O’Sullivan, Cliona, Bentman, Susanna, Bennett, Kathleen and Stokes, Maria
Rehabilitative ultrasound imaging of the lower trapezius muscle: technical description and reliability
Journal of Orthopaedic & Sports Physical Therapy, 37, (10), . (doi:10.2519/jospt.2007.2446).
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Study design: Exploratory and repeated measures reliability.
Background: Shoulder dysfunction is common and often difficult to diagnose and treat. The trapezius muscle is an important stabilizer and primary mover of the scapula. The potential use of rehabilitative ultrasound imaging (RUSI) to evaluate scapular muscle function warrants investigation.
Objectives: To establish a procedure for imaging the thickness of the lower trapezius muscle and to examine reliability, within and between investigators.
Methods: In 16 asymptomatic subjects (12 female), aged 20-41 years, 3 investigators used RUSI to image the left lower trapezius muscle with the subject at rest in prone. The principal investigator (Investigator 1) took 3 images on each of 2 days, while the other 2 investigators took 2 images each on the second day. All measurements of lower trapezius muscle thickness were made off-line, at a point 3cm lateral to the lateral edge of the spinous processes. To also obtain within scan reliability, each of the images taken by Investigator 1, once displayed on the scanner’s screen, were measured 3 times. Investigator 1 also measured lower trapezius muscle thickness 1cm medial to this site. Reliability was examined using intraclass correlation coefficients (ICC) and the Bland and Altman plot.
Results: The intrarater within scan reliability at the lateral site was ICC 3,3 = 0.99, (95% CI: 0.98 to 1.0).The intrarater between scan reliability (within day using the mean values of 3 measurements off the screen) at the lateral site, medial site, and combined sites (mean of medial and lateral) were ICC3,3=0.96; (95%CI = 0.90 to 0.98); ICC3,2=0.90 (95%CI = 0.78 to 0.96); and ICC3,2=0.99 (95%CI = 0.99 to 1.0) respectively. Intrarater (between day) reliability was good for the lateral site and combined sites (ICC3,3=0.91; 95%CI = 0.74 to 0.96 and ICC3,3 = 0.90; 95%CI = 0.70 to 0.96 respectively) and moderate for the medial site (ICC3,3=0.89; 95%CI= 0.68 to 0.96). Interrater reliability (between investigators) was also moderate (ICC2, 2=0.88; 95%CI = 0.73 to 0.96). Mean lower trapezius muscle thickness was approximately 3.1mm (SD=0.8).
Conclusion: Thickness of the lower trapezius muscle can be measured reliably with RUSI.
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