Reliability of Ultrasound Findings in Patients with Lumbar Multifidus Myofascial Pain Syndrome

Document Type : RESEARCH PAPER


1 Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

2 Neuroscience Research Center, Poorsina Hospital, Faculty of medicine, Guilan University of Medical Sciences, Rasht, Iran


Background: Lumbar multifidus muscle provides stability to the spine. The present study aimed to evaluate the 
reliability of ultrasound findings in patients with lumbar multifidus myofascial pain syndrome (MPS).
Methods: A total of 24 cases (7 females, 17 males, mean age: 40.13± 5.69, BMI: 26.48±4.96) with multifidus MPS were 
assessed. The variables were muscle thickness in rest and contraction, thickness changes, and cross-sectional area 
(CSA) in rest and contraction. Two examiners performed the test and retest sessions.
Results: The active trigger points of lumbar multifidus on the right and left side of the cases were 45.8 % and 54.2%, 
respectively. The intraclass correlation coefficient (ICC) values for muscle thickness and thickness changes showed 
moderate to very high reliability for both within and between intra-examiner measurements. (ICC, 1st examiner: 0.78-
0.96; ICC, 2nd examiner: 0.86-0.95). In addition, the ICC values of within and between-session intra-examiner for CSA 
were high. (ICC, 1st examiner: 0.83-0.88; ICC, 2nd examiner: 0.84-0.89). The ICC and standard error of measurement 
(SEM) of inter-examiner reliability ranged between 0.75 to 0.93 and 0.19 to 0.88 for multifidus muscle thickness and 
thickness changes. The ICC and SEM of inter-examiner reliability ranged between 0.78 to 0.88 and 0.33 to 0.90 for 
CSA of the multifidus muscle. 
Conclusion: The within and between-session reliability of multifidus thickness, thickness changes, and CSA was 
moderate to very high in patients with lumbar MPS when taken by two examiners. Furthermore, the inter-examiner 
reliability of these sonographic findings was high. 
Level of evidence: III


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