1
|
Caglar S, Ozyemisci-Taskiran O. Evaluation of the Interrater Reliability of Sonographic Measurements of Muscle Thickness of 38 Piriformis Muscles in 19 Patients with Piriformis Syndrome. Med Sci Monit 2024; 30:e943720. [PMID: 38616430 PMCID: PMC11027579 DOI: 10.12659/msm.943720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/06/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND The piriformis muscle is a flat superficial muscle of the deep gluteal muscles that externally rotates the hip. Ultrasound is widely used to identify the piriformis muscle, especially for guidance of the needle during injections; however, its diagnostic use has recently gained popularity. The operator-dependent nature of ultrasound requires demonstration of reliability between operators. This study aimed to evaluate interrater reliability of sonographic measurements of muscle thickness of 38 piriformis muscles in 19 patients with piriformis syndrome. MATERIAL AND METHODS An ultrasound transducer was placed transversely on the sacral spinous process and moved caudo-laterally until the piriformis muscle was visualized under the gluteus maximus while patients were lying in prone position. The thickness of piriformis muscle was measured with a 2 to 5-MHz broadband curvilinear transducer in 3 regions (thickest regions of muscle over the ilium, near the greater trochanter, and near the sacrum). The interrater reliability of measurements of 2 examiners who were blinded to each other's measurements was assessed by intraclass correlation coefficient. RESULTS In total, 114 samples from 38 piriformis muscles of 19 patients with a diagnosis of piriformis syndrome were evaluated by 2 raters in this study. The median (interquartile range) patient age was 41 (15) years. Intraclass correlation coefficient value for overall thickness measurements of piriformis muscle was 0.836. Intraclass correlation coefficient values for 3 different regions were over the ilium, near the greater trochanter, and near the sacrum were 0.777, 0.883, and 0.811, respectively. CONCLUSIONS Ultrasound measurement of piriformis muscle thickness has good interrater reliability.
Collapse
Affiliation(s)
- Sibel Caglar
- Physical Medicine and Rehabilitation Unit, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ozden Ozyemisci-Taskiran
- Department of Physical Medicine and Rehabilitation, Koc University School of Medicine, Istanbul, Turkey
| |
Collapse
|
2
|
Amabile AH, Larson SL, Hoglund LT, Guarnieri JP, McDonald M, Reich MR. Greater number of weekly stairs climbed is associated with lower low back pain prevalence among female but not male physical therapists. PLoS One 2023; 18:e0292489. [PMID: 37797076 PMCID: PMC10553291 DOI: 10.1371/journal.pone.0292489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION Certain cardiovascular health benefits of stair climbing are now widely accepted, but no prior studies have as yet been found linking the quantity of stairs climbed to low back pain (LBP) morbidity. Low back pain is a common musculoskeletal impairment, and research has begun to show an association between LBP and gluteus maximus (GM) weakness. With stair climbing being the activity which most activates GM, the aim of the present research was to assess the relationship between stair ambulation and LBP prevalence. The hypothesis of this cross-sectional study was that individuals with LBP would report a significantly lower numbers of stair flights climbed compared with individuals without LBP. METHODS A survey tool was developed and distributed via email to a convenience sample of orthopedic physical therapists. Survey items included information regarding medical history, physical activity, workplace, and LBP factors, using a one-year prevalence period. RESULTS A total of 363 respondents took the survey and, after application of exclusion criteria, 248 records remained in our final sample. When analyzing all genders together, non LBP (NLBP) respondents reported a mean of 51.62 flights climbed per week; and LBP respondents reported 37.82 flights climbed per week, with P = 0.077. When males and females were analyzed separately, a statistically significant difference in mean number of flights of stairs climbed was found among female respondents (61.51 flights climbed for NLBP and 35.61 flights climbed for LBP females; P = 0.031). When analyzed based on chronicity of LBP, an even stronger association between stairs climbed and LBP prevalence was found for female respondents with acute LBP (P = 0.009). CONCLUSIONS More weekly stairs climbed was associated with a lower LBP prevalence among females, especially with respect to acute LBP. Randomized, longitudinal research is, however, required to confirm a relationship between stair climbing and LBP.
Collapse
Affiliation(s)
- Amy H. Amabile
- Department of Biomedical Education and Data Science, Lewis Katz School of Medicine, Temple University, MERB 457, Philadelphia, PA, United States of America
| | - Sharon L. Larson
- College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Lisa T. Hoglund
- Department of Physical Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - John P. Guarnieri
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Maureen McDonald
- Department of Medical Imaging and Radiation Sciences, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Madeline R. Reich
- Department of Physical Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| |
Collapse
|
3
|
Frącz W, Matuska J, Szyszka J, Dobrakowski P, Szopka W, Skorupska E. The Cross-Sectional Area Assessment of Pelvic Muscles Using the MRI Manual Segmentation among Patients with Low Back Pain and Healthy Subjects. J Imaging 2023; 9:155. [PMID: 37623687 PMCID: PMC10455268 DOI: 10.3390/jimaging9080155] [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: 07/02/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023] Open
Abstract
The pain pathomechanism of chronic low back pain (LBP) is complex and the available diagnostic methods are insufficient. Patients present morphological changes in volume and cross-sectional area (CSA) of lumbosacral region. The main objective of this study was to assess if CSA measurements of pelvic muscle will indicate muscle atrophy between asymptomatic and symptomatic sides in chronic LBP patients, as well as between right and left sides in healthy volunteers. In addition, inter-rater reliability for CSA measurements was examined. The study involved 71 chronic LBP patients and 29 healthy volunteers. The CSA of gluteus maximus, medius, minimus and piriformis were measured using the MRI manual segmentation method. Muscle atrophy was confirmed in gluteus maximus, gluteus minimus and piriformis muscle for over 50% of chronic LBP patients (p < 0.05). Gluteus medius showed atrophy in patients with left side pain occurrence (p < 0.001). Muscle atrophy occurred on the symptomatic side for all inspected muscles, except gluteus maximus in rater one assessment. The reliability of CSA measurements between raters calculated using CCC and ICC presented great inter-rater reproducibility for each muscle both in patients and healthy volunteers (p < 0.95). Therefore, there is the possibility of using CSA assessment in the diagnosis of patients with symptoms of chronic LBP.
