Evaluation of the Ability of Physical Therapists to Palpate Intrapelvic Motion With the Stork Test on the Support Side

Hungerford, Barbara; Gilleard, Wendy L; Moran, Michael L.; Emmerson, Cathryn

doi:10.2522/ptj.20060014

Cited by 74 publications

(67 citation statements)

References 16 publications

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“…The clinical exam included measures of body mass and height, tests of lower extremity neural conductivity and mobility, 5 and lumbopelvic load transfer. 26,35 The participants in the LPP group completed 3 standardized questionnaires that provided further information about their perceived low back-related disability: the modified Oswestry Disability Questionnaire Version 2, 10 a numeric pain rating scale, 6 and the Fear-Avoidance Beliefs Questionnaire.…”

Section: Participantsmentioning

confidence: 99%

Association Between Changes in Electromyographic Signal Amplitude and Abdominal Muscle Thickness in Individuals With and Without Lumbopelvic Pain

Whittaker¹,

McLean²,

Hodder³

et al. 2013

J Orthop Sports Phys Ther

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The muscles of the abdominal wall play a role in controlling motion of the spine, 1,20,21,24 and there is evidence of dysfunction of this musculature in persons with lumbopelvic pain (LPP). Proposed dysfunctions range from delayed onset 23 and seemingly diminished responses (smaller increase in thickness) of the transversus abdominis (TrA) 46,48 to increased electromyographic (EMG) signal amplitude and greater responses (larger increase in thickness) of the rectus abdominis (RA) and external and internal oblique (EO and IO) muscles.2,39,49 As these abnormalities have been linked to pain and dysfunction, there is interest in developing methods to accurately assess function of the abdominal musculature.Ultrasound imaging (USI) is a noninvasive and valid method to quantify abdominal muscle size 19 and is currently used in rehabilitation, in part, under the assumption that changes in muscle thickness reflect the extent of muscle contraction.42,46,50 USI has also been used for screening purposes 18 and as a source of real-time biofeedback, as it is presumed to be reflective of muscle activity during exercises commonly employed in rehabilitation programs. 15,38 Although some authors have stated that changes in muscle thickness measured with USI can be used as surrogate measures of muscle activity 11,34,42 and activation, 31,40,41,44 evidence T T STUDY DESIGN: Validation study. T T OBJECTIVES:To investigate the association between changes in electromyographic (EMG) signal amplitude and sonographic measures of muscle thickness of 4 abdominal muscles, during 2 clinical tests, in adults with and without lumbopelvic pain. T T BACKGROUND:There is a trend in rehabilitation to use ultrasound imaging (USI) to determine the extent of abdominal muscle contraction. However, the literature investigating the relationship between abdominal muscle thickness change and level of activation is inconclusive and has not included clinically relevant tasks. T T METHODS:Simultaneous recording from finewire EMG and USI was performed for 4 abdominal muscles, in 7 adults with lumbopelvic pain (mean  SD age, 29.7  12.0 years) and 7 adults without lumbopelvic pain (32.0  10.6 years), during an active straight leg raise (ASLR) test and an abdominal drawing-in maneuver (ADIM). Cross-correlation functions and linear regression analyses were used to describe the relationship between the 2 measures. Analyses of variance were used to compare individuals with and without lumbopelvic pain, with an alpha set at .05. T T RESULTS:Across all muscles, peak crosscorrelation values were low (ASLR, r = 0.28  0.09; ADIM, r = 0.35  0.11), and there was large variability in associated time lags (ASLR, τ = 0.69  2.56 seconds; ADIM, τ = 0.53  3.75 seconds). Regression analyses did not detect a systematic pattern of association between EMG signal amplitude and USI measurements, and analyses of variance revealed no differences between cohorts.

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Section: Participantsmentioning

confidence: 99%

Association Between Changes in Electromyographic Signal Amplitude and Abdominal Muscle Thickness in Individuals With and Without Lumbopelvic Pain

Whittaker¹,

McLean²,

Hodder³

et al. 2013

J Orthop Sports Phys Ther

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“…In addition, all subjects completed the Nijmegen questionnaire and the Urogenital Distress Inventory, 44 and underwent a standardized clinical examination that served as a screening mechanism and provided a basic clinical profile. The clinical examination included measures of body mass and height, tests of lower extremity neural conductivity and mobility, 5 lumbopelvic load transfer (active straight leg raise), 27,33 and capnography testing 15 (CapnoTrainer; Better Physiology Ltd, Santa Fe, NM).…”

mentioning

confidence: 99%

Comparison of the Sonographic Features of the Abdominal Wall Muscles and Connective Tissues in Individuals With and Without Lumbopelvic Pain

