The use of real-time ultrasound imaging for biofeedback of lumbar multifidus muscle contraction in healthy subjects

Study Design: 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 hiofeedback when re-educating muscle activation. The effectiveness of this form of biofeedback for the multifidus muscle has not been reported. Methods and Measures: 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, I 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 multificlus muscle in the acquisition phase (P <.001) and the ability to recruit the multificlus muscle differed between groups (P <.05), with subjects in the group that received visual ultrasound hiofeedback 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). Conclusion: Real-time ultrasound imaging can be used to provide visual hiofeedback and improve performance and retention in the ability to activate the multificlus muscle in healthy subjects. J