PURPOSE: This study was conducted to investigate the effects of blood flow restriction and different support surfaces for bridge exercises on the thickness of the transverse abdominis and multifidus, which are trunk-stabilizing muscles. METHODS: The study's subjects were 45 adults who were divided into three groups that performed bridge exercises over a six-week period on their respective support surfaces after blood flow restriction. Changes in the thickness of the subjects' transverse abdominis and multifidus muscles were measured using ultrasonography before the experiment, then three and six weeks after the experiment. The changes in each variable over time were analyzed using a repeated-measures analysis of variance (ANOVA). RESULTS: The transverse abdominis showed significant differences in muscle thickness with regard to time and the interaction between time and each group (p<0.05), but no significant differences with regard to changes among groups (p>0.05). The multifidus showed significant differences in muscle thickness with regard to time, the interaction between time and each group, and changes between groups (p<0.05). CONCLUSION: Blood flow restriction and different support surfaces for bridge exercises led to significant differences in the thickness of the transverse abdominis and multifidus. This study's results may be used as the basis for future studies and for rehabilitation in clinical practice.
Adult ; Exercise ; Humans ; Muscles ; Paraspinal Muscles ; Rehabilitation ; Ultrasonography

PURPOSE: This study examined the effectiveness of iliopsoas self-stretching on the hip extension angle, gluteus maximus (GM) activity, and pelvic compensated angle during prone hip extension (PHE) in subjects with iliopsoas shortness. METHODS: Twenty-healthy subjects with iliopsoas shortness were recruited. Electromyography (EMG) was used to examine erector spinae (ES), multifidus (MF), GM, and biceps femoris (BF) while performing PHE. An electromagnetic tracking motion analysis device was used to measure the pelvic compensations. The pelvic compensations while performing PHE were considered to be anterior tilting and rotation. A modified Thomas test was used to monitor the hip extension angle before and after iliopsoas self-stretching. A paired t-test was used to investigate the significant difference after iliopsoas self-stretching during PHE. The level of statistical significance was set to α=0.05. RESULTS: Muscle activity of GM and hip extension angle were significantly greater after iliopsoas self-stretching compared to that before iliopsoas self-stretching during PHE (p < 0.05). BF and pelvic rotation angle were significantly lower after iliopsoas self-stretching compared to that before iliopsoas self-stretching during PHE (p < 0.05). The muscle activity of ES was not significantly different between PHE before and after iliopsoas self-stretching (p>0.05). CONCLUSION: Iliopsoas self-stretching can be effective in selectively strengthening the GM muscles with minimized pelvic compensation in subjects with iliopsoas shortness.
Compensation and Redress ; Electromyography ; Hip ; Magnets ; Muscles ; Paraspinal Muscles

OBJECTIVE: To determine the optimal number of muscles to detect lumbosacral radiculopathies. METHOD: Electrodiagnostic data of 152 patients who had been diagnosed as lumbosacral radiculopathy with the findings of operative record were obtained retrospectively. The findings of needle electromyography were reviewed and the frequency of abnormal spontaneous activities in L5 and S1 myotomes was investigated. We selected 8 individual muscles which had high sampling rate. These muscles were combined into different muscle screens and the detection rates were calculated that the frequency with which one or more muscles in the screen displayed abnormal spontaneous activity was divided by the total number of radiculopathies. RESULTS: The detection rates of lumbosacral radiculopathy were compared according to the number of muscle screens. Including paraspinal muscle, the detection rate of 6 muscle screens was higher than 5 muscle screens (p<0.05), but there was no significant difference of detection rate between 6 muscle screens and 7 muscle screens. The detection rates of each muscle screens without paraspinal muscle were lower than those including paraspinal muscle for all screens (p<0.05). CONCLUSION: Although there is controversy about selection of muscles, six muscle screen including paraspinal muscles may be optimal number for detecting lumbosacral radiculopathy.
Electromyography ; Humans ; Muscles* ; Needles ; Paraspinal Muscles ; Radiculopathy* ; Retrospective Studies

