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Cai S, Lin Y, Chen H, Huang Z, Zhou Y, Zheng Y. Automated analysis of pectoralis major thickness in pec-fly exercises: evolving from manual measurement to deep learning techniques. Vis Comput Ind Biomed Art 2024; 7:8. [PMID: 38625580 PMCID: PMC11021386 DOI: 10.1186/s42492-024-00159-6] [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: 12/05/2023] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
This study addresses a limitation of prior research on pectoralis major (PMaj) thickness changes during the pectoralis fly exercise using a wearable ultrasound imaging setup. Although previous studies used manual measurement and subjective evaluation, it is important to acknowledge the subsequent limitations of automating widespread applications. We then employed a deep learning model for image segmentation and automated measurement to solve the problem and study the additional quantitative supplementary information that could be provided. Our results revealed increased PMaj thickness changes in the coronal plane within the probe detection region when real-time ultrasound imaging (RUSI) visual biofeedback was incorporated, regardless of load intensity (50% or 80% of one-repetition maximum). Additionally, participants showed uniform thickness changes in the PMaj in response to enhanced RUSI biofeedback. Notably, the differences in PMaj thickness changes between load intensities were reduced by RUSI biofeedback, suggesting altered muscle activation strategies. We identified the optimal measurement location for the maximal PMaj thickness close to the rib end and emphasized the lightweight applicability of our model for fitness training and muscle assessment. Further studies can refine load intensities, investigate diverse parameters, and employ different network models to enhance accuracy. This study contributes to our understanding of the effects of muscle physiology and exercise training.
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Affiliation(s)
- Shangyu Cai
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Yongsheng Lin
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Haoxin Chen
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Zihao Huang
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong, 999077, China
| | - Yongjin Zhou
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China.
| | - Yongping Zheng
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong, 999077, China.
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Skibski A, Stout JR, Ingersoll CD, Mangum LC. Ultrasound Biofeedback Increases Abdominal Muscle Activation in Golfers With a History of Low Back Pain. Clin J Sport Med 2024:00042752-990000000-00174. [PMID: 38329285 DOI: 10.1097/jsm.0000000000001208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/18/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVES To compare activation ratios of the transverse abdominis (TrA) during an abdominal draw-in maneuver (ADIM) and abdominal obliques during a golf swing, with and without ultrasound biofeedback, and to determine intrarater reliability of these ultrasound thickness measures. DESIGN Single-session crossover study. SETTING Laboratory. PARTICIPANTS Sixteen adult golfers with 2 or more episodes of low back pain (LBP) in the past year. INTERVENTIONS Verbal cueing alone and verbal cueing with ultrasound biofeedback. MAIN OUTCOME MEASURES Bilateral TrA activation ratios were calculated during an ADIM with and without ultrasound biofeedback. Activation ratios of the abdominal obliques were calculated bilaterally during golf swings with and without ultrasound biofeedback. Intraclass correlation coefficients (ICCs) were calculated for average thickness across all muscles and conditions for the nonbiofeedback trials. RESULTS Transverse abdominis activation ratios were significantly higher when ultrasound biofeedback was provided bilaterally ( P < 0.001). Abdominal oblique activation ratios during the golf swing were also significantly higher with ultrasound biofeedback for the lead ( P = 0.014) and trail ( P < 0.001) sides. Intraclass correlation coefficient values ranged from 0.92 to 0.97 ( P < 0.001). CONCLUSIONS Ultrasound biofeedback can increase activation ratios of the TrA during a supine ADIM in adult golfers with a history of LBP. Postswing ultrasound biofeedback increases activation of the abdominal obliques during a golf swing in golfers with a history of LBP. Ultrasound thickness measures of the TrA and obliques have excellent intrarater reliability.
