Ultrasonography Method of Deep Cervical Muscles and Thickness Measurement Reliability in Cervicogenic Headache and Healthy Subjects: A Pilot Study
Introduction: In Cervicogenic Headache (CGH), motor control of muscles is impaired and deep upper neck muscles (extensor and flexor muscles) become atrophied. In this research, thickness measurement of Longus Capitis (LCap), Rectus Capitis Posterior Major (RCPM), and Obliquus Capitis Superior (OCS) muscles were conducted and intra-rater reliability of the thickness measurement of these muscles was assessed in CGH and healthy subjects.
Materials and Methods: Twenty subjects, including 10 healthy subjects (19-32 years old) and 10 CGH patients (20-35 years old) participated in this study. LCap thickness was measured at the level of C3-C4 in the supine position and posterior muscles (RCPM and OCS) thickness at the C1-C2 level in the sitting position. All ultrasound images were captured by a linear probe with a 50-mm footprint in B mode option and frequency range of 9-12 Hz. Intraclass Correlation Coefficients (ICC), Standard Error Of Measurement (SEM), and the Smallest Detectable Difference (SDD) were calculated for data analysis.
Results: The ICC for thickness measurement of LCap was from 0.70 to 0.91 (good to excellent), for RCPM thickness was from 0.69 to 0.94 and for OCS muscle thickness was from 0.87 to 0.98. SEM values for LCap were between 0.08 and 0.25 and the SDD values between 0.22 and 0.71. SEM values for RCPM were between 0.22 and 0.43 and these values were reported for OCS muscle between 0.19 and 0.45.
Conclusion: The results indicated that the presented position and the level of ultrasonography in this study are appropriate and ultrasound is a reliable tool to measure the deep upper neck muscle thickness in CGH and healthy subjects.
2. Nilsson N. The prevalence of cervicogenic headache in a random population sample of 20-59 year olds. Spine. 1995; 20(17):1884-8. [DOI:10.1097/00007632-199509000-00008] [PMID]
3. Pfaffenrath V, Kaube H. Diagnostics of cervicogenic headache. Functional Neurology. 1990; 5(2):159-64. [PMID]
4. Jull G, Amiri M, Bullock‐Saxton J, Darnell R, Lander C. Cervical musculoskeletal impairment in frequent intermittent headache. Part 1: Subjects with single headaches. Cephalalgia. 2007; 27(7):793-802. [DOI:10.1111/j.1468-2982.2007.01345.x] [PMID]
5. Rezasoltani A, Ahmadipoor AR, Khademi-Kalantari Kh, Javanshir Kh. The sign of unilateral neck semispinalis capitis muscle atrophy in patients with chronic non-specific neck pain. Journal of Back and Musculoskeletal Rehabilitation. 2012; 25(1):67-72. [DOI:10.3233/BMR-2012-0303] [PMID]
6. Falla DL, Jull GA, Hodges PW. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine. 2004; 29(19):2108-14. [DOI:10.1097/01.brs.0000141170.89317.0e] [PMID]
7. Zito G, Jull G, Story I. Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Manual Therapy. 2006; 11(2):118-29. [DOI:10.1016/j.math.2005.04.007] [PMID]
8. Javanshir Kh, Rezasoltani A, Mohseni-Bandpei MA, Amiri M, Ortega-Santiago R, Fernández-de-Las-Peñas C. Ultrasound assessment of bilateral longus colli muscles in subjects with chronic bilateral neck pain. American Journal of Physical Medicine & Rehabilitation. 2011; 90(4):293-301. [DOI:10.1097/PHM.0b013e31820173e5] [PMID]
9. Javanshir Kh, Amiri M, Mohseni-Bandpei MA, Rezasoltani A, Fernández-de-las-Peñas C. Ultrasonography of the cervical muscles: A critical review of the literature. Journal of Manipulative and Physiological Therapeutics. 2010; 33(8):630-7. [DOI:10.1016/j.jmpt.2010.08.016] [PMID]
10. Kristjansson E. Reliability of ultrasonography for the cervical multifidus muscle in asymptomatic and symptomatic subjects. Manual Therapy. 2004; 9(2):83-8. [DOI:10.1016/S1356-689X(03)00059-6]
11. Jesus FMR, Ferreira PH, Ferreira ML. Ultrasonographic measurement of neck muscle recruitment: A preliminary investigation. Journal of Manual & Manipulative Therapy. 2008; 16(2):89-92. [DOI:10.1179/106698108790818486] [PMID] [PMCID]
12. Stokes M, Hides J, Nassiri DK. Musculoskeletal ultrasound imaging: Diagnostic and treatment aid in rehabilitation. Physical Therapy Reviews. 1997; 2(2):73-92. [DOI:10.1179/ptr.1918.104.22.168]
13. Abaspour O, Javanshir Kh, Amiri M, Karimlou M. Relationship between cross sectional area of Longus Colli muscle and pain laterality in patients with cervicogenic headache. Journal of Back and Musculoskeletal Rehabilitation. 2015; 28(2):393-9. [DOI:10.3233/BMR-140532] [PMID]
