Reliability of sonomyography for pectoralis major thickness measurement.

OBJECTIVE Muscle thickness is a widely used parameter for quantifying muscle function in ultrasound imaging. However, current measurement techniques generally rely on manual digitization, which is subjective, time consuming, and prone to error. The primary purposes of this study were to develop an automated muscle boundary tracking algorithm to overcome these limitations and to report its intraexaminer reliability on pectoralis major muscle. METHODS Real-time B-mode ultrasound images of the pectoralis major muscles were acquired by an integrated data acquisition system. A transducer placement protocol was developed to facilitate better repositioning of an ultrasound transducer. Intraexaminer reliability of the tracking algorithm for static measurements was studied using intraclass correlation coefficient based on the thickness data from 11 healthy subjects recruited from a chiropractic college measured at 3 independent sessions. Standard error of measurement and minimal detectable change were calculated. Feasibility of using the tracking algorithm for dynamic measurements was also evaluated. RESULTS All calculated intraclass correlation coefficients were larger than 0.96, indicating excellent reliability of the sonomyographic measurements. Minimal detectable changes were 9.7%, 6.7%, and 6.8% of the muscle thickness at the lateral, central, and medial aspects, respectively. For a 400-frame image stack with 3 pairs of 40 x 40 pixels tracking windows, the tracking took about 80 seconds to complete. CONCLUSIONS The tracking algorithm offers precise and reliable measurements of muscle thickness changes in clinical settings with potential to quantify the effects of a wide variety of chiropractic techniques on muscle function.

[1]  Deydre S Teyhen,et al.  Reliability of rehabilitative ultrasound imaging of the transversus abdominis and lumbar multifidus muscles. , 2009, Archives of physical medicine and rehabilitation.

[2]  Qinghua Huang,et al.  Continuous Monitoring of Sonomyography, Electromyography and Torque Generated by Normal Upper Arm Muscles During Isometric Contraction: Sonomyography Assessment for Arm Muscles , 2008, IEEE Transactions on Biomedical Engineering.

[3]  Maria Stokes,et al.  Rehabilitative ultrasound imaging of the posterior paraspinal muscles. , 2007, The Journal of orthopaedic and sports physical therapy.

[4]  G. Lewith,et al.  A Review of the Literature in Applied and Specialised Kinesiology , 2008, Complementary Medicine Research.

[5]  D. Teyhen,et al.  Improved contraction of the transversus abdominis immediately following spinal manipulation: a case study using real-time ultrasound imaging. , 2007, Manual therapy.

[6]  P. Cerretelli,et al.  In vivo human gastrocnemius architecture with changing joint angle at rest and during graded isometric contraction. , 1996, The Journal of physiology.

[7]  B. Kaymak,et al.  A comparison of the benefits of sonography and electrophysiologic measurements as predictors of symptom severity and functional status in patients with carpal tunnel syndrome. , 2008, Archives of physical medicine and rehabilitation.

[8]  G. Hansson,et al.  Influence of the subcutaneous fat layer, as measured by ultrasound, skinfold calipers and BMI, on the EMG amplitude , 2003, European Journal of Applied Physiology.

[9]  Gregory J Lehman,et al.  Biomechanical assessments of lumbar spinal function. How low back pain sufferers differ from normals. Implications for outcome measures research. Part I: kinematic assessments of lumbar function. , 2004, Journal of manipulative and physiological therapeutics.

[10]  Y. Zheng,et al.  Assessment of muscle fatigue using sonomyography: muscle thickness change detected from ultrasound images. , 2007, Medical engineering & physics.

[11]  W. Herzog,et al.  Electromyographic responses of back and limb muscles associated with spinal manipulative therapy. , 1999, Spine.

[12]  Walter Herzog,et al.  Clinical Biomechanics of Spinal Manipulation , 2000 .

[13]  K. McGraw,et al.  Forming inferences about some intraclass correlation coefficients. , 1996 .

[14]  John D. Childs,et al.  The use of ultrasound imaging of the abdominal drawing-in maneuver in subjects with low back pain. , 2005, The Journal of orthopaedic and sports physical therapy.

[15]  Peter Holland,et al.  Removing ECG noise from surface EMG signals using adaptive filtering , 2009, Neuroscience Letters.

[16]  Preliminary Study of Skeletal Muscle with Multi-signals during Isometric Contraction , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[17]  Y. Zheng,et al.  Sonomyography: monitoring morphological changes of forearm muscles in actions with the feasibility for the control of powered prosthesis. , 2006, Medical engineering & physics.