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Affiliation(s)
- Andrew Skibski
- Rehabilitation, Athletic Assessment, & DYnamic Imaging (READY) Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, Florida
- College of Health Professions and Sciences, University of Central Florida, Orlando, Florida; and
| | - Jeffrey R Stout
- College of Health Professions and Sciences, University of Central Florida, Orlando, Florida; and
- Physiology of Work & Exercise Response (POWER) Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, Florida
| | - Christopher D Ingersoll
- College of Health Professions and Sciences, University of Central Florida, Orlando, Florida; and
| | - L Colby Mangum
- Rehabilitation, Athletic Assessment, & DYnamic Imaging (READY) Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, Florida
- College of Health Professions and Sciences, University of Central Florida, Orlando, Florida; and
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3
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Buffet-García J, Plaza-Manzano G, Varol U, Ríos-León M, Díaz-Arribas MJ, Álvarez-González J, Sánchez-Jorge S, Valera-Calero JA. Reliability of Panoramic Ultrasound in Assessing Rectus Femoris Size, Shape, and Brightness: An Inter-Examiner Study. Bioengineering (Basel) 2024; 11:82. [PMID: 38247959 PMCID: PMC10813357 DOI: 10.3390/bioengineering11010082] [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: 12/05/2023] [Revised: 01/02/2024] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
Extended field-of-view ultrasound (US) imaging, also known as panoramic US, represents a technical advance that allows for complete visualization of large musculoskeletal structures, which are often limited in conventional 2D US images. Currently, there is no evidence examining whether the experience of examiners influences muscle shape deformations that may arise during the glide of the transducer in panoramic US acquisition. As no studies using panoramic US have analyzed whether two examiners with differing levels of experience might obtain varying scores in size, shape, or brightness during the US assessment of the rectus femoris muscle, our aim was to analyze the inter-examiner reliability of panoramic US imaging acquisition in determining muscle size, shape, and brightness between two examiners. Additionally, we sought to investigate whether the examiners' experience plays a significant role in muscle deformations during imaging acquisition by assessing score differences. Shape (circularity, aspect ratio, and roundness), size (cross-sectional area and perimeter), and brightness (mean echo intensity) were analyzed in 39 volunteers. Intraclass correlation coefficients (ICCs), standard error of measurements (SEM), minimal detectable changes (MDC), and coefficient of absolute errors (CAE%) were calculated. All parameters evaluated showed no significant differences between the two examiners (p > 0.05). Panoramic US proved to be reliable, regardless of examiner experience, as no deformations were observed. Further research is needed to corroborate the validity of panoramic US by comparing this method with gold standard techniques.
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Affiliation(s)
- Jorge Buffet-García
- Department of Physiotherapy, Faculty of Health, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain; (J.B.-G.); (J.Á.-G.)
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (G.P.-M.); (M.J.D.-A.); (J.A.V.-C.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - Umut Varol
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
| | - Marta Ríos-León
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Servicio de Salud de Castilla-La Mancha (SESCAM), 45004 Toledo, Spain;
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45004 Toledo, Spain
| | - María José Díaz-Arribas
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (G.P.-M.); (M.J.D.-A.); (J.A.V.-C.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - Javier Álvarez-González
- Department of Physiotherapy, Faculty of Health, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain; (J.B.-G.); (J.Á.-G.)
| | - Sandra Sánchez-Jorge
- Department of Physiotherapy, Faculty of Health, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain; (J.B.-G.); (J.Á.-G.)
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (G.P.-M.); (M.J.D.-A.); (J.A.V.-C.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
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4
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Varol U, Valera-Calero JA, Sánchez-Jiménez E, Fernández-de-las-Peñas C, Ortega-Santiago R, Kobylarz MD, Navarro-Santana MJ. Levator Scapulae Stiffness Measurement Reliability in Individuals with and without Chronic Neck Pain by Experienced and Novel Examiners. SENSORS (BASEL, SWITZERLAND) 2024; 24:277. [PMID: 38203140 PMCID: PMC10781297 DOI: 10.3390/s24010277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/19/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Abstract
The levator scapulae muscle is a key structure in the etiopathology of neck and shoulder musculoskeletal pain. Although previous studies used shear-wave elastography (SWE) for characterizing this muscle elasticity, limited evidence assessed the inter-examiner reliability of this procedure. This study aimed to analyze the inter-examiner reliability for calculating Young's modulus and shear wave speed in a cohort of participants with and without chronic neck pain. A diagnostic accuracy study was conducted, acquiring a set of SWE images at the C5 level in participants with and without neck pain (n = 34 and 33, respectively) by two examiners (one experienced and one novel). After blinding the participants' identity, examiner involved, and side, the stiffness indicators were calculated by an independent rater in a randomized order. Intra-class correlation coefficients (ICC), standard error of measurement, minimal detectable changes, and coefficient of variation were calculated. Both cohorts had comparable sociodemographic characteristics (p > 0.05). No significant levator scapulae elasticity differences were found between genders, sides, or cohorts (all, p > 0.05). Inter-examiner reliability for calculating Young's modulus and shear wave speed was moderate-to-good for assessing asymptomatic individuals (ICC = 0.714 and 0.779, respectively), while poor-to-moderate in patients with neck pain (ICC = 0.461 and 0.546, respectively). The results obtained in this study support the use of this procedure for assessing asymptomatic individuals. However, reliability estimates were unacceptable to support its use for assessing elasticity in patients with chronic neck pain. Future studies might consider that the shear wave speed is more sensitive to detect real changes in comparison with Young's modulus.