PURPOSE: To investigate whether bone mineral density(BMD) occurs in association with fatty replacement oflower paraspinal muscles and whether it relates with the area ratio(Ps/V) of psoas muscle(Ps) divided by adjacentvertebral body(V). MATERIALS AND METHODS: For the evaluation of osteoporosis, 100 females underwent quantitativeCT. At L1,L2 and L3 levels, the fatty replacement of lower paraspinal muscles was numerically graded and therelationship between this and BMD of the vertebral body was evaluated. The correlation between BMD and Ps/V at L2and L3 levels was also evaluated, as was the relationship between the thickness of subcutaneous fat tissue at L1,L2 and L3 levels. RESULTS: BMD showed significant inverse correlations with the grade of the fatty replacement oflower paraspinal muscles at L1(p<.01), L2 level and L3 level(p<.001). In particular, significant differenceswere established between grade 0 and 2 (p<.05) at L1 level, and between grade 0 and 2, and 1 and 2 (p<.05) at L2and L3 levels. There was markedly low correlation (gamma=.33) between BMD and Ps/V at L3 level(p<.001) and lowercorrelation (gamma=.22) at L2 level(p<.05). At L2 and L3 levels, there was no correlation between the thickness ofsubcutanous fat tissue and BMD or Ps/V. CONCLUSION: The present study demonstrates that there was significantinverse correlation between BMD and fatty replacement of lower paraspinal muscles, and low correlation between BMDand Ps/V.
Bone Density* ; Female ; Humans ; Osteoporosis ; Paraspinal Muscles* ; Spine* ; Subcutaneous Fat

Analgesia ; Anesthetics, Local ; Humans ; Nephrolithotomy, Percutaneous ; Nerve Block ; Paraspinal Muscles

BACKGROUND AND OBJECTIVE

Low back pain is one of the most common work-related musculoskeletal disorders. Healthcare workers are prone to low back pain because of the nature of their profession. Low back pain may be related to lumbar multifidi atrophy or instability and poor core stability. Core stability can be assessed using the unilateral hip bridge endurance test. This cross-sectional study aims to determine the correlation between unilateral hip bridge endurance (UHBE) and sonologic characteristics of the bilateral L4-L5 lumbar multifidus muscles of physically active allied healthcare professionals.

Forty (40) physically active healthcare professionals (mean age = 31.3 ± 6.39 years, mean height = 161.17 ± 8.45 cm, mean weight = 61.88 ± 13.58 kg, mean BMI = 23.61 ± 3.68 kg/m2) were recruited via purposive sampling. The participants answered online versions of the Global Physical Activity Questionnaire (GPAQ) and Oswestry Disability Index. They subsequently underwent the UHBE test and ultrasound assessment of the L4-L5 multifidi. Multiplied anteroposterior (AP) and lateral linear (L) measurements were used to estimate L4-L5 multifidi size. The Pearson test was used to test for correlation between the primary outcomes of the study.

There was no statistically significant correlation between Lumbar Multifidi CSA and UHBE Scores (r = -0.172, p > 0.05), and between Lumbar Multifidi CSA% Difference and UHBE Scores (r = -0.140, p > 0.05). However, results showed a very weak negative correlation between the Lumbar Multifidi CSA% Difference and UHBE Scores.

There is no definite evidence showing a correlation between core stability tests such as the unilateral hip bridge test scores and sonologic characteristics of the lumbar multifidi. However, lumbar multifidi symmetry may have a role with core stability. The correlation between core stability tests and lumbar multifidus morphology should be further investigated.

OBJECTIVE: To investigate changes in lumbar multifidus (LM) and deep lumbar stabilizing abdominal muscles (transverse abdominis [TrA] and obliquus internus [OI]) during transcutaneous neuromuscular electrical stimulation (NMES) of lumbar paraspinal L4-L5 regions using real-time ultrasound imaging (RUSI). METHODS: Lumbar paraspinal regions of 20 healthy physically active male volunteers were stimulated at 20, 50, and 80 Hz. Ultrasound images of the LM, TrA, OI, and obliquus externus (OE) were captured during stimulation at each frequency. RESULTS: The thicknesses of superficial LM and deep LM as measured by RUSI were greater during NMES than at rest for all three frequencies (p<0.05). The thicknesses in TrA, OI, and OE were also significantly greater during NMES of lumbar paraspinal regions than at rest (p<0.05). CONCLUSION: The studied transcutaneous NMES of the lumbar paraspinal region significantly activated deep spinal stabilizing muscle (LM) and the abdominal lumbar stabilizing muscles TrA and OI as evidenced by RUSI. The findings of this study suggested that transcutaneous NMES might be useful for improving spinal stability and strength in patients having difficulty initiating contraction of these muscles.
Abdominal Muscles ; Electric Stimulation* ; Humans ; Male ; Muscles* ; Paraspinal Muscles ; Ultrasonography ; Volunteers