Collapse
Affiliation(s)
- Wiktoria Frącz
- Faculty of Biomedical Sciences, Medical University of Lodz, Al. Kosciuszki 4, 90-419 Lodz, Poland;
| | - Jakub Matuska
- Department of Physiotherapy, Poznan University of Medical Sciences, ul. 28 czerwca 1956r. nr 135/147, 61-545 Poznan, Poland;
- Doctoral School, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznań, Poland
- Doctoral School, Rovira I Virgili University, Carrer St. Llorenç No. 21, 43201 Reus, Spain
| | - Jarosław Szyszka
- Opole Rehabilitation Centre in Korfantów, Wyzwolenia 11, 48-317 Korfantów, Poland
| | - Paweł Dobrakowski
- Psychology Institute, Humanitas University in Sosnowiec, 41-200 Sosnowiec, Poland
| | - Wiktoria Szopka
- Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, 60-637 Poznań, Poland
| | - Elżbieta Skorupska
- Department of Physiotherapy, Poznan University of Medical Sciences, ul. 28 czerwca 1956r. nr 135/147, 61-545 Poznan, Poland;
| |
Collapse
|
4
|
Intra-operator Repeatability of Manual Segmentations of the Hip Muscles on Clinical Magnetic Resonance Images. J Digit Imaging 2023; 36:143-152. [PMID: 36219348 PMCID: PMC9984589 DOI: 10.1007/s10278-022-00700-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/11/2022] [Accepted: 09/02/2022] [Indexed: 01/10/2023] Open
Abstract
The manual segmentation of muscles on magnetic resonance images is the gold standard procedure to reconstruct muscle volumes from medical imaging data and extract critical information for clinical and research purposes. (Semi)automatic methods have been proposed to expedite the otherwise lengthy process. These, however, rely on manual segmentations. Nonetheless, the repeatability of manual muscle volume segmentations performed on clinical MRI data has not been thoroughly assessed. When conducted, volumetric assessments often disregard the hip muscles. Therefore, one trained operator performed repeated manual segmentations (n = 3) of the iliopsoas (n = 34) and gluteus medius (n = 40) muscles on coronal T1-weighted MRI scans, acquired on 1.5 T scanners on a clinical population of patients elected for hip replacement surgery. Reconstructed muscle volumes were divided in sub-volumes and compared in terms of volume variance (normalized variance of volumes - nVV), shape (Jaccard Index-JI) and surface similarity (maximal Hausdorff distance-HD), to quantify intra-operator repeatability. One-way repeated measures ANOVA (or equivalent) tests with Bonferroni corrections for multiple comparisons were conducted to assess statistical significance. For both muscles, repeated manual segmentations were highly similar to one another (nVV: 2-6%, JI > 0.78, HD < 15 mm). However, shape and surface similarity were significantly lower when muscle extremities were included in the segmentations (e.g., iliopsoas: HD -12.06 to 14.42 mm, P < 0.05). Our findings show that the manual segmentation of hip muscle volumes on clinical MRI scans provides repeatable results over time. Nonetheless, extreme care should be taken in the segmentation of muscle extremities.
Collapse
|
5
|
The reliability of the measurement of muscle volume using magnetic resonance imaging in typically developing infants by two raters. Sci Rep 2022; 12:18191. [PMID: 36307532 PMCID: PMC9616850 DOI: 10.1038/s41598-022-23087-y] [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: 11/22/2021] [Accepted: 10/25/2022] [Indexed: 12/31/2022] Open
Abstract
To assess intra-rater and inter-rater reliability of the manual segmentation of Magnetic Resonance Imaging (MRI) for the in vivo measurement of infant muscle volume of the knee extensor and flexor muscles by two raters. Muscles of the knee extensor and flexor muscle of ten typically developing infants (86 days ± 7 days) were scanned with MRI (Proton density sequence). Scans were then segmented using Slicer software, and volumes rendered by two raters. Intra-rater and inter-rater reliability were assessed using intra-class correlation (ICC), with mean difference (MD), standard error of the mean (SEM), and minimal detectable change (MDC) for each muscle calculated. ICCs for Intra-rater reliability of the segmentation process for the muscle volume of the muscles of the knee extensors and flexor muscles were 0.901-0.972, and 0.776-0.945 respectively, with inter-rater reliabilities between 0.914-0.954 and 0.848-0.978, for the knee extensor and flexors muscles respectively. For intra-rater reliability, MD ≤ - 0.47 cm3, MDCs for were < 1.09 cm3 and for inter-rater MD ≤ - 1.40 cm3, MDCs for were < 1.63 cm3 for all muscles. MRI segmentation for muscle volumes showed good to excellent reliability, though given the small volumes of the muscles themselves, variations between raters are amplified. Care should be taken in the reporting and interpretation of infant muscle volume.