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Affiliation(s)
- Umut Varol
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 29222 Alcorcón, Spain; (U.V.); (M.D.K.)
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.V.-C.); (M.J.N.-S.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | | | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Mateusz D. Kobylarz
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 29222 Alcorcón, Spain; (U.V.); (M.D.K.)
- Akademia Terapii Manualnej i Igłoterapii Suchej (ATMIS), 34-400 Nowy Targ, Poland
| | - Marcos José Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.V.-C.); (M.J.N.-S.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Kudo S, Hatanaka M, Kanazawa S, Hirakawa K, Hara S, Tsutsumi M. Effects of short foot exercises with ultrasound bio-feedback on motor learning and foot alignment: A double blinded randomized control trial. J Back Musculoskelet Rehabil 2024; 37:671-678. [PMID: 38160335 DOI: 10.3233/bmr-230163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Short foot exercises (SFE) take a long time to master and require a feedback tool to improve motor learning. OBJECTIVE This study aimed to investigate the effect of bio-feedback of talonavicular joint movements in learning SFE with ultrasound (US) imaging. METHODS This study included thirty-one healthy volunteers and was designed as a double-blind randomized control trial. Subjects were randomly assigned to one of two groups: the control group, which performed SFE under verbal instruction, and the US bio-feedback (USBF) group, which performed SFE with real-time bio-feedback of the talonavicular joint alignment. All subjects underwent two sessions of 5 minutes each, and SFE was performed as a self-exercise, between sessions, for one week. The difference in foot length and navicular height were assessed at baseline, after Session 1, before Session 2, and one week after Session 2. These differences were compared between the two groups using the Mann-Whitney U test. RESULTS In terms of navicular height change, the USBF group (7.5 ± 4.3 mm) was significantly higher than the control group (4.2 ± 3.3 mm) one week after session 2 (p= 0.04, effect size = 0.86). CONCLUSION SFE with USBF is an effective intervention for performing SFE.
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Affiliation(s)
- Shintarou Kudo
- Inclusive Medical Sciences Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
- Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka, Japan
- AR-Ex Medical Research Center, Tokyo, Japan
| | - Mizuki Hatanaka
- Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Seiya Kanazawa
- Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Keisuke Hirakawa
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Shigeyuki Hara
- Inclusive Medical Sciences Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan
- Department of Rehabilitation, Kindai University Nara Hospital, Nara, Japan
| | - Masahiro Tsutsumi
- Inclusive Medical Sciences Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
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Nagae M, Umegaki H, Yoshiko A, Fujita K. Muscle ultrasound and its application to point-of-care ultrasonography: a narrative review. Ann Med 2023; 55:190-197. [PMID: 36538042 PMCID: PMC9788691 DOI: 10.1080/07853890.2022.2157871] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Technological advances of hand-held ultrasound devices and educational programmes for their use, such as point-of-care ultrasonography (POCUS) training, have contributed to the increasing application of these devices in clinical practice. With the greater impact of frailty and sarcopenia in aging societies, attention is being focused on the use of ultrasound for skeletal muscle assessment. In this narrative review, we discuss how ultrasound can be applied to skeletal muscle assessment, especially that of the quadriceps muscle, in clinical practice. Muscle thickness by ultrasound has been shown to have good reliability and validity for the evaluation of muscle size, and echo intensity has been used to evaluate muscle quality. Muscle ultrasound has not only been useful to diagnose sarcopenia in various settings, but has also been validated to predict health-related outcomes such as death and functional disability. Recommended methods for muscle ultrasound was published recently, and the results of future studies are expected to be comparable. Although several challenging issues with muscle ultrasound remain, if it could be incorporated into educational programmes such as POCUS training, more clinicians may be able to use ultrasound for skeletal muscle assessment in the future.KEY MESSAGESThe evolution of hand-held ultrasound devices enables physicians to perform ultrasound at the bedside as part of regular medical examinations.Muscle ultrasound is considered an effective tool for evaluating muscle size and quality, and has been studied in various settings.More clinicians may be able to evaluate skeletal muscle assessment with the development of educational programmes on muscle ultrasound in the future.
