Reliability of Rehabilitative Ultrasound Imaging of the Transversus Abdominis and Lumbar Multifidus Muscles

• Published in: Archives of physical medicine and rehabilitation Vol. 90; no. 1; pp. 87 - 94
• Main Authors: Koppenhaver, Shane L., MPT, Hebert, Jeffrey J., DC, Fritz, Julie M., PhD, PT, ATC, Parent, Eric C., PhD, PT, Teyhen, Deydre S., PhD, PT, Magel, John S., DSc, PT
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2009; Elsevier
• Subjects: Abdominal muscles; Abdominal Muscles - diagnostic imaging; Abdominal Muscles - physiology; Adult; Biological and medical sciences; Diseases of the osteoarticular system; Diseases of the spine; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Low back pain; Low Back Pain - diagnostic imaging; Low Back Pain - rehabilitation; Male; Medical sciences; Middle Aged; Miscellaneous; Miscellaneous. Technology; Muscle Contraction - physiology; Observer Variation; Physical Medicine and Rehabilitation; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Reproducibility of Results; Rest; Ultrasonic investigative techniques; Ultrasonography; TrA; limits of agreement; active straight leg raise; Low back pain; ASLR; CI; abdominal drawing-in maneuver; transversus abdominis; ICC; Reproducibility of results; modified Oswestry Disability Index; MDC; minimal detectable change; ODI; rehabilitative ultrasound imaging; Ultrasonography; ADIM; intraclass correlation coefficient; confidence interval; Rehabilitation; LBP; Abdominal muscles; LOA; RUSI; Sonography; Lumbar spine; Ultrasound imaging; Diseases of the osteoarticular system; Spine disease; Abdomen; Pain; Reeducation; Reproducibility; Orthopedics; Echography; Rachialgia; Reliability
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2008.06.022

Abstract Koppenhaver SL, Hebert JJ, Fritz JM, Parent EC, Teyhen DS, Magel JS. Reliability of rehabilitative ultrasound imaging of the transversus abdominis and lumbar multifidus muscles. Objectives To evaluate the intraexaminer and interexaminer reliability of rehabilitative ultrasound imaging (RUSI) in obtaining thickness measurements of the transversus abdominis (TrA) and lumbar multifidus muscles at rest and during contractions. Design Single-group repeated-measures reliability study. Setting University and orthopedic physical therapy clinic. Participants A volunteer sample of adults (N=30) with current nonspecific low back pain (LBP) was examined by 2 clinicians with minimal RUSI experience. Interventions Not applicable. Main Outcome Measures Thickness measurements of the TrA and lumbar multifidus muscles at rest and during contractions were obtained by using RUSI during 2 sessions 1 to 3 days apart. Percent thickness change was calculated as thicknesscontracted –thicknessrest /thicknessrest . Intraclass correlation coefficients (ICC) were used to estimate reliability. Results By using the mean of 2 measures, intraexaminer reliability point estimates (ICC3,2 ) ranged from 0.96 to 0.99 for same-day comparisons and from 0.87 to 0.98 for between-day comparisons. Interexaminer reliability estimates (ICC2,2 ) ranged from 0.88 to 0.94 for within-day comparisons and from 0.80 to 0.92 for between-day comparisons. Reliability estimates comparing measurements by the 2 examiners of the same image (ICC2,2 ) ranged from 0.96 to 0.98. Reliability estimates were lower for percent thickness change measures than the corresponding single thickness measures for all conditions. Conclusions RUSI thickness measurements of the TrA and lumbar multifidus muscles in patients with LBP, when based on the mean of 2 measures, are highly reliable when taken by a single examiner and adequately reliable when taken by different examiners.