Journal of Back and Musculoskeletal Rehabilitation - Volume 29, issue 1

Authors: Sobczak, Stéphane | Dugailly, Pierre-Michel | Gilbert, Kerry K. | Hooper, Troy L. | Sizer, Jr., Phillip S. | James, C. Roger | Poortmans, Bernard | Matthijs, Omer C. | Brismée, Jean-Michel

Article Type: Research Article

Abstract: BACKGROUND: Stadiometry measures total trunk height variations but cannot quantify individual spinal segment height changes. Different methods exist to measure both intervertebral disc and lumbar spine height (LSH) variations but they are either limited by radiation exposure or cost. Musculoskeletal ultrasound could be a valuable alternative to measure spinal segmental height changes as a result of intervention. OBJECTIVE: To validate the use of musculoskeletal ultrasound (MSU) and new anatomical landmark references used in assessing inter-mammillary distances (IMD) and LSH changes resulting from lumbar spine traction. METHODS: Two unembalmed cadaveric lumbar spines were extracted …to assess (1) the reliability and validity of MSU, as compared to caliper, for measuring in vitro IMD and LSH using alternative anatomical landmarks than previously reported, and (2) the reliability of MSU for measuring in vitro IMD and lumbar spine height changes recorded during standardized mechanical traction up to 1.20 cm. RESULTS: Intra- and inter-rater reliability of musculoskeletal ultrasound for within and between sessions and for all experimental design, Standard Error ranged from 0.01 to 0.02 and from 0.03 to 0.04 cm for IMDs and LSHs, respectively. Root Mean Square Errors ranged from 1.6 to 6.8% and from 1 to 1.1% for IMDs and LSHs, respectively and mean ICC ranged from 0.98 to 1 for LSH. During traction, mean lumbar spine height measurement change using MSU was 1.15 ± 0.03 cm. Bland and Altman plots demonstrated confidence intervals included in the limits of agreement. Nevertheless, there were significant differences (p< 0.001) for both IMD measurements and lumbar spine height between caliper and ultrasound measurements. Musculoskeletal ultrasound overestimated distances of about 5.5 ± 1.5%. CONCLUSIONS: Musculoskeletal ultrasound is reliable and accurate for measuring intersegmental spinal distances and lumbar spine height with an apparent slight overestimation of distances. Based on mean differences, ultrasound technology seems to be valid for measuring lumbar spine height changes and could be suitable for in vivo research. Show more

Keywords: Lumbar spine, lumbar spine height, imaging, musculoskeletal ultrasound, spine, reliability, intervertebral disc

DOI: 10.3233/BMR-150613

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 29, no. 1, pp. 171-182, 2016

Authors: Cho, Hee Kyung | Jung, Gil Su | Kim, Eun Hyuk | Cho, Yun Woo | Kim, Sang Woo | Ahn, Sang Ho

Article Type: Research Article

Abstract: BACKGROUD: Low back pain is associated with transversus abdominis (TrA) dysfunction. Recently, it was proposed that Neuromuscular Electrical Stimulation (NMES) could be used to stimulate deep abdominal muscle contractions and improve lumbopelvic stability. OBJECTIVE: The purpose of this study was to determine the optimal stimulation frequency required during NMES for the activation of deep abdominal muscles. METHODS: Twenty healthy volunteers between the ages of 24 and 32 were included. The portable research-stimulator was applied using a 10 second contraction time, and a 10 second resting time at 20 Hz, 50 Hz, and 80 …Hz. Changes in muscle thicknesses were determined for the TrA, obliquus internus (OI), and obliquus externus (OE) by real time ultrasound imaging. RESULTS: Significant thickness increases in the TrA, OI, and OE were observed during NMES versus the resting state (p < 0.05). Of the frequencies examined, 50 Hz NMES produced the greatest increase in TrA thickness (1.33 fold as compared with 1.22 fold at 20 Hz and 1.21 fold at 80 Hz) (p < 0.05). CONCLUSIONS: Our results indicate that NMES can preferentially stimulate contractions in deep abdominal stabilizing muscles. Most importantly, 50 Hz NMES produced greater muscle thickness increases than 20 or 80 Hz. Show more

Keywords: Neuromuscular electrical stimulation, frequency, abdominal muscle thickness, transversus abdominis, low back pain, real time ultrasound imaging

DOI: 10.3233/BMR-150638

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 29, no. 1, pp. 183-189, 2016