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David M, Devantéry K, Nauche B, Chagnon M, Keezer M, Gaudreault N, Bureau NJ, Cloutier G. Ultrasound elastography of back muscle biomechanical properties: a systematic review and meta-analysis of current methods. Insights Imaging 2024; 15:206. [PMID: 39143409 PMCID: PMC11324641 DOI: 10.1186/s13244-024-01785-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/23/2024] [Indexed: 08/16/2024] Open
Abstract
OBJECTIVES To report the current elastography methods used to quantify back muscles' biomechanical characteristics in patients with musculoskeletal disorders (MSKd) and inform on their reliability, validity, and responsiveness. METHODS MEDLINE, Embase, CINAHL, Cochrane library and grey literature were consulted. Predefined criteria allowed for study selection and data extraction. The quality of evidence was rated using the COSMIN tool. Data were meta-analyzed in terms of pooled intraclass correlation coefficient (pICC) for reliability and pooled standardized mean difference (pSMD) for validity and responsiveness. Heterogeneity was assessed. RESULTS Seventy-nine studies were included in the meta-analysis (total number of participants N = 3178). Three elastography methods were identified: strain imaging (SI; number of cohorts M = 26), shear wave imaging (SWI; M = 50), and vibration sonoelastography (VSE; M = 3). Strain imaging and SWI studies reported good reliability measurement properties (pICC > 0.70) and a medium pSMD (0.58 for SI and 0.60 for SWI; p ≤ 0.020) in discriminating MSKd from controls' condition (validity). Strain imaging studies reported a medium pSMD (0.64; p = 0.005) in detecting within-group changes over time, whereas SWI pSMD was very high (1.24; p = 0.005). Only SWI reported significant but small pSMD (0.30; p = 0.003) in detecting between-group changes over time. The small number of VSE studies could not be meta-analyzed. Heterogeneity was high (I-squared > 90%; p < 0.001). CONCLUSIONS Elastography presents good reliability results and a medium pSMD in discriminating MSKd from control conditions. Responsiveness data suggest detectable changes within groups over time using SI and SWI, calling for long-term longitudinal studies. Assessing changes between groups over time using elastography still needs to be proven. Highly significant heterogeneity limits meta-analytic results. CRITICAL RELEVANCE STATEMENT While still in its early-stage exploration phase, musculoskeletal ultrasound elastography may reliably quantify back muscles' biomechanics in asymptomatic individuals, moderately discriminate back musculoskeletal disorders and detect biomechanical changes over time in these conditions, calling for long-term longitudinal studies. KEY POINTS Ultrasound elastography is reviewed for back pain and related musculoskeletal disorder assessments. Growing literature supports good reproducibility, some validity and responsiveness. Back muscle elastography considers assumptions calling for standardized protocols.
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Affiliation(s)
- Mercedes David
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montreal, QC, H2L 2W5, Canada
- Institute of Biomedical Engineering, University of Montreal, Montreal, QC, H3C 3J7, Canada
| | | | | | - Miguel Chagnon
- Department of Mathematics and Statistics, University of Montreal, Montreal, QC, H2C 3J7, Canada
| | - Mark Keezer
- University of Montreal Hospital, Montreal, QC, H3X 0C1, Canada
- Department of Neurology, University of Montreal, Montreal, QC, H2C 3J7, Canada
| | | | - Nathalie J Bureau
- University of Montreal Hospital, Montreal, QC, H3X 0C1, Canada
- Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, QC, H3C 3J7, Canada
| | - Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montreal, QC, H2L 2W5, Canada.
- Institute of Biomedical Engineering, University of Montreal, Montreal, QC, H3C 3J7, Canada.
- Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, QC, H3C 3J7, Canada.
