm，而在横向方向，平均拉伸为 0.29±0.18mm（p=0.001）。相比之下，在前腹直肌鞘中，纵向（0.78±0.43mm）和横向位移（0.50±0.23mm）之间没有显著差异（p=0.56）。
后腹直肌鞘在功能上与腹横肌的关系比与腹直肌的关系更密切。从这种联系，再加上后筋膜在横向方向上的特定刚度，可以假设腹横肌在 DRA 的病因学和治疗中发挥着重要作用。腹横肌和腹直肌共同协作支撑腹壁。
