Reliability of B-mode ultrasonography for abdominal muscles in asymptomatic and patients with acute low back pain

The purpose of this methological study was to develop a reliable method for measuring transversus abdominis, rectus abdominis, external oblique and internal oblique muscles in asymptomatic human subjects and patients with acute low back pain (ALBP). This was a single operator reliability design study using ultrasound imaging to measure muscle thickness in 27 subjects on three separate occasions. Intra-class correlation coefficients (ICC) and standard error of measurement (SEM) were used to analyze muscle thickness. The mean, SD, ICC and SEM for external oblique, internal oblique, transversus abdominis and rectus abdominis muscles in asymptomatic subjects were (5.38, 1.64, 0.96, 0.33), (9.35, 3.42, 0.97, 0.073), (4.36, 1.93, 0.81, 0.45), (10.8, 2.18, 0.85, 0.84), respectively. The mean, SD, ICC, SEM for external oblique, internal oblique and transversus abdominis muscles in patients with ALBP were (5.58, 0.97, 0.87, 0.35), (9.72, 1.92, 0.87, 0.31), (4.36, 1, 0.91, 0.3), respectively. Earlier study on ultrasonographic measurement for neck multifidus muscles has suggested that the reliability of muscle thickness is higher in asymptomatic subjects compared with those in the symptomatic subjects. However, the present study showed high reliability for both symptomatic and asymptomatic subjects. This difference may be related to non-atrophic changes in abdominal muscles in acute low back patients. The results of this study indicate that the measurement of abdominal muscle thickness with B-mode ultrasonography can be performed reliably even in patients with ALBP. © 2005 Elsevier Ltd. All rights reserved

Reliability of measuring abductor hallucis muscle parameters using two different diagnostic ultrasound machines

<p>Abstract</p> <p>Background</p> <p>Diagnostic ultrasound provides a method of analysing soft tissue structures of the musculoskeletal system effectively and reliably. The aim of this study was to evaluate within and between session reliability of measuring muscle dorso-plantar thickness, medio-lateral length and cross-sectional area, of the abductor hallucis muscle using two different ultrasound machines, a higher end Philips HD11 Ultrasound machine and clinically orientated Chison 8300 Deluxe Digital Portable Ultrasound System.</p> <p>Methods</p> <p>The abductor hallucis muscle of both the left and right feet of thirty asymptomatic participants was imaged and then measured using both ultrasound machines. Interclass correlation coefficients (ICC) with 95% confidence intervals (CI) were used to calculate both within and between session intra-tester reliability. Standard error of the measurement (SEM) calculations were undertaken to assess difference between the actual measured score across trials and the smallest real difference (SRD) was calculated from the SEM to indicate the degree of change that would exceed the expected trial to trial variability.</p> <p>Results</p> <p>The ICCs, SEM and SRD for dorso-plantar thickness and medial-lateral length were shown to have excellent to high within and between-session reliability for both ultrasound machines. The between-session reliability indices for cross-sectional area were acceptable for both ultrasound machines.</p> <p>Conclusion</p> <p>The results of the current study suggest that regardless of the type ultrasound machine, intra-tester reliability for the measurement the abductor hallucis muscle parameters is very high.</p

An investigation of the reproducibility of ultrasound measures of abdominal muscle activation in patients with chronic non-specific low back pain

Ultrasound (US) measures are used by clinicians and researchers to evaluate improvements in activity of the abdominal muscles in patients with low back pain. Studies evaluating the reproducibility of these US measures provide some information; however, little is known about the reproducibility of these US measures over time in patients with low back pain. The objectives of this study were to estimate the reproducibility of ultrasound measurements of automatic activation of the lateral abdominal wall muscles using a leg force task in patients with chronic low back pain. Thirty-five participants from an existing randomised, blinded, placebo-controlled trial participated in the study. A reproducibility analysis was undertaken from all patients using data collected at baseline and after treatment. The reproducibility of measurements of thickness, muscle activation (thickness changes) and muscle improvement/deterioration after intervention (differences in thickness changes from single images made before and after treatment) was analysed. The reproducibility of static images (thickness) was excellent (ICC2,1 = 0.97, 95% CI = 0.96–0.97, standard error of the measurement (SEM) = 0.04 cm, smallest detectable change (SDC) = 0.11 cm), the reproducibility of thickness changes was moderate (ICC2,1 = 0.72, 95% CI 0.65–0.76, SEM = 15%, SDC 41%), while the reproducibility of differences in thickness changes from single images with statistical adjustment for duplicate measures was poor (ICC2,1 = 0.44, 95% CI 0.33–0.58, SEM = 21%, SDC = 66.5%). Improvements in the testing protocol must be performed in order to enhance reproducibility of US as an outcome measure for abdominal muscle activation