Reliability of Ultrasonographic Measurement of Cervical Multifidus Muscle Dimensions during Isometric Contraction of Neck Muscles

Document Type : Original article

Authors

1 MSc in Physiotherapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Professor of Physiotherapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. (corresponding author)

3 Assistant Professor of Radiology, Faculty of Medicine, Mazandaran University of Medical Sciences. Sari, Iran.

4 MSc in Biostatistics, Faculty of Rehabilitation Sciences, Shahid beheshti University of Medical Sciences, Tehran, Iran

5 Assistant Professor of Physiotherapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Background and Aim: Cervical multifidus is considered as one of the most important neck stabilizers. Weakness and muscular atrophy of this muscle were seen in patients with chronic neck pain. Ultrasonographic imaging is a non-invasive and feasible technique that commonly used to record such changes and measure muscle dimensions. Therefore, the aim of this study was to evaluate the reliability of ultrasonographic measurement of cervical multifidus muscle’s dimensions during isometric contraction of neck muscles.
Materials and Method: Ten subjects (5 patients with chronic neck pain and 5 healthy subjects) were recruited in this study. Cervical multifidus muscle’s dimensions were measured at the level of forth cervical vertebrae. Ultrasonographic measurement of cervical multifidus muscle at rest, 50% and 100% of maximal voluntary contraction (MVC) were performed by one examiner within 1 week interval. The dimensions of cervical multifidus muscle including cross-sectional area (CSA), anterior posterior dimension (APD), and lateral dimension (LD) were measured. Intraclass correlation coefficients (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) were computed for data analysis.
Results: The between days reliability of maximum strength of neck muscles and multifidus muscle dimensions at rest, 50% and 100% of MVC of neck muscles were good to excellent (ICC=0.75-0.99).
Conclusion: The results of this study showed that ultrasonographic measuring of cervical multifidus muscle’s dimensions during isometric contraction of neck muscles at the level of C4 in females with chronic neck pain and healthy subjects is a reliable and repeatable method.

Keywords


  1. Anderson JS, Hsu AW, Vasavada AN. Morphology, architecture, and biomechanics of human cervical multifidus. Spine 2005; 30(4):E86-91.
  2. Samuel RW, Coll WK, Carolyn ME, et al. Architectural analysis and intraoperative measurements demonstrate the unique design of the multifidus muscle for lumbar spine stability. J Bone Joint Surg Am 2009; 91(1):176-85.
  3. Kristjansson E. Reliability of ultrasonography for the cervical multifidus muscle in asymptomatic and symptomatic subjects. Man Ther 2004; 9(2):83-8.
  4. Fernández-de-las-Peñas C, Albert-Sanchís JC, Buil M, Benitez J, Alburquerque-Sendín F. Cross-sectional area of cervical multifidus muscle in females with chronic bilateral neck pain compared to controls. J Orthop Sports Phys Ther 2008; 38(4):175-80.
  5. Chae SH, Lee SJ, Kim MS, et al. Cervical Multifidus Muscle Atrophy in Patients with Unilateral Cervical Radiculopathy. J Korean Acad Rehab Med 2010; 34(6): 743-751.
  6. Rezasoltani A, Ylinen JJ, Vihko V. Isometric cervical extension force and dimensions of semispinalis capitis muscle. J Rehabil Res Dev 2002; 39(3):423-8.
  7. Lee JP, Wang CL, Shau YW, Wang SF. Measurement of cervical multifidus contraction pattern with ultrasound imaging. J Electromyogr Kinesiol 2009; 19(3):391-7.
  8. Kiesel KB, Uhl TL, Underwood FB, Rodd DW, Nitz AJ. Measurement of lumbar multifidus muscle contraction with rehabilitative ultrasound imaging. Man Ther 2007;12(2):161-6
  9. Lee JP, Tseng WY, Shau YW, Wang CL, Wang HK, Wang SF. Measurement of segmental cervical multifidus contraction by ultrasonography in asymptomatic adults. Man Ther 2007;12(3):286-94
  10. Javanshir KH, Mohseni-Bandpei MA, Rezasoltani A, Amiri M, Rahgozar M. Ultrasonography of longus colli muscle: A reliability study on healthy subjects and patients with chronic neck pain. Bodywork and Movement Thera 2011; 15(1), 50-56.
  11. Lin YJ, Chai HM, Wang ShF. Reliability of thickness measurements of the dorsal muscle of the upper cervical spine: An ultrasonographic study. J Orthop Sports Phys Ther 2009; 39(12): 850-857.
  12. Cagnie B, Derese E, Vandamme L, Verstrate K and Cambier D. Validity and reliability of ultrasonography for the longus colli in asymptomatic subjects. Man Ther 2009; 14(4):421-6.
  13. Soltani AR, Kallinen M, Malkia E, Vihko V. Ultrasonography of the neck splenius capitis muscle investigation in a group of young healthy women. Acta Radiol 1996;37(5):647-50.
  14. Panjabi M, Abumi K, Duranceau J, Oxland T. Spinal stability and intersegment muscle forces. A biomechanical model. Spine 1989;14(2):194-200.
  15. Kristjansson E, Jonsson Jr. H. Is the sagittal configuration of the cervical spine changed in women with chronic whiplash syndrome? A comparative computer-assisted radiographic assessment. J Manipulative Physiol Ther 2002 ;25(9):550-5.
  16. Cagnie B cools A, De Loose V, Cambier D, Danneels L. Differences in isometric neck muscle strength between healthy controls and women with chronic neck pain: the use of reliable measurement. Arch Phys Med Rehabil 2007; 88(11):1441-5.
  17. Rezasoltani A, Ahmadi A, Emami D, Lajevardi ST, Okhovatian F. The reliability of isometer 2 device in measuring of cervical flexor and extensor muscles strength. J Rehab 2006; 7(2): 6-11.
  18. Rezasoltani A, Ylinen J, Bakhtiary AH, Norozi M, Montazeri M. Cervical muscle strength measurement is dependent on the location of thoracic support. Br J Sports Med 2008; 42(5):379-82.
  19. Rezasoltani A, Ahmadipor A, Khademi-kalantari Kh, Rahimi A. Preliminary study of neck muscle size and strength measurements in females with chronic non-specific neck pain and healthy control subjects. Man Ther 2010; 15(4):400-3.
  20. Ahmadipur A. The symmetry size of semispinalis capitis muscle and isometric strength measurement of neck muscles in a group of chronic non-specific neck pain and a control group. [MSc thesis], Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Science; 2007. [In Persian]
  21. Rezasoltani A, Kallinen M, Malkia E,Vihko V. Neck muscle ultrasonography of male weight-lifters, wrestlers and controls. Scand J Med Sci Sports 1999; 9(4):214-8.
  22. Rezasoltani A. The applicability of muscle ultrasonography in physiotherapy researches. J Phys Ther Sci 2003; 15(1): 33-37.
  23. Rosner B. Fundamental of Biostatics, 1st Ed, Belmont: Duxbury Press. 2006; p: 223.
Volume 1, Issue 2 - Serial Number 2
July and August 2012
Pages 36-44
  • Receive Date: 11 July 2011
  • Revise Date: 18 January 2012
  • Accept Date: 15 June 2012
  • First Publish Date: 21 June 2012