背景：復發性下背痛的病人在接受即時超音波影像回饋的特定穩定運動訓練可以減少疼痛和障
礙。視覺回饋可以加強深層肌肉的收縮，如腹橫肌、多裂肌以及骨盆底肌在過去研究皆有定性的
報導。為了確切瞭解腹部肌肉收縮表現及其訓練效果，量化腹部肌肉收縮十分重要，然而腹部肌
肉收縮量化表現在目前並無任何定量的研究。目的：本研究目的是測試無症狀受試者使用超音波
回饋在訓練前、訓練前期、訓練後期、訓練後、以及四天之後“留存”的腹部肌肉收縮表現。以
訓練前做為基準參考標準。方法：15名年齡介於20至35歲無下背痛症狀受試者參加本實驗。記
錄每一次訓練（20次）以及測試的超音波影像（訓練前、訓練後以及留存期）。方法使用之前研究所建立的良好信度之量測。使用重覆量測變異數分析（五個時間點）分析訓練前、訓練前期、訓練後期、訓練後以及留存期時前腹筋膜滑動、腹橫肌收縮比以及主要活化比的變化。分別比較訓練前和訓練前期、訓練前和訓練後期、訓練前和訓練後、訓練前和留存、訓練前期和訓練後期、訓練後期和訓練後、訓練後和留存之間各參數之邊緣平均數（marginal means）的差異。結果：只有前腹筋膜滑動在各期間有顯著的差異（p=0.024），而腹橫肌收縮比（p=0.559）以及主要活化比（p=0.449）量化參數在各期間沒有顯著的差異。在前腹筋膜參數部份，訓練前和訓練後（p=0.007）有顯著性的差異，但是訓練前和留存（p=0.009）接近顯著性的邊緣。至於其餘各組則沒有顯著的差異。結論：無腰痛受試者使用即時超音波影像回饋，教導腹肌收縮使用後，只有前腹筋膜滑動有明顯進步，且於四天後仍維持相同程度之表現。未來可進一步探討超音波回饋應用於治療下背痛患者的效果。（物理治療 2009;34(4):244-252）

Background: Visual feedback has been reported to enhance the contraction of the deep muscles,such as the transversus abdominis (TrA), the multifidus, and the pelvic floor muscles. While exploring the effect of using ultrasound images as feedback for deep muscle training, most of the
studies used visual determination to detect whether the performance of the abdominal muscles is improved or not. Limited investigations of quantitative and reliable measurements were known to assess the performance of the deep abdominal muscles. Purpose: The purpose of this study is to examine the performance of abdominal muscle contraction using ultrasound feedback for asymptomatic adults at the pre-training, initial phase of training, final phase of training, posttraining, and four days after training retention. Methods: Fifteen subjects without low back pain (LBP), aged from 20 to 35 years old, were recruited. The ultrasound images of each trial of training (20 trials) and testing (three trials at the pre-training, initial phase of training, final phase of training, post-training, and retention) were recorded. The outcome measures were lateral movement of the fascia and thickness change of TrA and internal oblique (IO) muscles. Changes of variables during pre-training, post-training and retention were assessed using analyses of variance (ANOVA) with repeated measures. The marginal means will be compared between different intervals of measurements. Results: Significant difference of lateral movement in anterior abdominal fascia between different phases (p=0.024) was observed. No significant differences of contraction ratio of TrA (p=0.559) and preferential activation ratio (p=0.449) between phases were detected. In lateral movement of anterior abdominal fascia, difference between pre-training and post-training (p=0.007) existed. Near significant difference between pre-training and retention (p=0.009) was seen. No difference in lateral anterior abdominal fascia movement between other phases could be observed. Conclusions: Using real-time ultrasound
feedback to educate abdominal muscle contraction and quantitatively measuring the training outcome in asymptomatic subjects demonstrated further improvement of lateral movement of the fascia of abdominal muscle after practices. This phenomenon can be maintained for four days. This result might serve as baseline information for further examination of the performance of patients with recurrent low back pain. (FJPT 2009;34(4):244-252)