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Seidel A, Brandl A, Egner C, Schleip R. Examination of Myofascial Stiffness and Elasticity in the Upper Trapezius Region in Patients with Unilateral Neck Pain: A Cross-Sectional Study. J Clin Med 2023; 12:6339. [PMID: 37834984 PMCID: PMC10573173 DOI: 10.3390/jcm12196339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: Globally, neck pain is prevalent, affecting around thirty percent of the population annually. To better understand the influence of pain on the myofascial layers, the present study investigated these on the upper trapezius muscle in unilateral, more severe neck pain. (2) Methods: This study was a cross-sectional study. Forty patients (42.2 ± 14.7) with a confirmed diagnosis of unilateral neck pain were examined using durometry and indentometry. This study evaluated the stiffness, elasticity, and pressure pain threshold of both sides of the neck (symptomatic side: SS; healthy side: HS). Furthermore, the range of motion of the cervical spine (lateral flexion, rotation) was quantified using a digital goniometer. (3) Results: A significant lateral discrepancy was observed in stiffness between groups (durometry: SS-33.76 ± 7.78, HS-29.75 ± 7.45, p < 0.001; indentometry: SS-59.73 ± 33.93, HS-4.18 ± 12.69, p = 0.024). In contrast, no differences were found between the comparison sides of the upper trapezius for the parameter's elasticity (SS-0.101 ± 1.09, HS--0.006 ± 0.29, p = 0.416), cervical spine mobility (lateral flexion: SS-37.08 ± 8.15, HS-37.73 ± 7.61, p = 0.559; rotation: SS-73.55 ± 12.37, HS-72.85 ± 11.10, p = 0.660), and algometry (SS-36.41 ± 17.53, HS-37.22 ± 17.00, p = 0.657). (4) Conclusion: Overall, it can be concluded that more severe neck pain unilaterally shows differences in stiffness on the same side. Future research is needed to investigate the links.
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Affiliation(s)
- Anika Seidel
- Department of Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
| | - Andreas Brandl
- Department of Sports Medicine, Institute for Human Movement Science, Faculty for Psychology and Human Movement Science, University of Hamburg, 20148 Hamburg, Germany
- Conservative and Rehabilitative Orthopedics, Department of Sport and Health Sciences, Technical University of Munich, 80333 Munich, Germany
| | - Christoph Egner
- Department of Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
| | - Robert Schleip
- Department of Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
- Conservative and Rehabilitative Orthopedics, Department of Sport and Health Sciences, Technical University of Munich, 80333 Munich, Germany
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Assessment of Neck Muscle Shear Modulus Normalization in Women with and without Chronic Neck Pain. Diagnostics (Basel) 2022; 12:diagnostics12081791. [PMID: 35892502 PMCID: PMC9331943 DOI: 10.3390/diagnostics12081791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Identifying the objective stiffness of the neck muscles facilitates the early and specific diagnosis of neck pain and targeted therapy. However, individual variation in the muscle shear modulus obscures differences between healthy and diseased individuals. Normalization may improve the comparability between individuals. The shear modulus at different functional tasks served as a reference for normalizing the neck muscles’ shear modulus of 38 women, 20 with chronic neck pain and 18 asymptomatic. Reference tasks were maximal voluntary contraction, relaxed sitting, prone head lift, balancing 1 kg on the head, and neck extension at 48 N. The effects of normalization on within-group variation and between-group differences were compared. Normalization with maximal voluntary contraction was discarded due to imaging problems. Normalization with relaxed sitting, prone head lift, balancing 1 kg, and neck extension at 48 N reduced within-group variation, by 23.2%, 26.8%, 11.6%, and 33.6%, respectively. All four normalization approaches reduced the p-values when testing for between-group differences. For the pain group, normalization with relaxed sitting and head lift indicated less normalized muscle stiffness, while normalization with balancing 1 kg and extension at 48 N indicated higher stiffness. The contradictory results are explainable by non-significant group differences in the reference tasks. Normalization of the muscle shear modulus is effective to reduce within-group variation, but a trustworthy normalization approach for group comparisons has yet to be identified.
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Myofascial Tissue and Depression. COGNITIVE THERAPY AND RESEARCH 2021; 46:560-572. [PMID: 34955570 PMCID: PMC8688142 DOI: 10.1007/s10608-021-10282-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/06/2022]
Abstract
Background The myofascial system plays a fundamental role in the mechanics of the body, in body tension regulation and the etiology of pathological states like chronic pain. Moreover, it contains contractile elements and preliminary evidence suggests that its properties are linked to psychological factors. The aim of the present research was to investigate characteristics of the myofascial tissue in patients with Major Depressive Disorder (MDD) and to examine whether the state of the myofascial tissue causally affects pathopsychological processes in MDD. Methods In Study 1, stiffness and elasticity of the myofascial tissue of 40 inpatients suffering from MDD measured with a tissue compliance meter were compared with those of 40 matched never-depressed participants. In Study 2, 69 MDD patients were randomly assigned to single-session self-myofascial release intervention (SMRI) or a placebo intervention. Effects on memory bias and affect were investigated. Results Results showed that MDD patients displayed heightened stiffness and reduced elasticity of the myofascial tissue and that patients in the SMRI group showed a reduced negative memory bias and more positive affect compared to patients in the placebo condition. Conclusions The preliminary results of our studies indicate that the myofascial tissue might be part of a dysfunctional body-mind dynamic that maintains MDD. Supplementary Information The online version contains supplementary material available at 10.1007/s10608-021-10282-w.
