Lumbar multifidus muscle size does not differ whether imaging is performed in prone or side lying

This methodological study examined the influence of body position when measuring multifidus muscle size using real-time ultrasound imaging. Previous studies examined multifidus with the subject prone but people with certain conditions cannot be studied in this position, so side lying was investigated as an alternative posture. In 20 normal females (aged 19-45 years), the cross-sectional area (CSA) of lumbar multifidus was measured at the level of the fifth lumbar vertebra (L5) on both the right and left sides, with the subject in prone and in side lying.Multifidus CSA was highly correlated between the two positions on both the right (r=0.90) and left (r=0.91) sides. Paired t-tests found no significant differences between the measurements made in the two scanning postures (right P=0.77 left P=0.16). Bland and Altman plots showed good agreement between the two positions, with no systematic difference.These findings demonstrate that measurements of lumbar multifidus at L5 can be made in either prone or side lying and a valid comparison of the results obtained in both positions can be made

Postpartum characteristics of rectus abdominis on ultrasound imaging

This cross-sectional and partial longitudinal study aimed to characterize changes in rectus abdominis (RA) and provide reference ranges for the first year postpartum. Ultrasound scanning was used at four stages postnatally to measure cross-sectional area (CSA), thickness, width (indirectly using a shape value) and inter-recti distance (IRD). One hundred and fifteen postnatal women (though some postnatal subjects appeared in more than one postnatal group thus giving a total of 183 data points) and 69 age-matched nulliparous female controls were recruited. Postnatal subjects were studied at Day 1 (PN1; n=63) and at 2 (PN2; n=55), 6 (PN3; n=39) and 12 (PN4; n=26) months postpartum. Longitudinal data were analysed for CSA, thickness, shape (indirect width measurement) (df=67) and IRD (df=62). The mean CSA of the PN1 group was significantly larger (P<0.001) than in controls and decreased (P<0.0021) by 12 months. In all postnatal groups, RA was significantly thinner (P<0.0001, PN1–PN3; P<0.0478, PN4), wider (P<0.0001, PN1–PN3; P=0.0326, PN4) and the IRD was significantly larger (P<0.0001, PN1–PN4) than in controls. Over 2 months postpartum, RA became thicker (P=0.0003) and the width and IRD decreased (P<0.0001 and P=0.0002, respectively) but did not return to control values by 12 months. These results have implications for strength of RA postpartum and anterior abdominal wall stiffness, which together with other muscle characteristics could inform development of effective postnatal exercise programmes

Postpartum characteristics of rectus abdominis on ultrasound imaging

This cross-sectional and partial longitudinal study aimed to characterize changes in rectus abdominis (RA) and provide reference ranges for the first year postpartum. Ultrasound scanning was used at four stages postnatally to measure cross-sectional area (CSA), thickness, width (indirectly using a shape value) and inter-recti distance (IRD). One hundred and fifteen postnatal women (though some postnatal subjects appeared in more than one postnatal group thus giving a total of 183 data points) and 69 age-matched nulliparous female controls were recruited. Postnatal subjects were studied at Day 1 (PN1; n=63) and at 2 (PN2; n=55), 6 (PN3; n=39) and 12 (PN4; n=26) months postpartum. Longitudinal data were analysed for CSA, thickness, shape (indirect width measurement) (df=67) and IRD (df=62). The mean CSA of the PN1 group was significantly larger (P<0.001) than in controls and decreased (P<0.0021) by 12 months. In all postnatal groups, RA was significantly thinner (P<0.0001, PN1–PN3; P<0.0478, PN4), wider (P<0.0001, PN1–PN3; P=0.0326, PN4) and the IRD was significantly larger (P<0.0001, PN1–PN4) than in controls. Over 2 months postpartum, RA became thicker (P=0.0003) and the width and IRD decreased (P<0.0001 and P=0.0002, respectively) but did not return to control values by 12 months. These results have implications for strength of RA postpartum and anterior abdominal wall stiffness, which together with other muscle characteristics could inform development of effective postnatal exercise programmes

Physiotherapy in Women’s Health

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