Huei-Ming Chai

Comparison of proprioceptive functions between computerized proprioception facilitation exercise and closed kinetic chain exercise in patients with knee osteoarthritis

AimThe aim of this study was to compare proprioceptive function between computerized proprioception facilitation exercise (CPFE) and closed kinetic chain exercise (CKCE) for knee osteoarthritis.DesignRandomized–controlled.SettingKinesiology laboratory.PatientsEighty-one patients with bilateral knee osteoarthritis were randomly assigned to CPFE, CKCE, and control groups.InterventionBoth exercise groups underwent an 8-week program of three sessions per week. The control group received no training. The CPFE program included a 20-min computer game to be played by the trained foot of the subject. CKCE included 10 sets of 10 repetitions of repeated knee extension and flexion with resistance of 10–25% of body weight.Main outcome measuresAbsolute reposition error, functional score, walking speed, and knee muscle strength were assessed with an electrogoniometer, the physical function subscale of Western Ontario and McMaster Osteoarthritis Index, a CASIO stopwatch, and a Cybex 6000 dynamometer before and after the 8-week period.ResultsThe results of this study showed that both CPFE and CKCE were effective in improving joint position sense, functional score, walking speed, and muscle strength. Furthermore, CKCE showed greater effect in increasing knee extensor torque in patients with knee osteoarthritis.ConclusionClinical effects of CPFE were the same as those of CKCE except for knee extensor torque. The increase in knee extensor torque in CPFE patients was not as great as that seen in CKCE patients.

Reliability and Relationship Between 2 Measurements of Transversus Abdominis Dimension Taken During an Abdominal Drawing-in Maneuver Using a Novel Approach of Ultrasound Imaging

STUDY DESIGN Reliability study of clinical measurement. OBJECTIVES The primary purpose was to develop a reliable method for measuring muscle length changes of the transversus abdominis (TrA) during contraction. The secondary purpose was to investigate the relationship between changes in thickness and length (as indicated by the lateral sliding of the anterior muscle-fascia junction) of the TrA muscle during an abdominal drawing-in maneuver. We also provide data on between-day reliability of change in thickness (ΔT) of the TrA. BACKGROUND Ultrasound imaging measurements of TrA thickness at rest (Thr) and during maximal contraction (Thm) have been shown to be reliable. However, limited data exist on quantifying changes in TrA length (as indicated by the lateral sliding of the muscle-fascia junction [Δx]) and ΔT during contraction. METHODS Eighteen healthy adults (mean ± SD age, 22.6 ± 2.5 years) participated in this study. Brightness mode ultrasound images of the TrA were collected at rest and during an abdominal drawing-in maneuver. Subjects were examined by the same examiner twice within a 48-hour period. ΔT, ΔT/Thr, Thr, Thm, and Δx of the TrA were calculated. Medial-lateral movement of the transducer during measurement was corrected through a custom-written program that used an internal marker created by an echo-absorptive thread attached to the skin. Intraclass correlation coefficients (ICC3,1), within-subject coefficient of variance, and standard error of measurement were calculated. The relationship between ΔT and adjusted Δx of the TrA muscle was investigated. RESULTS The ICC values for Thr, Thm, and ΔT of the TrA muscle were greater than 0.75, with the exception of the left ΔT (0.62) and left ΔT/Thr (0.49). After adjusting for medial-lateral motion of the transducer, the ICC values of adjusted Δx were above 0.75, and the within-subject coefficient of variance was below 10%. There was no significant correlation between ΔT and adjusted Δx of the TrA. CONCLUSION Ultrasound imaging measurements of TrA thickness and length change were shown to be reliable using a novel method to control for medial-lateral transducer motion. Measuring different but unrelated dimensional changes in the TrA might provide further insight as to the function of the TrA.