Collapse
|
6
|
Intra- and Inter-rater Reliability of a Magnetic Resonance Imaging-Based Volumetric Analysis of the Abductor Hallucis Muscle. IRANIAN JOURNAL OF RADIOLOGY 2022. [DOI: 10.5812/iranjradiol-128725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: The muscle volume considerably changes with aging, pathologies, mechanical loading and exercise, and immobilization. It is recognized as an important parameter that can be measured by various methods to evaluate the effectiveness of interventions focusing on muscle strengthening and function. However, before the application of any measurement method, their reliability needs to be investigated and established. Objectives: This study aimed to evaluate the inter- and intra-rater reliability of the manual measurement method of the abductor hallucis muscle volume in feet with hallux valgus deformities using magnetic resonance imaging (MRI). Patients and Methods: The MRI images of the feet of 15 samples with a hallux valgus deformity were selected in this study. The cross-sectional areas of the abductor hallucis muscle were measured in the cuts along the entire length of the foot and multiplied by slice thickness. Two trained raters performed the measurements. The second rater repeated the measurements after five days to eliminate the memory effect. The intra-rater reliability and inter-rater reliability were assessed based on the intraclass correlation coefficient [ICC (2, 1)] to evaluate the extent of agreement between the raters at a 95% confidence interval. Results: The between- and within-rater ICCs were 0.92 (0.79 - 0.97) and 0.99 (0.97 - 0.99), respectively. The standard error of measurements was also small in both inter-rater (6.2%) and intra-rater (2.1%) reliability analyses. Conclusion: The manually outlined slice-by-slice volume measurement of the abductor hallucis muscle based on MRI images showed excellent inter- and intra-rater reliability. The excellent intra-rater reliability, besides the lower standard error percentage of measurements, indicates the superiority of measurements by a single person. However, further studies with a larger sample size are recommended.
Collapse
|
7
|
Piriformis syndrome: muscle thickness or volume does not correlate with response to CT-guided injection. Skeletal Radiol 2022; 51:1407-1414. [PMID: 34921609 DOI: 10.1007/s00256-021-03970-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine whether size of the piriformis muscle, as characterized by either the coronal width or a segmented volume, correlates with outcomes after CT-guided injections. MATERIALS AND METHODS A consecutive series of 81 patients with piriformis syndrome received CT-guided injections of the sciatic nerve and piriformis muscle. Volume and thickness measurements of the piriformis were taken from T1W and T2W pre-injection images by two readers. A logistic regression was used to test volume and size effect on first injection response. A cox proportional hazards model was used to evaluate pain-free survival. Identical analyses were performed to test the effects of muscle mass abnormality, nerve abnormality, body mass index, and presence of a split sciatic nerve. RESULTS There were 15/94 negative responses, 31/94 possible positive responses, and 48/94 positive responses to CT-guided injection. The average pain-free survival time was 38.91 ± 64.43 days. There was no significant correlation of first injection responses with muscle thickness or volume. There was no significant correlation in pain-free survival for muscle thickness or volume. There was no significant correlation in first injection response or pain-free survival with body mass index, muscle abnormalities, nerve abnormalities, or split sciatic nerves. The intraclass correlation was excellent between the two readers for both muscle volume (0.95-0.98) and thickness (0.92-0.97). CONCLUSION Piriformis muscle volume or thickness did not significantly correlate with post-injection outcome (first injection response and pain-free survival). Thus, if the patient has clinical symptoms of piriformis syndrome, the size of muscle should not determine whether injection is advisable.