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Janczyk EM, Champigny N, Michel E, Raffaelli C, Annweiler C, Zory R, Guérin O, Sacco G. Sonoelastography to Assess Muscular Stiffness Among Older Adults and its Use for the Diagnosis of Sarcopenia: A Systematic Review. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2021; 42:634-642. [PMID: 33187010 DOI: 10.1055/a-1293-8057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Changes in muscle stiffness have been reported with sarcopenia. Sonoelastography is an accessible and non-radiating imaging technique allowing quantification of elastic properties of tissue. We performed a systematic review of the literature to investigate whether sonoelastography can be a reliable method to assess sarcopenia in older patients. We searched Medline, Google Scholar, Scopus, SpringerLink and Science direct from January 1, 1990 to April 1, 2020. Three independent review authors assessed trial eligibility, extracted the data, and assessed risk of bias. We intended to learn which types of elastography have been tested, if such measures are repeatable, and if they have been compared to the currently accepted diagnostic method. Ten studies met the inclusion criteria. Most followed a cross-sectional design with young and older adult subgroups. The gastrocnemius, rectus femoris, and vastus intermedius appeared most frequently. Nine of the included studies used shear wave elastography and one-strain elastography. The passive elastic constant was significantly greater in sarcopenic versus healthy subjects after passive stretching (124.98 ± 60.82 vs. 46.35 ± 15.85, P = 0.004). However, even in non-sarcopenic patients, the age of the patient was responsible for about 45.5 % of the variance in SWV. Among ten included articles, four reported higher stiffness in the muscles of older adults, two reported lower stiffness, and four found no significant difference. Due to the substantial heterogenicity of actual data, we could not make any conclusions about the potential usefulness of elastography to assess sarcopenia. Further studies are needed, including a larger sample of older patients and using a standardized and reproducible protocol.
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Affiliation(s)
- Ewa Magdalena Janczyk
- Department of Therapeutic and Geriatric Medicine, University Hospital Centre of Nice, Côte d'Azur University, Nice, France
| | - Noémie Champigny
- Department of Therapeutic and Geriatric Medicine, University Hospital Centre of Nice, Côte d'Azur University, Nice, France
| | - Emeline Michel
- Department of Therapeutic and Geriatric Medicine, University Hospital Centre of Nice, Côte d'Azur University, Nice, France
- LAMHESS UPR 6312, Côte d'Azur University, Nice, France
| | - Charles Raffaelli
- Department of Ultrasounds, University Hospital Centre of Nice, Côte d'Azur University, Nice, France
| | - Cédric Annweiler
- Robarts Research Institute, Department of Medical Biophysics, University of Western Ontario Schulich School of Medicine and Dentistry, London, Canada
- UPRES EA 4638, University of Angers, France
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
| | - Raphael Zory
- LAMHESS UPR 6312, Côte d'Azur University, Nice, France
| | - Olivier Guérin
- Department of Therapeutic and Geriatric Medicine, University Hospital Centre of Nice, Côte d'Azur University, Nice, France
- Institute for Research on Cancer and Aging Nice (IRCAN) CNRS UMR 7284/INSERM U108, Côte d'Azur University, Nice, France
| | - Guillaume Sacco
- UPRES EA 4638, University of Angers, France
- Research Center Edmon and Lily Safra, Memory Clinic, University Hospital Centre Nice, Côte d'Azur University, Nice, France
- CoBTek Lab UPR 7276, Côte d'Azur University, Nice, France
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Cebula A, Cebula M, Kopyta I. Muscle Ultrasonographic Elastography in Children: Review of the Current Knowledge and Application. CHILDREN 2021; 8:children8111042. [PMID: 34828755 PMCID: PMC8623756 DOI: 10.3390/children8111042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/06/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023]
Abstract
Ultrasonographic elastography is a relatively new imaging modality for the qualitative and quantitative assessments of tissue elasticity. While it has steadily gained use in adult clinical practice, including for liver diseases, breast cancer, thyroid pathologies, and muscle and tendon diseases, data on its paediatric application is still limited. Moreover, diagnosis of muscular diseases in children remains challenging. The gold standard methods, namely biopsy, electroneurography, and electromyography, are often limited owing to their invasive characteristics, possible contraindications, complications, and need for good cooperation, that is, a patient’s ability to perform certain tasks during the examination while withstanding discomfort, which is a significant problem especially in younger or uncooperative children. Genetic testing, which has broad diagnostic possibilities, often entails a high cost, which limits its application. Thus, a non-invasive, objective, repeatable, and accessible tool is needed to aid in both the diagnosis and monitoring of muscle pathologies. We believe that elastography may prove to be such a method. The aim of this review was to present the current knowledge on the use of muscle elastography in the paediatric population and information on the limitations of elastography in relation to examination protocols and factors for consideration in everyday practice and future studies.
