压力反馈生物反馈仪与实时超声成像作为反馈工具对腹横肌收缩的比较：一项健康老年人的随机对照试验。

Comparison of the Pressure Biofeedback Unit and Real-Time Ultrasound Imaging as Feedback Tools to Contract the Transversus Abdominis Muscle: A Randomized Controlled Trial in Healthy Older Adults.

机构信息

École de réadaptation, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada.

Research Center on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, Canada.

出版信息

J Geriatr Phys Ther. 2022;45(1):25-33. doi: 10.1519/JPT.0000000000000295.

DOI:10.1519/JPT.0000000000000295

PMID:33577235

Abstract

BACKGROUND AND PURPOSE

The transversus abdominis (TrA) is a key muscle for lumbar stabilization and is often retrained in physical therapy. Feedback tools, such as the pressure biofeedback unit (PBU) and rehabilitative ultrasound imaging (RUSI), are frequently used by physical therapists to train their patients and improve their patients' ability to contract this muscle. However, the effect of these tools in rehabilitating the TrA in older adults remains to be demonstrated, as is their efficiency in transferring the skill of recruiting the TrA from a supine position to a standing position.The objective of the study was to compare the immediate effectiveness of the PBU and RUSI to reeducate the TrA muscle in a population of asymptomatic older adults (without pain).

METHODS

Forty participants were randomized into 2 groups (RUSI or PBU). The intervention included a training session involving 15 TrA contractions held for 10 seconds with the corresponding feedback device. The dependent variable, TrA thickness (a muscle activation indicator), was measured using ultrasound images before and after the intervention in a supine and standing position. Nonparametric analyses were used for inter- and intragroup comparisons.

RESULTS AND DISCUSSION

The results showed no between-group differences in TrA activation ratio (AR) in the supine or standing position (supine AR: TrA RUSI thickness change P = .53 vs PBU thickness change P = .73, comparison between groups P = .51; standing AR: TrA RUSI thickness change P = .003 vs PBU thickness change P = .10; comparison between groups P = .61). However, the change in TrA thickness compared to the other abdominal wall muscles in a standing position was significantly less post-intervention for the RUSI group only (RUSI P = .006 vs PBU P = .72). Both groups remained similar post-intervention for this outcome (P = .20).

CONCLUSIONS

Neither the RUSI nor the PBU seems to have the desired effect on the activation of TrA in asymptomatic older adults.

摘要

背景与目的

腹横肌（TrA）是腰椎稳定的关键肌肉，在物理治疗中经常被重新训练。物理治疗师经常使用反馈工具，如压力生物反馈单元（PBU）和康复超声成像（RUSI）来训练他们的患者并提高他们收缩该肌肉的能力。然而，这些工具在恢复老年人 TrA 方面的效果仍有待证明，以及它们将 TrA 从仰卧位招募到站立位的技能转移的效率。本研究的目的是比较 PBU 和 RUSI 在无症状老年人（无疼痛）人群中重新教育 TrA 肌肉的即时效果。

方法

40 名参与者随机分为 2 组（RUSI 或 PBU）。干预措施包括 15 次 TrA 收缩的训练课程，每次收缩持续 10 秒，并使用相应的反馈设备。在仰卧位和站立位下，使用超声图像测量依赖变量（肌肉激活指标）TrA 厚度。使用非参数分析进行组内和组间比较。

结果与讨论

结果显示，仰卧位或站立位的 TrA 激活率（AR）在两组之间没有差异（仰卧位 AR：TrA RUSI 厚度变化 P =.53 与 PBU 厚度变化 P =.73，组间比较 P =.51；站立 AR：TrA RUSI 厚度变化 P =.003 与 PBU 厚度变化 P =.10，组间比较 P =.61）。然而，只有 RUSI 组在干预后站立位时与其他腹壁肌肉相比，TrA 厚度的变化明显减少（RUSI P =.006 与 PBU P =.72）。两组在干预后对于这一结果仍保持相似（P =.20）。