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Affiliation(s)
- Masaaki Nagae
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Akito Yoshiko
- Faculty of Liberal Arts and Sciences, Chukyo University, Aichi, Japan
| | - Kosuke Fujita
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
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7
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Loomis KJ, Shin J, Roll SC. Current and future utility of ultrasound imaging in upper extremity musculoskeletal rehabilitation: A scoping review. J Hand Ther 2023:S0894-1130(23)00141-2. [PMID: 37863730 DOI: 10.1016/j.jht.2023.09.014] [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: 11/21/2022] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/22/2023]
Abstract
STUDY DESIGN This study was a scoping review. BACKGROUND Continued advances in musculoskeletal sonography technology and access have increased the feasibility of point-of-care use to support day-to-day clinical care and decision-making. Sonography can help improve therapeutic outcomes in upper extremity (UE) rehabilitation by enabling clinicians to visualize underlying structures during treatment. PURPOSE OF THE STUDY This study aimed to (1) evaluate the growth, range, extent, and composition of sonography literature supporting UE rehabilitation; (2) identify trends, gaps, and opportunities with regard to anatomic areas and diagnoses examined and ultrasound techniques used; and (3) evaluate potential research and practice utility. METHODS Searches were completed in PubMed, CINAHL, SPORTDiscus, PsycINFO, and BIOSIS. We included data-driven articles using ultrasound imaging for upper extremity structures in rehabilitation-related conditions. Articles directly applicable to UE rehabilitation were labeled direct articles, while those requiring translation were labeled indirect articles. Articles were further categorized by ultrasound imaging purpose. Article content between the two groups was descriptively compared, and direct articles underwent an evaluation of evidence levels and narrative synthesis to explore potential clinical utility. RESULTS Average publication rates for the final included articles (n = 337) steadily increased. Indirect articles (n = 288) used sonography to explore condition etiology, assess measurement properties, inform medical procedure choice, and grade condition severity. Direct articles (n = 49) used sonography to assess outcomes, inform clinical reasoning, and aid intervention delivery. Acute UE conditions and emerging sonography technology were rarely examined, while tendon, muscle, and soft tissue conditions and grayscale imaging were common. Rheumatic and peripheral nerve conditions and Doppler imaging were more prevalent in indirect than direct articles. Among reported sonography service providers, there was a high proportion of nonradiologist clinicians. CONCLUSION Sonography literature for UE rehabilitation demonstrates potential utility in evaluating outcomes, informing clinical reasoning, and assisting intervention delivery. A large peripheral knowledge base provides opportunities for clinical applications; however, further research is needed to determine clinical efficacy and impact for specific applications.
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Affiliation(s)
- Katherine J Loomis
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.
| | - Jiwon Shin
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Shawn C Roll
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
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Tavahomi M, Dadgoo M, Vasaghi-Gharamaleki B, Talebian S, Emami M, Shanbehzadeh S. Lateral abdominal muscle thickness during breathing maneuvers in women with and without stress urinary incontinence. Int Urogynecol J 2023; 34:1939-1946. [PMID: 36811632 PMCID: PMC9944775 DOI: 10.1007/s00192-023-05458-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/30/2022] [Indexed: 02/24/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Stress urinary incontinence (SUI) patients predominantly experience involuntary leakage during respiratory functions that induce a rapid increase in intra-abdominal pressure (IAP) such as coughing and sneezing. The abdominal muscles have an important role in the forced expiration and modulation of IAP. We hypothesized that SUI patients have different thickness changes in the abdominal muscles compared to healthy individuals during breathing maneuvers. METHODS This case-control study was conducted on 17 adult women with SUI and 20 continent women. Muscle thickness changes were measured by ultrasonography at the end of deep inspiration and expiration, and the expiratory phase of voluntary coughing for external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) muscles. The percent thickness changes of muscles were used and analyzed with a two-way mixed ANOVA test and post-hoc pairwise comparison at a confidence level of 95% (p < 0.05). RESULTS The percent thickness changes of TrA muscle were significantly lower in SUI patients at deep expiration (p < 0.001, Cohen's d = 2.055) and coughing (p < 0.001, Cohen's d=1.691). While, percent thickness changes for EO (p = 0.004, Cohen's d=0.996) and IO thickness (p < 0.001, Cohen's d=1.784) were greater at deep expiration and deep inspiration, respectively. CONCLUSIONS The percent thickness changes of abdominal muscles differed between women with and without SUI during breathing maneuvers. The present study provided information regarding the altered function of abdominal muscles during breathing maneuvers; therefore, it is important to consider the respiratory role of abdominal muscles for the rehabilitation of SUI patients.
