Reliability of Shear Wave Elastography for Measuring the Elastic Properties of the Quadratus Lumborum Muscle

<b>Background/Objectives</b>: The quadratus lumborum (QL) muscle is a key structure involved in patients with low back pain (LBP). Since the discriminative capability of morphological descriptors is uncertain and considering the high prevalence of myofascial trigger points and the poor r...

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Main Authors: Mónica López-Redondo, Juan Antonio Valera-Calero, Javier Álvarez-González, Alberto Roldán-Ruiz, Sandra Sánchez-Jorge, Jorge Buffet-García, Germán Monclús-Díez, Davinia Vicente-Campos
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/6/722
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author Mónica López-Redondo
Juan Antonio Valera-Calero
Javier Álvarez-González
Alberto Roldán-Ruiz
Sandra Sánchez-Jorge
Jorge Buffet-García
Germán Monclús-Díez
Davinia Vicente-Campos
author_facet Mónica López-Redondo
Juan Antonio Valera-Calero
Javier Álvarez-González
Alberto Roldán-Ruiz
Sandra Sánchez-Jorge
Jorge Buffet-García
Germán Monclús-Díez
Davinia Vicente-Campos
author_sort Mónica López-Redondo
collection DOAJ
description <b>Background/Objectives</b>: The quadratus lumborum (QL) muscle is a key structure involved in patients with low back pain (LBP). Since the discriminative capability of morphological descriptors is uncertain and considering the high prevalence of myofascial trigger points and the poor reliability of manual palpation in this condition, developing a reliable procedure for assessing the QL’s tenderness is needed for facilitating the diagnosis and monitoring changes over time. We aimed to analyze the intra- and inter-examiner reliability of SWE for calculating the QL tenderness in patients with LBP. <b>Methods</b>: Using a convex transducer, longitudinal shear wave elastography (SWE) images of the QL muscle were acquired bilaterally twice in 52 volunteers with moderate LBP and disability by one experienced examiner and one novel examiner to measure shear wave speed and Young’s modulus as stiffness metrics. <b>Results</b>: Intra-examiner reliability estimates demonstrated high consistency independently of the examiner’s experience (intraclass correlation coefficients (ICCs) > 0.930) for both metrics. However, experienced examiners showed smaller minimal detectable changes. Additionally, inter-examiner reliability was lower, with ICCs ranging from 0.57 to 0.68, and significant differences in mean values between examiners (<i>p</i> < 0.01) were found. <b>Conclusions</b>: This procedure exhibited excellent intra-examiner reliability for assessing QL muscle stiffness in patients suffering LBP, indicating high repeatability of measurements when performed by the same examiner. In addition, experienced examiners demonstrated greater sensitivity in detecting real changes not attributed to measurement errors. However, inter-examiner reliability was moderate, highlighting the need for consistent examiner use to avoid measurement variability and averaging multiple measurements to enhance the accuracy.
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spelling doaj-art-71081f6279724ca09be04b5dc168bfb82025-08-20T02:42:42ZengMDPI AGDiagnostics2075-44182025-03-0115672210.3390/diagnostics15060722Reliability of Shear Wave Elastography for Measuring the Elastic Properties of the Quadratus Lumborum MuscleMónica López-Redondo0Juan Antonio Valera-Calero1Javier Álvarez-González2Alberto Roldán-Ruiz3Sandra Sánchez-Jorge4Jorge Buffet-García5Germán Monclús-Díez6Davinia Vicente-Campos7Faculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Madrid, SpainDepartment of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, SpainFaculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Madrid, SpainFaculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Madrid, SpainFaculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Madrid, SpainFaculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Madrid, SpainDepartment of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, SpainFaculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Madrid, Spain<b>Background/Objectives</b>: The quadratus lumborum (QL) muscle is a key structure involved in patients with low back pain (LBP). Since the discriminative capability of morphological descriptors is uncertain and considering the high prevalence of myofascial trigger points and the poor reliability of manual palpation in this condition, developing a reliable procedure for assessing the QL’s tenderness is needed for facilitating the diagnosis and monitoring changes over time. We aimed to analyze the intra- and inter-examiner reliability of SWE for calculating the QL tenderness in patients with LBP. <b>Methods</b>: Using a convex transducer, longitudinal shear wave elastography (SWE) images of the QL muscle were acquired bilaterally twice in 52 volunteers with moderate LBP and disability by one experienced examiner and one novel examiner to measure shear wave speed and Young’s modulus as stiffness metrics. <b>Results</b>: Intra-examiner reliability estimates demonstrated high consistency independently of the examiner’s experience (intraclass correlation coefficients (ICCs) > 0.930) for both metrics. However, experienced examiners showed smaller minimal detectable changes. Additionally, inter-examiner reliability was lower, with ICCs ranging from 0.57 to 0.68, and significant differences in mean values between examiners (<i>p</i> < 0.01) were found. <b>Conclusions</b>: This procedure exhibited excellent intra-examiner reliability for assessing QL muscle stiffness in patients suffering LBP, indicating high repeatability of measurements when performed by the same examiner. In addition, experienced examiners demonstrated greater sensitivity in detecting real changes not attributed to measurement errors. However, inter-examiner reliability was moderate, highlighting the need for consistent examiner use to avoid measurement variability and averaging multiple measurements to enhance the accuracy.https://www.mdpi.com/2075-4418/15/6/722low back painquadratus lumborumreliabilityreproducibility of resultsshear wave elastography
spellingShingle Mónica López-Redondo
Juan Antonio Valera-Calero
Javier Álvarez-González
Alberto Roldán-Ruiz
Sandra Sánchez-Jorge
Jorge Buffet-García
Germán Monclús-Díez
Davinia Vicente-Campos
Reliability of Shear Wave Elastography for Measuring the Elastic Properties of the Quadratus Lumborum Muscle
Diagnostics
low back pain
quadratus lumborum
reliability
reproducibility of results
shear wave elastography
title Reliability of Shear Wave Elastography for Measuring the Elastic Properties of the Quadratus Lumborum Muscle
title_full Reliability of Shear Wave Elastography for Measuring the Elastic Properties of the Quadratus Lumborum Muscle
title_fullStr Reliability of Shear Wave Elastography for Measuring the Elastic Properties of the Quadratus Lumborum Muscle
title_full_unstemmed Reliability of Shear Wave Elastography for Measuring the Elastic Properties of the Quadratus Lumborum Muscle
title_short Reliability of Shear Wave Elastography for Measuring the Elastic Properties of the Quadratus Lumborum Muscle
title_sort reliability of shear wave elastography for measuring the elastic properties of the quadratus lumborum muscle
topic low back pain
quadratus lumborum
reliability
reproducibility of results
shear wave elastography
url https://www.mdpi.com/2075-4418/15/6/722
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