OBJECTIVE: To measure lumbar multifidus muscles by ultrasonography and to study its correlation with the isometric peak touque of back. METHOD: Bilateral L5 and S1 multifidus muscle sizes of 18 healthy volunteers were measured in prone position by ultrasonography with 7.5 MHz, 40 mm-length probe. Multifidus muscles were identified using anatomic landmark-spinous process and lamina and vertical and horizontal diameter were measured. Boundary of muscle was traced and cross sectional area was measured. Lumbar spinal range of motion (ROM) and isometric peak torque of three axes-flexion/ extension, rotation and lateral flexion-were measured by Isostation B-200R back muscle tester. RESULTS: Multifidus muscle cross sectional areas were well correlated with isometric peak torque in all direction of movements. Muscle size and lumbar spine ROM showed no correlation. CONCLUSION: Ultrasonographic measure of lumbar multifidus muscles could be a useful tool to estimate back muscle function.
Back Muscles ; Healthy Volunteers ; Muscles* ; Paraspinal Muscles* ; Prone Position ; Range of Motion, Articular ; Spine ; Torque* ; Ultrasonography

OBJECTIVE: To examine using surface electromyography whether stair climbing with abdominal hollowing (AH) is better at facilitating local trunk muscle activity than stair climbing without AH. METHODS: Twenty healthy men with no history of low back pain participated in the study. Surface electrodes were attached to the multifidus (MF), lumbar erector spinae, thoracic erector spinae, transverse abdominus - internal oblique abdominals (TrA-IO), external oblique abdominals (EO), and the rectus abdominis. Amplitudes of electromyographic signals were measured during stair climbing. Study participants performed maximal voluntary contractions (MVC) for each muscle in various positions to normalize the surface electromyography data. RESULTS: AH during stair climbing resulted in significant increases in normalized MVCs in both MFs and TrA-IOs (p<0.05). Local trunk muscle/global trunk muscle ratios were higher during stair climbing with AH as compared with stair climbing without AH. Especially, right TrA-IO/EO and left TrA-IO/EO were significantly increased (p<0.05). CONCLUSION: Stair climbing with AH activates local trunk stabilizing muscles better than stair climbing without AH. The findings suggest that AH during stair climbing contributes to trunk muscle activation and trunk stabilization.
Cross-Sectional Studies* ; Electrodes ; Electromyography ; Humans ; Low Back Pain ; Male ; Muscles* ; Paraspinal Muscles ; Rectus Abdominis

OBJECTIVE: The Bertrand's method of selective peripheral denervation for spasmodic torticollis has already been established as being an effective and safe method. However, such effectiveness has not yet been established in Korea. The authors have performed several cases of selective denervation for the treatment of spasmodic torticollis and we hereby describe the details of the operative method to determine the effectiveness of the method. METHODS: Ten patients who had the selective denervation for the spasmodic torticollis from October 1997 to December 2003, were analyzed. There were 4 rotational and 6 combined types (3 rotational plus retrocollis, 3 rotational plus laterocollis). We performed preoperative electromyograms and neck muscle tonograms in all cases. The technique was used to involve denervation of the ipsilateral posterior paraspinal muscles. Denervation of the sternocleidomastoid muscle was performed on the contralateral side for rotational torticollis and on the ipsilateral side for laterocollis combined type. The surgery was followed by a rigorous physical therapy program. RESULTS: The surgical results were divided into 4 groups labeled excellent, good, fair, and poor. There were 5 excellent patients who showed no detectable abnormal movements, 4 good patients who showed slight residual deviations or slight residual abnormal movements, and 1 fair patient with appreciable residual abnormal movements. Postoperative pain was well tolerated. There was no significant surgical complications. CONCLUSION: The study confirms that selective peripheral denervation for the treatment of spasmodic torticollis is a very useful and safe surgical technique.
Denervation* ; Dyskinesias ; Humans ; Korea ; Neck Muscles ; Pain, Postoperative ; Paraspinal Muscles ; Torticollis*