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Affiliation(s)
- Mahnaz Tavahomi
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mehdi Dadgoo
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Behnoosh Vasaghi-Gharamaleki
- Rehabilitation Research Center, Department of Rehabilitation Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Saeed Talebian
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Maryam Emami
- Department of Urology, School of Medicine, Hasheminejad Kidney Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Sanaz Shanbehzadeh
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
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9
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Valera-Calero JA, Gómez-Sánchez S, Fernández-de-Las-Peñas C, Plaza-Manzano G, Sánchez-Jorge S, Navarro-Santana MJ. A Procedure for Measuring Anterior Scalene Morphology and Quality with Ultrasound Imaging: An Intra- and Inter-rater Reliability Study. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1817-1823. [PMID: 37188569 DOI: 10.1016/j.ultrasmedbio.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/20/2023] [Accepted: 04/15/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Ultrasound (US) imaging is an essential tool for clinicians because of its cost-effectiveness and accessibility for assessing multiple muscle metrics including muscle quality, size and shape. Although previous studies highlighted the importance of the anterior scalene muscle (AS) in patients with neck pain, studies analyzing the reliability of US measurements for this muscle are lacking. This study aimed to develop a protocol for assessing AS muscle shape and quality measured with US and investigating its intra- and inter-examiner reliability. METHODS Through use of a linear transducer, B-mode images of the anterolateral neck region at the C7 level were acquired in 28 healthy volunteers by two examiners (one experienced and one novel). Cross-sectional area, perimeter, shape descriptors and mean echo-intensity were measured twice by each examiner in randomized order. Intra-class correlation coefficients (ICCs), standard errors of measurement and minimal detectable changes were calculated. RESULTS Results indicated no muscle side-to-side asymmetries (p > 0.05). Gender differences were found for muscle size (p < 0.01), but muscle shape and brightness were comparable (p > 0.05). Intra-examiner reliability was good to excellent for all metrics for the experienced and (ICC >0.846) and novel (ICC >780) examiners. Although inter-examiner reliability was good for most of the metrics (ICC >0.709), the estimates for assessing solidity and circularity were unacceptable (ICC <0.70). CONCLUSION This study found that the described ultrasound procedure for locating and measuring anterior scalene muscle morphology and quality is highly reliable in asymptomatic individuals.
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Affiliation(s)
- Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain; Grupo In Physio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain; Grupo In Physio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Sandra Sánchez-Jorge
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain
| | - Marcos José Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain; Grupo In Physio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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10
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Perotti L, Stamm O, Mesletzky L, Vorwerg S, Fournelle M, Müller-Werdan U. Needs and Attitudes of Older Chronic Back Pain Patients towards a Wearable for Ultrasound Biofeedback during Stabilization Exercises: A Qualitative Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4927. [PMID: 36981835 PMCID: PMC10049307 DOI: 10.3390/ijerph20064927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
Chronic back pain has a high prevalence, especially in older adults, and seriously affects sufferers' quality of life. Segmental stabilization exercise (SSE) is often used during physiotherapy to enhance core stability. The execution of SSE requires the selective contraction of deep abdominal and back muscles. Motor learning can be supported using ultrasound imaging as visual biofeedback. ULTRAWEAR is a mobile ultrasound system that provides deep learning-based biofeedback on SSE execution, which is currently under development. We interviewed 15 older chronic back pain patients (CBPPs) to investigate their pain management behavior, experience with SSE, as well as their needs and requirements for ULTRAWEAR. We also gathered information about future-usage scenarios. CBPPs reported a high willingness to use the system as a feedback tool both in physiotherapeutic practices and at home. The automated detection and evaluation of muscle contraction states was highlighted as a major benefit of the system compared to the more subjective feedback provided by traditional methods such as palpation. The system to be developed was perceived as a helpful solution to support learning about SSE.
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Affiliation(s)
- Luis Perotti
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Oskar Stamm
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Lisa Mesletzky
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Susan Vorwerg
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Marc Fournelle
- Department of Ultrasound, Fraunhofer Institute for Biomedical Engineering, 66280 Sulzbach, Germany
| | - Ursula Müller-Werdan
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
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Varol U, Navarro-Santana MJ, Valera-Calero JA, Antón-Ramírez S, Álvaro-Martínez J, Díaz-Arribas MJ, Fernández-de-las-Peñas C, Plaza-Manzano G. Convergent Validity between Electromyographic Muscle Activity, Ultrasound Muscle Thickness and Dynamometric Force Measurement for Assessing Muscle. SENSORS (BASEL, SWITZERLAND) 2023; 23:2030. [PMID: 36850629 PMCID: PMC9967681 DOI: 10.3390/s23042030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Muscle fatigue is defined as a reversible decline in performance after intensive use, which largely recovers after a resting period. Surface electromyography (EMG), ultrasound imaging (US) and dynamometry are used to assess muscle activity, muscle morphology and isometric force capacity. This study aimed to assess the convergent validity between these three methods for assessing muscle fatigue during a manual prehension maximal voluntary isometric contraction (MVIC). A diagnostic accuracy study was conducted, enrolling 50 healthy participants for the measurement of simultaneous changes in muscle thickness, muscle activity and isometric force using EMG, US and a hand dynamometer, respectively, during a 15 s MVIC. An adjustment line and its variance (R2) were calculated. Muscle activity and thickness were comparable between genders (p > 0.05). However, men exhibited lower force holding capacity (p < 0.05). No side-to-side or dominance differences were found for any variable. Significant correlations were found for the EMG slope with US (r = 0.359; p < 0.01) and dynamometry (r = 0.305; p < 0.01) slopes and between dynamometry and US slopes (r = 0.227; p < 0.05). The sample of this study was characterized by comparable muscle activity and muscle thickness change between genders. In addition, fatigue slopes were not associated with demography or anthropometry. Our findings showed fair convergent associations between these methods, providing synergistic muscle fatigue information.