Collapse
|
8
|
Perraton Z, Lawrenson P, Mosler AB, Elliott JM, Weber KA, Flack NA, Cornwall J, Crawford RJ, Stewart C, Semciw AI. Towards defining muscular regions of interest from axial magnetic resonance imaging with anatomical cross-reference: a scoping review of lateral hip musculature. BMC Musculoskelet Disord 2022; 23:533. [PMID: 35658932 PMCID: PMC9166386 DOI: 10.1186/s12891-022-05439-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/09/2022] [Indexed: 12/03/2022] Open
Abstract
Background Measures of hip muscle morphology and composition (e.g., muscle size and fatty infiltration) are possible with magnetic resonance imaging (MRI). Standardised protocols or guidelines do not exist for evaluation of hip muscle characteristics, hindering reliable and valid inter-study analysis. This scoping review aimed to collate and synthesise MRI methods for measuring lateral hip muscle size and fatty infiltration to inform the future development of standardised protocols. Methods Five electronic databases (Medline, CINAHL, Embase, SportsDISCUS and AMED) were searched. Healthy or musculoskeletal pain populations that used MRI to assess lateral hip muscle size and fatty infiltration were included. Lateral hip muscles of interest included tensor fascia late (TFL), gluteus maximus, gluteus medius, and gluteus minimus. Data on MRI parameters, axial slice location, muscle size and fatty infiltrate measures were collected and analysed. Cross referencing for anatomical locations were made between MRI axial slice and E-12 anatomical plastinate sections. Results From 2684 identified publications, 78 studies contributed data on volume (n = 31), cross sectional area (CSA) (n = 24), and fatty infiltration (n = 40). Heterogeneity was observed for MRI parameters and anatomical boundaries scrutinizing hip muscle size and fatty infiltration. Seven single level axial slices were identified that provided consistent CSA measurement, including three for both gluteus maximus and TFL, and four for both gluteus medius and minimus. For assessment of fatty infiltration, six axial slice locations were identified including two for TFL, and four for each of the gluteal muscles. Conclusions Several consistent anatomical levels were identified for single axial MR slice to facilitate muscle size and fatty infiltration muscle measures at the hip, providing the basis for reliable and accurate data synthesis and improvements in the validity of future between studies analyses. This work establishes the platform for standardised methods for the MRI assessment of lateral hip musculature and will aid in the examination of musculoskeletal conditions around the hip joint. Further studies into whole muscle measures are required to further optimise methodological parameters for hip muscle assessment.
Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05439-x.
Collapse
Affiliation(s)
- Zuzana Perraton
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Peter Lawrenson
- School of Allied Health, La Trobe University, Melbourne, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.,Department of Anatomy, School of Biomedical Sciences, The University of Otago, Dunedin, New Zealand
| | - Andrea B Mosler
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - James M Elliott
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.,Faculty of Medicine and Health and Northern Sydney Local Health District, The University of Sydney, The Kolling Institute, Sydney, Australia.,Department of Physical Therapy and Human Movement Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Kenneth A Weber
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, USA
| | - Natasha Ams Flack
- Department of Anatomy, School of Biomedical Sciences, The University of Otago, Dunedin, New Zealand
| | - Jon Cornwall
- University of Otago, Centre for Early Learning in Medicine, Otago Medical School, Dunedin, New Zealand
| | | | | | - Adam I Semciw
- School of Allied Health, La Trobe University, Melbourne, Australia. .,Allied Health Research, Northern Health, Epping, VIC, Australia.
| |
Collapse
|
9
|
Magnetic Resonance Imaging Evaluation of Changes in Gluteal Muscles After Treatments With the High-Intensity Focused Electromagnetic Procedure. Dermatol Surg 2020; 47:386-391. [DOI: 10.1097/dss.0000000000002764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
10
|
Dorado C, López-Gordillo A, Serrano-Sánchez JA, Calbet JAL, Sanchis-Moysi J. Hypertrophy of Lumbopelvic Muscles in Inactive Women: A 36-Week Pilates Study. Sports Health 2020; 12:547-551. [PMID: 32396038 DOI: 10.1177/1941738120918381] [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: 11/16/2022] Open
Abstract
BACKGROUND The use of Pilates in various fields of sport sciences and rehabilitation is increasing; however, little is known about the muscle adaptations induced by this training method. HYPOTHESIS A standardized Pilates training program for beginners (9 months; 2 sessions of 55 minutes per week) will increase the muscle volume and reduce potential side-to-side asymmetries of the quadratus lumborum, iliopsoas, piriformis, and gluteus muscles (gluteus maximus, medius, and minimus). STUDY DESIGN Controlled laboratory study. LEVEL OF EVIDENCE Level 3. METHOD A total of 12 inactive, healthy women (35.7 ± 5.4 years) without previous experience in Pilates were randomly selected to participate in a supervised Pilates program (36 weeks, twice weekly). Muscle volume (cm3) was determined using magnetic resonance imaging at the beginning and end of the intervention program. Side-to-side asymmetry was calculated as [(left - right volume) × 100/right volume]. RESULTS Small, nonsignificant (P > 0.05) differences in the volume of the quadratus lumborum, iliopsoas, piriformis, and gluteus muscles were observed between pre- and post-Pilates program timepoints. Before and after Pilates, side-to-side asymmetry was less than 6% and nonsignificant in all muscles analyzed. CONCLUSION Modern Pilates performed twice weekly for 9 months did not elicit substantial changes in the volume and degree of asymmetry of the selected lumbopelvic muscles in inactive women. CLINICAL RELEVANCE The benefits of Pilates in rehabilitation or training are likely elicited by neuromuscular rather than morphological adaptations. Pilates has no significant impact on muscle volume and does not alter side-to-side ratios in muscle volume (degree of asymmetry) of the lumbopelvic muscles.
