Comparison of the Changes in Thickness of the Abdominal Wall Muscles of Stroke Patients According to the Duration of Their Illness as Observed Using Ultrasonographic Images

Abstract

[Purpose] This study was conducted in order to investigate the importance of trunk muscle strength in stroke patients. By comparing the thicknesses of the abdominal wall muscles through ultrasonography, relative to the duration of illness, the results of the objective data were applied. [Methods] Thirty stroke patients were divided into three groups including an acute phase group participating in the study within 1 month after the onset of a stroke (n=10), a subacute phase group participating less than 6 months (n=10) after a stroke, and a chronic phase group participating more than 6 months (n=10) after suffering a stroke. The thicknesses of the transversus abdominis muscles (TrA), internal oblique muscle (IO), and the external oblique muscle (EO) were measured at rest and during abdominal draw-in maneuver (ADIM) in a supine hook-lying position, and their differences were compared. [Results] The results showed that, in comparison of the thicknesses of the paretic and nonparetic sides, the TrA of the subacute phase and chronic phase groups showed significant differences. In addition, the IO of the subacute phase group and the EO of the chronic phase groups also showed significant differences. [Conclusion] According to the duration of illness in stroke patients, the abdominal wall muscles become noticeably infirm and asymmetric. By improving their symmetry, the functions of the trunk muscles can be recovered.

Audiovisual Biofeedback-Based Trunk Stabilization Training Using a Pressure Biofeedback System in Stroke Patients: A Randomized, Single-Blinded Study

“…Vasseljen and Fladmark [ 20 ] applied the ADIM using RTUI in patients with lower back pain patients and reported an increase of 3% in the thickness of TrA. Seo et al [ 48 ] applied trunk stabilization exercises using a PBU in chronic stroke patients and reported results similar to those of the present study, with an improvement of 17% and 15% in the thickness of TA during contraction on the affected and unaffected sides, respectively.…”

“…Pressure feedback was used in patients with lower back pain patients to facilitate independent contraction of TrA, and it was found to be effective for stabilization of the sacroiliac joint [ 7 , 14 ]. RTUI has been reported to be more accurate and more effective than pressure feedback [ 44 , 46 , 47 ]; Seo et al [ 48 ] therefore used RTUI in stroke patients to effectively implement trunk stabilization training. Using RTUI may be effective; however, it has the following disadvantages: It requires expensive equipment; patients experience some discomfort when the ultrasound transducer is placed against their skin; and patients have difficulty interpreting the ultrasound images.…”

The effect of trunk training on muscle thickness and muscle activity: a systematic review

“…bridging exercises [21,[23][24][25][26][27]. The EO is mostly involved in rotational movements whereas TrA is involved in all movements [34,35]. Moreover, TrA contracts prior to movement, known as anticipatory postural adjustments, and thereby acts as a local stabiliser [34].…”

“…The EO is mostly involved in rotational movements whereas TrA is involved in all movements [34,35]. Moreover, TrA contracts prior to movement, known as anticipatory postural adjustments, and thereby acts as a local stabiliser [34]. Since training programs consisted mostly of exercises focusing on extension patterns, EO received less training in comparison to TrA.…”

“…Also, it is important to consider the type of training since not all exercises induce changes in specific muscle groups. For example, chances to see improvement in EO muscle thickness are smaller when performing bridging exercises compared to rotational exercises [34,35].…”