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Real-time Ultrasound Biofeedback is a great tool in your physiotherapy or rehabilitation program. This service allows you and your physiotherapist to see the exact muscles that are being activated when you move.
With the visual biofeedback of diagnostic ultrasound, physiotherapists look for such things as changes in associated structures such as the bladder base, tissue deformation and movement; it can however also be used to assess muscle structure and behaviour and to perform measurements of muscle thickness as evidence of muscle activation.(1)
You may be struggling with an exercise, or finding it difficult to engage the right muscles in movements or positions. This is when the Ultrasound Biofeedback service can help! It is a teaching tool used to improve outcomes and helps the patient reliably perform the task. It allows for confirmation of a task being learnt and performed. (2-4)
A gel is applied to the area, and the Ultrasound probe is moved over the area. The probe will send our ultrasound waves that reflect off the bones, muscles and tendons to produce a real time image as you move.
This is not necessarily used to diagnose a problem, rather your physiotherapist will use this information to educate you on muscle activation.
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(1) Whittaker JL, Teyhen DS, Elliott JM et al. Rehabilitative ultrasound imaging: understanding the technology and its applications. J Orthop Sports Phys Ther 2007; 37(8): 434– 49.
(2) Baessler K, Schussler B, Burgio KL, Moore KH, Norton PA, Stanton SL. Pelvic Floor Re-education Principles and Practice, 2nd edn. London: Springer; 2008.
(3) Teyhen DS, Miltenberger CE, Deiters HM et al. The Use of ultrasound imaging of the abdominal drawing – in maneuver in subjects with low back pain. J Orthop Sports Phys Ther 2005; 35(6): 346– 55.
(4) Frost N, Clarke J. Ultrasound for biofeedback in physiotherapy. soundeffects 2004; 4: 10– 3.
Common conditions that can benefit from Ultrasound Biofeedback:
- Lower back pain: Transversus Abdominus or Multifidus
- Sciatica
- Back Pain
- Pregnancy Back Pain
- Pelvic Instability
- Hip Pain
- Shoulder Pain
- Knee Pain
- Foot Exercises
- Pelvic Floor
Ultrasound Biofeedback is especially helpful for Core exercises used for treating back pain. It was found the best way to activate the correct core muscles is to see them working in real time through Ultrasound Biofeedback. For example, the Transversus Abdominis is located deep within the abdomen, and it can be hard to figure out if it is correctly activating. The ultrasound scanner can provide a visualization of this muscle activation and match up exactly what you are feeling to what is happening. Then, when you go to perform the same exercise, you will know what to feel when you activate the right muscle!(5)
(5) Van, K., Hides, J.A. and Richardson, C.A. (2006). The Use of Real-Time Ultrasound Imaging for Biofeedback of Lumbar Multifidus Muscle Contraction in Healthy Subjects. Journal of Orthopaedic & Sports Physical Therapy, 36(12), pp.920–925. doi:10.2519/jospt.2006.2304.
FAQs:
1. How do I prepare for an Ultrasound Biofeedback session?
Like all physiotherapy sessions, it is best to wear clothes that you are comfortable in. It is great to wear clothes that will allow easy access to your problem areas; however, you can always bring a change of clothes as well.
If this session is being used in relation to pelvic floor problems, please empty your bladder around two hours before your appointment, and drink 500-1000mL of water one hour before your appointment. It is best to try and hold liquid in until after the ultrasound, however if you do need to go to the bathroom, it is important to continue drinking fluids to replenish what was lost. By filling your bladder, the ultrasound scanner can properly image your lower abdomen and scan through the fluid filled bladder.
Other areas do not require special preparation, unless specified prior by your physiotherapist.
2. How can Ultrasound Biofeedback help with incontinence or pelvic pain?
An exercise that you may do to improve and strengthen your pelvic muscles is a bridge. It is important that you are engaging the pelvic muscles to lift your body up, rather than your core or leg muscles. With a real-time Ultrasound Biofeedback scan, you will see which muscles are activating, how to activate the correct one, and how it should feel.
Another common exercise is to sit on a chair and perform a pelvic floor muscle lift (like you’re squeezing and lifting a marble). It was found that 40% of women were actually activating the wrong muscles and were pushing down rather than lifting.(6) Through Ultrasound Biofeedback, it was possible to recognize that the wrong muscles were being activated, and therefore your physiotherapist can help you target the right muscles to fix the problem.
(6) Next Wave. (2020). Ultrasound and Physiotherapy. https://www.nextwavetherapy.com.au/latest-news/2020/5/16/ultrasound-and-physiotherapy
3. How does Ultrasound Biofeedback differ from Ultrasound Therapy?
Both services use the same type of sound waves (Ultrasound), and in both services, the muscles will reflect or absorb the sound waves (dependent on frequency and intensity. When the sound waves are absorbed, this allows the therapeutic aspects of soundwaves to work, however when they are reflected, we can capture the reflected waves and display the results as a real-time image.
For Ultrasound therapy, we do not require capturing the real-time image; rather, this therapy is more concerned with the correct frequencies and intensities to elicit a desired therapeutic response.