Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
권호 표지

Reliability and Validity of Ultrasound Imaging and sEMG Measurement to External Abdominal Oblique and Lumbar Multifidus Muscles

외복사근과 다열근에 대한 초음파 영상과 표면 근전도 측정방법의 신뢰도와 타당도

  • Kim, Chang-Yong (Dept. of Physical Therapy, The Graduate School, Daejeon University) ;
  • Choi, Jong-Duk (Dept. of Physical Therapy, College of Health Sports Science, Daejeon University) ;
  • Kim, Suhn-Yeop (Dept. of Physical Therapy, College of Health Sports Science, Daejeon University) ;
  • Oh, Duck-Won (Dept. of Physical Therapy, College of Health Sports Science, Daejeon University) ;
  • Kim, Jin-Kyung (Dept. of Occupational Therapy, Hanseo University)
  • 김창용 (대전대학교 대학원 물리치료학과) ;
  • 최종덕 (대전대학교 보건스포츠과학대학 물리치료학과) ;
  • 김선엽 (대전대학교 보건스포츠과학대학 물리치료학과) ;
  • 오덕원 (대전대학교 보건스포츠과학대학 물리치료학과) ;
  • 김진경 (한서대학교 작업치료학과)
  • Received : 2011.01.03
  • Accepted : 2011.02.05
  • Published : 2011.02.19
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Abstract

The purpose of this study was to investigate intra-rater reliability and determine the validity of electromyography (EMG) measurements to represent muscle activity and ultrasonography (US) to represent muscle thickness during manual muscle testing (MMT) to external abdominal oblique (EO) and lumbar multifidus (MF). Twenty healthy subjects were recruited for this study and asked to perform MMT at differing levels. The subjects' muscle activity using EMG was measured by a ratio to maximum voluntary contraction (MVC) and root mean square (RMS) methods. The subjects' muscle thickness using US was measured by raw muscle thickness and change ratio of thickness to maximum (MVC) or resting condition. In three trials, measurements were performed on each subject by one examiner. The intra-rater reliability of measurements of EMG and US to EO and MF was calculated using intra-class coefficients. The intra-rater reliability of all measurements was excellent (ICC=.75~.98) in EMG and US. The conduct validity was calculated by one-way ANOVA with repeated measurements to compare whether the EMG and US measurements were different between MMT at different levels. There was only a significant difference between all grades at %MVC thickness measurement of US. These results suggest that a %MVC thickness measurement of US was a more sensitive and discriminate in all manual muscle testing grades. This information will be useful for the selection of US measurement and analysis methods in clinics.

