Shear-wave elastography for assessment of trapezius muscle stiffness: Reliability and association with low-level muscle activity

Abstract

Shear-wave elastography has been recognized a useful tool for quantifying muscle stiffness, commonly reported as shear modulus, however the reports on reliability are often limited to test-retest correlations. In this study, we explored the reliability of shear-wave elastography for assessment of the trapezius muscle stiffness and its relationship with lowlevel muscle activity. Methods Twenty participants were included in a two-session experiment. Measurements of shear modulus and muscle activity were performed at rest and during low-level activity, induced by shoulder abduction without additional external resistance. Results Good to excellent intra-session repeatability (ICC > 0.80) and moderate inter-rater and inter-session reproducibility (ICC = 0.66-0.74) were observed. Typical errors were acceptable (7.6% of the mean value) only for intra-session measurements in resting conditions, but not acceptable for all conditions with low-level muscle activity (10.2-16.6% of the mean value). Inverse relationships between shear modulus and muscle activity at 40˚and 60˚of shoulder abduction (r =-0.53 and-0.57) were observed on a group level. We also found higher shear modulus in males compared to females, for the parallel probe position compared to the perpendicular position (in relation to muscle fiber orientation), and for the dominant side of the body compared to the non-dominant side. Conclusions This study showed an inverse relationship between muscle activity in low-level range and shear modulus on a group level, suggesting inherent passive stiffness could account for a larger portion of the variance (compared to muscle activity) in shear modulus when the

Is Shear-Wave Elastography a Clinical Severity Indicator of Myofascial Pain Syndrome? An Observational Study

“…However, manual palpation is a high subjectivity test based on the pain response of the patients which could imply bias and, therefore, objective methods (with high sensitivity, specificity, reliability and validity) are prioritized [30]. Although SWE is an objective alternative to manual palpation which showed to be a feasible tool for assessing the upper trapezius muscle intra-session stiffness [22], the main limitation found for this method is that its reliability showed to be moderate just if performed in rigorous conditions (e.g., reporting both shear wave speed and young modulus assessed in the longitudinal plane [31]. Therefore, those studies assessing transverse planes [32,33] or using operator-dependent elastography methods (e.g., strain elastography) should be interpreted carefully [11].…”

“…All participants were positioned in the same orientation used for the MTrP identification protocol. Since the longitudinal plane showed higher intra-and inter-examiner reliability (ICC = 0.66-0.74) than the transversal assessment [22], all images were acquired with the transducer oriented longitudinally with the muscle fibers and positioning the center of the probe over the MTrP and the control point locations. Two images were obtained from each patient and measurement point to improve the accuracy of the measurements.…”

Determination of Reference Values of the Masseter Muscle Stiffness in Healthy Adults Using Shear Wave Elastography

“…Olchowy et al assessed the reliability of SWE measurements for the masseter muscle using intraclass correlation coefficients and observed excellent results [12]. Other researchers also proved this method to be reliable for different muscles [25][26][27]. Another limitation is that we examined only healthy adult subjects.…”

Changes in Circadian Variations in Blood Pressure, Pain Pressure Threshold and the Elasticity of Tissue after a Whole-Body Photobiomodulation Treatment in Patients with Fibromyalgia: A Tripled-Blinded Randomized Clinical Trial

“…A physiotherapist, with 10 years of experience and an expert in musculoskeletal imaging, used the Logiq S7 with 15 MHz linear probe (GE Healthcare, Milwaukee, WI, USA) to carry out measurements on the subjects following the orientation guidelines used for tender point recognitions [ 41 ]. Given that the longitudinal plane demonstrated both a higher intra- and inter-examiner reliability (ICC = 0.66–0.74) than the transversal one [ 42 ], the transducer was positioned longitudinally to the muscle fibers with the center of the probe over the tender and control point locations and approximately 2–5 mm of compression was applied to the tissue. The recommended compression size was evaluated using the integrated software quality control system, which visually displays one to five green bars, with the most acceptable size showing five bars.…”