The Use Of Real-Time Ultrasound For Feedback In Rehabilitation

(extract from MPA In Touch, Issue 2, 2003 by Julie Hides PHD)

"Recent research has highlighted the importance of the local synergy of muscles, which control, protect and stabilize the lumbo-pelvic region. These four muscles include the transverses abdominus, the multifidus, the pelvic floor and the diaphragm. This system has been described as an internal corset, and is reliant on the muscles tensioning the fascias (musculofascial). The muscles of the local synergy and the fascias can be imaged using Real Time Ultrasound imaging.

Real Time Ultrasound imaging allows evaluation of the muscles at rest, and allows examination of patterns of activation. This is used both for assessment and to provide direct feedback of patterns of muscle activation to the patient. We have called our Rehabilitation approach “segmental stabilization training”.

The fascias appear white because they reflect the sound waves back to the transducer of the Ultrasound Unit. Muscles appear dark as they are filled with fluid (blood). There are definite features that can be observed during the drawing in action of the abdominal wall using the transverses abdominus muscles. Similarly, the multifidus and lumbar erector spinae are also cable of contributing to the tension in the thoraco-lumbar fascia.

The Ultrasound can also be used to provide feedback in the sitting and standing position. Further more it can be used not only to provide feedback of activation of the local synergy muscles but also to provide feedback of relaxation of over-active global muscles.”