Reliability of rehabilitative ultrasound imaging of the transversus abdominis and lumbar multifidus muscles

Arch Phys Med Rehabil. 2009 Jan;90(1):87-94. doi: 10.1016/j.apmr.2008.06.022.


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 thickness(contracted)-thickness(rest)/thickness(rest). Intraclass correlation coefficients (ICC) were used to estimate reliability.

Results: By using the mean of 2 measures, intraexaminer reliability point estimates (ICC(3,2)) 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 (ICC(2,2)) 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 (ICC(2,2)) 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Muscles / diagnostic imaging*
  • Abdominal Muscles / physiology
  • Adult
  • Female
  • Humans
  • Low Back Pain / diagnostic imaging*
  • Low Back Pain / rehabilitation*
  • Male
  • Middle Aged
  • Muscle Contraction / physiology*
  • Observer Variation
  • Reproducibility of Results
  • Rest
  • Ultrasonography