Reference values for the cross-sectional area of the lumbar multifidus muscle in children.

BACKGROUND: The multifidus muscle plays a major role in the growth and postural control of children. Therefore, the reference values of the cross-sectional area (CSA) of the lumbar multifidus muscle represent an important tool for assessing muscle development and the early monitoring of musculoskeletal disorders. OBJECTIVE: The aim of this study was to provide percentile scores for the CSA of the lumbar multifidus muscle in eutrophic children aged 5 to 10 years. METHODS: This was a cross-sectional, observational study, involving 736 children. An anthropometric assessment was conducted and ultrasound (US) imaging was used to assess the CSA of the lumbar (vertebral level L5) multifidus muscle. The CSA was expressed as percentile scores. RESULTS: The CSA in the boys ranged from 1.8 cm2 to 5.3 cm2 and in girls from 1.9 cm2 to 5.9 cm. The CSA in the 50th percentile scores of both sexes was 3.4 cm2. There was an increase in the CSA between 5 and 7 years old in both sexes. The CSA presented a greater variance in girls than in boys. After 8 years of age, the multifidus CSA increased in girls and decreased in boys. CONCLUSION: The present study has provided percentile scores for the CSA of the lumbar multifidus muscle for eutrophic children aged 5 to 10 years. An increase was observed of the CSA of the multifidus muscle between the ages of 5 and 7 years and there were no differences in the CSA percentiles in relation to sex. An increase in the CSA after 8 years of age was only observed in the girls.

The accuracy of computerized biophotogrammetry in diagnosing changes in the cervical spine and its reliability for the cervical lordosis angle.

BACKGROUND: Accuracy studies of biophotogrammetry protocols require standardization similar to radiography. OBJECTIVE: To estimate the diagnostic accuracy of a biophotogrammetric assessment protocol for cervical hyperlordosis, compared to radiography, and its intra- and inter-examiner reliability for measuring the cervical lordosis angle. METHODS: A study of diagnostic accuracy in women complaining of cervical pain. Two photos were taken using the CorelDraw biophotogrammetric protocol and one radiograph using the Cobb C1-C7 method. The Intra- and Inter-examiner reliability was calculated using the Kappa index and the intraclass correlation coefficient (ICC). The Bland-Altman plot and the ROC curve were presented. RESULTS: The sample consisted of 19 women. The accuracy of biophotogrammetry was 94.73% and the reliability between biophotogrammetry and radiography presented an ICC of 0.84 and a Kappa of 0.87. The excellent intra (ICC = 0.94) and inter-examiner (ICC = 0.86) reliability of the biophotogrammetry was confirmed. The area under the ROC curve was 93.5%. The Bland-Altman plot indicated differences between the two instruments close to the mean (1.5∘). CONCLUSION: The biophotogrammetric protocol proved to be accurate in diagnosing cervical hyperlordosis, with excellent reliability between the biophotogrammetric and radiographic assessments. It also demonstrated excellent intra- and inter-examiner reliability in measuring the cervical lordosis angle.