慢性下腰痛老年人躯干肌肉大小和组成评估：一项检查者内和检查者间可靠性研究。
Trunk Muscle Size and Composition Assessment in Older Adults with Chronic Low Back Pain: An Intra-Examiner and Inter-Examiner Reliability Study.
作者信息
Sions Jaclyn Megan, Smith Andrew Craig, Hicks Gregory Evan, Elliott James Matthew
机构信息
*Department of Physical Therapy, University of Delaware, Newark, Delaware, USA;
Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
出版信息
Pain Med. 2016 Aug;17(8):1436-46. doi: 10.1093/pm/pnv023. Epub 2015 Dec 7.
OBJECTIVE
To evaluate intra- and inter-examiner reliability for the assessment of relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area, i.e., total cross-sectional area minus intramuscular fat, from T1-weighted magnetic resonance images obtained in older adults with chronic low back pain.
DESIGN
Reliability study.
SUBJECTS
n = 13 (69.3 ± 8.2 years old)
METHODS
After lumbar magnetic resonance imaging, two examiners produced relative cross-sectional area measurements of multifidi, erector spinae, psoas, and quadratus lumborum by tracing regions of interest just inside fascial borders. Pixel-intensity summaries were used to determine muscle-to-fat infiltration indices; relative muscle cross-sectional area was calculated. Intraclass correlation coefficients were used to estimate intra- and inter-examiner reliability; standard error of measurement was calculated.
RESULTS
Intra-examiner intraclass correlation coefficient point estimates for relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area were excellent for multifidi and erector spinae across levels L2-L5 (ICC = 0.77-0.99). At L3, intra-examiner reliability was excellent for relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area for both psoas and quadratus lumborum (ICC = 0.81-0.99). Inter-examiner intraclass correlation coefficients ranged from poor to excellent for relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area.
CONCLUSIONS
Assessment of relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area in older adults with chronic low back pain can be reliably determined by one examiner from T1-weighted images. Such assessments provide valuable information, as muscle-to-fat infiltration indices and relative muscle cross-sectional area indicate that a substantial amount of relative cross-sectional area may be magnetic resonance-visible intramuscular fat in older adults with chronic low back pain.
目的
评估在患有慢性下腰痛的老年人中，从T1加权磁共振图像评估相对横截面积、肌肉与脂肪浸润指数以及相对肌肉横截面积（即总横截面积减去肌内脂肪）时，检查者内和检查者间的可靠性。
设计
可靠性研究。
受试者
n = 13（年龄69.3±8.2岁）
方法
在腰椎磁共振成像后，两名检查者通过描绘筋膜边界内的感兴趣区域，对多裂肌、竖脊肌、腰大肌和腰方肌进行相对横截面积测量。使用像素强度汇总来确定肌肉与脂肪浸润指数；计算相对肌肉横截面积。使用组内相关系数来估计检查者内和检查者间的可靠性；计算测量标准误差。
结果
对于L2 - L5水平的多裂肌和竖脊肌，检查者内组内相关系数对相对横截面积、肌肉与脂肪浸润指数以及相对肌肉横截面积的点估计均极佳（ICC = 0.77 - 0.99）。在L3水平，对于腰大肌和腰方肌的相对横截面积、肌肉与脂肪浸润指数以及相对肌肉横截面积，检查者内可靠性均极佳（ICC = 0.81 - 0.99）。对于相对横截面积、肌肉与脂肪浸润指数以及相对肌肉横截面积，检查者间组内相关系数范围从差到极佳。
结论
患有慢性下腰痛的老年人的相对横截面积、肌肉与脂肪浸润指数以及相对肌肉横截面积可由一名检查者从T1加权图像中可靠地确定。此类评估提供了有价值的信息，因为肌肉与脂肪浸润指数以及相对肌肉横截面积表明，在患有慢性下腰痛的老年人中，相当一部分相对横截面积可能是磁共振可见的肌内脂肪。
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