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Abstract：
BACKGROUND: The prevalence of low back pain is rising among the young adult population. Altered lumbar muscle tone was suggested to be associated with underlying pathologies and symptoms. To date, there is minimum information available on the repeatability of lumbar spine muscle mechanical properties in the young adults who experienced low back pain. This study aimed to assess the reproducibility of mechanical properties of lumbar spinal muscle in young adults with spinal pain by myotonometer and explored the difference in reproducibility when different number of indentations was used.
METHODS: Participants who aged between 18 to 25 and reported chronic LBP were recruited. Lumbar muscle tone (Hz) and stiffness (N/m) were assessed by myotonometer on one occasion by two assessors. Parameters were recorded by triple scans and 5-scans mode. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), smallest real difference (SRD), Bland and Altman analysis were used to assess agreement between two measurements. The relationship between muscle mechanical properties and pain score and disability level were assessed by Spearman\'s rank correlation coefficient.
RESULTS: The results of ICCs indicated excellent repeatability in triple scans and 5-scans mode for each lumbar level bilaterally (ICC > 0.75). SEM and SRD were smaller in triple scans than 5-scans mode for most levels. Bland and Altman analysis revealed no systematic bias. Spearman\'s rank correlation analysis indicated significant high correlations between muscle tone and disability level (r = 0.80, p < 0.05), and between muscle stiffness and disability level (r = 0.81, p < 0.05).
CONCLUSIONS: This study found that lumbar spinal muscle tone and stiffness were repeatable parameters when measured by myotonometer. The reproducibility of muscle mechanical parameters did not appear to differ between the two scanning modes with different number of indentations. Muscle tone and stiffness measured by myotonometer may therefore be reliable as outcome measures to assess intervention induced changes. The lack of significant association between intensity of pain and mechanical properties of paraspinal muscles may suggest that muscle properties measured at rest might not be related to pain level at rest but more related to pain elicited during movement.
METHODS: Participants who aged between 18 to 25 and reported chronic LBP were recruited. Lumbar muscle tone (Hz) and stiffness (N/m) were assessed by myotonometer on one occasion by two assessors. Parameters were recorded by triple scans and 5-scans mode. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), smallest real difference (SRD), Bland and Altman analysis were used to assess agreement between two measurements. The relationship between muscle mechanical properties and pain score and disability level were assessed by Spearman\'s rank correlation coefficient.
RESULTS: The results of ICCs indicated excellent repeatability in triple scans and 5-scans mode for each lumbar level bilaterally (ICC > 0.75). SEM and SRD were smaller in triple scans than 5-scans mode for most levels. Bland and Altman analysis revealed no systematic bias. Spearman\'s rank correlation analysis indicated significant high correlations between muscle tone and disability level (r = 0.80, p < 0.05), and between muscle stiffness and disability level (r = 0.81, p < 0.05).
CONCLUSIONS: This study found that lumbar spinal muscle tone and stiffness were repeatable parameters when measured by myotonometer. The reproducibility of muscle mechanical parameters did not appear to differ between the two scanning modes with different number of indentations. Muscle tone and stiffness measured by myotonometer may therefore be reliable as outcome measures to assess intervention induced changes. The lack of significant association between intensity of pain and mechanical properties of paraspinal muscles may suggest that muscle properties measured at rest might not be related to pain level at rest but more related to pain elicited during movement.
摘要：
背景：下腰痛在年轻成年人群中的患病率正在上升。腰肌张力的改变被认为与潜在的病理和症状有关。迄今为止,在经历下腰痛的年轻人中，关于腰椎肌肉机械特性的可重复性的信息最少。本研究旨在通过肌压计评估患有脊柱疼痛的年轻成年人的腰椎肌肉机械性能的可重复性，并探讨使用不同数量的压痕时的可重复性差异。
方法：招募年龄在18至25岁之间并报告慢性LBP的参与者。腰肌张力（Hz）和僵硬度（N/m）由两名评估员一次通过肌压计进行评估。通过三次扫描和5扫描模式记录参数。组内相关系数(ICC)，测量标准误差(SEM)，最小实差(SRD)，Bland和Altman分析用于评估两个测量之间的一致性。采用Spearman等级相关系数评价肌肉力学性质与疼痛评分及残疾程度的关系。
结果：ICC的结果表明，对于双侧每个腰椎水平（ICC>0.75），在三重扫描和5扫描模式下具有出色的可重复性。对于大多数级别，三重扫描中的SEM和SRD比5扫描模式小。Bland和Altman分析显示没有系统性偏差。Spearman等级相关分析显示,肌张力与残疾水平之间存在显著的高度相关(r=0.80,p<0.05)。肌肉僵硬度与残疾水平之间(r=0.81,p<0.05)。
结论：这项研究发现，当通过肌压计测量时，腰椎脊髓肌张力和刚度是可重复的参数。在具有不同压痕数量的两种扫描模式之间，肌肉机械参数的可重复性似乎没有差异。因此，通过肌压计测量的肌肉张力和硬度可能是评估干预引起的变化的可靠结果指标。疼痛强度与椎旁肌肉的机械特性之间缺乏显着关联可能表明，在休息时测得的肌肉特性可能与休息时的疼痛水平无关，而与运动过程中引起的疼痛有关。
方法：招募年龄在18至25岁之间并报告慢性LBP的参与者。腰肌张力（Hz）和僵硬度（N/m）由两名评估员一次通过肌压计进行评估。通过三次扫描和5扫描模式记录参数。组内相关系数(ICC)，测量标准误差(SEM)，最小实差(SRD)，Bland和Altman分析用于评估两个测量之间的一致性。采用Spearman等级相关系数评价肌肉力学性质与疼痛评分及残疾程度的关系。
结果：ICC的结果表明，对于双侧每个腰椎水平（ICC>0.75），在三重扫描和5扫描模式下具有出色的可重复性。对于大多数级别，三重扫描中的SEM和SRD比5扫描模式小。Bland和Altman分析显示没有系统性偏差。Spearman等级相关分析显示,肌张力与残疾水平之间存在显著的高度相关(r=0.80,p<0.05)。肌肉僵硬度与残疾水平之间(r=0.81,p<0.05)。
结论：这项研究发现，当通过肌压计测量时，腰椎脊髓肌张力和刚度是可重复的参数。在具有不同压痕数量的两种扫描模式之间，肌肉机械参数的可重复性似乎没有差异。因此，通过肌压计测量的肌肉张力和硬度可能是评估干预引起的变化的可靠结果指标。疼痛强度与椎旁肌肉的机械特性之间缺乏显着关联可能表明，在休息时测得的肌肉特性可能与休息时的疼痛水平无关，而与运动过程中引起的疼痛有关。