14. Rankin G, Stokes M, Newham DJ. Size and shape of the posterior neck muscles measured by ultrasound imaging: Normal values in males and females of different ages. Manual Therapy. 2005; 10(2):108-15. [DOI:10.1016/j.math.2004.08.004] [PMID]
15. O’sullivan C, Bentman S, Bennett K, Stokes M. Rehabilitative ultrasound imaging of the lower trapezius muscle: Technical description and reliability. The Journal of Orthopaedic and Sports Physical Therapy. 2007; 37(10):620-6. [DOI:10.2519/jospt.2007.2446] [PMID]
16. Franchi MV, Longo S, Mallinson J, Quinlan JI, Taylor T, Greenhaff PL, et al. Muscle thickness correlates to muscle cross‐sectional area in the assessment of strength training‐induced hypertrophy. Scandinavian Journal of Medicine & Science in Sports. 2018; 28(3):846-53. [DOI:10.1111/sms.12961] [PMID] [PMCID]
17. Strasser EM, Draskovits T, Praschak M, Quittan M, Graf A. Association between ultrasound measurements of muscle thickness, pennation angle, echogenicity and skeletal muscle strength in the elderly. AGE. 2013; 35(6):2377-88. [DOI:10.1007/s11357-013-9517-z] [PMID] [PMCID]
18. Muraki S, Fukumoto K, Fukuda O. Prediction of the muscle strength by the muscle thickness and hardness using ultrasound muscle hardness meter. SpringerPlus. 2013; 2:457.[DOI:10.1186/2193-1801-2-457] [PMID] [PMCID]
19. Fernández-De-Las-Peñas C, Albert-Sanchís JC, Buil M, Benitez JC, Alburquerque-Sendín F. Cross-sectional area of cervical multifidus muscle in females with chronic bilateral neck pain compared to controls. The Journal of Orthopaedic and Sports Physical Therapy. 2008; 38(4):175-80. [DOI:10.2519/jospt.2008.2598] [PMID]
20. Rezasoltani A, Kallinen M, Mälkiä E, Vihko V. Ultrasonography of the neck splenius capitis muscle: Investigation in a group of young healthy women. Acta Radiologica. 1996; 37(3P2):647-50. [DOI:10.1177/02841851960373P245] [PMID]
21. Rezasoltani A, Kallinen M, Mälkiä E, Vihko V. Neck semispinalis capitis muscle size in sitting and prone positions measured by real-time ultrasonography. Clinical Rehabilitation. 1998; 12(1):36-44. [DOI:10.1191/026921598673972662] [PMID]
22. Lin YJ, Chai HM, Wang SF. Reliability of thickness measurements of the dorsal muscles of the upper cervical spine: An ultrasonographic study. The Journal of Orthopaedic and Sports Physical Therapy. 2009; 39(12):850-7. [DOI:10.2519/jospt.2009.3005] [PMID]
23. Abbaspour Khajeh O, Amiri M, Javanshir Kh, Karimlo M. [Reliability of longus colli muscle size measurement in healthy subjects and patients with cervicogenic headache using ultrasonography (Persian)]. Journal of Babol University of Medical Sciences. 2012; 14(4):97-101. http://jbums.org/article-1-4143-en.html
24. Kendall FP, McCreary EK. Muscles: Testing and function. Philadelphia: Lippincott Williams & Wilkins; 1983. pp. 141-52. https://books.google.com/books?id=SA1tAAAAMAAJ&q
25. Sjaastad O, Fredriksen TA, Pfaffenrath V. Cervicogenic headache: Diagnostic criteria. Headache: The Journal of Head and Face Pain. 1998; 38(6):442-5. [DOI:10.1046/j.1526-4610.1998.3806442.x] [PMID]
26. Rosner B. Fundamentals of Biostatistics. Solutions manual for fundamentals of biostatistics 5th Edition. California: Duxbury Press; 2006.
27. Martin Bland J, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. The Lancet. 1986; 327(8476):307-10. [DOI:10.1016/S0140-6736(86)90837-8]
28. Cho JCS, Haun DW, Kettner NW, Scali F, Clark TB. Sonography of the normal greater occipital nerve and obliquus capitis inferior muscle. Journal of Clinical Ultrasound. 2010; 38(6):299-304. [DOI:10.1002/jcu.20693] [PMID]
29. Øverås CK, Myhrvold BL, Røsok G, Magnesen E. Musculoskeletal diagnostic ultrasound imaging for thickness measurement of four principal muscles of the cervical spine -a reliability and agreement study. Chiropractic & Manual Therapies. 2017; 25:2. [DOI:10.1186/s12998-016-0132-9] [PMID] [PMCID]
30. Cagnie B, Derese E, Vandamme L, Verstraete K, Cambier D, Danneels L. Validity and reliability of ultrasonography for the longus colli in asymptomatic subjects. Manual Therapy. 2009; 14(4):421-6. [DOI:10.1016/j.math.2008.07.007] [PMID]
31. Javanshir Kh, Mohseni-Bandpei MA, Rezasoltani A, Amiri M, Rahgozar M. Ultrasonography of longus colli muscle: A reliability study on healthy subjects and patients with chronic neck pain. Journal of Bodywork and Movement Therapies. 2011; 15(1):50-6. [DOI:10.1016/j.jbmt.2009.07.005] [PMID]
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