Collapse
Affiliation(s)
- Cecilia Dorado
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Ana López-Gordillo
- Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - José A Serrano-Sánchez
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - José A L Calbet
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Joaquín Sanchis-Moysi
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| |
Collapse
|
11
|
Kameda M, Tanimae H, Kihara A, Matsumoto F. Does low back pain or leg pain in gluteus medius syndrome contribute to lumbar degenerative disease and hip osteoarthritis and vice versa? A literature review. J Phys Ther Sci 2020; 32:173-191. [PMID: 32158082 PMCID: PMC7032979 DOI: 10.1589/jpts.32.173] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 11/07/2019] [Indexed: 12/11/2022] Open
Abstract
[Purpose] Gluteus medius syndrome is one of the major causes of back pain or leg pain
and is similar to greater trochanteric pain syndrome, which also presents with back pain
or leg pain. Greater trochanteric pain syndrome is associated with lumbar degenerative
disease and hip osteoarthritis. The objective of this review was to demonstrate gluteus
medius syndrome as a disease entity by reviewing relevant articles to elucidate the
condition. [Methods] Gluteus medius syndrome was defined as myofascial pain syndrome
arising from the gluteus medius. We performed a search of the literature using the
following keywords: “back pain”, “leg pain”, “greater trochanteric pain syndrome”,
“degenerative lumbar disease”, “hip osteoarthritis”, and “gluteus medius”. We reviewed
articles related to gluteus medius syndrome and described the findings in terms of
diagnosis and treatment based on the underlying pathology. [Results] A total of 135
articles were included in this review. Gluteus medius syndrome is similar as a disease
entity to greater trochanteric pain syndrome, which presents with symptoms of low back
pain and leg pain. Gluteus medius syndrome is also related to lumbar degenerative disease,
hip osteoarthritis, knee osteoarthritis, and failed back surgery syndrome. [Conclusion]
Accurate diagnosis of gluteus medius syndrome and appropriate treatment could possibly
improve lumbar degenerative disease and osteoarthritis of the hip and knee, as well as
hip-spine syndrome and failed back surgery syndrome.
Collapse
Affiliation(s)
- Masahiro Kameda
- Senshunkai Hospital: 2-14-26 Kaiden, Nagaokakyo, Kyoto 617-0826, Japan
| | | | - Akinori Kihara
- Kuretake Gakuen Clinical Research Institute of Oriental Medicine, Japan
| | | |
Collapse
|
12
|
Sadler S, Cassidy S, Peterson B, Spink M, Chuter V. Gluteus medius muscle function in people with and without low back pain: a systematic review. BMC Musculoskelet Disord 2019; 20:463. [PMID: 31638962 PMCID: PMC6805550 DOI: 10.1186/s12891-019-2833-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/13/2019] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Globally, low back pain (LBP) is one of the greatest causes of disability. In people with LBP, dysfunction of muscles such as the gluteus medius have been demonstrated to increase spinal loading and reduce spinal stability. Differences in gluteus medius function have been reported in those with LBP compared to those without, although this has only been reported in individual studies. The aim of this systematic review was to determine if adults with a history, or current LBP, demonstrate differences in measures of gluteus medius function when compared to adults without LBP. METHODS MEDLINE, EMBASE, AMED, PsycINFO, PubMED, Pro Quest Database, CINAHL and SPORTDiscus were searched from inception until December 2018 for published journal articles and conference abstracts. No language restrictions were applied. Only case-control studies with participants 18 years and over were included. Participants could have had any type and duration of LBP. Studies could have assessed gluteus medius function with any quantifiable clinical assessment or measurement tool, with the participant non-weight bearing or weight bearing, and during static or dynamic activity. Quality appraisal and data extraction were independently performed by two authors. RESULTS The 24 included articles involved 1088 participants with LBP and 998 without LBP. The gluteus medius muscle in participants with LBP tended to demonstrate reduced strength and more trigger points compared to the gluteus medius muscle of those without LBP. The level of activity, fatigability, time to activate, time to peak activation, cross sectional area, and muscle thickness showed unclear results. Meta-analysis was not performed due to the heterogeneity of included studies. CONCLUSION Clinically, the findings from this systematic review should be considered when assessing and managing patients with LBP. Future studies that clearly define the type and duration of LBP, and prospectively assess gluteus medius muscle function in those with and without LBP are needed. TRIAL REGISTRATION PROSPERO ( CRD42017076773 ).
Collapse
Affiliation(s)
- Sean Sadler
- Discipline of Podiatry, University of Newcastle, Ourimbah, NSW, 2258, Australia.
