Reliability of B-mode ultrasonography to measure lumbar multifidus muscle dimensions in patients with unilateral lumbar disc herniation.

OBJECTIVES: To evaluate Ultrasound Imaging (USI) reliability for measurement of lumbar multifidus (LMF) muscle thickness and cross sectional area (CSA) at rest and during contraction in patients with unilateral lumbar disc herniation. SETTING: Laboratory. DESIGN: Reliability Study. PARTICIPANTS: Thirty patients, aged 25-50 years (37.55 ±â€¯9.55), with unilateral L4-L5 lumbar disc herniation participated in this study. MAIN OUTCOME MEASURES: Thickness and CSA of LMF were measured using B-mode ultrasound by two raters in prone position. RESULTS: Same day and multiple day inter-rater and same day intra-rater reliability showed good to excellent reliability (intraclass correlation coefficients ranged from 0.70 to 0.91). Also standard error of measurement and minimal detectable change for USI reliabilities ranged from 0.06 to 0.57 and 0.16 to 1.31, respectively. CONCLUSIONS: Reliability of USI for measurements of LMF muscle thickness and CSA was high, and consistent with previous studies conducted on reliability of USI to measure LMF dimensions in other populations.

Effect of Chronic Low Back Pain on Lumbar Spine Lordosis During Sit-to-Stand and Stand-to-Sit.

OBJECTIVE: This study aimed to evaluate lumbar lordosis during sit-to-stand (STS) and stand-to-sit (SIT) in individuals with and without chronic nonspecific low back pain (CNLBP). The second objective was to investigate sex-related differences in lumbar lordosis. METHODS: Twenty-six patients with CNLBP and 26 controls were recruited. Controls were matched with cases using a frequency matching method. Reflective markers were placed over the spinous process of T12, L3, S2, and the anterior and posterior superior iliac spines. The participants were instructed to stand up at a self-selected pace and maintain their normal upright standing posture for 3 seconds, and then sit down. Kinematic data were recorded at a sampling frequency of 100 Hz using a motion capture system. Lumbar lordosis angle was calculated from the intersection between the line joining T12 and L3, and the line joining L3 to S2. RESULTS: Lumbar lordosis was decreased in patients with CNLBP during STS and SIT compared with the asymptomatic group (mean difference = 2.68°-9.32°; P ≤ .005). Furthermore, no differences were seen in lumbar lordosis at starting position between CNLBP and asymptomatic groups during STS and SIT (mean difference = 2.68°-3.75°; P ≥ .099). Interestingly, the magnitude of the effect size suggested that the difference in lumbar lordosis values between female and male participants was relatively large (Cohen's d = -1.81 to 0.20). CONCLUSION: Decreased lumbar lordosis in patients with CNLBP during STS and SIT could be considered as an important point during rehabilitation. Moreover, the present study showed that there is a sex-related difference among women and men in lumbar lordosis during STS and SIT tasks.

Kinematics of the Spine During Sit-to-Stand Movement Using Motion Analysis Systems: A Systematic Review of Literature.

CONTEXT: Clinical evaluation of the spine is commonplace in musculoskeletal therapies, such as physiotherapy, physical medicine/rehabilitation, osteopathic, and chiropractic clinics. Sit-to-stand (STS) is one of the most mechanically demanding daily activities and crucial to independence. Difficulty or inability to perform STS is common in individuals with a variety of motor disabilities, such as low back pain (LBP). OBJECTIVE: The purpose of this systematic review was to evaluate available evidence in literature to determine 2-dimensional and 3-dimensional kinematics of the spine during STS in patients with LBP and healthy young adult participants using motion analysis systems (electromagnetic and marker based). METHODS: Electronic databases (PubMed/MEDLINE [National Library of Medicine], Scopus, ScienceDirect, and Google Scholar) were searched between January 2002 and February 2017. Additionally, the reference lists of the articles that met the inclusion criteria were also searched. Prospective studies published in peer-reviewed journals, with full text available in English, investigating the kinematics of the spine during STS in healthy subjects (mean age between 18 and 50 y) or in patients with LBP using motion analysis systems, were included. Sixteen studies fulfilled the eligibility criteria. All information relating to methodology and kinematic modeling of the spine segments along with the outcome measures was extracted from the studies identified for synthesis. RESULTS: The results indicated that the kinematics of the spine are greatly changed in patients with LBP. In order to develop a better understanding of spine kinematics, studies recommended that the trunk should be analyzed as a multisegment. It has been shown that there is no difference between the kinematics of patients with LBP and healthy population when the spine is analyzed as a single segment. Furthermore, between-gender differences are present during STS movement. CONCLUSION: This review provided a valuable summary of the research to date examining the kinematics of the spine during STS.