Need for Visual Biofeedback of Deep Muscle Action

Specifically, real-time ultrasound imaging is needed to provide a patient with visual biofeedback during rehabilitation of impaired muscles.  Visualization of deep muscle action helps to ensure separate contraction of transversus abdominis, independent of unwanted superficial abdominal muscle recruitment of the outer unit.  Studies indicate that the "ideal response" of transversus abdominis occurs at very low level of maximum voluntary contraction with non LBP subjects.  It is a very subtle contraction that is difficult to palpate with an degree of certainty.

Sonography is also used to improve precision in segmental multifidus recruitment.  Precise feedback is given to ensure the very specific activation of the deep portion of multifidus is emphasized over its superficial fibers and that the patient is activating the multifidus at the affected segment.  A patient's tonic holding capacity of these inner unit muscles can also be monitored. 

Research demonstrates that by using real time ultrasound imaging as a form of visual biofeedback we can facilitate our patients' ability to learn to control the muscle activity of their stabilizing muscles, to improve proprioception, and to speed up the motor learning process involved in retraining an isolated transversus abdominis and multifidus co-contraction (Hides 1998).

Let's explore more of what the experts are saying about the use of diagnostic ultrasound imaging for biofeedback in rehabilitation.

Visualization of the muscle activity on the ultrasound imaging monitor provides knowledge of performance and this form of feedback has been acknowledged as the most effective method of motor learning strategies.  Knowledge of result is also provided in the form of timed tonic holding capacity and measurements of changes in muscle depth upon isometric contraction.