Trunk muscle size and composition assessment in older adults with chronic low back pain: An intra-examiner and inter-examiner reliability study

Jaclyn Megan Sions, Andrew Craig Smith, Gregory Evan Hicks, James Matthew Elliott*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objective. To evaluate intra-and inter-examiner reliability for the assessment of relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area, i.e., total cross-sectional area minus intramuscular fat, from T1-weighted magnetic resonance images obtained in older adults with chronic low back pain. Design. Reliability study. Subjects. n = 13 (69.3 ± 8.2 years old) Methods. After lumbar magnetic resonance imaging, two examiners produced relative crosssectional area measurements of multifidi, erector spinae, psoas, and quadratus lumborum by tracing regions of interest just inside fascial borders. Pixelintensity summaries were used to determine muscle-to-fat infiltration indices; relative muscle cross-sectional area was calculated. Intraclass correlation coefficients were used to estimate intra-and inter-examiner reliability; standard error of measurement was calculated. Results. Intra-examiner intraclass correlation coefficient point estimates for relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area were excellent for multifidi and erector spinae across levels L2-L5 (ICC = 0.77-0.99). At L3, intra-examiner reliability was excellent for relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area for both psoas and quadratus lumborum (ICC = 0.81-0.99). Inter-examiner intraclass correlation coefficients ranged from poor to excellent for relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area. Conclusions. Assessment of relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area in older adults with chronic low back pain can be reliably determined by one examiner from T1-weighted images. Such assessments provide valuable information, as muscle-to-fat infiltration indices and relative muscle cross-sectional area indicate that a substantial amount of relative cross-sectional area may be magnetic resonance-visible intramuscular fat in older adults with chronic low back pain.

Original languageEnglish (US)
Pages (from-to)1436-1446
Number of pages11
JournalPain Medicine (United States)
Volume17
Issue number8
DOIs
StatePublished - Aug 1 2016

Keywords

  • Intramuscular fat
  • Low back pain
  • Magnetic resonance imaging
  • Multifidi
  • Muscle

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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