| | - Samuel Cassidy
- Discipline of Podiatry, University of Newcastle, Ourimbah, NSW, 2258, Australia
| | - Benjamin Peterson
- Discipline of Podiatry, University of Newcastle, Ourimbah, NSW, 2258, Australia
| | - Martin Spink
- Discipline of Podiatry, University of Newcastle, Ourimbah, NSW, 2258, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
| | - Vivienne Chuter
- Discipline of Podiatry, University of Newcastle, Ourimbah, NSW, 2258, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
| |
Collapse
|
13
|
Pourahmadi M, Asadi M, Dommerholt J, Yeganeh A. Changes in the macroscopic morphology of hip muscles in low back pain. J Anat 2019; 236:3-20. [PMID: 31475359 DOI: 10.1111/joa.13086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2019] [Indexed: 01/11/2023] Open
Abstract
Low back pain is a major health issue affecting the lumbopelvic muscles. Morphological changes in hip muscles, such as alterations in the muscle cross-sectional area and muscle volume, may occur in patients with low back pain. This systematic review was conducted to investigate whether patients with low back pain have macroscopic changes in their hip muscle morphology compared with asymptomatic, healthy individuals, based on current evidence. The electronic databases of PubMed/Medline, Ovid, Scopus, Embase® , and Google Scholar were searched from the inception to August 31, 2018. We only included full texts of original studies regarding macroscopic morphological alterations, including atrophy and fat infiltration, in hip muscles of patients with low back pain compared with asymptomatic controls. The quality of the included studies was determined using an assessment tool based on the Newcastle-Ottawa Scale. The scale was modified for the purposes of this study. Sixteen comparative observational studies were found eligible to be included in this review. Eleven were classified as high quality and four as moderate quality. The morphological changes in the psoas major, gluteus maximus, gluteus medius, gluteus minimus, and piriformis muscles were assessed in the primary studies. All selected studies were considered B level of evidence studies. The strength of conclusions for the psoas major, gluteal, and piriformis muscles was moderate. The results revealed that there is substantial controversy about the morphological changes in hip muscles in patients with low back pain; however, the majority of high-quality studies concluded that atrophy of hip muscles is evident in patients with low back pain. The psoas major muscle was the most commonly investigated hip muscle for morphological changes. Major methodological limitations of the included studies were identified and discussed. The present systematic review does not include a formal meta-analysis because of very significant differences in the primary studies in terms of study populations and methodologies. Finally, in clinical practice, it is recommended that physical therapists develop exercise programs to improve hip muscle function in patients with low back pain.
Collapse
Affiliation(s)
- Mohammadreza Pourahmadi
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Asadi
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ali Yeganeh
- Trauma and Injury Research Center, Rasoul Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
14
|
Tan BKL, Khan RJK, Haebich SJ, Maor D, Blake EL, Breidahl WH. Piriformis-Sparing Minimally Invasive Versus the Standard Posterior Approach for Total Hip Arthroplasty: A 10-Year Follow-Up of a Randomized Control Trial. J Arthroplasty 2019; 34:319-326. [PMID: 30442467 DOI: 10.1016/j.arth.2018.10.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 10/07/2018] [Accepted: 10/09/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Despite the popularity of minimally invasive approaches in total hip arthroplasty, studies regarding their impact on soft tissues and long-term benefits are lacking. This study aims to compare the 10-year functional outcome of the piriformis-sparing minimally invasive approach to the standard posterior approach for total hip arthroplasty surgery. METHODS Hundred patients were randomized, 48 patients to the piriformis-sparing approach and 52 to the standard approach. Primary outcomes were hip function and piriformis muscle volume and grade on magnetic resonance imaging. Secondary outcomes were pain, satisfaction score, and complications. Evaluators were blinded to allocation. Participants were followed up to 10 years. RESULTS Ten years following surgery, both groups reported excellent pain relief, improved hip function, and high satisfaction. The significant differences were improvement in piriformis muscle volume (P = .001) and muscle grade (P = .007) in the piriformis-sparing group compared to the standard group. There were no significant differences in all other outcomes. CONCLUSION Aside from being less injurious to the piriformis muscle, the piriformis-sparing approach offered the same long-term functional benefits as the standard posterior approach at 10 years.
Collapse
Affiliation(s)
- Brady K L Tan
- Department of Orthopaedics, Hollywood Private Hospital, Nedlands, Western Australia, Australia; The Joint Studio, Hollywood Medical Centre, Nedlands, Western Australia, Australia
| | - Riaz J K Khan
- Department of Orthopaedics, Hollywood Private Hospital, Nedlands, Western Australia, Australia; The Joint Studio, Hollywood Medical Centre, Nedlands, Western Australia, Australia; University of Notre Dame, Fremantle, Western Australia, Australia
| | - Samantha J Haebich
- The Joint Studio, Hollywood Medical Centre, Nedlands, Western Australia, Australia; Department of Physiotherapy, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Dror Maor
- Fiona Stanley & Fremantle Hospital Group
| | - Emma L Blake
- Department of Physiotherapy, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | | |
Collapse
|
15
|
Pons C, Borotikar B, Garetier M, Burdin V, Ben Salem D, Lempereur M, Brochard S. Quantifying skeletal muscle volume and shape in humans using MRI: A systematic review of validity and reliability. PLoS One 2018; 13:e0207847. [PMID: 30496308 PMCID: PMC6264864 DOI: 10.1371/journal.pone.0207847] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 11/07/2018] [Indexed: 12/11/2022] Open
Abstract
AIMS The aim of this study was to report the metrological qualities of techniques currently used to quantify skeletal muscle volume and 3D shape in healthy and pathological muscles. METHODS A systematic review was conducted (Prospero CRD42018082708). PubMed, Web of Science, Cochrane and Scopus databases were searched using relevant keywords and inclusion/exclusion criteria. The quality of the articles was evaluated using a customized scale. RESULTS Thirty articles were included, 6 of which included pathological muscles. Most evaluated lower limb muscles. Partially or completely automatic and manual techniques were assessed in 10 and 24 articles, respectively. Manual slice-by-slice segmentation reliability was good-to-excellent (n = 8 articles) and validity against dissection was moderate to good(n = 1). Manual slice-by-slice segmentation was used as a gold-standard method in the other articles. Reduction of the number of manually segmented slices (n = 6) provided good to excellent validity if a sufficient number of appropriate slices was chosen. Segmentation on one slice (n = 11) increased volume errors. The Deformation of a Parametric Specific Object (DPSO) method (n = 5) decreased the number of manually-segmented slices required for any chosen level of error. Other automatic techniques combined with different statistical shape or atlas/images-based methods (n = 4) had good validity. Some particularities were highlighted for specific muscles. Except for manual slice by slice segmentation, reliability has rarely been reported. CONCLUSIONS The results of this systematic review help the choice of appropriate segmentation techniques, according to the purpose of the measurement. In healthy populations, techniques that greatly simplified the process of manual segmentation yielded greater errors in volume and shape estimations. Reduction of the number of manually segmented slices was possible with appropriately chosen segmented slices or with DPSO. Other automatic techniques showed promise, but data were insufficient for their validation. More data on the metrological quality of techniques used in the cases of muscle pathology are required.