Whittaker¹,

Warner²,

Stokes³

2013

Journal of Orthopaedic & Sports Physical Therapy

138

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Study Design Cross-sectional, case-control study. Objectives To measure and compare the resting thickness of the 4 abdominal wall muscles, their associated perimuscular connective tissue (PMCT), and interrecti distance (IRD) in persons with and without lumbopelvic pain (LPP), using ultrasound imaging. Background The muscles and PMCT of the abdominal wall assist in controlling the spine. Functional deficits of the abdominal wall muscles have been detected in populations with LPP. Investigations of the abdominal wall in those with LPP are primarily concerned with muscle, most commonly the transversus abdominis (TrA) and internal oblique (IO). Because the abdominal wall functions as a unit, all 4 abdominal muscles and their associated connective tissues should be considered concurrently. Methods B-mode ultrasound imaging was used to measure the resting thickness of the rectus abdominis (RA), external oblique, IO, and TrA muscles; the PMCT planes; and IRD in 50 male and female subjects, 25 with and 25 without LPP (mean ± SD age, 36.3 ± 9.4 and 46.6 ± 8.0 years, respectively). Univariate correlation analysis was used to identify covariates. Analyses of covariance (ANCOVAs) and the Kruskal-Wallis test (IRD) were used to compare cohorts (α = .05). Results The LPP cohort had less total abdominal muscle thickness (LPP mean ± SD, 18.9 ± 3.0 mm; control, 20.3 ± 3.0 mm; ANCOVA adjusted for body mass index, P = .03), thicker PMCT (LPP, 5.5 ± 0.2 mm; control, 4.3 ± 0.2 mm; ANCOVA adjusted for body mass index, P = .007), and wider IRD (LPP, 11.5 ± 2.0 mm; control, 8.4 ± 1.8 mm; Kruskal-Wallis, P = .005). Analysis of individual muscle thickness revealed no difference in the external oblique, IO, and TrA, but a thinner RA in the LPP cohort (LPP mean ± SD, 7.8 ± 1.5 mm; control, 9.1 ± 1.2 mm; ANCOVA adjusted for body mass index, P<.001). Conclusion To our knowledge, this is the first study to investigate the morphological characteristics of all 4 abdominal muscles and PMCT in individuals with LPP. The results suggest that there may be altered loading of the PMCT and linea alba secondary to an altered motor control strategy involving a reduced contribution of the RA. Further, the change in RA and connective tissue morphology may be more evident than changes in external oblique, IO, and TrA thickness in persons with LPP. The causes and functional implications of these changes warrant further investigation, as does the role of the RA muscle in the development and persistence of LPP. J Orthop Sports Phys Ther 2013;43(1):11–19. Epub 16 November 2012. doi:10.2519/jospt.2013.4450

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“…As a functional test, the active straight leg raise (ASLR) test is also a valid inclusion [4]. The Stork test (stance phase) is a good indicator of muscle recruitment patterns [29].…”

Section: Clinical Assessmentmentioning

confidence: 99%

Metabolic disturbances identified by SPECT-CT in patients with a clinical diagnosis of sacroiliac joint incompetence

et al. 2013

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Purpose To establish the sensitivity and specificity of cross-sectional scintigraphy [single photon emission computed tomography (SPECT)] combined with computed X-ray tomography (CT) in the detection of sacroiliac joint (SIJ) mechanical dysfunction and evaluate reproducibility of reporting. Methods Patients with pelvic girdle pain either on the basis of peri-partum SIJ dysfunction or trauma were included. These patients were imaged with bone scintigraphy with hybrid imaging with SPECT/CT. Results The study group comprised 100 patients (72 females, 28 males). Trauma accounted for 52 % and the remainder were patients with peri-partum pain. Average age was 43 years and average length of history was [2 years. The major finding was increased uptake in the upper SIJ and posterior soft-tissues/ligaments. Hybrid imaging had a sensitivity of 95 % and specificity of 99 %. Positive predictive value was 99 % and negative predictive value 94 %. Power of the test was 1.0. Reproducibility of the test was good with kappa values of 0.85. ConclusionHybrid imaging with SPECT/CT reproducibly demonstrates metabolic alterations around the SIJ in patients with SIJ dysfunction, which we have termed SIJ incompetence. The condition is more common than previously recognised and frequently occurs after trauma, which has not been reported previously.

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Evaluation of the Ability of Physical Therapists to Palpate Intrapelvic Motion With the Stork Test on the Support Side

Cited by 74 publications

References 16 publications

Association Between Changes in Electromyographic Signal Amplitude and Abdominal Muscle Thickness in Individuals With and Without Lumbopelvic Pain

Association Between Changes in Electromyographic Signal Amplitude and Abdominal Muscle Thickness in Individuals With and Without Lumbopelvic Pain

Comparison of the Sonographic Features of the Abdominal Wall Muscles and Connective Tissues in Individuals With and Without Lumbopelvic Pain

Metabolic disturbances identified by SPECT-CT in patients with a clinical diagnosis of sacroiliac joint incompetence

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