Continued research highlights that the primary impairment of the muscular system in individuals with lumbopelvic dysfunction is not one of strength, endurance or functional capacity, but rather of motor impairment. In particular it has been suggested that there is a pattern of hyperactivity of the superficial, and hypoactivity of the deep muscles of the region. The clinical extrapolation of this is that the initial and pivotal focus in rehabilitation must address these motor impairments by retraining a coordinated contraction of the deep trunk muscles, and restoring appropriate activation of the superficial muscles. Success hinges upon the ability to detect the specific motor deficits of each individual patient. This requires a high level of clinical skill as some of these muscles are located deep and their desired contraction is sub-maximal. Consequently, the evaluation and the initial retraining phase can be augmented with the aid of ULTRASOUND IMAGING technology. REHABILITATIVE ULTRASOUND IMAGING (RUSI) has been used by research driven clinicians as a safe and cost effective method to enhance both the assessment and treatment of patients with motor impairments of the lumbo-pelvic muscles, (including; external and internal oblique, rectus abdominis, transversus abdominis, lumbar multifidus, the diaphragm and the pelvic floor muscles).
The value of RUSI is that it allows for real time study of these muscles as they contract and impact their associated fascial attachments. This allows both the patient and the therapist to view the contraction as it happens, leaving little room for supposition. Consequently RUSI can be used as both an assessment tool, and maybe more importantly as a form of biofeedback, providing patients with knowledge of performance, in the early stages of motor relearning.