[18]  Constantinos N. Maganaris,et al.  Ultrasonographic assessment of human skeletal muscle size , 2003, European Journal of Applied Physiology.

[19]  J. Harlaar,et al.  The application of generalizability theory to reliability assessment: an illustration using isometric force measurements. , 1993, Physical therapy.

[20]  J. Hides,et al.  Intrarater and interrater reliability of assessment of lumbar multifidus muscle thickness using rehabilitative ultrasound imaging. , 2007, The Journal of orthopaedic and sports physical therapy.

[21]  Lida Mademli,et al.  Behaviour of the human gastrocnemius muscle architecture during submaximal isometric fatigue , 2005, European Journal of Applied Physiology.

[22]  N. Őzgirgin,et al.  The biomechanics of the lumbosacral region in acute and chronic low back pain patients. , 2008, Pain physician.

[23]  G. Leisman,et al.  Electromyographic Effects of Fatigue and Task Repetition on the Validity of Estimates of Strong and Weak Muscles in Applied Kinesiological Muscle-Testing Procedures , 1995, Perceptual and motor skills.

[24]  J. V. van Dieën,et al.  Thoracic Kyphosis Affects Spinal Loads and Trunk Muscle Force , 2007, Physical Therapy.

[25]  H. Prather,et al.  The effects of active release technique on carpal tunnel patients: A pilot study. , 2006, Journal of chiropractic medicine.

[26]  I Iandelli,et al.  In vivo ultrasound assessment of respiratory function of abdominal muscles in normal subjects. , 1997, The European respiratory journal.

[27]  Tadeusz J. Janik,et al.  How do anterior/posterior translations of the thoracic cage affect the sagittal lumbar spine, pelvic tilt, and thoracic kyphosis? , 2002, European Spine Journal.

[28]  T. Fukunaga,et al.  Determination of fascicle length and pennation in a contracting human muscle in vivo. , 1997, Journal of applied physiology.

[29]  J. Herzenberg,et al.  The adaptation of perimuscular connective tissue during distraction osteogenesis. , 2000, Clinical orthopaedics and related research.

[30]  S. Gandevia,et al.  Measurement of muscle contraction with ultrasound imaging , 2003, Muscle & nerve.

[31]  Vasilios Baltzopoulos,et al.  Human calf muscle responses during repeated isometric plantarflexions. , 2006, Journal of biomechanics.

[32]  H. Snoussi,et al.  Number of Sources Uncertainty in Blind Source Separation. Application to EMG Signal Processing , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[33]  Deydre S Teyhen,et al.  Observed changes in lateral abdominal muscle thickness after spinal manipulation: a case series using rehabilitative ultrasound imaging. , 2007, The Journal of orthopaedic and sports physical therapy.

[34]  William S Marras,et al.  Revised protocol for the kinematic assessment of impairment. , 2004, The spine journal : official journal of the North American Spine Society.

[35]  Aydin Akan,et al.  Prediction of externally applied forces to human hands using frequency content of surface EMG signals , 2010, Comput. Methods Programs Biomed..

[36]  J. Weir.  Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. , 2005, Journal of strength and conditioning research.

[37]  J. Basmajian.  Muscles Alive—their functions revealed by electromyography , 1963 .

[38]  A. Nitz,et al.  Measurement of lumbar multifidus muscle contraction with rehabilitative ultrasound imaging. , 2007, Manual therapy.

[39]  R. Shiel,et al.  Case report: Myofascial pain syndrome: a double crush-like appearance. , 2003, Journal of chiropractic medicine.

[40]  C. Maganaris,et al.  Repeated contractions alter the geometry of human skeletal muscle. , 2002, Journal of applied physiology.

[41]  H. Devries.  MUSCLES ALIVE-THEIR FUNCTIONS REVEALED BY ELECTROMYOGRAPHY , 1976 .

[42]  J. Mcmeeken,et al.  The relationship between EMG and change in thickness of transversus abdominis. , 2004, Clinical biomechanics.

[43]  M. Yamaga,et al.  Conservative Treatment for Thoracic Outlet Syndrome , 1997 .

[44]  C. H. Wang,et al.  Stretching and strengthening exercises: their effect on three-dimensional scapular kinematics. , 1999, Archives of physical medicine and rehabilitation.

[45]  J. Ring,et al.  Test-retest-reliability and validity of the Kinesiology muscle test. , 2001, Complementary therapies in medicine.

[46]  T Fukunaga,et al.  Nonisometric behavior of fascicles during isometric contractions of a human muscle. , 1998, Journal of applied physiology.

[47]  W. Herzog.  On sounds and reflexes. , 1996, Journal of manipulative and physiological therapeutics.