scholarly journals Ultrasound Imaging Analysis of the Lumbar Multifidus Muscle Echo Intensity: Intra-Rater and Inter-Rater Reliability of a Novice and an Experienced Rater

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 512
Author(s):  
Maryse Fortin ◽  
Brent Rosenstein ◽  
Jerome Levesque ◽  
Neil Nandlall
Keyword(s):  
Ultrasound Imaging ◽  
Muscle Quality ◽  
Ultrasound Images ◽  
Echo Intensity ◽  
Multifidus Muscle ◽  
Cross Sectional ◽  
Rater Reliability ◽  
Lumbar Multifidus ◽  
The Right ◽  
Lumbar Multifidus Muscle

Background and Objectives: Ultrasound echo intensity (EI) of the lumbar multifidus muscle (LMM) could offer valuable insights regarding muscle quality in people with low back pain (LBP). However, whether the rater’s experience noticeably influences the reliability and precision of LMM EI measurements has not been established. The aims of this study were to investigate the intra-rater and inter-rater reliability of LMM EI measurements, and to compare the reliability and SEM between a novice and an experienced rater. Materials and Methods: Twenty athletes (10 females, 10 males) with a history of LBP were included in this study. Transverse ultrasound images of LMM were taken at L5 in prone. LMM EI measurements were obtained bilaterally by tracing the maximum ROI representing the LMM cross-sectional area (CSA), avoiding the inclusion of bone or surrounding fascia. All measurements were performed by two novice raters and an experienced researcher. Each measurement was acquired by each rater three times for each side on three different images, and the average was used in the analyses. Raters were blinded to each other’s measurements and the participant’s clinical information. Intra-class correlation coefficients (ICCs) were obtained to assess the intra-rater and inter-rater reliability. Results: The intra-rater ICC values for the LMM measurements for the experienced rater were excellent (ICC all > 0.997). The inter-rater reliability ICC values showed moderate to excellent reliability (0.614 to 0.994) and agreement between the novice raters and the experienced rater, except for Novice 1 for the right LMM, which revealed lower ICCs and a wider 95% CI. Intra-rater and inter-rater reliability results were similar when separately looking at the right and left side of the muscle and participant gender. Conclusions: Our findings support the clinical use of ultrasound imaging for the assessment of LMM EI in individuals with LBP.

Study on the cross-sectional area of the multifidus muscle at the L4-L5 level on ultrasound images of Olympic-style weightlifting and judo athletes

2021 ◽  
pp. 1-8
Author(s):  
Kenan Erdağı ◽  
Necdet Poyraz
Keyword(s):  
Cross Sectional Area ◽  
Ultrasound Images ◽  
Sectional Area ◽  
Multifidus Muscle ◽  
Cross Sectional ◽  
Lumbar Multifidus ◽  
Imaging Results ◽  
Judo Athletes ◽  
The Cross ◽  
Lumbar Multifidus Muscle

BACKGROUND: The multifidus muscle is located near the spine and controls the erection of the spine and stabilization during movements of the spine and extremities, and assists in all other spinal movements. Differences in paraspinal muscles between sides and levels, particularly in he multifidus, have been proposed as possible indicators of low back pain or spinal pathology. OBJECTIVE: This study aims to examine the cross-sectional area of the lumbar multifidus muscle at L4-L5 vertebral levels on ultrasound images of athletes in Olympic-style weightlifting, judo athletes and sedentary individuals. METHODS: This study included asymptomatic male athletes (athletes in Olympic-style weightlifting, n= 17, age: 19.24 ± 1.88, judo athletes, n= 17, age: 19.18 ± 1.23) and sedentary individuals (n= 17, age: 19.88 ± 1.31). The cross-sectional area of lumbar multifidus muscles was assessed bilaterally at the L4-L5 segments level in prone and using ultrasound imaging. RESULTS: Lumbar multifidus muscle cross-sectional areas of athletes in Olympic-style weightlifting and judo athletes were larger than those of sedentary individuals (p< 0.004). No asymmetric development was observed in cross-sectional areas of right-left lumbar multifidus muscle at L4-L5 levels of athletes in Olympic-style weightlifting and sedentary individuals (p> 0.008). The cross-sectional areas of the right and left lumbar multifidus muscle at L5 segment of individuals in judo athletes was found to be asymmetrical (p< 0.008). CONCLUSION: Our study shows that the cross-sectional areas of athletes in Olympic-style weightlifting and judo athletes are larger than that of sedentary individuals. The difference in the cross-sectional area of the lumbar multifidus muscle of athlete and sedentary groups might be said to result from hypertrophic effect of trainings of these athletes on the cross-sectional area of the lumbar multifidus muscle.

