Purpose To investigate intra-and inter-rater reliability of the ultrasound measurement of transversus abdominis (TrA) thickness and thickness change (difference between thickness at rest and during contraction) in asymptomatic, trained subjects. To define the number of repeated measurements that provide acceptable level of reliability. To investigate variability of the measurements over time of 5 days and the reliability of duplicate analysis of images. Methods A single-group repeated-measures design was used to assess reliability. Healthy volunteers (n = 10) were subjected to 1-week training in voluntary activation of TrA. Real-time ultrasound imaging and subsequent measurement of the TrA thickness at rest and during voluntary contraction were repeated on Monday, Wednesday and Friday of the next week. Results Using a single repeated measurement, intraclass correlation coefficients (ICCs) for TrA thickness were: 0.86-0.95 (intra-rater), 0.86-0.92 (inter-rater); and for TrA thickness change: 0.34-0.56 (intra-rater), 0.47-0.61 (interrater). Using the mean of three repeated measurements respective values were: 0. 97, 0.96-0.98; and 0.81-0.84, 0.80-0.90. No significant differences were found between mean values of TrA thickness as well as thickness change obtained on three consecutive measurement days. Duplicate analysis of the images was highly reliable with ICCs of 0.89-0.99. Conclusions Two repeated measurements for TrA thickness and at least three measurements for TrA thickness change are needed to achieve acceptable levels of intraand inter-rater reliability. In healthy trained volunteers TrA thickness and thickness change are relatively stable parameters over a 5-day period. Duplicate analysis of the same images by two blinded observers is reliable.

The aim of this article is to present a novel method of evaluating the activity of lateral abdominal muscles using M-mode sonography. The method leads to calculation of the tissue deformation index, representing the percent change in lateral abdominal muscle thickness over time. The objectives of this study were as follows: (1) to establish the mean tissue deformation index values for individual lateral abdominal muscles; and (2) to establish the reliability of the tissue deformation index. In a group of 34 healthy young volunteers (mean age, 24.03 years; body mass, 68.89 kg; body height, 174.25 cm), the reflex response of the lateral abdominal muscles to postural perturbation in the form of rapid arm abduction was recorded in 2 series, with 6 repetitions each, and the tissue deformation index was calculated. The mean tissue deformation index values formed a gradient, increasing from deep to superficial lateral abdominal muscles: 0.06%/ms for transversus abdominis, 0.11%/ms for oblique internal, and 0.16 for oblique external muscles. The tissue deformation index values differed significantly among individual lateral abdominal muscles (all paired comparisons, P < .001). Three repeated measurements are sufficient to achieve good intra-rater reliability of the tissue deformation index (intraclass correlation coefficient, > 0.8).

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