PURPOSE: This study examined whether or not supplementing typical clinical instruction with visual feedback from real-time ultrasound images of the anterolateral abdominal wall facilitates performance of the abdominal hollowing exercise for people with low back pain. METHODS: Nineteen patients with low back pain were randomly divided into two feedback groups. Group 1 received typical clinical instruction whilst attempting the abdominal hollowing exercise, whereas group 2 additionally received visual feedback from the ultrasound image. A retention test was performed on each patient within four days of the initial testing session. Three consecutive correct repetitions out of ten attempts within each 20-minute session were defined as successful learning. RESULTS: During the initial testing session, significantly more patients in group 2 reached the criteria for consistency of performance compared to group 1 (p = 0.01), and group 2 had fewer trials to performance criteria compared to group 1 (p = 0.0002). During retention testing there was no significant difference (p = 0.09) in the number of patients who reached the criteria for consistency of performance; however group 2 reached performance criteria in fewer number of trials (p = 0.05). CONCLUSION: Visual feedback provided by ultrasound imaging can enhance the learning of the abdominal hollowing exercise in patients with low back pain, making it a useful clinical teaching tool for physiotherapists.

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