scholarly journals Methodological consistency and measurement reliability of transversus abdominis real time ultrasound imaging in chronic low back pain populations: a systematic review

2017 ◽  
Vol 22 (1-2) ◽  
pp. 48-59 ◽  
Author(s):  
Connie Jean Whittle ◽  
Carol Ann Flavell ◽  
Susan Jayne Gordon
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Real Time ◽  
Ultrasound Imaging ◽  
Chronic Low Back Pain ◽  
Transversus Abdominis ◽  
Low Back ◽  
Measurement Reliability

scholarly journals Changes in Morphometry of Trunk Muscles, Pain, and Disability Associated With Motor Control Training in People With Chronic Low Back Pain: a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Sanaz Shanbehzadeh ◽  
Shabnam ShahAli ◽  
Julie Hides ◽  
Ismail Ebrahimi-Takamjani ◽  
Omid Rasouli
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Motor Control ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Mean Difference ◽  
Transversus Abdominis ◽  
Trunk Muscles ◽  
Low Back

Abstract Background: This study aimed to review studies investigating the effects of motor control training (MCT) on the morphometry of trunk muscles (measured by ultrasound imaging; USI) and pain/or disability in individuals with chronic low back pain (CLBP).Method: PubMed, Web of Science, Scopus, and Cochrane Library databases were searched from inception until January 2020. Randomized control trials (RCTs) which included measurements of both muscle morphometry using USI and assessments of pain or disability in individuals with CLBP were included. Study selection, data extraction and quality assessment were done by two reviewers independently. Modified Downs and Black tool and grading of recommendations assessment, development, and evaluation tool were used to assess risk of bias and quality of evidence, respectively. A meta-analysis was performed using a random-effects model with mean difference (MD) or standardized mean difference (SMD). Results: Fifteen RCTs were included. The results revealed that there were no differences in the size (thickness) of the transversus abdominis (TrA), internal and external oblique, and lumbar multifidus muscles in studies which did and did not include MCT interventions. However, the contraction ratio for the TrA muscle was greater in response to MCT, with a high effect size (SMD= 0.93 CI: - 0.0 to 1.85). Pain (visual analogue scale, MD=1.00, 95%CI -1.77 to -0.24) and disability (SMD=-0.55, 95% CI: -0.94 to -0.16) scores were lower in the groups who underwent MCT compared with other interventions, with moderate and low effect sizes.Conclusions: MCT interventions were superior to other interventions for measures of TrA muscle function. Despite changes in pain and disability following MCT interventions, corresponding changes in trunk muscle morphometry (evaluated using thickness measures) were not evident. This could be due to the effect of other factors such as psychosocial factors that impact the clinical outcomes for those with CLBP.Systematic review registration: PROSPERO: CRD42019144768

scholarly journals Measurement of transversus abdominis activation in chronic low back pain patients using a novel standardized real-time ultrasound imaging method

Ultrasound ◽  
2018 ◽  
Vol 27 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Carol A Flavell ◽  
Laurence G Marshman ◽  
Susan J Gordon
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Ultrasound Imaging ◽  
Chronic Low Back Pain ◽  
Transversus Abdominis ◽  
Imaging Method ◽  
Low Back ◽  
Intra Class Correlation ◽  
Observer Reliability ◽  
Intra Class Correlation Coefficient

