STUDY DESIGN: Reliability study of clinical measurement. OBJECTIVES: The primary purpose was to develop a reliable method for measuring muscle length changes of the transversus abdominis (TrA) during contraction. The secondary purpose was to investigate the relationship between changes in thickness and length (as indicated by the lateral sliding of the anterior muscle-fascia junction) of the TrA muscle during an abdominal drawing-in maneuver. We also provide data on between-day reliability of change in thickness (ΔT) of the TrA. BACKGROUND: Ultrasound imaging measurements of TrA thickness at rest (Thr) and during maximal contraction (Thm) have been shown to be reliable. However, limited data exist on quantifying changes in TrA length (as indicated by the lateral sliding of the muscle-fascia junction [Δx]) and ΔT during contraction. METHODS: Eighteen healthy adults (mean ± SD age, 22.6 ± 2.5 years) participated in this study. Brightness mode ultrasound images of the TrA were collected at rest and during an abdominal drawing-in maneuver. Subjects were examined by the same examiner twice within a 48-hour period. ΔT, ΔT/Thr, Thr, Thm, and Δx of the TrA were calculated. Medial-lateral movement of the transducer during measurement was corrected through a custom-written program that used an internal marker created by an echo-absorptive thread attached to the skin. Intraclass correlation coefficients (ICC_3,1), within-subject coefficient of variance, and standard error of measurement were calculated. The relationship between ΔT and adjusted Δx of the TrA muscle was investigated. RESULTS: The ICC values for Thr, Thm, and ΔT of the TrA muscle were greater than 0.75, with the exception of the left ΔT (0.62) and left ΔT/Thr (0.49). After adjusting for medial-lateral motion of the transducer, the ICC values of adjusted Δx were above 0.75, and the within-subject coefficient of variance was below 10%. There was no significant correlation between ΔT and adjusted Δx of the TrA. CONCLUSION: Ultrasound imaging measurements of TrA thickness and length change were shown to be reliable using a novel method to control for medial-lateral transducer motion. Measuring different but unrelated dimensional changes in the TrA might provide further insight as to the function of the TrA.

J Orthop Sports Phys Ther 2010;40(12):826-832, Epub 10 November 2010. doi:10.2519/jospt.2010.3000

KEY WORDS: abdomen, low back pain, lumbar spine, stabilization

STUDY DESIGN: Clinical measurement, reliability. OBJECTIVES: To examine the intraday intrarater reliability of measuring thickness of the upper dorsal neck muscles at rest, as well as at 50% of maximum voluntary isometric contraction (MVIC), for upper cervical extension. BACKGROUND: Methodology for measuring the thickness of the lower dorsal neck muscles, including semispinalis capitis and multifidus muscles, during contraction using ultrasonography has been established. Thickness measurements for the upper dorsal neck muscles have not been documented. METHODS: Ten subjects (21 to 30 years of age) without neck pain and headache were recruited. Their upper dorsal neck muscles were measured both at rest and during 50% MVIC for upper cervical extension in sitting position using rehabilitative ultrasound imaging (RUSI). Muscles measured included the rectus capitis posterior major, oblique capitis superior, semispinalis capitis, and splenius capitis. All measurements were repeated after 10 minutes of rest, on the same day, by the same rater. Descriptive statistics were supplemented by calculations of intraclass correlation coefficient (ICC_3,1), standard error of measurement (SEM), within-subject coefficient of variation (CV_w), and minimal detectable change (MDC). RESULTS: ICC_3,1 results ranged from 0.87 to 0.99 for thickness measurements made at rest and from 0.90 to 0.98 for thickness measurements made with a 50% MVIC. The SEMs for thickness measurements at rest and at 50% MVIC ranged from 0.11 to 0.46 mm and 0.23 to 0.52 mm, while the CV_ws ranged from 3.5% to 6.1% and 3.7% to 6.4%, and MDC95 ranged from 0.35 to 1.46 mm and 0.73 to 1.65 mm, respectively. The thickness of all upper dorsal neck muscles measured during a 50% MVIC was greater than when measured at rest (P<.029). CONCLUSION: Thickness measurements of the upper dorsal neck muscles using RUSI were reliable both at rest and during a 50% effort isometric contraction.

J Orthop Sports Phys Ther 2009;39(12):850-857. doi:10.2519/jospt.2009.3005

KEY WORDS: muscle thickness, neck, rehabilitation ultrasound imaging, suboccipital muscle, ultrasonography