Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital.
Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Busan, Republic of Korea.
Medicine (Baltimore). 2021 Mar 5;100(9):e24973. doi: 10.1097/MD.0000000000024973.
An abdominal pseudohernia is a protrusion of the abdominal wall that there is no actual muscular disruption. This report presents a case in which abdominal muscle activities were accurately and quantitatively measured using ultrasonography (US) and surface electromyography in a patient with abdominal pseudohernia.
A 62-year-old man presented with a marked protrusion on the left abdomen with increasing abdominal pressure.
First, the thickness of the abdominal muscle was measured with US while the patient constantly blew the positive expiratory pressure device. When the force was applied to the abdomen, the mean thickness of the muscle layer on the lesion site was found to be thinner. Second, the activities of the abdominal muscles were measured using surface electromyography by attaching electrodes to 8 channels at the same time. When the same pressure was applied on both sides of the abdomen, more recruitment occurred to compensate for muscle weakness at the lesion site. Through the previous 2 tests, the decrease in muscle activity in the lesion area could be quantitatively evaluated. Third, the denervation of the muscle was confirmed using US-guided needle electromyography.
The patient in this case was wearing an abdominal binder. In addition, he had been training his abdominal muscles through McGill exercise and breathing exercises such as with a positive expiratory pressure device.
The patient was able to understand his symptoms. A follow-up test will be performed to see if there is any improvement.
By using these outstanding assessment methods, proper diagnosis and rehabilitation treatment strategies can be developed.
腹壁假性疝是一种腹壁突出，实际上没有肌肉破裂。本报告介绍了一例使用超声（US）和表面肌电图对腹壁假性疝患者的腹壁肌肉活动进行准确和定量测量的病例。
一名 62 岁男性，表现为左腹部明显突出，腹压增加。
首先，在患者持续吹正压呼气装置时，用 US 测量腹壁肌肉的厚度。当力施加到腹部时，发现病变部位的肌肉层平均厚度变薄。其次，通过同时在 8 个通道上贴电极，使用表面肌电图测量腹部肌肉的活动。当在腹部两侧施加相同的压力时，更多的肌肉募集发生以补偿病变部位的肌肉无力。通过前 2 项测试，可以定量评估病变区域肌肉活动的减少。第三，使用 US 引导的针肌电图确认肌肉失神经。
本例患者佩戴了腹部束带。此外，他一直在通过 McGill 运动和正压呼气装置等呼吸练习来训练腹部肌肉。
患者能够了解自己的症状。将进行随访测试以观察是否有任何改善。
通过使用这些出色的评估方法，可以制定出适当的诊断和康复治疗策略。