Keywords

Acknowledgement

Supported by : 대전대학교

References

  1. 이충휘. 물리치료사와 작업치료사를 위한 연구방법론. 제 3판. 서울, 계축문화사, 2008:194-195.
  2. Axler CT, McGill SM. Low back loads over a variety of abdominal exercises: Searching for the safest abdominal challenge. Med Sci Sports Exerc. 1997;29(6):804-811. https://doi.org/10.1097/00005768-199706000-00011
  3. Behm DG, Anderson K, Curnew RS. Muscle force and activation under stable and unstable conditions. J Strength Cond Res. 2002;16(3):416-422.
  4. Bergmark A. Stability of the lumbar spine: A study in mechanical engineering. Acta Orthop Scand Suppl. 1989;230:1-54.
  5. Brown SH, McGill SM. A comparison of ultrasound and electromyography measures of force and activation to examine the mechanics of abdominal wall contraction. Clin Biomech(Bristol, Avon). 2010;25(2):115-123. https://doi.org/10.1016/j.clinbiomech.2009.10.001
  6. Butcher SJ, Craven BR, Cilibeck PD, et al. The effect of trunk stability training on vertical takeoff velocity. J Orthop Sports Phys Ther. 2007;37(5):223-231. https://doi.org/10.2519/jospt.2007.2331
  7. Cholewicki J, MeGill SM. Mechanical stability of the in vivo lumbar spine: Implications for injury and chronic low back pain. Clin Biomech(Bristol, Avon). 1996;11(1):1-15. https://doi.org/10.1016/0268-0033(95)00035-6
  8. Cram JR, Kasman GS, Holtz J. Introduction to Surface Electromyography. Maryland, Aspen Publishers Inc, 1998:360-374.
  9. Ferreira PH, Ferreira ML, Hodges PW. Changes in recruitment. of the abdominal muscles in people with low back pain: Ultrasound measurement of muscle activity. Spine(Phila Pa 1976). 2004;29(22):2560-2566. https://doi.org/10.1097/01.brs.0000144410.89182.f9
  10. Hides J, Wilson S, Stanton W, et al. An MRI investigation into the function of the transversus abdominis muscle during 'drawing-in' of the abdominal wall. Spine(Phila Pa 1976). 2006;31(6)175-178.
  11. Hislop HJ, Montgomery J, Connolly B. Daniels and Worthingham's Muscle Testing: Techniques of manual examination. 6th ed. Philadelphia, PA, W.B. Saunders Co., 2003:35-48.
  12. Hodges P, Richardson C, Jull G. Evaluation of the relationship bet Teen laboratory and clinical tests of transversus abdominis function. Physiother Res Int. 1996;1(1):30-40. https://doi.org/10.1002/pri.45
  13. Hodges P, Richardson C, Jull G. Evaluation of the relationship bet Teen laboratory and clinical tests of transversus abdominis function. Physiother Res Int. 1996;1(1):30-40. https://doi.org/10.1002/pri.45
  14. Hodges PW, Richardson CA. Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. Arch Phys Med Rehabil. 1999;80(9):1005-1012. https://doi.org/10.1016/S0003-9993(99)90052-7
  15. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain: A motor control evaluation of transversus abdominis. Spine(Phila Pa 1976). 1996; 21(22):2640-2650. https://doi.org/10.1097/00007632-199611150-00014
  16. Hungerford B, Gilleard W, Hodges P. Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spind(Phila Pa 1976). 2003;28(14):1593-1600.
  17. Imai A, Kaneoka K, Okubo Y, et al. Trunk muscle activity during lumbar stabilization exercises on both a stable and unstable surface. J Orthop Sports Phys Ther. 2010;40(6):369-375. https://doi.org/10.2519/jospt.2010.3211
  18. John EK, Beith ID. Can activity within the external abdominal oblique be measured using real-time ultrasound imaging? Clin Biomech(Bristol, Avon) 2007;22(9):972-979. https://doi.org/10.1016/j.clinbiomech.2007.07.005
  19. Leetun DT, Ireland ML, Willson JD, et al. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004;36(6):926-934. https://doi.org/10.1249/01.MSS.0000128145.75199.C3
  20. Mannion AF, Pulkovski N, Gubler D, et al. Muscle thickness changes during abdominal hollowing: An assessment of between-day measurement error in controls and patients with chronic low back pain. Eur Spine J 2008;17(4):494-501. https://doi.org/10.1007/s00586-008-0589-x
  21. McGill SM. Low back stability: From formal description to issues for performance and rehabilitation. Exerc Sport Sci Rev. 2001;29(1):26-31. https://doi.org/10.1097/00003677-200101000-00006
  22. McMeeken JM, Beith ID, Newham DJ, et al. The relationship between EMG and change in thickness of transversus abdominis. Clin Biomech(Bristol, Avon). 2004;19(4):337-342. https://doi.org/10.1016/j.clinbiomech.2004.01.007
  23. Moseley GL, Hodges PW, Gandevia SC. Deep and superficial fillers of the lumbar multifidus muscle are differentially active during voluntary arm movements. Spine(Phila Pa 1976). 2002;27(2):E29-36. https://doi.org/10.1097/00007632-200201150-00013
  24. Ng JK, Kippers V, Richardson CA. Muscle fibre orientation of abdominal muscles and suggested surface EMG electrode positions. Electromyogr Clin Neurophysiol. 1998;38(1):51-58.
  25. O'Sullivan PB, Phyty GD, Twomey LT, et al. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine(Phila Pa 1976). 1997;22(24):2959-2967. https://doi.org/10.1097/00007632-199712150-00020
  26. Peach JP, Sutarno CG, McGill SM, Three-dimensional Kinematics and trunk muscle myoelectric activity in the young lumbar spine: A database. Arch Phys Med Rehabil. 1998:79(6):663-669. https://doi.org/10.1016/S0003-9993(98)90041-7
  27. Queiroz BC, Cagliari MF, Amorim CF, et al. Muscle activation during four Pilates core stability exercises in quadruped position. Arch Phys Med Rehabil. 2010;91(1):86-92. https://doi.org/10.1016/j.apmr.2009.09.016
  28. Rankin G, Stokes M, Newham DJ. Abdominal muscle size and symmetry in normal subjects. Muscle Nerve. 2006;34(3):320-326. https://doi.org/10.1002/mus.20589
  29. Rasmussen-Barr E, Ang B, Arvidsson I, et al. Graded exercise for recurrent low-back pain: A randomized, controlled trial with 6-, 12-, and 36-month follow-ups. Spine (Phila Pa 1976). 2009;34(3):221-228. https://doi.org/10.1097/BRS.0b013e318191e7cb
  30. Roy SH, De Luca CJ, Emley M, et al. Classification of back muscle impairment based on the surface electromyographic signal. J Rehabil Res Dev. 1997;34(4):405-414.
  31. Shrout PE, Fleiss JL, Intraclass correlations: Uses in assessing rater reliability. Psychol Bull. 1976;86(2)420-428.
  32. Vasseljen O, Dahl HH, Mork PJ, et al. Muscle activity onset in the lumbar multifidus muscle recorded simultaneously by ultrasound imaging and intramuscular electromyography. Clin Biomech(Bristol, Avon). 2006;21(9):905-13. https://doi.org/10.1016/j.clinbiomech.2006.05.003
  33. Whittaker JL. Ultrasound imaging of the lateral abdominal wall muscles in individuals with lumbopelvic pain and signs of concurrent hypocapnia. Man Ther. 2008:13(5):404-410. https://doi.org/10.1016/j.math.2007.03.008
  34. Wilke HJ, Wolf S, Claes LE, et al. Stability increase of the lumbar spine with different muscle groups: A biomechanical in vitro study. Spine(Phila Pa 1976). 1995;20(2):192-198. https://doi.org/10.1097/00007632-199501150-00011