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Affiliation(s)
- Umut Varol
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28933 Alcorcón, Spain
| | - Marcos J. Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
| | - Sergio Antón-Ramírez
- VALTRADOFI Research Group, Universidad Camilo José Cela, 28692 Villanueva de la Cañada, Spain
| | - Javier Álvaro-Martínez
- VALTRADOFI Research Group, Universidad Camilo José Cela, 28692 Villanueva de la Cañada, Spain
| | - María José Díaz-Arribas
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia, Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
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12
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Antonio Valera-Calero J, Plaza-Manzano G, Ortega-Santiago R, Fernández-de-Las-Peñas C, Varol U. Panoramic ultrasound imaging does not produce muscle morphology deformation during imaging acquisition: A validity study. Phys Med 2023; 106:102530. [PMID: 36634596 DOI: 10.1016/j.ejmp.2023.102530] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/30/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Despite panoramic ultrasound imaging (US) is a promising advance for the morphological and histological assessment of large musculature which cannot be entirely assessed using B-mode, there is no evidence assessing if this technology produces muscle deformation during imaging acquisition. We aimed to analyze differences in size, shape and brightness descriptors between B-mode and panoramic US images and to assess the concordance between both methods. Methods We analyzed size (cross-sectional area and perimeter), shape (circularity, aspect ratio and roundness) and brightness (mean echo-intensity) features of cervical multifidus (CM) and short rotators (SR) in 46 healthy volunteers. Images were acquired in B-mode and extended field-of-view mode. For validity analysis, mean differences between methods were calculated. For agreement analysis, intraclass correlation coefficients (ICCs), standard error of measurements (SEM), minimal detectable changes (MDC) and coefficient of variation (CV%) were calculated. RESULTS All parameters showed no significant differences between both methods for either CM or SR (P > 0.05). Panoramic US showed excellent concordance with B-mode for assessing all CM parameters (all ICCs > 0.9), while for SR the agreement ranged from good-to-excellent (ICC from 0.861 to 0.978). CONCLUSION Panoramic US seems to be a valid tool for assessment of muscle size, shape and brightness as no deformation in comparison with B-mode images was seen. Further research is needed to corroborate these findings comparing panoramic US imaging with Gold Standard methods.
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Affiliation(s)
- Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, Spain; Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, Spain; Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Umut Varol
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28933 Alcorcón, Spain
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13
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Varol U, Navarro-Santana MJ, Gómez-Sánchez S, Plaza-Manzano G, Sánchez-Jiménez E, Valera-Calero JA. Inter-Examiner Disagreement for Assessing Cervical Multifidus Ultrasound Metrics Is Associated with Body Composition Features. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23031213. [PMID: 36772252 PMCID: PMC9921918 DOI: 10.3390/s23031213] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/06/2023] [Accepted: 01/18/2023] [Indexed: 05/28/2023]
Abstract
Ultrasound imaging (US) is a biosensing technique that is widely used in several healthcare disciplines (including physiotherapy) for assessing multiple muscle metrics, such as muscle morphology and quality. Since all biosensors need to be tested in order to demonstrate their reliability, accuracy, sensitivity, and specificity, identifying factors that affect their diagnostic accuracy is essential. Since previous studies analyzed the impact of sociodemographic but not body composition characteristics in US errors, this study aimed to assess whether body composition metrics are associated with ultrasound measurement errors. B-mode images of the lumbar multifidus muscle at the L5 level were acquired and analyzed in 47 healthy volunteers by two examiners (one experienced and one novice). The cross-sectional area, muscle perimeter, and mean echo intensity were calculated bilaterally. A correlation analysis and a multivariate linear regression model were used for assessing the inter-examiner differences with respect to body composition metrics. The results demonstrated good-to-excellent reliability estimates for the cross-sectional area, muscle perimeter, aspect ratio, roundness, circularity, and mean brightness metrics (all ICC > 0.85). However, solidity showed unacceptable reliability (ICC < 0.7). Age, height, total lean mass, trunk lean mass, and water volume were associated with inter-examiner disagreement on mean echo intensity. Cross-sectional area, perimeter, and roundness measurement errors were associated with lean mass and water volume.
