Immediate Effects of Whole-Body versus Local Dynamic Electrostimulation of the Abdominal Muscles in Healthy People Assessed by Ultrasound: A Randomized Controlled Trial

Figures

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  Figure 1. Diagram of the intervention procedure.

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  Figure 2. Ultrasound images of the lateral abdominal wall musculature showing the 3 muscle layers from top to bottom: External Oblique (EO), Internal Oblique (IO), and the deepest, Transverse Abdomen (TrA); separated from each other by intermuscular connective tissue (hyperechoic lines). (A) Image at rest. (B) An image taken during muscle activity showing a change in muscle thickness. Measurements are always taken at the same point, 2 cm (the orange mark) from the insertion of the TrA in the RA.

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  Figure 3. Ultrasonic images of the rectus abdominis (RA). (A) at rest and (B) during muscle activity. Measurements are taken between the internal borders of the widest area of the muscle belly. An increase in muscle thickness is appreciable during contraction (B).

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  Figure 4. Ultrasound images of the rectus abdominis distance (IRD). (A) Right and left abdominal rectus abdominis (areas between the red lines) and intermediate fascia corresponding to the IRD (represented by the yellow line). (B) Ultrasound image of the IRD at rest. (C) Ultrasound image of the IRD during muscle activity.

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  Figure 5. Reference points for the RUSI images [47,50]. (A) Midway between ASIS (antero superior iliac spine) and the last rib, on the midaxillary line, to obtain images of the TrA, IO, and EO muscles. A horizontal line was drawn 2 cm lateral to the TrA insertion in the RA connective tissue as a reference for TrA, IO, and EO measurements at rest and during muscle contraction; (B) Midway along the RA muscle at the level of the umbilicus, transverse to acquire the RA image. The reference point for RA thickness measurement was the mean distance of the width of each RA; (C) In the middle of the abdomen, a distance of 2 cm above the umbilicus to measure IRD.

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  Figure 6. Flow diagram including all phases of the randomized clinical trial [34].

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  Figure 7. Bar graphs showing HR mean differences after interventions completed with SD among the EMS, WB-EMS, and control groups. Abbreviations: bpm, beats per minute; EMS, electrical muscle stimulation; SD, standard deviations; WB-EMS, whole body electrical muscle stimulation.

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  Figure 8. Linear graphs showing HR means before and after interventions as well as intra- and intergroup comparisons among the EMS, WB-EMS, and control groups. Abbreviations: bpm, beats per minute; EMS, electrical muscle stimulation; WB-EMS, whole body electrical muscle stimulation. * Intragroup comparisons showed statistically significant differences (p < 0.05). ** Intergroup comparisons showed statistically significant differences (p < 0.05).

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  Figure 9. Linear graphs showing temperature means before and after interventions as well as intragroup comparisons among the EMS, WB-EMS, and control groups. Abbreviations: EMS, electrical muscle stimulation; WB-EMS, whole body electrical muscle stimulation. * Intragroup comparisons showed statistically significant differences (p < 0.05).

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  Figure 10. Linear graphs showing IRD change before and after interventions as well as intragroup comparisons among the EMS, WB-EMS, and control groups. Abbreviations: cm, centimeters; EMS, electrical muscle stimulation; IRD, inter-rectus distance; WB-EMS, whole body electrical muscle stimulation. * Intragroup comparisons showed statistically significant differences (p < 0.05).