Changes in muscle thickness across positions on ultrasound imaging in participants with or without a history of low back pain

Abstract

Context: Injury-prediction models have identified trunk muscle function as an identifiable factor for future injury. A history of low back pain (HxLBP) may also place athletes at increased risk for future low back pain. Reduced muscle thickness of the lumbar multifidus (LM) and transversus abdominis (TrA) has been reported among populations with clinical low back pain via ultrasound imaging in multiple positions. However, the roles of the LM and TrA in a more functional cohort and for injury prediction are still unknown. Objectives: To (1) assess the reliability of LM and TrA ultrasound measures, (2) compare changes in muscle thickness across positions between persons reporting or not reporting HxLBP, and (3) determine the ability to distinguish between groups. Design: Cross-sectional study. Setting: Research laboratory. Patients or Other Participants: Participants were 34 people who did not report HxLBP (age ¼ 22 6 7 years, body mass index ¼ 23.7 6 2.7) and 25 people who reported HxLBP (age ¼ 25 6 10 years, body mass index ¼ 24.0 6 3.2). Main Outcome Measure(s): Muscle thickness and changes in muscle thickness of the LM and TrA as shown on ultrasound imaging. Results: Intraclass correlation coefficients ranged from 0.641 to 0.943 for all thickness measures and from 0 to 0.693 for all averaged thickness modulations bilaterally. Participants who reported HxLBP had voluntarily reduced TrA thickness modulations compared with those not reporting HxLBP (P ¼ .03), and the testing position influenced TrA thickness modulations (P, .01). No differences were observed for LM thickness modulations between groups or positions (P . .05). A tabletop cutoff value of 1.32 had a sensitivity of 0.640 and a specificity of 0.706, whereas a seated cutoff value of 1.18 had a sensitivity of 0.600 and a specificity of 0.647. Conclusions: In participants reporting HxLBP, TrA thickness modulations were lower and both tabletop and seated thickness modulations were able to distinguish reported HxLBP status. These findings suggest that TrA muscle function may be altered by HxLBP.