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Affiliation(s)
- Agnieszka Cebula
- Department of Paediatric Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Medykow Str 16, 40-752 Katowice, Poland;
- Correspondence: ; Fax: +48-322071546
| | - Maciej Cebula
- Department of Radiodiagnostics, Invasive Radiology and Nuclear Medicine, Department of Radiology and Nuclear Medicine, Faculty of Medicine in Katowice, Medical University of Silesia in Katowice, Medykow Str 14, 40-752 Katowice, Poland;
| | - Ilona Kopyta
- Department of Paediatric Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Medykow Str 16, 40-752 Katowice, Poland;
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Is early diagnosis of myofascial pain syndrome possible with the detection of latent trigger points by shear wave elastography? Pol J Radiol 2021; 86:e425-e431. [PMID: 34429789 PMCID: PMC8369817 DOI: 10.5114/pjr.2021.108537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/02/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose The aim of the study was to investigate the contribution of shear wave elastography to the diagnosis of myo-fascial pain syndrome (MPS) of the upper part of the trapezius. Material and methods Ethical committee approval was obtained for the study. Thirty volunteer women with trigger points in the upper part of the trapezius muscle and 30 healthy women with a similar age distribution were included in the study. The patient group performed a self-stretching exercise program for 4 weeks. No intervention was applied to the control group. Muscle stiffness values of both groups were evaluated with shear wave elastography (SWE), and pain levels of all volunteers were evaluated by the Visual Analogue Scale at the beginning and the end of the study. The statistical analyses were performed using SPSS version 18.0. Results There was a significant decrease after the treatment in terms of upper trapezius muscle stiffness and the pain levels in the patient group (p < 0.001 and p < 0.001). In the patient group, there was a moderate correlation between the decrease in the pain level and the reductions in muscle stiffness (r = 0.595). In control group, there was no significant difference in terms of both muscle stiffness and pain levels before and after treatment (p > 0.05). Conclusions SWE is a reliable method for detecting latent trigger points in MPS, and it can be used for evaluating the response to treatment.
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Tokunaga A, Shimizu M. Age-related change in shear elastic modulus of the thoracolumbar multifidus muscle in healthy Beagle dogs using ultrasound shear wave elastography. J Vet Sci 2021; 22:e3. [PMID: 33522155 PMCID: PMC7850783 DOI: 10.4142/jvs.2021.22.e3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/19/2020] [Accepted: 10/30/2020] [Indexed: 11/21/2022] Open
Abstract
Background Multifidus muscle stiffness decreases in patients with lumbar intervertebral disk herniation; however, age-related changes in humans have not been reported. Objectives The reliability of ultrasound shear wave elastography in dogs, and changes in the shear elastic modulus of the thoracolumbar multifidus muscle with aging in dogs, were investigated. Methods Twelve beagle dogs were divided into 2 groups based on the age of onset of intervertebral disk herniation: young (aged not exceeding 2 years; 1.3 ± 0.6 years old, n = 5) and adult (4.9 ± 1.2 years old, n = 7). The shear elastic modulus of the multifidus muscle, from the thirteenth thoracic spine to the fourth lumbar spine, was measured using ultrasound shear wave elastography. The length, cross-sectional area and muscle to fat ratio of the multifidus muscle, and the grade of intervertebral disk degeneration, were assessed using radiographic and magnetic resonance imaging examinations. Results The length and cross-sectional area of the multifidus muscle increased caudally. In the young group, the shear elastic modulus of the multifidus muscle of the thirteenth thoracic spine was less than that of the third lumbar spine. In the adult group, the shear elastic modulus of the multifidus muscle of first and third lumbar spine was lower than that of the same site in the young group. Conclusions Ultrasound can be used to measure shear wave elastography of the thoracolumbar multifidus in dogs. If the multifidus muscle stiffness decreases, we should consider age-related change.
