Kutuk Burak, Ones Kadriye, Dogan Yunus Emre
Department of Physical Medicine and Rehabilitation, Health Sciences University, Physical Therapy Rehabilitation Training and Research Hospital, 34903 Istanbul, Turkey.
Department of Physical Medicine and Rehabilitation, Health Sciences University, Fatih Sultan Mehmet Training and Research Hospital, 34752 Istanbul, Turkey.
Medicina (Kaunas). 2025 May 15;61(5):897. doi: 10.3390/medicina61050897.
This study aimed to evaluate the predictive value of ultrasonographic abdominal muscle thickness and thickening ratios for expiratory muscle strength in SCI patients. A case-controlled, cross-sectional study was conducted with 36 SCI patients and 30 age- and sex-matched healthy controls. Ultrasonographic measurements of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) were performed at rest and during forced expiration. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured to assess respiratory muscle strength. Correlation and regression analyses were performed to determine the relationship between ultrasonography (USG) parameters and expiratory muscle function. SCI patients exhibited significantly lower MIP (76.27 ± 29 cmHO vs. 91.63 ± 17.3 cmHO, = 0.007) and MEP (64.52 ± 21.55 cmHO vs. 119.1 ± 26.48 cmHO, < 0.001) compared to healthy individuals. Ultrasonographic measurements revealed a significant reduction in forced thickness and thickening ratios of EO, IO, and TrA muscles in SCI patients ( < 0.001). MEP was positively correlated with EO forced thickness (r = 0.333, = 0.047), IO forced thickness (r = 0.501, = 0.002), and TrA forced thickness (r = 0.530, = 0.001). Multiple linear regression analysis identified TrA forced thickness as the strongest predictor of MEP (β = 0.49, = 0.001). Ultrasonographic measurements of abdominal muscle thickness and thickening ratios provide valuable insights into expiratory muscle dysfunction in SCI patients. TrA forced thickness demonstrated the strongest association with MEP, suggesting its potential as a novel, non-invasive biomarker for expiratory muscle weakness. These results support the use of USG as a practical clinical tool for guiding respiratory assessment and rehabilitation strategies in patients with spinal cord injury.
本研究旨在评估超声测量的腹部肌肉厚度和增厚率对脊髓损伤（SCI）患者呼气肌力量的预测价值。对36例SCI患者和30例年龄及性别匹配的健康对照者进行了病例对照横断面研究。在静息状态和用力呼气时对腹直肌（RA）、腹外斜肌（EO）、腹内斜肌（IO）和腹横肌（TrA）进行超声测量。测量最大吸气压力（MIP）和最大呼气压力（MEP）以评估呼吸肌力量。进行相关性和回归分析以确定超声（USG）参数与呼气肌功能之间的关系。与健康个体相比，SCI患者的MIP（76.27±29cmH₂O对91.63±17.3cmH₂O，P = 0.007）和MEP（64.52±21.55cmH₂O对119.1±26.48cmH₂O，P < 0.001）显著降低。超声测量显示，SCI患者的EO、IO和TrA肌肉的用力厚度和增厚率显著降低（P < 0.001）。MEP与EO用力厚度（r = 0.333，P = 0.047）、IO用力厚度（r = 0.501，P = 0.002）和TrA用力厚度（r = 0.530，P = 0.001）呈正相关。多元线性回归分析确定TrA用力厚度是MEP的最强预测因子（β = 0.49，P = 0.001）。超声测量腹部肌肉厚度和增厚率可为SCI患者呼气肌功能障碍提供有价值的见解。TrA用力厚度与MEP的关联最强，表明其作为呼气肌无力的新型非侵入性生物标志物的潜力。这些结果支持将USG用作指导脊髓损伤患者呼吸评估和康复策略的实用临床工具。