Collapse
Affiliation(s)
- Christelle Pons
- Pediatric rehabilitation department, Fondation ILDYS, Brest, France
- Laboratoire de Traitement de l’Information Médicale, INSERM, Brest, France
| | - Bhushan Borotikar
- Laboratoire de Traitement de l’Information Médicale, INSERM, Brest, France
| | - Marc Garetier
- Laboratoire de Traitement de l’Information Médicale, INSERM, Brest, France
- Radiology department, hôpital d'Instruction des Armées Clermont-Tonnerre, Brest, France
| | - Valérie Burdin
- Laboratoire de Traitement de l’Information Médicale, INSERM, Brest, France
- IMT Atlantique, Brest, France
| | - Douraied Ben Salem
- Laboratoire de Traitement de l’Information Médicale, INSERM, Brest, France
- Université de Bretagne Occidentale, Brest, France
- Radiology department, CHRU de Brest, Brest, France
| | - Mathieu Lempereur
- Laboratoire de Traitement de l’Information Médicale, INSERM, Brest, France
- Université de Bretagne Occidentale, Brest, France
- PMR department, CHRU de Brest, Hopital Morvan, Brest, France
| | - Sylvain Brochard
- Pediatric rehabilitation department, Fondation ILDYS, Brest, France
- Laboratoire de Traitement de l’Information Médicale, INSERM, Brest, France
- Université de Bretagne Occidentale, Brest, France
- PMR department, CHRU de Brest, Hopital Morvan, Brest, France
| |
Collapse
|
16
|
Garneau AP, de Cotret PR, Tesolin M, Isenring P. Progressive renal failure complicated by transient and recurrent ureteral obstruction. CMAJ 2018; 190:E1168-E1170. [PMID: 30274994 DOI: 10.1503/cmaj.180514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Alexandre P Garneau
- Nephrology Center (Garneau, Isenring, de Cotret); Departments of Radiology of the L'Hôtel-Dieu de Québec Hospital and Medicine (Tesolin), Faculty of Medicine, Laval University, Québec, Que.; Cardiometabolic Research Group (Garneau), Department of Kinesiology, University of Montreal, Montréal, Que
| | - Paul René de Cotret
- Nephrology Center (Garneau, Isenring, de Cotret); Departments of Radiology of the L'Hôtel-Dieu de Québec Hospital and Medicine (Tesolin), Faculty of Medicine, Laval University, Québec, Que.; Cardiometabolic Research Group (Garneau), Department of Kinesiology, University of Montreal, Montréal, Que
| | - Maude Tesolin
- Nephrology Center (Garneau, Isenring, de Cotret); Departments of Radiology of the L'Hôtel-Dieu de Québec Hospital and Medicine (Tesolin), Faculty of Medicine, Laval University, Québec, Que.; Cardiometabolic Research Group (Garneau), Department of Kinesiology, University of Montreal, Montréal, Que
| | - Paul Isenring
- Nephrology Center (Garneau, Isenring, de Cotret); Departments of Radiology of the L'Hôtel-Dieu de Québec Hospital and Medicine (Tesolin), Faculty of Medicine, Laval University, Québec, Que.; Cardiometabolic Research Group (Garneau), Department of Kinesiology, University of Montreal, Montréal, Que.
| |
Collapse
|
17
|
Muscle Atrophy Measurement as Assessment Method for Low Back Pain Patients. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1088:437-461. [PMID: 30390264 DOI: 10.1007/978-981-13-1435-3_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Low back pain is one of the most common pain disorders defined as pain, muscle tension, or stiffness localized below the costal margin and above the inferior gluteal folds, sometimes with accompanying leg pain. The meaning of the symptomatic atrophy of paraspinal muscles and some pelvic muscles has been proved. Nowadays, a need for new diagnostic tools for specific examination of low back pain patients is posited, and it has been proposed that magnetic resonance imaging assessment toward muscle atrophy may provide some additional information enabling the subclassification of that group of patients.
