title: The use of real-time ultrasound imaging for biofeedback of lumbar multifidus muscle contraction in healthy subjects.
abstract: METHODS
  Randomized controlled trial.
  
  
  OBJECTIVE
  To determine if the provision of visual biofeedback using real-time ultrasound imaging enhances the ability to activate the multifidus muscle.
  
  
  BACKGROUND
  Increasingly clinicians are using real-time ultrasound as a form of biofeedback when re-educating muscle activation. The effectiveness of this form of biofeedback for the multifidus muscle has not been reported.
  
  
  METHODS
  Healthy subjects were randomly divided into groups that received different forms of biofeedback. All subjects received clinical instruction on how to activate the multifidus muscle isometrically prior to testing and verbal feedback regarding the amount of multifidus contraction, which occurred during 10 repetitions (acquisition phase). In addition, 1 group received visual biofeedback (watched the multifidus muscle contract) using real-time ultrasound imaging. All subjects were reassessed a week later (retention phase).
  
  
  RESULTS
  Subjects from both groups improved their voluntary contraction of the multifidus muscle in the acquisition phase (P<.001) and the ability to recruit the multifidus muscle differed between groups (P<.05), with subjects in the group that received visual ultrasound biofeedback achieving greater improvements. In addition, the group that received visual ultrasound biofeedback retained their improvement in performance from week 1 to week 2 (P>.90), whereas the performance of the other group decreased (P<.05).
  
  
  CONCLUSIONS
  Real-time ultrasound imaging can be used to provide visual biofeedback and improve performance and retention in the ability to activate the multifidus muscle in healthy subjects.
authors.affiliation: Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Australia.
authors.forename: Khai
authors.initials: K
authors.lastname: Van
authors.forename: Julie A
authors.initials: JA
authors.lastname: Hides
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Richardson
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001676:Biofeedback, Psychology; D005260:Female; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology*; D008161:Lumbosacral Region / Q000502:physiology; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging* / Q000502:physiology; D014463:Ultrasonography / Q000379:methods; D014785:Vision, Ocular