Reliability of Thickness Measurements of the Dorsal Muscles of the Upper Cervical Spine: An Ultrasonographic Study

Abstract

Ya-Jung Lin, PT, MS1 • Huei-Ming CHai, PT, PhD2 • SHwu-Fen wang, PT, PhD3 Reliability of Thickness Measurements of the Dorsal Muscles of the Upper Cervical Spine: An Ultrasonographic Study changes during contraction to represent muscle function either using MRI or real-time ultrasonography for the cervical region. 12,13,21 Rehabilitative ultrasound imaging (RUSI) is less expensive and more mobile when compared to the "gold-standard" MRI. In addition, the clinical use of RUSI can provide for a rapid observation of muscle contraction. Change in muscle thickness has been shown to be associated with EMG signal amplitude 4,7,14 and level of contraction, 8,11,13,26 particularly during submaximal efforts. 4,7,13 A significant relationship between change in muscle thickness and EMG signal amplitude has been demonstrated for actions when the muscle acts as a prime mover 5 or at submaximal efforts. 4,7 Previous work suggests that the muscle architecture changes very little with efforts above 50% maximum voluntary isometric contraction (MVIC), 4 because additional efforts do not further stretch the tendon and surrounding connective tissue and, therefore, contribute to minimal change in muscle length or thickness. 25 Furthermore, most functional activities are performed at relatively low levels of muscular efforts. 25 Therefore, measuring the change in muscle thickness below 50% MVIC effort using ultrasonography may best represent muscle activation.RUSI measurement of the thickness R eal-time ultrasonography has been used to investigate changes in muscle morphology during contraction. The ability to quantify changes in muscle morphology to reflect muscle contraction using magnetic resonance imaging (MRI) or ultrasound imaging allows the study of the deep muscles and, in some cases, the visualization of the whole muscle, without the disadvantage t Study deSign: Clinical measurement, reliability.t 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. t 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.t 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 (...

Ultrasound Imaging and Muscle Function

“…57 The reliability of USI techniques for measuring various muscles and parameters are reported widely in the literature. 33,39,47,49,55 In general, these studies conclude that USI is a reliable method to measure the muscle parameter of interest. However, as highlighted by Costa et al, 9 using the lateral abdominal wall muscles as an example, the majority of the investigations published prior to 2009, regardless of muscle or parameter, were of low quality (small sample sizes, lack of information about blinding or order of tests, and poorly defined time intervals between tests) and only specific to healthy cohorts.…”

Ultrasonography of the Cervical Muscles: A Critical Review of the Literature

“…23,[30][31][32] In 7 studies, RUSI was performed with subjects in prone position 4,21,24,26,28,29,33 ; in 4 studies, the subjects were in sitting position 15,23,27,34 ; in 2 studies, both positions were used 22,25 ; and in the last 3, RUSI was performed with the subjects in supine position. [30][31][32] Three studies quantified the size change of muscles in relation to muscle contraction 15,27,34 ; 3 studies evaluated the relationship between the cross-sectional area (CSA), linear dimensions, and anthropometric variables 21,22,26 ; and 1 study evaluated the training-induced differences in cervical muscle size. 24 One study investigated the differences in muscle shape and CSA of the cervical multifidus (MF) muscle between chronic neck pain patients and controls.…”

“…4,15,[21][22][23][24][25][26][27][28][29][30][31][32][33][34] In 12 of 16 studies, the posterior muscles were assessed, 4,15,21,22,[24][25][26][27][28][29]33,34 whereas in the remaining 4, the anterior muscles were studied. 23,[30][31][32] In 7 studies, RUSI was performed with subjects in prone position 4,21,24,26,28,29,33 ; in 4 studies, the subjects were in sitting position 15,23,27,34 ; in 2 studies, both positions were used 22,25 ; and in the last 3, RUSI was performed with the subjects in supine position. [30][31][32] Three studies quantified the size change of muscles in relation to muscle contraction …”

Rehabilitative ultrasound imaging of the supraspinatus muscle: Intra- and interrater reliability of thickness and cross-sectional area

“…For physical therapists, biofeedback can be a useful technique to assist in the application of therapeutic interventions and evaluate clinical outcomes. Most of the studies regarding morphometry have evaluated muscles in the axial skeleton (Costa et al, 2009;Ferreira et al, 2011;Hides et al, 2007;Javanshir et al, 2011;Lin et al, 2009;Norasteh et al, 2007;; few studies have been performed in appendicular skeleton muscles (Bemben, 2002;Cameron et al, 2008;English et al, 2012;Noorkoiv et al, 2010a;Reeves et al, 2004).…”