Noninvasive evaluation of trunk muscle recruitment after trunk exercises using diffusion-weighted MR imaging

Purpose: We evaluated trunk muscle recruitment in abdominal and back exercises with magnetic resonance (MR) diffusion-weighted imaging. Methods: Twelve men performed bent-knee sit-up, crunch, trunk lateral flexion, and trunk extension exercises. We obtained axial diffusion-weighted images of the trunk before and after each exercise using a 1.5-tesla MR system, calculated apparent diffusion coefficient (ADC) values from the right and left rectus abdominis, lateral abdominal, psoas major, quadratus lumborum, and intrinsic back muscles to evaluate the activity of these muscles during each exercise, and compared ADC values before and after exercise using a paired t-test. Results: The ADCs of the rectus abdominis (right, +19.1%; left, +11.7%), lateral ab­dominal (right, +15.5%; left, +14.1%), and psoas major (right, +14.8%; left, +15.9%) muscles on both sides increased after the bent-knee sit-up (P < 0.01). The ADCs of the rectus abdominis (right, +16.8%; left, +10.2%) and lateral abdominal (right, +8.4%; left, +7.0%) muscles on both sides increased after the crunch exercise (P < 0.01). Trunk lateral flexion resulted in increased ADC on only the right side of all of the muscles (rectus abdominis, +12.3%; lateral abdominal muscles, +20.3%; quadratus lumborum, +17.1%; intrinsic back muscles, +12.0%; psoas major, +15.4%) (P < 0.01). The ADCs of the lat­eral abdominal (right, +5.2%; left, +5.6%), quadratus lumborum (right, +6.0%; left, +3.0%), and intrinsic back (right, +13.2%; left, +14.6%) musclesonbothsides were elevated after trunk extension (right lateral abdominal muscles and left quadratus lumbo-rum, P < 0.05; other muscles, P < 0.01). Conclusion: Diffusion-weighted imaging reveals the recruitment patterns of superficial and deep trunk muscles in abdominal and back exercises through exercise-induced activation in intramuscular water movement.