Dear Uri,
I am not totally sure of the costs, but it is simply a diagnostic
ultrasound. The same that is used for scanning. We have a specific clinic
run by the University at
one of the hospitals in Brisbane that uses the ultrasound to get a cross
sectional view of transverse abdominus, internal and external obliques. With
the correct activation of TA you see the cross sectional width of it
increase while EO and IO remain constant. You also see the fibres of TA draw
around towards the lumbar spine. The patient can view this in real time and
get feedback. The same can be done with multifidus along the fibres of the
muscle so that you can view the superficial and deep fibres as they run from
vertebra to vertebra. With the correct activation, you see the deeper fibres
contact and glide while the superficial fibres remain relaxed. I believe
that this is better then EMG as you can't get to TA or the deeper fibres of
multifidus without fine wire. I hope this helps.
Regards
Ivan
-----Original Message-----
From: אורי <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Wednesday, 3 May 2000 20:44
Subject: RE: Ab Exercise Myths
-----Original Message-----
From: Ivan Hooper [SMTP:[log in to unmask]]
Sent: ? ??? 01 2000 18:54
To: Physio List
Subject: Re: Ab Exercise Myths
In response to Mel's email, I agree that conscious activation of transverse
abdominus in complex daily activities is not going to achieve what alot of
people think it will. The initial work of Hodges, Richardson and Jull
demonstrated a delay in the onset timing of TA whilst performing both upper
limb and lower limb tasks in those subjects with chronic low back pain. His
work (and that of Hides) suggests that TA and multifidus have a role to
activate immediately prior to limb movements to enhance segmental stiffness
and thereby protect the spine from the displacing forces generated by the
limb movement.
Jull et al (1998) report on two cases where isolated activation training of
TA and multifidus has changed the involuntary activation timing of these
muscles during limb activities (ie decreased the delay in onset), and also
changed the VAS pain scores of the two subjects. But having had numerous
discussions with Jull and Richardson about this very topic, they don't
believe that we should be getting patients / athletes to consciously
activate TA and Multifidus during activity. Obviously to have any effect on
what are subconscious motor engrams, thousands of repetitions of the correct
pattern need to be performed. Our aim is to make the correct pattern of
activation the dominant pattern. To achieve this we as therapists need to
ensure that an exercises that are performed are done correctly. Exercises
done incorrectly simply reinforce the wrong movement pattern. That is why we
are now tending to do alot of these isolation exercises with the aid of the
ultrasound feedback.
Generally, asking a patient / athlete to activate TA and multifidus during
normal or sporting activities causes overactivity of the rectus abdominus
and obliques, thus generating a "global activation" of the whole abdominal
muscle group. Precisely the pattern we are trying to break down. Certainly
with athletes, who all tend to do things at 100%, they try "too hard".
Instead of activating TA at 20 - 30% MVC to enhance it's tonic stability
role, they activate at much higher percentages of MVC. Jull and Richardson
believe that the patient / athlete needs to perform enough repetitions of
the activation of these muscles in isolation so that eventually there may be
some small flow over to normal activities.
The therapeutic exercises used to rehabilitate the function TA and
multifidus take a great deal of conscious thought and thorough self and
therapist directed error checking and feedback. Even though the correct
activation of these muscles in all activity is what we ultimately want,
training them this way doesn't necessarily work. Until the very late stages
of rehabilitation, I believe it is near impossible to get patients to
perform the correct activation of these muscles in functional / sporting
movement patterns.
I hope this input is of use.
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Ivan Hooper
Sports Physiotherapist
Optima Physiotherapy & Massage Therapy
Cnr Ashgrove Ave & Enoggera Rd
Newmarket Q 4051
(W) 07 3356 3312 (F) 07 3356 0234
(H) 07 3371 7881 (M) 0413 946 308
EMail : [log in to unmask]
<< File: ATT00000.html >>
[אורי]
dear Ivan
c
an u send me more details about ] the [אורי] ultrasound biofeedback
thank u in advance
uri yaros
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