RELIABILITY AND RESPONSIVENESS OF MUSCULOSKELETAL ULTRASOUND IN SUBJECTS WITH AND WITHOUT SPINAL CORD INJURY

Ultrasound Med Biol, 2010 · DOI: 10.1016/j.ultrasmedbio.2010.07.019 · Published: October 1, 2010

Spinal Cord Injury Medical Imaging Rehabilitation

Simple Explanation

This study investigates the use of ultrasound (US) for examining muscle and tendon changes in people with spinal cord injury (SCI). Rehabilitation aims to maintain the musculoskeletal system, but US suitability for this is unclear. The research assesses how reliable US measurements are when taken by different operators and whether US can effectively detect muscle and tendon adaptations after training in SCI subjects. The study involved both SCI subjects and healthy controls, with US images of muscles and tendons being analyzed to determine the reliability and responsiveness of the technique.

Study Duration

Not specified

Participants

7 SCI subjects and 16 controls

Evidence Level

Not specified

Key Findings

1
Ultrasound detected muscle hypertrophy (p < 0.05) following electrical stimulation training in subjects with SCI (responsiveness), but did not detect differences in tendon thickness.
2
For control subjects, within-operator concordance (ICC(3,1)) ranged from 0.58 to 0.95 for novice operators and exceeded 0.86 for the experienced operator.
3
Between-operator concordance (ICC (2,1)) ranged from 0.62 to 0.74.

Research Summary

This study evaluated the reliability and responsiveness of musculoskeletal ultrasound (US) in assessing muscle and tendon characteristics in individuals with and without spinal cord injury (SCI). The research quantified within- and between-operator reliability for US measurements of the vastus lateralis, patellar tendon, soleus, and Achilles tendon, and examined US responsiveness to post-training muscle/tendon adaptations in SCI subjects. The findings suggest that US can reliably detect muscle hypertrophy following electrical stimulation training in SCI, but may not be as sensitive in detecting changes in tendon thickness. The reliability estimates support the use of US in future post-SCI training studies.

Practical Implications

Clinical Assessment

Ultrasound can be used to assess muscle hypertrophy in SCI patients undergoing electrical stimulation training.

Research Tool

The reliability and responsiveness data support the use of ultrasound in future research studies involving muscle and tendon adaptations post-SCI.

Training Programs

Monitoring muscle changes with ultrasound can help optimize electrical stimulation training programs for SCI patients.

Study Limitations

1
The confounding influences of gender and anthropometric factors may mask adaptations when unmatched subject cohorts are compared.
2
Secondly, the discovery of abnormal echotexture in paralyzed muscle raises the question of whether a novice operator could obtain interpretable images of tissues from persons with SCI.
3
Finally, because all scans were conducted on a single day for each subject, this study does not provide an estimate of within-subject, between-session variability.

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