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Shear wave elastography (SWE) is a potential modality that quantitatively measures the elasticity (shear wave speed [SWS]) of musculoskeletal structure. This SWS was bilaterally measured in the rectus abdominis (RA), external oblique (EO) muscle, internal oblique (IO) muscle and transversus abdominis (TrA) using SWE in 28 patients with incisional hernia and 14 healthy controls. The differences in muscle thickness for IO and TrA were significant between the two groups (p < 0.05). The SWS of RA, EO, IO and TrA was significantly higher in the incisional hernia patient group than in the healthy controls (p < 0.05). Significant differences were also observed between the upper and lower points in both groups (p < 0.05). The measurements of SWS help in evaluating the elastic properties of abdominal wall muscles, which could further aid in preparing treatment plans to improve muscle strength., (Copyright © 2020 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Objective: To determine if hip fracture patients would have smaller cross-sectional area (CSA) and lower radiological attenuation (suggesting greater fat infiltration) in all trunk muscles as compared to older adults without hip fractures., Design: Cross-sectional analysis of computed tomography (CT) scans., Setting: Clinical imaging facility., Participants: Forty-one white participants (19 men, 22 women) from the Baltimore Hip Studies seventh cohort at 2 months postfracture were compared to 693 white participants (424 men, 269 women) from the Health, Aging and Body Composition (Health ABC) study at the year 6 visit (N=734)., Intervention: Not applicable., Main Outcome Measures: Trunk muscle CSA and attenuation values were obtained from a single 10-mm, axial CT scan completed at the L4-L5 disc space in each participant., Results: The hip fracture cohort had significantly smaller CSA for all trunk muscles (range: 12.1%-38% smaller) compared to the Health ABC cohort (P<.01), with the exception of the rectus abdominus muscle in men (P=.12). But, hip fracture patients, particularly female patients, had higher attenuation levels (lower intramuscular fat) in all trunk muscles (P<.0001)., Conclusions: Findings are consistent with atrophy of the trunk muscles in the hip fracture population without a high level of intramuscular fat. Future work should evaluate the role of trunk muscle composition in the functional recovery of older adults after hip fracture., (Copyright © 2018 American Congress of Rehabilitation Medicine. All rights reserved.)

Background: Lateral approaches to the spine are increasing in popularity. However, details of the innervation pattern of the abdominal oblique muscles with the initial dissection have not been well studied., Methods: Ten adult fresh-frozen cadavers (20 sides) were placed in the lateral position. On each side, the region in which transpsoas approaches are performed, between the iliac crest and the 12th rib, was dissected. The nerves, their course, and their muscular supply were studied., Results: The subcostal nerve is the predominant nerve supply for the anterolateral abdominal muscle innervation. It is larger and has a wider field of distribution and more branches (8 on average) compared with the L1 (4 on average) and 11th intercostal nerves (2 on average 2). The proximal 6-10 cm of each nerve has few if any branches. The subcostal nerve is often (75%) located up to 5 cm inferior to the 12th rib in its initial course. The area of least concentration ("safe zone") is located at an approximate midpoint between the lower edge of the 12th rib and the superior-most aspect of the iliac crest. A previously undescribed branch of the subcostal nerve was found traveling posterior to the quadratus lumborum and joining the remaining subcostal nerve in an anastomosis at or near the lateral position., Conclusions: Knowledge of the innervation and nerve dominance patterns might help decrease postoperative complications such as sensory deficits or abdominal wall hernias. The subcostal nerve is the dominant nerve in both size and innervation of the oblique muscles in the lateral position, transpsoas approach., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Purpose: This study aimed to investigate atrophy in the deep abdominal muscles, spinal extensors, and the effect of high-load resistive exercise with and without whole-body vibration after 60 d of strict bed rest., Methods: Twenty-four subjects underwent 60 d of head-down tilt bed rest and performed either resistive vibration exercise (RVE), resistive exercise only (RE), or no exercise control (2nd Berlin BedRest Study). The thickness of the transversus abdominis, internal oblique, and erector spinae muscles and the area of the multifidus muscle were measured bilaterally via real-time ultrasound. Intention-to-treat analysis was implemented, and P values were adjusted by the false discovery rate method., Results: At the end of the bed rest, transversus abdominis thickness was reduced by 18.3% in the inactive group (P = 0.00011) with no significant change in the RVE (-4.0%; P = 0.014 vs control) or RE (-5.0%; P = 0.10 vs control) groups. In the inactive subjects, internal oblique thickness reduced by 10.6% (P = 0.0025) and by 7% (P > 0.05) in each of the training groups. The lengthening of the lumbar spine was greatest on day 1 (+7.4%, P = 0.004) and day 2 (+6.3%, P = 0.004; day 54: +4.1%, P = 0.023). A 4.7% reduction of multifidus area was observed on day 1 of bed rest (P = 0.0049) and a 4.2% reduction of erector spinae thickness was observed on day 2 (P = 0.0011). Extensor atrophy and spinal lengthening was not affected by exercise. No significant difference was seen between RVE and RE., Conclusion: Bed rest leads to atrophy of the transversus abdominis and internal oblique muscles. The exercise program, which implemented lower-limb and back extension exercises against shoulder restraints, was able to reduce atrophy seen in transversus abdominis in bed rest.