The use of real-time ultrasound feedback in teaching abdominal hollowing exercises to healthy subjects

J Orthop Sports Phys Ther. 2005 Jun;35(6):338-45. doi: 10.2519/jospt.2005.35.6.338.


Study design: Randomized controlled trial.

Objectives: To determine if supplementing typical clinical instruction with real-time ultrasound feedback facilitates performance and retention of the abdominal hollowing exercise (AHE).

Background: Increasingly clinicians are using real-time ultrasound imaging as a form of feedback when teaching patients trunk stabilization exercises; however, there has been no justification for this practice.

Methods and measures: Forty-eight subjects were divided randomly into 3 groups that received different types of feedback: group 1 received minimal verbal feedback, group 2 received verbal and palpatory feedback, and group 3 received real-time ultrasound, verbal, and palpatory feedback. If the subject performed 3 consecutive correct AHEs during the initial session, she/he returned for a retention test. The performance of 3 consecutive, correct AHEs was the criterion measure; the number of trials to criterion was also recorded during the initial and retention test sessions.

Results: The ability to perform the AHE differed among groups (P<.001). During the initial session, 12.5% of subjects in group 1, 50.0% of subjects in group 2, and 87.5% of subjects in group 3 were able to perform 3 consecutive AHEs. Group 3 subjects achieved the criterion in fewer trials than the other 2 groups (P = .0006). No differences among groups were found for the retention testing; however, low power due to fewer subjects precluded a strong interpretation of this finding.

Conclusion: Real-time ultrasound feedback can decrease the number of trials needed to consistently perform the AHE; however, the data are inconclusive with regard to retention of this skill.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Abdominal Muscles / diagnostic imaging*
  • Adolescent
  • Adult
  • Biofeedback, Psychology*
  • Exercise Therapy
  • Female
  • Humans
  • Knowledge of Results, Psychological*
  • Male
  • Middle Aged
  • Task Performance and Analysis*
  • Teaching
  • Ultrasonography