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Comparative Study
, 44 (6), 425-34

Ultrasound Imaging: Intraexaminer and Interexaminer Reliability for Multifidus Muscle Thickness Assessment in Adults Aged 60 to 85 Years Versus Younger Adults

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Comparative Study

Ultrasound Imaging: Intraexaminer and Interexaminer Reliability for Multifidus Muscle Thickness Assessment in Adults Aged 60 to 85 Years Versus Younger Adults

J Megan Sions et al. J Orthop Sports Phys Ther.

Abstract

Study design: Intraexaminer and interexaminer, within- and between-day reliability study.

Objectives: To compare the intraexaminer and interexaminer procedural reliability of ultrasound imaging (USI) thickness measurements of the lumbar multifidus muscle at rest and during a contralateral lower-limb lift (CLL) between older (60-85 years of age) and younger (18-40 years of age) adults.

Background: Among younger adults, USI has been shown to be reliable and valid for assessing multifidus thickness. Older adults present with age-related changes that may impact assessment. To our knowledge, no USI studies have focused on establishing reliability for multifidus thickness assessments in older adults.

Methods: Two examiners performed assessments of lumbar multifidus thickness at rest and during a CLL in 30 older and 31 younger adults. Intraclass correlation coefficient (ICC) with 95% confidence interval, standard error of measurement, 95% minimal detectable change for resting and during the CLL, and percent thickness change were calculated.

Results: Within-day interexaminer procedural reliability for multifidus thickness measurements was similar among younger (ICC = 0.90-0.92) and older adults (ICC = 0.86-0.90), as was between-day intraexaminer and interexaminer reliability (younger adults, ICC = 0.84-0.94; older adults, ICC = 0.86-0.93). Throughout, estimates of percent thickness change were inconsistent (ICC = 0.31-0.86), and standard errors of measurement and minimal detectable changes were larger for older adults.

Conclusion: Ultrasound imaging reliability for measurements of multifidus thickness at rest and during a CLL among older adults is consistent with previously published findings for younger adults. Among older adults, it may be preferable to have a single examiner conduct USI assessments.

Figures

FIGURE 1
FIGURE 1
Parasagittal imaging with the transducer placed just lateral to the spinous processes and angled medially to view the L4/5 facet joint.
FIGURE 2
FIGURE 2
On the left are ultrasound images of the multifidus obtained via parasagittal imaging at rest (A) and during a straight leg raise (B) in a younger adult. On the right are anatomical diagrams showing the standard measurement technique for multifidus thickness, where (a) represents multifidus muscle. The standard measurement is taken from the facet joint to the last dark pixel before the muscle’s fascial line.
FIGURE 3
FIGURE 3
On the left are ultrasound images of the multifidus obtained via parasagittal imaging at rest (A) and during a straight leg raise (B) in an older adult. On the right are anatomical diagrams showing the proposed alternative measurement technique for multifidus thickness, where (a) represents multifidus muscle and its fascia. The alternative measurement is taken from the facet joint to the first dark pixel beyond the muscle’s fascial line.

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