Collapse
|
18
|
Centeno C, Markle J, Dodson E, Stemper I, Williams CJ, Hyzy M, Ichim T, Freeman M. Treatment of lumbar degenerative disc disease-associated radicular pain with culture-expanded autologous mesenchymal stem cells: a pilot study on safety and efficacy. J Transl Med 2017; 15:197. [PMID: 28938891 PMCID: PMC5610473 DOI: 10.1186/s12967-017-1300-y] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 09/14/2017] [Indexed: 12/17/2022] Open
Abstract
Background Degenerative disc disease (DDD) is a common cause of lower back pain with radicular symptoms and has a significant socioeconomic impact given the associated disability. Limited effective conservative therapeutic options result in many turning to surgical alternatives for management, which vary in the rate of success and also carry an increased risk of morbidity and mortality associated with the procedures. Several animal based studies and a few human pilot studies have demonstrated safety and suggest efficacy in the treatment of DDD with mesenchymal stem cells (MSCs). The use of bone marrow-derived MSCs for the treatment of DDD is promising and in the present study we report on the safety and efficacy findings from a registry based proof of concept study using a percutaneous intradiscal injection of cultured MSCs for the management of DDD with associated radicular symptoms. Methods Thirty-three patients with lower back pain and disc degeneration with a posterior disc bulge diagnosed on magnetic resonance imaging (MRI) met the inclusion criteria and were treated with culture-expanded, autologous, bone marrow-derived MSCs. Prospective registry data was obtained at multiple time intervals up to 6 years post-treatment. Collected outcomes included numeric pain score (NPS), a modified single assessment numeric evaluation (SANE) rating, functional rating index (FRI), measurement of the intervertebral disc posterior dimension, and adverse events. Results Three patients reported pain related to procedure that resolved. There were no serious adverse events (i.e. death, infection, or tumor) associated with the procedure. NPS change scores relative to baseline were significant at 3, 36, 48, 60, and 72 months post-treatment. The average modified SANE ratings showed a mean improvement of 60% at 3 years post-treatment. FRI post-treatment change score averages exceeded the minimal clinically important difference at all time points except 12 months. Twenty of the patients treated underwent post-treatment MRI and 85% had a reduction in disc bulge size, with an average reduction size of 23% post-treatment. Conclusions Patients treated with autologous cultured MSCs for lower back pain with radicular symptoms in the setting of DDD reported minor adverse events and significant improvements in pain, function, and overall subjective improvement through 6 years of follow-up. NCT03011398. A Clinical Registry of Orthobiologics Procedures. https://clinicaltrials.gov/ct2/show/NCT03011398?term=orthobiologics&rank=1
Collapse
Affiliation(s)
- Christopher Centeno
- Centeno-Schultz Clinic, Broomfield, CO, 80021, USA.,Regenerative Sciences, LLC, 403 Summit Blvd Suite 201, Broomfield, CO, 80021, USA
| | - Jason Markle
- Centeno-Schultz Clinic, Broomfield, CO, 80021, USA
| | - Ehren Dodson
- Regenerative Sciences, LLC, 403 Summit Blvd Suite 201, Broomfield, CO, 80021, USA.
| | - Ian Stemper
- Regenerative Sciences, LLC, 403 Summit Blvd Suite 201, Broomfield, CO, 80021, USA
| | | | - Matthew Hyzy
- Centeno-Schultz Clinic, Broomfield, CO, 80021, USA
| | | | - Michael Freeman
- CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| |
Collapse
|
19
|
Atrophy of gluteus maximus among women with a history of chronic low back pain. PLoS One 2017; 12:e0177008. [PMID: 28715424 PMCID: PMC5513394 DOI: 10.1371/journal.pone.0177008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 04/20/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although the relationship between low back pain (LBP) and the size of certain trunk muscles has been extensively studied, the relationship between gluteus maximus (GM) size and LBP has been only minimally examined. Determining whether such a relationship exists would help improve our understanding of the etiology of LBP, and possibly provide a rationale for the use of therapeutic exercise interventions targeting GM with LBP patients. The objective of this study was to compare gluteus maximus cross-sectional area in individuals with chronic LBP, and in a group of individuals without LBP. Our hypothesis was that individuals with LBP would have greater atrophy in their gluteus maximus muscles than our control group. MATERIALS AND METHODS For this case-control study, we analyzed medical history and pelvic computed tomography (CT) scans for 36 female patients with a history of chronic LBP, and 32 female patients without a history of LBP. Muscle cross-sectional area of gluteus maximus was measured from axial CT scans using OsiriX MD software, then was normalized to patient height, and used to compare the two groups. The number of back pain-related medical visits was also correlated with gluteus maximus cross-sectional area. RESULTS Mean normalized cross-sectional area was significantly smaller in the LBP group than in the control group, with t = 2.439 and P<0.05. The number of back pain-related visits was found to be significantly correlated with normalized cross-sectional area, with r = -0.270 and P<0.05. The atrophy seen in the present research may reflect incidental disuse atrophy seen with LBP, which is present in many muscle groups after prolonged immobilization or with a sedentary lifestyle. CONCLUSIONS This research demonstrated a previously only minimally explored relationship between gluteus maximus cross-sectional area and LBP in women. Further research is indicated in individuals with varying age, sex, and LBP diagnoses.
Collapse
|
20
|
Lube J, Flack NAMS, Cotofana S, Özkurtul O, Woodley SJ, Zachow S, Hammer N. Pelvic and lower extremity physiological cross-sectional areas: an MRI study of the living young and comparison to published research literature. Surg Radiol Anat 2017; 39:849-857. [DOI: 10.1007/s00276-016-1807-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 12/19/2016] [Indexed: 10/20/2022]
|