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. 2024 Apr;68(1):35-39.

Intra-observer reliability study of lumbar segmental measurements utilizing ultrasonography

Ralph Kruse  1 , Maruti Ram Gudavalli  1 , Bret White  2 , Geracimo Bracho  1 , Stacey Rider  3
Affiliations

Intra-observer reliability study of lumbar segmental measurements utilizing ultrasonography

Ralph Kruse et al. J Can Chiropr Assoc. 2024 Apr.

Abstract
in English, French

Background: Spinal Manipulative Therapy (SMT) benefits LBP patients, but its mechanism is not well documented. One hypothesis indicates that SMT restores interspinal movements. Ultrasound measurement (UM) of spinous process separation (SPS) assesses the intersegmental movements.

Methods: We used the test-retest reliability of UM between the L3, L4, L5, and S1 spinous processes on fifteen asymptomatic volunteers while lying prone on a chiropractic table. The participants then walked around for over 5 minutes, and ultrasound images were reperformed prone. UM identified the tips of the spinous processes and distances between L3-L4, L4-L5, and L5-S1. Reliability was assessed using intra-class correlation coefficient (ICC).

Results: ICC values of SPS measurements were 0.982 for L3-L4, 0.992 for L4-L5, and 0.997 for L5-S1. Rootmean square difference between the two measures were 0.35mm for L5-S1, 0.36mm for L4-L5, and 0.57mm for L3-L4.

Conclusions: This study found UM to be reliable in measuring interspinous distance.

Étude de la fiabilité intra-observateur des mesures segmentaires lombaires par échographie.

Contexte: La thérapie par manipulation vertébrale (TMV) est bénéfique pour les patients souffrant de lombalgie, mais son mécanisme n’est pas bien établi. L’une des hypothèses est que la TMV rétablit les mouvements intervertébraux. La mesure par échographie (UM) de la séparation de l’apophyse épineuse évalue les mouvements intersegmentaires.

Méthodologie: Nous avons utilisé la fiabilité de testretest de l’UM entre les apophyses épineuses L3, L4, L5 et S1 sur quinze bénévoles asymptomatiques en position couchée sur une table de chiropratique. Les participants ont ensuite marché pendant plus de 5 minutes et les images échographiques ont été refaites en position couchée. L’UM a permis de repérer les extrémités des apophyses épineuses et de déterminer les distances entre L3-L4, L4-L5 et L5-S1. La fiabilité a été évaluée à l’aide du coefficient de corrélation intraclasse (CCI).

Résultats: Les valeurs CCI des mesures de la séparation de l’apophyse épineuse étaient de 0,982 pour L3-L4, 0,992 pour L4-L5 et 0,997 pour L5-S1. La différence quadratique moyenne entre les deux mesures était de 0,35 mm pour L5-S1, 0,36 mm pour L4-L5 et 0,57 mm pour L3-L4.

Conclusions: Cette étude a montré que l’UM était fiable pour mesurer la distance interépineuse.

Keywords: chiropractic; diagnostic ultrasound; intersegmental motion; low back pain; reliability; spinal manipulation.

PubMed Disclaimer

Conflict of interest statement

The authors have no disclaimers, competing interests, or sources of support or funding to report in the preparation of this manuscript.

Figures

Figure 1
Figure 1
A photograph of volunteer in prone position, experienced sonographer performing an ultrasound scan of the lumbar spine.
Figure 2
Figure 2
Spinous process landmarks for measuring distance between vertebrae
See this image and copyright information in PMC

References

    1. Coulter ID, Crawford C, Hurwitz EL, et al. Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. Spine J. 2018;18(5):866–879. doi: 10.1016/j.spinee.2018.01.013.. - DOI - PMC - PubMed
    1. Licciardone JC, Kearns CM, Crow WT. Changes in biomechanical dysfunction and low back pain reduction with osteopathic manual treatment: results from the OSTEOPATHIC Trial. Man Ther. 2014;19(4):324–330. doi: 10.1016/j.math.2014.03.004.. - DOI - PubMed
    1. Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009;14(5):531–538. doi: 10.1016/j.math.2008.09.001.. - DOI - PMC - PubMed
    1. Bialosky JE, George SZ, Bishop MD. How spinal manipulative therapy works: why ask why? J Orthop Sports Phys Ther. 2008;38(6):293–295. doi: 10.2519/jospt.2008.0118.. - DOI - PubMed
    1. Chleboun GS, Amway MJ, Hill JG, Root KJ, Murray HC, Sergeev AV. Measurement of segmental lumbar spine flexion and extension using ultrasound imaging. J Orthop Sports Phys Ther. 2012;42(10):880–885. doi: 10.2519/jospt.2012.3915. - DOI - PubMed

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