Wiley
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Ultrasound (US) imaging can be used for the measurement of trunk muscle activity. The displacements of US transducer, especially during more dynamic situations, however, may disturb the measurement results. To control this variable, some studies have used transducer fixator (TF), but no study evaluated the effect of using TF on US reliability in dynamic situations. The present study discriminated this issue.
To investigate the intrasession and intersession reliability of lateral abdominal muscle thickness measurement in dynamic standing postural tasks by using US with and without TF in participants with and without chronic low back pain (CLBP).
An intersession and intrasession reliability study.
Biomechanics laboratory, Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
Twenty‐three patients with CLBP and 23 healthy matched individuals.
Abdominal muscle thickness of all the subjects was evaluated with use of US imaging with the patient in the supine position and double‐leg stance at different levels of platform stability of BBS (static, levels 6 and 3), with and without using TF. Intraclass correlation coefficients (ICCs), standard errors of measurement, minimal metrically detectable changes, and coefficients of variation were calculated to determine intersession and intrasession reliability of muscle activity measure.
Lateral abdominal muscle thickness.
The intersession ICCs in the conditions with TF ranged from 0.93 to 0.98 and 0.97 to 0.99 in CLBP and healthy individuals, respectively. The intersession ICCs in the conditions without TF ranged from 0.67 to 0.79 and 0.7 to 0.86 in CLBP and healthy groups, respectively. In addition, smaller standard errors of measurement and minimal metrically detectable change values were observed with US measurement in both the groups when TF was used.
US imaging appears to have acceptable reliability for the assessment of abdominal muscle thickness during dynamic standing tasks in individuals with and without CLBP. The use of TF results in greater levels of reliability during US measurement of abdominal muscle.
III
Radiofrequency ablation (RFA) has become an option for those with chronic or refractory sacroiliac (SI) joint pain. The purpose of this critical review is to assess the existing literature and conduct a meta‐analysis to assess the effectiveness of RFA of the SI joint for pain relief at 3 and 6 months' after an RFA procedure. An electronic search of PubMed, OVID, Medline, and CINAHL were conducted with keywords; sacroiliac joint, sacroiliac pain, sacroiliac syndrome, sacroiliac radiofrequency ablation, sacroiliac neurolysis, sacroiliac injection, and low back pain. Articles that addressed RFA of the SI joint were reviewed. Ten articles ranging from inception to January 1, 2010, were found. The main outcome measure was a reduction of pain by ≥50% post‐RFA procedure. At 3 months, 7 groups met the criteria and at 6 months, 6 groups met the criteria. A meta‐analysis with a forest plot was done at the 3‐ and 6‐month patient follow‐up intervals. The associated standard error was calculated for each study group. An overall weighted average with respective standard error was also obtained. A calculation of 95% confidence intervals (95% CI) was then derived. A test for heterogeneity, publication bias, and file drawer effect was also done at the 3‐ and 6‐month intervals. At 3 months, a range of 0.538‐0.693 was found to have a 95% CI, with a pooled mean of 0.616. At 6 months, a 95% CI of 0.423‐0.576 was found, with a pooled mean of 0.499. The meta‐analysis demonstrated that RFA is an effective treatment for SI joint pain at 3 months and 6 months. This study is limited by the available literature and lack of randomized controlled trials. Further standardization of RFA lesion techniques needs to be established, coupled with prospective randomized controlled trials.