Real-time ultrasound imaging (US) to measure abdominal muscle dimensions has aided low back pain rehabilitation and research. Notwithstanding, ultrasound imaging measurement of transversus abdominis muscle activation in chronic low back pain populations has been characterized by variable and generally suboptimal intra-observer reliability. Methodological deficiencies of ‘freehand’ ultrasound imaging are uncontrolled probe–skin pressure, inclination and roll of the probe. Despite previous attempts to standardize these parameters, intra-observer reliability in chronic low back pain was poor to moderate (0.32–0.62). Therefore, a standardized method that controls and records probe force, inclination and roll during ultrasound imaging may optimize measurement reliability in chronic low back pain. This pilot study investigated utility, standardization and intra-observer reliability of ultrasound imaging transversus abdominis thickness measurement in chronic low back pain patients (n = 17). Transversus abdominis imaging over two separate measurement sessions was conducted using a novel method to standardize probe parameters. Resting and contracted transversus abdominis thickness, and transversus abdominis activation measurements were obtained from duplicate paired images (n = 68). Intra-class correlation coefficients were reported with 95% confidence intervals. Transversus abdominis thickness at rest (intra-class correlation coefficient = 0.97 confidence interval: 0.93, 0.99), when contracted (intra-class correlation coefficient = 0.99 confidence interval: 0.97, 0.99) and transversus abdominis activation (intra-class correlation coefficient = 0.93 confidence interval: 0.81, 0.97) measurements were highly reliable. Ultrasound imaging of transversus abdominis using the novel standardized ultrasound imaging method produced highly reliable intra-observer transversus abdominis measurements, superior to ‘freehand’ ultrasound imaging, despite the physical limitations typically associated with a chronic low back pain population. Unique standardizing ranges for ‘probe force device’ probe parameters were obtained. This novel standardized ultrasound imaging method may optimize transversus abdominis activation assessment in chronic low back pain and other populations, aiding future research.

scholarly journals Intervertebral disc therapies for non-specific chronic low back pain: a systematic review and meta-analysis

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110280
Author(s):  
Camille Daste ◽  
Stéphanie Laclau ◽  
Margaux Boisson ◽  
François Segretin ◽  
Antoine Feydy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Activity Limitations ◽  
Low Back ◽  
Short Term

Objectives: We aim to evaluate the benefits and harms of intervertebral disc therapies (IDTs) in people with non-specific chronic low back pain (NScLBP). Methods: We conducted a systematic review and meta-analysis of randomized trials of IDTs versus placebo interventions, active comparators or usual care. EMBASE, MEDLINE, CENTRAL and CINHAL databases and conference abstracts were searched from inception to June 2020. Two independent investigators extracted data. The primary outcome was LBP intensity at short term (1 week–3 months), intermediate term (3–6 months) and long term (after 6 months). Results: Of 18 eligible trials (among 1396 citations), five assessed glucocorticoids (GCs) IDTs and were included in a quantitative synthesis; 13 assessed other products including etanercept ( n = 2), tocilizumab ( n = 1), methylene blue ( n = 2), ozone ( n = 2), chymopapaine ( n = 1), glycerol ( n = 1), stem cells ( n = 1), platelet-rich plasma ( n = 1) and recombinant human growth and differentiation factor-5 ( n = 2), and were included in a narrative synthesis. Standardized mean differences (95% CI) for GC IDTs for LBP intensity and activity limitations were −1.33 (−2.34; −0.32) and −0.76 (−1.85; 0.34) at short term, −2.22 (−5.34; 0.90) and −1.60 (−3.51; 0.32) at intermediate term and −1.11 (−2.91; 0.70) and −0.63 (−1.68; 0.42) at long term, respectively. Odds ratios (95% CI) for serious and minor adverse events with GC IDTs were 1.09 (0.25; 4.65) and 0.97 (0.49; 1.91). Conclusion: GC IDTs are associated with a reduction in LBP intensity at short term in people with NScLBP. Positive effects are not sustained. IDTs have no effect on activity limitations. Our conclusions are limited by high heterogeneity and a limited methodological quality across studies. Registration PROSPERO: CRD42019106336.

scholarly journals Structural and functional brain abnormalities in chronic low back pain: A systematic review☆

2015 ◽  
Vol 45 (2) ◽  
pp. 229-237 ◽  
Author(s):  
Jeroen Kregel ◽  
Mira Meeus ◽  
Anneleen Malfliet ◽  
Mieke Dolphens ◽  
Lieven Danneels ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Brain Abnormalities ◽  
Functional Brain
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