Sunday, June 7, 2015

Jue 3, 2015 Pelvic PTDistance Journal Club Recording

Next call July 8, 2015

Comparison of the sonographic features of the abdominal wall muscles and connective tissues in individuals with and without lumbopelvic pain

Whittaker JL, Warner MB, Stokes M. JOSPT 2013; 43(1):11-19.
Ann Dunbar PT, DPT, MS, WCS
June 3, 2015


  • Muscles of the abdominal wall, multifidii, pelvic floor, and respiratory diaphragm function to pressurize the abdominopelvic cavity for load transfer.
  • Researchers have identified functional deficits in abdominal mm in persons with lumbopelvic pain (LPP) however, most studies consider only the transverse abdominis and internal oblique.  Morphologically the 4 layers are different.
Primary Aim: “ to measure and compare the resting thickness of the 4 abdominal wall muscles and their perimuscular connective tissue (PMCT) planes, as well as interrecti distance (IRD) in persons with and without lumbopelvic pain, using ultrasound imaging.

Functional gastrointestinal disorders are associated with the joint hypermobility syndrome in secondary care: a case-control study

Fikree A, Aktar R, Grahame R, Hakim AJ, Morris JK, Knowles CH, Aziz Q; 2015 Neurogastroenterol 27: (569-579).

Ann Dunbar PT, DPT, MS, WCS
June 3, 2015


  • Functional gastrointestinal disorders (FGID) account for 40% of visits to GI clinics.
  • Despite increasing focus on research, diagnostic biomarkers and etiology are not well established.
  • It is well established that inflammatory connective tissue disorders are associated with GI dysfunction and evidence is increasing that non-inflammatory disorders (such as joint hypermobility disorders) may also be related.
  • Due to lack of distinct biomarker, current gold standard for diagnosing joint hypermobility syndrome (JHS) is 1998 Brighton classification for JHS (see Table 1 in article).
  • It has been recognized more recently that JHS is a disorder of multiple systems (eg chronic pain syndromes, dysautonomia, urinary symptoms, GI symptoms, and anxiety disorders). GI sx such as globus, bloating, reflux, postprandial fullness, and early satiety have a high prevalence in rheumatology and genetics clinics. In GI clinics, 1/3 of pts have undiagnosed JHS suggesting association between GI symptoms and this syndrome however, conclusive evidence is limited due to lack of controlled studies.