scholarly journals Intra-rater and inter-rater reliability of the process of obtaining cross-sectional area and echo intensity measurements of muscles from ultrasound images

2021 ◽  
Vol 21 (84) ◽  
pp. e7-e11
Author(s):  
Eric J. Sobolewski ◽  
◽  
Leah D. Wein ◽  
Jacquelyn M. Crow ◽  
Kaitlyn M. Carpenter ◽  
...  
Keyword(s):  
Vastus Lateralis ◽  
Measurement Techniques ◽  
Subcutaneous Fat ◽  
Cross Sectional Area ◽  
Muscle Quality ◽  
Ultrasound Images ◽  
Sectional Area ◽  
Echo Intensity ◽  
Cross Sectional ◽  
Rater Reliability

Introduction: The use of ultrasound images for analyzing muscle quality and size is continuing to grow in the literature. However, many of these manuscripts fail to properly describe their measurement techniques and steps involved in analyzing ultrasound images. Aim of this study: To evaluate the intra- and inter-rater reliability of the steps involved when analyzing ultrasound images to measure cross-sectional area and echo intensity. Material and methods: Twenty ultrasound images of the rectus femoris and vastus lateralis images were blinded and replicated, and then analyzed by experienced raters. The raters then were asked to analyze the images using open-source software for scaling measurements, subcutaneous fat thickness, cross-sectional area, and echo intensity. Matched image values for each measurement where compared for intra- and inter-rater reliability. Results: Intra-rater reliability ranged from fair (ICC3,1 = 0.32) to high (0.98), with echo intensity values being the least reliable (>0.55), and scaling and depth measurements being the most reliable (<0.85). Inter-rater reliability ranged from good (0.77) to high (0.97). Conclusion: Ultrasound- derived measures of cross-sectional area and echo intensity can be measured reliably, with echo intensity being the most difficult to replicate. However, reliability measures are unique to the rater and study and, therefore, should be clearly reported in every paper.

Effects of Lumbar Stabilization Exercises with Real-Time Ultrasound Imaging Biofeedback on Lumbar Multifidus Muscle Cross-Sectional Area in Individuals with Chronic Nonspecific Low Back Pain: A Study Protocol for a Randomized Controlled Trial

2021 ◽  
Author(s):  
Sarafadeen Raheem ◽  
Sokunbi O. Ganiyu ◽  
Aminu A. Ibrahim ◽  
Anas Ismail ◽  
Mukadas O. Akindele ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cross Sectional Area ◽  
Low Back ◽  
Sectional Area ◽  
Multifidus Muscle ◽  
Cross Sectional ◽  
Lumbar Multifidus ◽  
Lumbar Stabilization ◽  
Lumbar Multifidus Muscle

Abstract Background: Impairments in the lumbar multifidus muscle such as reduced muscle thickness and fat infiltrations are evident in individuals with low back pain. Lumbar stabilization exercises (LSE) with real-time ultrasound imaging (RUSI) biofeedback has been reported to improve preferential activation of as well as retention in the ability to activate of the lumbar multifidus muscle, thus enhancing recovery. However, the effects of using this treatment approach in individuals with nonspecific chronic low back pain (NCLBP) seemed not to have widely reported. The purpose of this study is, therefore, to investigate the effects of LSE with RUSI biofeedback on lumbar multifidus muscle cross-sectional area in individuals with NCLBP patients. Method: This study is a prospective, single-center, assessor-blind three-arm, randomized controlled to be conducted at National Orthopedic Hospital, Kano State, Nigeria. Ninety-one individuals with NCLBP will be randomly assigned into one of the three treatment groups of equal sample size (n = 30); LSE group, LSE with RUSI biofeedback group, or control (minimal intervention). The participants in the LSE and LSE with RUSI biofeedback group will also receive the same intervention as the control group. All participants will receive treatment twice weekly for 8 weeks. The primary outcome will be lumbar multifidus muscles cross-sectional area while the secondary outcomes will be pain, functional disability and quality of life. All outcomes will be assessed at baseline, and at 8 weeks and 3 months post-intervention.Discussion: The outcome of the study may support the evidence for the effectiveness of LSE with RUSI biofeedback in the rehabilitation of individuals with NCLBP. It may also provide a rationale for the physiotherapists to make use of diagnostic ultrasound as a feedback mechanism in enhancing the performance and retention of LSE program as well as monitoring the patient’s recovery.Trial registration: Pan African Clinical Trials Registry, (PACTR201801002980602), Registered on 16 January 2018.