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Affiliation(s)
- Umut Varol
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 29222 Alcorcón, Spain
| | | | - Sonia Gómez-Sánchez
- Faculty of Health, Universidad Católica de Ávila, C/Canteros, s/n, 05005 Ávila, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Elena Sánchez-Jiménez
- Faculty of Health, Universidad Católica de Ávila, C/Canteros, s/n, 05005 Ávila, Spain
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Ultrasonography as Biofeedback to Increase Muscle Activation During the Mendelsohn Maneuver in Healthy Adults. Dysphagia 2022:10.1007/s00455-022-10542-1. [DOI: 10.1007/s00455-022-10542-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022]
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15
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Valera-Calero JA, Navarro-Santana MJ, Plaza-Manzano G, Fernández-de-las-Peñas C, Ortega-Santiago R. Identifying Demographic, Clinical, Muscular and Histological Factors Associated with Ultrasound Cervical Multifidus Measurement Errors in a Chronic Neck Pain Population. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22218344. [PMID: 36366042 PMCID: PMC9653930 DOI: 10.3390/s22218344] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 06/01/2023]
Abstract
Ultrasound imaging (US) is a widely used imaging tool in physiotherapy for assessing muscle morphology and quality, among other purposes, such as ensuring the patients’ safety during invasive procedures or providing visual feedback during motor control exercises. Identifying factors associated with measurement errors is essential to target avoid bias in high-risk of bias populations. Therefore, this study aimed to assess whether demographic, clinical, muscular and histological factors are associated with ultrasound measurement errors in patients with idiopathic chronic neck pain. B-mode images were acquired and analyzed in 126 patients with chronic neck pain by two experienced examiners. Cross-sectional area, muscle perimeter, mean echo intensity and percentage of fatty infiltration were analyzed. The interexaminer agreement was assessed by calculating the absolute error, intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable changes (MDC). A Pearson’s correlation matrix including all variables was calculated to conduct a multivariate linear stepwise regression model for estimating the explained variance for each measurement error. Results demonstrated excellent reliability (ICC = 0.965) for assessing the cross-sectional area, and good reliability for assessing the muscle perimeter, mean echo intensity and intramuscular infiltrates estimation (ICC = 0.898, 0.882 and 0.758, respectively). Although clinical variables were not associated with measurement errors (p > 0.05), multiple correlations were found between demographic and cervical multifidus characteristics with measurement errors.
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Affiliation(s)
- Juan Antonio Valera-Calero
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
| | | | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
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Morales-Sánchez V, Falcó C, Hernández-Mendo A, Reigal RE. Efficacy of Electromyographic Biofeedback in Muscle Recovery after Meniscectomy in Soccer Players. SENSORS 2022; 22:s22114024. [PMID: 35684645 PMCID: PMC9185253 DOI: 10.3390/s22114024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/17/2022] [Accepted: 05/23/2022] [Indexed: 12/10/2022]
Abstract
Electromyographic biofeedback (EMG-BF) is a therapeutic technique that has been used successfully in the rehabilitation of injuries. Although it has been applied to athletes, its use in this field is not very widespread. The objective of this study is to analyze its effectiveness in the recovery of electromyographic activity of the quadriceps after meniscectomy, evaluated through isometric contraction of the vastus lateralis. The sample comprised ten professional footballers in the Spanish League (2nd Division A) who had previously suffered a meniscus injury in their knee and had undergone a meniscectomy. The intervention consisted of EMG-BF treatment lasting between 6 and 10 sessions. The electromyographic signal was recorded using a Thought Technology ProComp Infiniti 8-channel biofeedback unit with a sampling rate of 2048 samples/second. For each session, a within-subject ABA design of 6 or 10 trials per session was used, with three pre- and three post-measures, which determined the gain for each session. The results indicated (1) improvements in all cases, (2) EMG-BF was effective, (3) the working model was statistically significant with an explained variance of between 67% and 75%, and (4) the generalizability analysis showed that the results are reliable and generalizable. The results indicate that EMG-BF is effective in neuromuscular rehabilitation after this type of intervention.
