Automated ultrasound measurements of lateral abdominal muscles under controlled breathing phases.

BACKGROUND AND OBJECTIVES: A breathing phase during ultrasound measurements of the lateral abdominal muscles (LAMs) are usually indirectly controlled by visual inspection of the position of the transversus abdominis (TrA) muscle. This is due to the lack of devices to directly control airflow that are connected to the ultrasound in order to automatically and simultaneously freeze ultrasound images at the programmed breathing phase. Such indirect control may be related with potential measurement error because LAMs are respiratory muscles. Thus, the aim of this study was to present a newly developed and automatic measurement procedure to directly control airflow and at the same time automatically collect ultrasound images at the programed breathing phase. Additionally, it was decided to compare LAMs measurements obtained manually by the examiner and with an external device controlling the peak phase of tidal inspiration and expiration and compare the elasticity and thickness measurements between tidal inspiration and expiration in young participants. METHODS: The study was carried out on 10 healthy youth. The thickness and shear modulus were measured by an Aixplorer ultrasound scanner. The measurements were obtained manually by the examiner and with a newly developed external device controlling the peak phases of tidal inspiration and expiration. RESULTS: A significant difference in external/internal oblique thickness between the expiration and inspiration phases depended on the measurement procedure. The TrA thickness was similar during inspiration and expiration. During inspiration, the TrA shear modulus was higher than during expiration, and the TrA shear modulus depended on the measurement procedure. CONCLUSION: Although the raw LAMs thickness and external/internal oblique thickness/shear modulus data were similar, the measurement procedure may affect the interpretation of the results. The TrA shear modulus is the most vulnerable to errors related to the measurement procedure. Construction of this study device controlling airflow and automatically collecting ultrasound images at the selected breathing phase seems to be promising in future studies considering measurements of respiratory muscles in a strictly defined breathing phase.

Lateral Abdominal Muscles Shear Modulus and Thickness Measurements under Controlled Ultrasound Probe Compression by External Force Sensor: A Comparison and Reliability Study.

The aim of this study was to perform a reliability and agreement analysis and to compare lateral abdominal muscles (LAMs) thickness and elasticity results obtained by an experienced operator, by a non-experienced operator, and in an ultrasound imaging probe compression controlled (PCC) condition with minimal force necessary to obtain a proper ultrasound image. The sample consisted of 39 adolescents. An Aixplorer ultrasound scanner was used to evaluate the LAM. The probe in PCC condition was positioned in a prepared probe holder coupled with a pressure sensor. The LAM thickness and elasticity measurements were significantly (p < 0.05) different in the ultrasound PCC condition, compared to results obtained by both examiners. The abdominal oblique external and internal muscle thickness measurements were underestimated and all LAM shear moduli were overestimated during measurements without controlling the probe compression by an external sensor. The intra-class correlation coefficient was excellent in all conditions, but the smallest detectable differences were approximately 43-60% lower during the measurements collected in PCC condition. Differences in LAM measurements between PCC and 'on-hand' conditions may be clinically irrelevant when the force applied by the probe is consciously controlled by the examiner. However, during ultrasound measurements of the LAM morphology, the potential under/over estimation should always be considered when measurements are performed without controlling probe compression by an external sensor.

Quality of body posture and postural stability in people with intellectual disability playing volleyball.

PURPOSE: The quality of body posture and its balance depends on the efficiency of the receptors, the good work of the central nervous system integrating and coordinating the postural system and the effective musculoskeletal system. Physical activity of people with intellectual disability can stimulate the processes of improving the posture and its postural stability, improving the quality of life. METHODS: The study was conducted in 2017. 20 randomly selected volleyball players with intellectual disabilities and 10 healthy players took part in it. Body posture was recorded using a photogrammetric system. To evaluate the use of the Frohner Posture Index and the Dolphens classification, stability of the posture was assessed on the Zebris FDM power plate, analyzing the basic stabilographic parameters sway path and sway area. RESULTS: Athletes with intellectual disabilities had significantly poorer posture and body balance than healthy players. There were no differences in postural stability between the groups studied. Some linear correlations were found between the quality of posture and balance and stabilographic variables. CONCLUSIONS: Incorrect postural patterns, observed in people with intellectual disabilities, require the development of special recovery programs. Qualified physical activity can help them improve their balance systems, reducing the risk of falls and injuries. The lack of the possibility of an unequivocal relationship between the quality of body posture and its stability requires research on a larger research material. New evaluation methods used (Frohner Posture index and Dolphens classification) confirmed their usefulness and gave new possibilities of application in postural research.

The use of modern telemedicine technologies in an innovative optimal cardiac rehabilitation program for patients after myocardial revascularization: Concept and design of RESTORE, a randomized clinical trial.

Despite proven efficacy of cardiac rehabilitation (CR) in reducing the all-cause mortality in patients after myocardial revascularization, the penetration of CR, due to patient-related factors and referral rates remains limited. To improve the outcomes, home-based tele-rehabilitation (TR) has been proposed recently. In theory TR enhances the effects of standard CR procedures due to implementation of an intelligent monitoring system designed to ensure optimal training through on-demand transmission of vital signs, aimed at motivating the patients through daily schedule reminders, setting daily goals and creating a platform for mutual feedback. Several meta-analyses assessing various studies comparing these two methods (CR and TR) have proven that they are at least equally effective, with some of the research showing superiority of TR. Although there was a small sample size, lack of long-term follow-up, reporting effects of TR itself, no integration with tools designed for coaching, motivating and promoting a healthy lifestyle constitutes an important limitation. The latter carries a hopeful prognosis for improvement when utilizing a broad-spectrum approach, especially with use of dedicated technological solutions exploiting the fact of a large and yet rapidly increasing penetration of smartphones, mobile PCs and tablets in the population. The above-mentioned findings worked as the basis and rationale for commencing the RESTORE project aimed at developing and delivering state-of-the-art, comprehensive TR for patients after myocardial revascularization and evaluating its molecular aspect in view of how it influences the atherosclerosis progression attenuation. This paper presents the current state and rationale behind the project based on up-to-date TR efficacy data.

Reliability of the lateral abdominal muscle thickness measurements in idiopathic scoliosis patients.

BACKGROUND: To date, the reliability of ultrasound imaging (US) measures of the abdominal muscle thickness in idiopathic scoliosis (IS) patients during early stages of adolescence has not been confirmed. OBJECTIVE: To assess the intra-rater reliability of US measures of the thickness of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) on convex and concave body sides in adolescents with IS. DESIGN: One-way repeated-measures analysis of variance (ANOVA) and reliability study. METHODS: Fifteen patients diagnosed IS were included between the ages of 9 and 14 years. Three repeated US measurements were recorded in the supine resting position over 2 sessions, 24 h apart. RESULTS: By assessing the mean value from the first two measurements (ICC3,2), the reliability was between .76 and .95 for all examined muscles on the convex and concave sides. The reliability for the mean values from three measurements (ICC3,3) was between .81 and .96. The smallest detectable difference values for single measurements were twice as high on the convex side than on the concave side for all examined abdominal muscles. CONCLUSION: US measurements of the thickness of the EO, IO, and TrA muscles in supine rest position in adolescent IS patients are reliable. In order to increase measurement reliability, and due to variability in reliability between concave and convex body side, we recommend using the mean of three consecutive measurements of the EO, IO, and TrA muscles for adolescents with IS.