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Affiliation(s)
- Akari Tokunaga
- Department of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan
| | - Miki Shimizu
- Department of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan.
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Young BA, Koppenhaver SL, Timo-Dondoyano RM, Baumann K, Scheirer VF, Wolff A, Sutlive TG, Elliott JM. Ultrasound shear wave elastography measurement of the deep posterior cervical muscles: Reliability and ability to differentiate between muscle contraction states. J Electromyogr Kinesiol 2020; 56:102488. [PMID: 33189075 DOI: 10.1016/j.jelekin.2020.102488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 10/22/2020] [Accepted: 10/30/2020] [Indexed: 12/15/2022] Open
Abstract
The deep posterior cervical muscles (DPCM), specifically the semispinalis cervicis and cervical multifidus, are often impaired in patients with neck disorders and have been assessed by several imaging techniques. Prior ultrasound shear wave elastography (SWE) imaging and reliability assessments of the DPCM were performed utilizing similar positioning as assessments for the more superficial cervical extensors. Our objectives were to describe an SWE imaging technique for the DPCM, establish intra-rater reliability of DPCM SWE, and compare DPCM shear modulus during rest and submaximal contraction in both prone and seated positions in individuals without spinal pain. In sixteen participants, the DPCM was located using B-mode ultrasound, then muscle shear modulus was assessed via SWE at both rest and with contraction against a 2-kg resistance applied at the C2 spinous process. Within-day intra-rater reliability was moderate to good (ICC = 0.70-0.88). The DPCM were stiffer during contraction than at rest in the prone position (p = 0.002), and at rest in sitting versus at rest in prone (p = 0.003). Further research is needed to assess DPCM-specific SWE in symptomatic individuals and compare DPCM shear modulus to electromyography across contraction intensities.
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Affiliation(s)
- Brian A Young
- Baylor University Doctoral Program in Physical Therapy, Waco, TX, USA.
| | | | | | - Katrina Baumann
- Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA
| | - Vanessa F Scheirer
- Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA
| | - Axel Wolff
- Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA
| | - Thomas G Sutlive
- Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA
| | - James M Elliott
- The University of Sydney, Faculty of Medicine Health Sciences, & the Northern Sydney Local Health District, The Kolling Research Institute, St. Leonards, NSW, Australia; Northwestern University, Feinberg School of Medicine, Physical Therapy and Human Movement Sciences Chicago, IL, USA
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Lohr C, Schmidt T, Braumann KM, Reer R, Medina-Porqueres I. Sex-Based Differences in Tensiomyography as Assessed in the Lower Erector Spinae of Healthy Participants: An Observational Study. Sports Health 2020; 12:341-346. [PMID: 32511080 DOI: 10.1177/1941738120917932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Although there is mounting evidence on sex-linked differences in paraspinal muscle function, it is unknown whether sex-based variations in mechanical and contractile characteristics of the lumbar erector spinae (LES) can be monitored noninvasively in healthy participants at rest using tensiomyography (TMG). HYPOTHESIS Sex-specific effects in muscle displacement (Dm) and velocity of muscle deformation (Vd) will be observed via TMG assessed in the LES. STUDY DESIGN Observational study. LEVEL OF EVIDENCE Level 3. METHODS LES response was measured in a relaxed state in 40 healthy adults (20 females). Possible differences between the conditions were investigated using mixed-model analyses of variance. Two-stage hierarchical linear regression analyses were performed to predict the outcome of TMG Dm and Vd based on participant sex. RESULTS There were significant main effects of sex with large effect sizes for both TMG parameters, resulting from lower mean values in women compared with men (Dm, P < 0.01; Vd, P < 0.01). In contrast, neither the main effect of side (left vs right LES) nor the interaction between the side and sex reached significance (all P > 0.3). Introducing the sex variable in stage 2 of the regression analyses significantly improved the prediction of the TMG parameters (all ∆R2 ≥ 0.18; all P < 0.01; all f2 ≥ 0.29). CONCLUSION Sex-based differences in muscle stiffness and contractile characteristics could be observed by TMG on LES muscles in healthy individuals at rest. The data suggest that these disparities are not exclusively attributable to anthropometric measures but may be linked to intrinsic sex-based differences in skeletal muscle characteristics. CLINICAL RELEVANCE We recommend implementing TMG in a clinical setting using the obtained results as a basis to factor for the patient's biological sex when assessing effects of therapeutic/exercise regimens aiming at the optimization of myofascial tissue regeneration and performance.
