Reliability of Real-time Ultrasound Imaging for the Assessment of Trunk Stabilizer Muscles: A Systematic Review of the Literature

J Ultrasound Med. 2019 Jan;38(1):15-26. doi: 10.1002/jum.14661. Epub 2018 Apr 24.


Rehabilitative ultrasound (US) imaging is one of the popular methods for investigating muscle morphologic characteristics and dimensions in recent years. The reliability of this method has been investigated in different studies. As studies have been performed with different designs and quality, reported values of rehabilitative US have a wide range. The objective of this study was to systematically review the literature conducted on the reliability of rehabilitative US imaging for the assessment of deep abdominal and lumbar trunk muscle dimensions. The PubMed/MEDLINE, Scopus, Google Scholar, Science Direct, Embase, Physiotherapy Evidence, Ovid, and CINAHL databases were searched to identify original research articles conducted on the reliability of rehabilitative US imaging published from June 2007 to August 2017. The articles were qualitatively assessed; reliability data were extracted; and the methodological quality was evaluated by 2 independent reviewers. Of the 26 included studies, 16 were considered of high methodological quality. Except for 2 studies, all high-quality studies reported intraclass correlation coefficients (ICCs) for intra-rater reliability of 0.70 or greater. Also, ICCs reported for inter-rater reliability in high-quality studies were generally greater than 0.70. Among low-quality studies, reported ICCs ranged from 0.26 to 0.99 and 0.68 to 0.97 for intra- and inter-rater reliability, respectively. Also, the reported standard error of measurement and minimal detectable change for rehabilitative US were generally in an acceptable range. Generally, the results of the reviewed studies indicate that rehabilitative US imaging has good levels of both inter- and intra-rater reliability.

Keywords: abdominal muscles; low back pain; multifidus; musculoskeletal; reliability; systematic review; ultrasound.

Publication types

  • Systematic Review

MeSH terms

  • Abdominal Muscles / diagnostic imaging*
  • Abdominal Muscles / physiopathology
  • Back Muscles / diagnostic imaging*
  • Back Muscles / physiopathology
  • Humans
  • Lumbosacral Region / diagnostic imaging
  • Reproducibility of Results
  • Torso / diagnostic imaging
  • Ultrasonography / methods*