scholarly journals Quantitative Ultrasound Imaging Differences in Multifidus and Thoracolumbar Fasciae between Athletes with and without Chronic Lumbopelvic Pain: A Case-Control Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2647
Author(s):  
Jaime Almazán-Polo ◽  
Daniel López-López ◽  
Carlos Romero-Morales ◽  
David Rodríguez-Sanz ◽  
Ricardo Becerro-de-Bengoa-Vallejo ◽  
...  
Keyword(s):  
Ultrasound Imaging ◽  
Effect Size ◽  
Case Control Study ◽  
Case Control ◽  
Muscle Quality ◽  
Lumbar Region ◽  
Cross Sectional ◽  
Lumbar Multifidus ◽  
Moderate Effect Size ◽  
Control Study

New trends in ultrasound imaging are focused on exploration of morphology and muscle quality. The main goal of the study was to evaluate the first-order descriptor and echostructure of lumbar multifidus at the L4 vertebral level in athletes with and without chronic lumbopelvic pain (CLPP). A case-control study was performed in 15 semiprofessional athletes with CLPP and 15 without (healthy athletes). Lumbar multifidus echointensity and echovariation were measured for muscle quality assessment. Echostructure was used to evaluate lumbar multifidus cross-sectional area (CSA) at resting and during muscle contraction, respective differences during both phases (CSADif.), activation patterns, and thoracolumbar fasciae morphology and thickness. Significant differences with a large effect size were observed in quantitative data from CLPP and healthy athletes for left lumbar multifidus CSADif. and thoracolumbar fasciae morphology. Categorical data showed statistically significant differences with a small-to-moderate effect size for lumbar multifidus activation pattern and thoracolumbar fasciae morphology. Athletes with CLPP showed a reduced CSA difference between lumbar multifidus contraction and at resting and higher disorganization of thoracolumbar fasciae morphology compared to healthy athletes. These findings suggest the importance of dynamic exploration of the lumbar region and connective tissue in sports performance and injury prevention.

scholarly journals Effectiveness of lumbar stabilization exercise with real-time ultrasound imaging biofeedback on lumbar multifidus muscle cross-sectional area in individuals with non-specific chronic low back pain: a study protocol for a randomized controlled trial

Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Raheem Sarafadeen ◽  
Sokunbi O. Ganiyu ◽  
Aminu A. Ibrahim ◽  
Anas Ismail ◽  
Mukadas O. Akindele ◽  
...  
Keyword(s):  
Chronic Low Back Pain ◽  
Controlled Trial ◽  
Cross Sectional Area ◽  
Low Back ◽  
Sectional Area ◽  
Multifidus Muscle ◽  
Cross Sectional ◽  
Lumbar Multifidus ◽  
Muscle Cross Sectional Area ◽  
Lumbar Multifidus Muscle

Abstract Background Structural impairment of the lumbar multifidus muscle, such as reduced cross-sectional area, is evident among individuals with chronic low back pain. Real-time ultrasound imaging (RUSI) biofeedback has been reported to improve preferential activation of as well as retention in the ability to activate the lumbar multifidus muscle during lumbar stabilization exercises (LSE). However, evidence of the effectiveness of this treatment approach in individuals with non-specific chronic low back pain (NCLBP) is still limited. The purpose of this study is, therefore, to determine the effectiveness of LSE with RUSI biofeedback on lumbar multifidus muscle cross-sectional area in individuals with NCLBP. Methods/Design This study is a prospective, single-center, assessor-blind, three-arm, parallel randomized controlled trial to be conducted at National Orthopedic Hospital, Kano State, Nigeria. Ninety individuals with NCLBP will be randomized in a 1:1:1: ratio to receive LSE, LSE with RUSI biofeedback, or minimal intervention. All participants will receive treatment twice weekly for 8 weeks. The primary outcome will be the lumbar multifidus muscle cross-sectional area. The secondary outcomes will include pain (Numerical Pain Rating Scale), functional disability (Roland–Morris Disability Questionnaire), and quality of life (12-Item Short-Form Health Survey). All outcomes will be assessed at baseline, 8 weeks post-intervention,  and 3 months follow-up. Discussion To our knowledge, this study will be the first powered randomized controlled trial to compare the effectiveness of LSE training with and without RUSI biofeedback in individuals with NCLBP. The outcome of the study may provide evidence for the effectiveness of LSE with RUSI biofeedback on enhancing the recovery of the lumbar multifidus muscle in individuals with NCLBP. Trial registration Pan African Clinical Trials Registry (PACTR201801002980602). Registered on January 16, 2018.

Sign in / Sign up

Export Citation Format

Share Document