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Affiliation(s)
- Christine Lohr
- Department of Sports Medicine, Institute for Human Movement Science, Faculty for Psychology and Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Tobias Schmidt
- Department of Sports Medicine, Institute for Human Movement Science, Faculty for Psychology and Human Movement Science, University of Hamburg, Hamburg, Germany.,Department of General Practice, University Medical Center Göttingen, Göttingen, Germany.,Osteopathie Schule Deutschland (OSD) Hamburg, Hamburg, Germany
| | - Klaus-Michael Braumann
- Department of Sports Medicine, Institute for Human Movement Science, Faculty for Psychology and Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Rüdiger Reer
- Department of Sports Medicine, Institute for Human Movement Science, Faculty for Psychology and Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Ivan Medina-Porqueres
- Department of Physical Therapy, Faculty of Health Sciences, University of Malaga, Malaga, Spain
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Neck Muscle Stiffness Measured With Shear Wave Elastography in Women With Chronic Nonspecific Neck Pain. J Orthop Sports Phys Ther 2020; 50:179-188. [PMID: 31905095 DOI: 10.2519/jospt.2020.8821] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Utilizing shear wave elastography, we compared the stiffness of the neck extensor muscles and the stiffness in muscle-specific regions between women with chronic nonspecific neck pain and asymptomatic controls. DESIGN Cross-sectional observational study. METHODS We measured the average muscle stiffness over multiple neck extensor muscles and in regions corresponding approximately to the trapezius, splenius capitis, semispinalis capitis, semispinalis cervicis, and multifidus muscles using ultrasound shear wave elastography in 20 women with chronic nonspecific neck pain and 18 asymptomatic women during multiple tasks. The measurements were automatically quality controlled and computer processed over the complete visible neck region or a large muscle-specific region. RESULTS Pooled over all tasks, neck muscle stiffness was not significantly different between those with neck pain and asymptomatic controls (neck pain median, 11.6 kPa; interquartile range, 8.9 kPa and control median, 13.3 kPa; interquartile range, 8.6 kPa; P = .175). The measure of neck muscle stiffness was not correlated with the intensity of neck pain or perceived disability. CONCLUSION Shear wave elastography revealed similar muscle stiffness in people with and without chronic neck pain, despite the sensation of increased neck stiffness in those with chronic neck pain. Therapeutic interventions aiming to reduce neck muscle tone are often based on the assumption that perceived neck stiffness corresponds to objective muscle stiffness. The current results question this assumption. J Orthop Sports Phys Ther 2020;50(4):179-188. Epub 6 Jan 2020. doi:10.2519/jospt.2020.8821.
