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. 2024 Jan 3;24(1):277.
doi: 10.3390/s24010277.

Levator Scapulae Stiffness Measurement Reliability in Individuals with and without Chronic Neck Pain by Experienced and Novel Examiners

Umut Varol  1 , Juan Antonio Valera-Calero  2   3 , Elena Sánchez-Jiménez  4 , César Fernández-de-Las-Peñas  5   6 , Ricardo Ortega-Santiago  5   6 , Mateusz D Kobylarz  1   7 , Marcos José Navarro-Santana  2   3
Affiliations

Levator Scapulae Stiffness Measurement Reliability in Individuals with and without Chronic Neck Pain by Experienced and Novel Examiners

Umut Varol et al. Sensors (Basel). .

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.

Keywords: diagnostic accuracy study; levator scapulae; neck pain; shear wave elastography; ultrasound imaging.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Raw ultrasound imaging acquired at the C5 level (A), contouring the targeted structure (levator scapulae) and references used (upper trapezius and transverse process of C5) (B) and shear wave elastography imaging (C).
Figure 2
Figure 2
Bland–Altman plot comparing Young’s modulus and shear wave speed scores obtained by the experienced and novel examiner in asymptomatic subjects. Lines represent the regression line (black) and the 95% confidence interval (red).
Figure 3
Figure 3
Bland–Altman plot comparing Young’s modulus and shear wave speed scores obtained by the experienced and novel examiner in patients with chronic neck pain. Lines represent the regression line (black) and the 95% confidence interval (red).
See this image and copyright information in PMC

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