Ultrasonography of multifidus muscle morphology and function in ice hockey players with and without low back pain

Fortin, Maryse; Rizk, Amanda; Frenette, Stephane; Boily, Mathieu; Rivaz, Hassan

doi:10.1016/j.ptsp.2019.03.004

Cited by 32 publications

(84 citation statements)

References 59 publications

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“…While the total % body fat was strongly correlated to LMM EI and LMM CSA, BMI was not. These findings are in accordance with a previous study in collegiate hockey players [23] and provide additional evidence to support that body composition cannot be ignored when assessing LMM morphology, especially in athletes. Additional related studies should consider using DEXA to assess body composition in athletes and how such measurements may influence muscle morphology, function, injury and performance in athletes.…”

Section: Discussionsupporting

confidence: 92%

“…In accordance with Fortin et al, a significant increase in LMM CSA was observed when measurements were obtained in the standing position [23]. This finding was also reported in non-athletic populations [33].…”

Section: Discussionsupporting

confidence: 89%

“…A limitation of this study is the relatively small sample size. Although comparable to other studies in elite athletes, [6,9,11,23,[28][29][30][31][32] this study may be underpowered. Second, only 18 players were available for the endseason assessment.…”

Section: Discussionsupporting

confidence: 67%

“…The different results may relate to the level of competition, as well as features of the training regimen. While university level hockey players [23] and professional ballet dancers [34] with LBP also showed deficits in resting LMM CSA compared to their asymptomatic counterparts, other studies in athletes reported no such association [28][29][30]. The discrepancy in findings suggests that some athletic populations may behave differently with regards to LMM size, training effects and LBP [28].…”

Section: Discussionmentioning

confidence: 99%

“…The rater also received prior training by a senior musculoskeletal ultrasound radiologist prior to the beginning of this study. The intra-rater reliability of the same rater for all LMM measurements (ICC 3,1 ) was tested in a previous related study [23] and ranged between 0.96-0.99, 0.96-0.98 and 0.99 for the prone, standing and EI LMM measurements, respectively.…”

Section: Images Assessmentmentioning

confidence: 99%

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The effect of low back pain and lower limb injury on lumbar multifidus muscle morphology and function in university soccer players

Nandlall

Rivaz

Rizk

et al. 2020

BMC Musculoskelet Disord

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Background: The lumbar multifidus muscle (LMM) plays a critical role to stabilize the spine. While low back pain (LBP) is a common complaint in soccer players, few studies have examined LMM characteristics in this athletic population and their possible associations with LBP and lower limb injury. Therefore, the purpose of this study was to 1) investigate LMM characteristics in university soccer players and their potential association with LBP and lower limb injury; 2) examine the relationship between LMM characteristics and body composition measurements; and 3) examine seasonal changes in LMM characteristics. Methods: LMM ultrasound assessments were acquired in 27 soccer players (12 females, 15 males) from Concordia University during the preseason and assessments were repeated in 18 players at the end of the season. LMM crosssectional area (CSA), echo-intensity and thickness at rest and during contraction (e.g. function) were assessed bilaterally in prone and standing positions, at the L5-S1 spinal level. A self-reported questionnaire was used to assess the history of LBP and lower limb injury. Dual-energy x-ray absorptiometry (DEXA) was used to acquire body composition measurements. Results: Side-to-side asymmetry of the LMM was significantly greater in males (p = 0.02). LMM thickness when contracted in the prone position (p = 0.04) and LMM CSA in standing (p = 0.02) were also significantly greater on the left side in male players. The LMM % thickness change during contraction in the prone position was significantly greater in players who reported having LBP in the previous 3-months (p < 0.001). LMM CSA (r = − 0.41, p = 0.01) and echo-intensity (r = 0.69, p < 0.001) were positively correlated to total % body fat. There was a small decrease in LMM thickness at rest in the prone position over the course of the season (p = 0.03). Conclusions: The greater LMM contraction in players with LBP may be a maladaptive strategy to splint and project the spine. LMM morphology measurements were correlated to body composition. The results provide new insights with regards to LMM morphology and activation in soccer players and their associations with injury and body composition measurements.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Images Assessmentmentioning

confidence: 99%

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The effect of low back pain and lower limb injury on lumbar multifidus muscle morphology and function in university soccer players

Nandlall

Rivaz

Rizk

et al. 2020

BMC Musculoskelet Disord

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Uncorrected and subcutaneous fat‐corrected echo intensities are similarly associated with magnetic resonance imaging per cent fat

Rush,

Garlapati,

Lortie

et al. 2024

JCSM Communications

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BackgroundEstablishing interchangeable biomedical imaging‐based measures to assess myosteatosis clinically may lead to the prevention of muscle wasting, yet neither a consensus measure nor a conversion between measures exists. Ultrasound echo intensity (EI) potentially assesses myosteatosis, but subcutaneous adipose tissue (SAT) thickness and user force application have been shown to influence EI. Although correction factors exist to adjust EI for SAT thickness, they are modelled against poor or no reference measures. Modelling EI corrections against a robust reference measure of myosteatosis, like magnetic resonance imaging (MRI)‐based proton density fat fraction (PDFF), is necessary for EI's clinical application.MethodsHealthy young adults, healthy older adults, and older adults undergoing treatment for lung cancer (n = 10 per group with 50% females) had PDFF and EI at 0, 5, 10, and 15 N measured on their right rectus femoris (RF). We compared EI, SAT thickness, and RF thickness between forces and groups and assessed the relationships between EI adjusted by four different correction factors and PDFF.ResultsThe mean age of our sample was 48.63 ± 19.68 years and had a body mass index of 25.21 ± 5.19 kg/m2. The correlation between PDFF and raw EI was r = 0.59 (P < 0.001) with negligible increases by previously published correction factors (Young: 0.62, P < 0.001; Neto Müller: 0.61, P < 0.001). EI, SAT thickness, and RF thickness did not significantly differ between forces (χ2 = 0.31, P = 0.957; χ2 = 2.39, P = 0.496; and χ2 = 7.75, P = 0.051, respectively). EI and PDFF were significantly lower among young healthy adults compared with older adult groups (χ2 = 12.88, P = 0.002, and χ2 = 9.13, P = 0.010, respectively).ConclusionsEI is correlated with PDFF regardless of force with no improvement from previously published correction factors. Our results suggest that EI is clinically useful and influenced by fat content, yet correction factors must account for more than SAT thickness alone and require further investigation.

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Echo-intensity and fatty infiltration ultrasound imaging measurement of cervical multifidus and short rotators in healthy people: A reliability study

Valera‐Calero

Arias-Buría

Fernández‐de‐las‐Peñas

et al. 2021

Musculoskeletal Science and Practice

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Ultrasonography of multifidus muscle morphology and function in ice hockey players with and without low back pain

Cited by 32 publications

References 59 publications

The effect of low back pain and lower limb injury on lumbar multifidus muscle morphology and function in university soccer players

The effect of low back pain and lower limb injury on lumbar multifidus muscle morphology and function in university soccer players

Uncorrected and subcutaneous fat‐corrected echo intensities are similarly associated with magnetic resonance imaging per cent fat

Echo-intensity and fatty infiltration ultrasound imaging measurement of cervical multifidus and short rotators in healthy people: A reliability study

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