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Timanin EM, Potekhina YP, Mokhov DE. Studies of the Viscoelastic Characteristics of the Muscles of the Neck and Upper Thorax by the Method of Vibrational Viscoelastometry. BIOMEDICAL ENGINEERING 2020. [DOI: 10.1007/s10527-020-09937-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Xie Y, Thomas L, Hug F, Johnston V, Coombes BK. Quantifying cervical and axioscapular muscle stiffness using shear wave elastography. J Electromyogr Kinesiol 2019; 48:94-102. [PMID: 31272075 DOI: 10.1016/j.jelekin.2019.06.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/10/2019] [Accepted: 06/20/2019] [Indexed: 11/26/2022] Open
Abstract
This study aimed to assess intra-rater (intra-session and inter-day) reliability and influence of side dominance and the scapular resting position on the shear modulus (an index of stiffness) of resting cervical and axioscapular muscles. Sixteen healthy participants were recruited. On day one, ultrasound shear wave elastography was used to measure the shear modulus of superficial and deep cervical extensor and axioscapular muscles bilaterally. Clinical assessments of scapular resting position were performed bilaterally. On day two, testing was repeated on the dominant side. Both intra-session and inter-day reliability were good to excellent for shear modulus of superficial muscles, and poor to excellent for deep muscles. Side differences of shear modulus for posterior upper trapezius were statistically significant but clinically irrelevant. The shear modulus of posterior upper trapezius and middle trapezius were significantly correlated with scapular depression. Ultrasound shear wave elastography is a reliable tool for quantitatively assessing stiffness of superficial cervical and axioscapular muscles. The influence of scapular position should be considered in future comparative studies of healthy controls and patients with neck/shoulder pain. This study provides the necessary first step for future studies on assessing and interpreting the stiffness of cervical and axioscapular muscles for neck and shoulder musculoskeletal disorders.
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Affiliation(s)
- Yanfei Xie
- School of Health and Rehabilitation Science, The University of Queensland, Australia.
| | - Lucy Thomas
- School of Health and Rehabilitation Science, The University of Queensland, Australia
| | - François Hug
- Laboratory "Movement, Interactions, Performance" (EA 4334), UFR STAPS, University of Nantes, France; Institut Universitaire de France (IUF), Paris, France; School of Biomedical Sciences, The University of Queensland, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Science, The University of Queensland, Australia; RECOVER Injury Research Centre, The University of Queensland, Australia
| | - Brooke K Coombes
- School of Health and Rehabilitation Science, The University of Queensland, Australia; School of Allied Health Sciences, Griffith University, Australia
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Paramalingam S, Counsel P, Mastaglia FL, Keen H, Needham M. Imaging in the diagnosis of idiopathic inflammatory myopathies; indications and utility. Expert Rev Neurother 2019; 19:173-184. [PMID: 30661408 DOI: 10.1080/14737175.2019.1572507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of muscle diseases that carry a significant morbidity and mortality risk. The utilization of imaging in the diagnostic pathway of IIM is therefore important to obtain early diagnosis and even monitor patients over time. Areas covered: Magnetic resonance imaging (MRI) has been the main imaging modality used to detect myositis but limitations include cost and accessibility, leading to delays in time to scan, and patient contraindications. This has led to the exploration of other imaging techniques to diagnose and monitor response to therapy. This article is based primarily on a literature search via PubMed using Boolean terms 'myositis' and the various imaging modalities. Expert opinion: Imaging is sensitive to pathology in IIM and may contribute to the diagnostic process. Learning how specific imaging features can distinguish different forms of IIM may allow more rapid diagnosis of myositis subtype and treatment planning, and to monitor disease activity particularly in patients who respond poorly to treatment. However, more work is needed to investigate the validity and relative utility of these imaging modalities.
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Affiliation(s)
- Shereen Paramalingam
- a Department of Rheumatology , Fiona Stanley Hospital , Murdoch , Australia.,b School of Medicine , Notre Dame University Australia , Fremantle , Australia
| | - Peter Counsel
- c Department of Radiology , Perth Radiology Clinic , Subiaco , Australia.,d Department of Radiology , Perth Children's Hospital , Nedlands , Australia
| | - Frank L Mastaglia
- e School of Medicine , University of Western Australia , Crawley , Australia.,f Department of Neurology , Perron Institute for Neurological and translational science , Nedlands , Australia
| | - Helen Keen
- a Department of Rheumatology , Fiona Stanley Hospital , Murdoch , Australia.,e School of Medicine , University of Western Australia , Crawley , Australia.,g School of Medicine , Murdoch University , Murdoch , Australia
| | - Merrilee Needham
- b School of Medicine , Notre Dame University Australia , Fremantle , Australia.,g School of Medicine , Murdoch University , Murdoch , Australia.,h Department of Neurology , Fiona Stanley Hospital , Murdoch , Australia
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