Reliability of measurement of lumbar multifidus thickness using ultrasonography
Keywords:
lumbar multifidus, reliability, ultrasonographyAbstract
Background: The objective of this study was to evaluate the reliability of measurement of lumbar multifidus muscle thickness using real-time ultrasonography.
Material and methods: Ten subjects (F = 4) aged 19–26 years were selected for participation. All were students of the University of Physical Education presenting relatively similar, active lifestyle. All met the following inclusion criteria: lack of any current pain in the area of the lumbar spine, pelvis and lower limbs; lack of any previous injuries/ surgeries in these areas of the body in the past. A Mindray DP6600 ultrasound device was used with a linear 75L38EA array. The measurements were carried out three times a week (Monday, Wednesday, Friday). Measurements were repeated five times by the two investigators. This allowed for estimation of reliability indices and identification of the measurement error size and its sources.
Results: The results indicate that two repetitions of the muscle thickness measurements are sufficient to obtain fair and excellent reliability defined by intraclass correlation coefficients (ICCs ranging from 0,81 to 0,99). Five repetitions of change in muscle thickness measurement are necessary to obtain fair reliability (ICCs ranging from 0,82 to 0,86).
Conclusions: To evaluate the reliability of muscle thickness change authors indicate to perform five measurements of mentioned variable, to evaluate muscle thickness reliability alone – two measurement. Such a number of repeated measurements justifies the use of presented methodology in clinical and scientific settings.
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References
Stokes M, Young A. Measurement of quadriceps cross-sectional area by ultrasonography: a description of the technique and its application in physiotherapy. Physiother Theor Pract, 1986; 2:31-36.
Loo A, Stokes J. Diagnostic ultrasound scanning for clinical estimation of quadriceps size and estimation of strength. In: Proceedings of the III-rd International Physiotherapy Congress. Hong Kong 1990, pp: 655-660.
Martinson H, Stokes M. Measurement of anterior tibial muscle size using real-time ultrasound imaging. Eur J Physiol. 1991; 63: 250-254.
Hides J, Cooper D, Stokes J. Diagnostic ultrasound imaging for measurement of the lumbar multifidus muscle in normal young adults. Physiother Theor Pract, 1992; 8: 19-26.
Hides J, Stokes M, Saide M, Jull G, Cooper D. Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine, 1994; 19: 165-172.
Hides J, Richardson C, Jull G. Magnetic resonance imaging and ultrasonography of the lumbar multifidus muscle: Comparison of two different modalities. Spine, 1995; 20: 54-58.
Hides J, Richardson C, Jull G. Multifidus muscle recovery is not automatic following resolution of acute first episode low back pain. Spine, 1996; 21: 2763-2769.
Sipila S, Suominen H. Muscle ultrasonography and computer tomography in elderly trained and untrained women. Muscle Nerve, 1993; 16: 294-300.
Cresswell A, Grundstrom A, Thorstensson A. Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man. Acta Physiol Scand. 1992; 144: 409-418.
Hodges P, Richardson C. Relationship between limb movement speed and associated contraction of the trunk muscles. Ergonomics, 1997; 40: 1220-1230.
Damen L, Stijen T, Roebroeck M, Snijders C, Stam H. Reliability of sacroiliac joint laxity measurement with Doppler imaging of vibrations. Ultrasound Med Biol. 2002; 28: 407-414.
Richardson C, Snijders C, Hides J, Damen L, Pas M, Storm J. The relation between the transverses abdominis muscles, sacroiliac joint mechanics and low back pain. Spine, 2002; 27: 399-405.
Gnat R, Saulicz E, Miądowicz B. Reliability of real-time ultrasound measurement of transversus abdominis thickness in healthy trained subjects. Eur Spine J, Epub. Feb. 2012.
Brenner A, Gill N, Buscema C, Kiesel K. Improved activation of lumbar multifidus following spinal manipulation: a case report applying rehabilitative ultrasound imaging. J Orthop Sports Phys Ther. 2007; 37(10): 613-619.
Wallwork T, Hides J, Stanton W. Intrarater and interrater reliability of assessment of lumbar multifidus muscle thickness using rehabilitative ultrasound imaging. J Orthop Sports Phys Ther. 2007; 37(10): 608-612.
Koppenhaver S, Hebert J, Fritz J, Parent E, Teyhen D, Magel J. Reliability of rehabilitative ultrasound imaging of the transversus abdominis and lumbar multifidus muscles. Arch Phys Med Rehabil. 2009; 90(1): 87-94.
Herbert W, Heiss D, Basso D. Influence of feedback schedule in motor performance and learning of a lumbar multifidus muscle task using rehabilitative ultrasound imaging: a randomized clinical trial. Phys Ther. 2008; 88(2): 261-269.
Koppenhaver S, Parent E, Teyhen D, Hebert J, Fritz J. The effect of averaging multiple trials on measurement error during ultrasound imaging of transversus abdominis and lumbar multifidus muscles in individuals with low back pain. J Orthop Sports Phys Ther. 2009; 39(8): 604-611.
Kiesel K, Uhl T, Underwood F, Nitz A. Rehabilitative ultrasound measurement of select trunk muscle activation during induced pain. Man Ther. 2008; 13(2): 132-138.
Kiesel K, Underwood F, Mattacola C, Nitz A, Malone T. A comparison of select trunk muscle thickness change between subjects with low back pain classified in the treatment-based classification system and asymptomatic controls. J Orthop Sports Phys Ther. 2007; 37(10): 596-607.
Pressler J, Heiss D, Buford J, Chidley J. Between-day repeatability and symmetry of multifidus cross-sectional area measured using ultrasound imaging. J Orthop Sports Phys Ther. 2006; 36(1): 10-18.
Herbert W, Heiss D, Basso D. Influence of feedback schedule in motor performance and learning of a lumbar multifidus muscle task using rehabilitative ultrasound imaging: a randomized clinical trial. Phys Ther. 2008; 88(2): 261-269.
Van K, Hides J, Richardson C. The use of real-time ultrasound imaging for biofeedback of lumbar multifidus muscle contraction in healthy subjects. J Orthop Sports Phys Ther. 2006; 36(12): 920-925.
Hodges P, Holm A, Hansson T, Holm S. Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury. Spine, 2006; 31(25): 2926-2933.
Vasseljen O, Dahl H, Mork P, Torp H. Muscle activity onset in the lumbar multifidus muscle recorded simultaneously by ultrasound imaging and intramuscular electromyography. Clin Biomech. 2006; 21(9): 905-913.
Stokes M, Rankin G, Newham D. Ultrasound imaging of lumbar multifidus muscle: normal reference ranges for measurements and practical guidance on the technique. Man Ther. 2005; 10(2): 116-126.
Coldron Y, Stokes M, Cook K. Lumbar multifidus muscle size does not differ whether ultrasound imaging is performed in prone or side lying. Man Ther. 2003; 8(3): 161-165.
Portney L, Watkins M. Statistical measures of reliability. W: Portney L, Watkins M. (red.). Foundations of clinical research applications to practice. Prentice-Hall, New Jersey 2000; 557-584.
Worsley P, Smith N, Warner M, Stokes M. Ultrasound transducer shape has no effect on measurements of lumbar multifidus muscle size. Man Ther. 2012; 17(2): 187-191.
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