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Trial registered on ANZCTR
Registration number
ACTRN12613001077752
Ethics application status
Approved
Date submitted
19/09/2013
Date registered
26/09/2013
Date last updated
26/09/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Inter- and Intra-rater Reliability of Ultrasound Imaging of Lumbar Multifidus and Transverse Abdominal Muscles in Subjects with and without Low Back Pain
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Scientific title
Inter- and Intra-rater Reliability of Ultrasound Imaging of Lumbar Multifidus and Transverse Abdominal Muscles in Subjects with and without Low Back Pain
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Secondary ID [1]
283250
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nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
low back pain
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Condition category
Condition code
Physical Medicine / Rehabilitation
290507
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0
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Physiotherapy
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Musculoskeletal
290539
290539
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
three days
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Target follow-up type
Weeks
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Description of intervention(s) / exposure
Subjects with low back pain and healthy controls were assessed in three consecutive days: their lumbar multifidus muscle and transverse abdominal muscle thickness were measured by ultrasound at rest and during contraction. During measuring the thickness of transverse abdominal muscle, subjects were in supine position, and the measurements were taken at rest and while draw in their anterior abdominal wall. The measurement of lumbar multifidus muscle was taken while subject were in prone position at rest and while lifting the contralateral arm. The assessment lasted about 10 minutes per subject. Two raters, blinded to each other's measurements, assessed all the subjects on all 3 days
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Intervention code [1]
287980
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Not applicable
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Comparator / control treatment
control healthy group was assessed a the exactly same way as subjects with low back pain (as described in Description of intervention/exposure)
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Control group
Active
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Outcomes
Primary outcome [1]
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lumbar multifidus muscle and transverse abdominal muscle thickness measured by ultrasound caliper at rest and during muscle contraction
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Assessment method [1]
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Timepoint [1]
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three concecutive days
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Primary outcome [2]
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Intraclass correlation coefficient ICC2,1
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Assessment method [2]
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Timepoint [2]
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three days
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Secondary outcome [1]
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nil
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Assessment method [1]
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Timepoint [1]
304734
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nil
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Eligibility
Key inclusion criteria
subjects with low back pain: low back pain that lasted at least 3 months, self reported pain level 4 or more on Pain Numeric Rating Scale
control subjects: no low back pain for at least one year, no low back surgery, no neurological condition with muscle weakness and/or coordination issues
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
younger than 18 years, pregnancy, spinal factures and operations, severe forms of scoliosis, cancer, hip diseases
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
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Timing
Prospective
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Statistical methods / analysis
based on confidence level (95%), confidence interval (10), population size (100000), the estimated sample size was 96. Our sample size was 98
Since our primary interest was to see the level of agreement between two raters' measurements, we used the measures of relative and absolute agreement, and these are Intraclass coefficient ICC 2,1"and Standard error of measurement and Minimal Detectable Change
Bland Altman Analysis was used to see if there is systematic error in two raters' measurements
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
31/08/2011
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Actual
1/09/2011
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Date of last participant enrolment
Anticipated
1/12/2011
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Actual
22/12/2011
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
96
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
5423
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Serbia and Montenegro
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State/province [1]
5423
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Serbia
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Clinic for Rehabilitation, Medical Faculty University of Belgrade
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Address [1]
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13 Sokobanjska, Belgrade, Serbia
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Country [1]
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Serbia and Montenegro
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Primary sponsor type
Hospital
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Name
Clinic for Rehabilitation Medical Faculty University of Belgrade
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Address
13 Sokobanjska, Belgrade,
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Country
Serbia and Montenegro
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Secondary sponsor category [1]
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None
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Name [1]
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nil
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Address [1]
286708
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nil
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Country [1]
286708
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Ethics approval
Ethics application status
Approved
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Summary
Brief summary
Study design: Two-group repeated-measures reliability study Objectives: Determine inter- and intra-rater reliability of ultrasound (US) measurements of transverse abdominis (TrA) and lumbar multifidus (LM) thickness during rest and contraction by an experienced and a novice raters. Background: No previous reliability study included larger samples of low back pain (LBP) and healthy subjects, assessed thickness of TrA and LM during rest and contraction, over several days, and by raters with different experience. Methods: Two blinded raters measured TrA and LM thickness in 42 healthy and 56 LBP subjects during rest and contraction over 3 consecutive days. The thickness change from rest to contraction was also calculated (%). Intraclass correlation coefficients (ICC2,k) and 95% minimal detectable differences (MDC95) were derived. Results: Inter-rater ICC2,1 for single-measure muscle thickness were 0.71-0.87 for LBP subjects and 0.94-1.0 for healthy subjects. The inter-rater ICC2,3 for averaged measures over 3 days were similar (LBP 0.73-0.84, healthy 0.93-1.0). Both single-measure ICC2,1 and average-measure ICC2,3 were lower for the relative thickness change (0.61-0.96). Intra-rater ICC2,1 across 3 days were high for both raters (LBP 0.95-1.00, healthy 0.93-1.00), albeit lower for the relative thickness change (0.79-0.99). The MDC95 were <10% of the respective muscle thickness means. Conclusion: Good-to-excellent reliability was found for US measurements of TrA and LM muscle thickness performed by the experienced and novice raters in subjects with and without LBP. One-time thickness measurements appear sufficient. The estimates of absolute measurement error (MDC95) indicate that >10% difference in muscle thickness may be considered true change over time.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Olivera Djordjevic
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Address
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Medical Faculty University of Belgrade,
Clinic for Rehabilitation, 13 Sokobanjska
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Country
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Serbia and Montenegro
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Phone
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+381658542279
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Olivera Djordjevic
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Address
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Medical Faculty University of Belgrade,
Clinic for Rehabilitation, 13 Sokobanjska
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Country
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Serbia and Montenegro
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Phone
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+381658542279
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Olivera Djordjevic
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Address
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Medical Faculty University of Belgrade,
Clinic for Rehabilitation, 13 Sokobanjska
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Country
43080
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Serbia and Montenegro
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Phone
43080
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+381658542279
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Fax
43080
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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