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Affiliation(s)
- Verónica Morales-Sánchez
- Department of Social Psychology, Social Anthropology, Social Work and Social Services, University of Málaga, 29071 Málaga, Spain; (V.M.-S.); (A.H.-M.)
| | - Coral Falcó
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, 5020 Bergen, Norway;
| | - Antonio Hernández-Mendo
- Department of Social Psychology, Social Anthropology, Social Work and Social Services, University of Málaga, 29071 Málaga, Spain; (V.M.-S.); (A.H.-M.)
| | - Rafael E. Reigal
- Department of Social Psychology, Social Anthropology, Social Work and Social Services, University of Málaga, 29071 Málaga, Spain; (V.M.-S.); (A.H.-M.)
- Correspondence:
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Cao N, Liang H, Zhang R, Li Y, Cao H. A New Nonlinear Photothermal Iterative Theory for Port-Wine Stain Detection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5637. [PMID: 35565029 PMCID: PMC9104969 DOI: 10.3390/ijerph19095637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 01/19/2023]
Abstract
The development of appropriate photothermal detection of skin diseases to meet complex clinical demands is an urgent challenge for the prevention and therapy of skin cancer. An extensive body of literature has ignored all high-order harmonics above the second order and their influences on low-order harmonics. In this paper, a new iterative numerical method is developed for solving the nonlinear thermal diffusion equation to improve nonlinear photothermal detection for the noninvasive assessment of the thickness of port-wine stain (PWS). First, based on the anatomical and structural properties of skin tissue of PWS, a nonlinear theoretical model for photothermal detection is established. Second, a corresponding nonlinear thermal diffusion equation is solved by using the new iterative numerical method and taking into account harmonics above the second-order and their effects on lower-order harmonics. Finally, the thickness and excitation light intensity of PWS samples are numerically simulated. The simulation results show that the numerical solution converges fasterand the physical meaning of the solution is clearerwith the new method than with the traditional perturbation method. The rate of change in each harmonic with the sample thickness for the new method is higher than that for the conventional perturbation method, suggesting that the proposed numerical method may provide greater detection sensitivity. The results of the study provide a theoretical basis for the clinical treatment of PWS.
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Affiliation(s)
| | | | | | | | - Hui Cao
- Shaanxi Key Laboratory of Ultrasound, School of Physics and Information Technology, Shaanxi Normal University, Xi’an 710062, China; (N.C.); (H.L.); (R.Z.); (Y.L.)
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18
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Plaza-Manzano G, Navarro-Santana MJ, Valera-Calero JA, Fabero-Garrido R, Fernández-de-Las-Peñas C, López-de-Uralde-Villanueva I. Reliability of lumbar multifidus ultrasound assessment during the active straight leg raise test. Eur J Clin Invest 2022; 52:e13728. [PMID: 34882303 DOI: 10.1111/eci.13728] [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: 10/29/2021] [Revised: 11/22/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous evidence showed altered lumbar multifidus (LM) activation in populations with chronic nonspecific low back pain (LBP). We aimed to investigate the test-retest and inter-examiner reliability of ultrasound imaging (US) for assessing LM thickness at rest and activation during the active straight leg raise test (ASLR) and the association between thickness changes with clinical outcomes. METHODS Fifty-two patients with LBP and two examiners (one experienced and one novice) participated in this study. A total of 18 B-mode images at L4-L5 or L5-S1 level (both sides, 3 at rest and 6 during ASLR) were collected. For assessing test-retest reliability, the experienced examiner repeated the procedure after 7 days. Intraclass correlation coefficients (ICC), standard error of measurements (SEM) and minimal detectable changes (MDC) were calculated. RESULTS Inter-examiner agreement was good to excellent (ICC3,2 = 0.71-0.92) and test-retest reliability was excellent (ICC3,1 = 0.91-0.98). Mean average of multiple measurements improved the agreement. Greater LM thickness at rest (p < .05) and greater thickness change after 3 s (p < .01) and 10 s (homolateral side, p < .01; contralateral side, p < .05) were associated with less pain intensity. CONCLUSIONS US is a reliable method to assess the LM thickness at rest and contracted during the ASLR in patients with LBP. The measurement at 3 s after maintaining ASLR, as well as the use of the mean of three measurements, has been shown to be the most reliable method for measuring LM muscle thickness during ASLR.
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Affiliation(s)
- Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, Spain
| | - Marcos J Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan Antonio Valera-Calero
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692, Spain
| | - Raúl Fabero-Garrido
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy,Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain.,Clínica e Investigación en Fisioterapia: Terapia Manual, Cátedra Institucional en Docencia, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, Spain
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