Reliability of Thickness Measurements of the Dorsal Muscles of the Upper Cervical Spine: An Ultrasonographic Study

STUDY DESIGN Clinical measurement, reliability. OBJECTIVES To examine the intraday intrarater reliability of measuring thickness of the upper dorsal neck muscles at rest, as well as at 50% of maximum voluntary isometric contraction (MVIC), for upper cervical extension. BACKGROUND Methodology for measuring the thickness of the lower dorsal neck muscles, including semispinalis capitis and multifidus muscles, during contraction using ultrasonography has been established. Thickness measurements for the upper dorsal neck muscles have not been documented. METHODS Ten subjects (21 to 30 years of age) without neck pain and headache were recruited. Their upper dorsal neck muscles were measured both at rest and during 50% MVIC for upper cervical extension in sitting position using rehabilitative ultrasound imaging (RUSI). Muscles measured included the rectus capitis posterior major, oblique capitis superior, semispinalis capitis, and splenius capitis. All measurements were repeated after 10 minutes of rest, on the same day, by the same rater. Descriptive statistics were supplemented by calculations of intraclass correlation coefficient (ICC3,1), standard error of measurement (SEM), within-subject coefficient of variation (CVw), and minimal detectable change (MDC). RESULTS ICC3,1 results ranged from 0.87 to 0.99 for thickness measurements made at rest and from 0.90 to 0.98 for thickness measurements made with a 50% MVIC. The SEMs for thickness measurements at rest and at 50% MVIC ranged from 0.11 to 0.46 mm and 0.23 to 0.52 mm, while the CVws ranged from 3.5% to 6.1% and 3.7% to 6.4%, and MDC95 ranged from 0.35 to 1.46 mm and 0.73 to 1.65 mm, respectively. The thickness of all upper dorsal neck muscles measured during a 50% MVIC was greater than when measured at rest (P<.029). CONCLUSION Thickness measurements of the upper dorsal neck muscles using RUSI were reliable both at rest and during a 50% effort isometric contraction.

Inter-session reliability of the measurement of the deep and superficial layer of lumbar multifidus in young asymptomatic people and patients with low back pain using ultrasonography

STUDY DESIGN Reliability study. OBJECTIVE To investigate the inter-session reliability of measuring the thickness of deep (dMF) and superficial layer of lumbar multifidus (sMF) using ultrasonography for participants with and without low back pain (LBP). BACKGROUND The lumbar multifidus is an important muscle in maintaining spinal stability. The dMF is considered important in maintaining tonic contraction and joint stability. Motor control impairment is also discovered in patients with LBP. However, no study to date has investigated the method of observing both the sMF and dMF through ultrasound imaging (USI). METHODS Twenty subjects aged 18-35 years old with LBP (N=10) and without LBP (N=10) were recruited. Every subject extended the upper trunk in prone lying with maximal isometric contraction. Simultaneously, the examiner measured the thickness of the dMF and the sMF using ultrasonography after ensuring the muscle belly was located. The participants performed three trials of isometric trunk extension in each session, with 30 min between each session. The reliability of measuring the change of thickness is represented by the intra-class correlation coefficient (ICC). RESULTS Through averaging three trials of measurement, the reliability of measuring the thickness of the dMF or the sMF in static or in the contracted condition, and the change of the thickness during contraction, is reliable (ICC=0.84-1.00). CONCLUSIONS The intra-rater inter-session reliability of measurement of the dMF and the sMF with USI has been established. This method could be applied to the qualification of the activation level of the dMF and the sMF with specific tasks.

Reliability and Validity of Transversus Abdominis Measurement at the Posterior Muscle-Fascia Junction with Ultrasonography in Asymptomatic Participants.

OBJECTIVE The purposes of this study were (1) to establish the intrarater sliding and change in thickness of the transversus abdominis (TrA) measurement at the posterior muscle-fascia junction and (2) to examine the relationship between the muscle thickness and sliding of the TrA at the anterior and posterior sites. METHODS Asymptomatic participants (n = 20) were placed into the hook-lying position to perform the abdominal drawing-in maneuver viewed in B-mode with a 5- to 12-MHz linear ultrasound transducer. The outcome variables included the resting thickness, the thickness during contraction, the change of thickness, and the change of sliding length. Both intraclass correlation coefficient and Pearson correlation were used for analysis. RESULTS Measuring the thickness and sliding of the TrA at the posterior muscle-fascia junction showed good reliability (intraclass correlation coefficient (3,3), 0.89-0.98). The correlations between the sliding measurements of the TrA at the anterior and posterior sites were moderate to good (r = 0.41-0.74). CONCLUSION This study found that measuring the musculofascial corset from the posterior site using ultrasonography is reliable, allowing for ultrasound measurements at both the anterior and posterior sites of the TrA to provide a comprehensive evaluation of the TrA fascia.