Comparison of trunk muscle thickness and brightness in collegiate female athletes with and without a history of low back pain

Abstract

BACKGROUND:

Trunk muscle thickness and brightness are associated with injuries.

OBJECTIVE:

This study compared trunk muscle thickness and brightness between female college athletes with and without history of low back pain.

METHODS:

15 sprinters, 22 volleyball-, and 18 basketball players, all females, were included. The participants were grouped based on the presence of low back pain. Short-axis ultrasound images of the rectus abdominis, external oblique, internal oblique, transverse abdominis, and lumbar multifidus were obtained. The muscle brightness was calculated after selecting the region of interest for each muscle. Muscle thickness and brightness in both groups were compared.

RESULTS:

In sprinters, the right lumbar multifidus thickness was significantly thinner in the low back pain group (24.66 $\pm$ 2.98 mm) than in the healthy group (28.13 $\pm$ 2.84 mm). Volleyball and basketball players showed no significant differences in muscle thickness between the two groups for any muscle type. In volleyball players, the right transverse abdominis thickness is inclined toward thinness in the low back pain group than in the healthy group, but the difference was not significant. In all sports, there were no significant differences in muscle brightness between the two groups.

CONCLUSIONS:

Low back pain in female college athletes may not be related to trunk muscle thickness and brightness.

Keywords

Trunk muscle low back pain thickness female athlete

Table 1
Participant characteristics based on the sport engaged

	Age (y)	Height (cm)	Weight (Kg)	Career duration (years)
Sprinters
LBP ( $n=$ 8)	20.4 $\pm$ 0.9	161.1 $\pm$ 5.9	55.0 $\pm$ 3.8	9.8 $\pm$ 2.2
Healthy ( $n=$ 7)	20.4 $\pm$ 0.8	160.4 $\pm$ 5.9	55.6 $\pm$ 6.1	9.5 $\pm$ 1.5
Volleyball players
LBP ( $n=$ 11)	19.6 $\pm$ 1.2	167.9 $\pm$ 5.5	63.6 $\pm$ 9.2	10.6 $\pm$ 2.5
Healthy ( $n=$ 11)	19.6 $\pm$ 0.8	167.9 $\pm$ 5.3	63.7 $\pm$ 8.4	11.3 $\pm$ 2.4
Basketball players
LBP ( $n=$ 7)	19.9 $\pm$ 0.4	166.5 $\pm$ 5.9	62.4 $\pm$ 6.6	12.0 $\pm$ 2.1
Healthy ( $n=$ 11)	19.9 $\pm$ 0.8	167.0 $\pm$ 5.4	63.2 $\pm$ 6.8	12.2 $\pm$ 1.4

Group characteristics are expressed as mean $\pm$ standard deviation (SD). Low back pain (LBP).

1. Introduction

Athletes have a higher frequency of history of low back pain (LBP) than non-athletes [1]. The frequency of lumbar injuries caused by sports was investigated, and in sprinters, the frequency of lumbar injuries was the highest compared with all other injury sites [2]. Approximately 40% of female college volleyball players have experienced LBP in the past year [3], indicating a high frequency of LBP in various sports. Those engaged in volleyball and basketball have 3.8 and 2.5 times higher instances of developing LBP compared with those who did not exercise regularly [1]. Thus, the prevention of low back disorders is necessary owing to the high frequency of LBP in athletes, regardless of the sport.

Quantitative factors such as trunk muscle thickness are involved in LBP [4, 5]. In middle-aged individuals with LBP, the cross-sectional area of the multifidus ipsilateral to the side of pain decreases [4]. In a study of young athletes, it has been established that the cross-sectional area of the lumbar MF and TrA thickness is significantly lower in cyclists with LBP than in healthy participants [6]. Additionally, in young soccer players, oblique abdominal muscle thickness is decreased in players with a history of LBP compared with healthy players [5].

In recent years, not only quantitative factors but also qualitative factors have been considered. Muscle brightness has gained popularity as an index that may be used to estimate the degree of adipose tissue and intramuscular fibrous within skeletal muscles. Muscle brightness is the degree of black and white (echo intensity) of the muscle on ultrasound images and is considered to be an estimation of muscle quality. High muscle brightness indicates a high degree of adipose tissue and intramuscular fibrous within skeletal muscle. A significant correlation between muscle composition calculated using muscle brightness, and that calculated by muscle biopsy has been reported [7], indicating the validity of evaluating muscle brightness.

Muscle brightness has also been reported to be related to muscle strength and injury. For example, reports indicate that muscle brightness is correlated with muscle strength in the elderly [8], suggesting the importance of muscle luminance assessment. In addition, the brightness of the peroneus longus muscle in individuals with chronic ankle instability (CAI) was higher on the CAI side than on the non-CAI side in their twenties [9]. Thus, it has been reported that muscle brightness is associated with the presence or absence of ankle joint injury, even in young adults. LBP and trunk muscle brightness in athletes may also be related, but the relationship between LBP and muscle brightness is unknown.

Since athletes have a high frequency of LBP, investigating whether muscle quality and thickness are related to LBP may help prevent LBP. Most investigations on muscle thickness and brightness in athletes have been conducted on male athletes [5, 6, 7, 8, 9]. Investigating whether muscle brightness and thickness are related to LBP in female athletes may aid in preventing LBP. Therefore, in this study, we aimed to clarify the relationship between the history of LBP, trunk muscle thickness, and muscle brightness in female athletes.

2. Methods

2.1 Participants

Fifty-five collegiate female athletes were included in this study (Table 1). Athletes from 3 sports were included: 15 sprinters in track and field, 22 in volleyball, and 18 players in basketball. Those with at least 5 years of athletic history were included. Eleven sprinters (73.3%) were at the national competition level, and four (26.7%) were at the regional competition level. Eighteen volleyball players (81.8%) were at the national competition level, and four (18.2%) were at the regional competition level. All basketball players (100%) were at the national competition level. All participants were members of the same university athletic team. Participants decided to participate in the study of their own free will after the teams in each sport were asked to participate in the study. To eliminate the influence of recent physical activity on muscle brightness, measurements were taken at least 12 h after the end of the exercise. Those with a history of spinal surgery were excluded.

The inclusion criteria for the LBP group were as follows: at least 5 episodes of LBP in the lifetime, at least 3 episodes in the past 3 years, and at least 1 episode within 6 months [10]. LBP was defined as pain between the 12th rib and the inferior end of the gluteal fold lasting more than 1 day. The participants were informed of the study in writing, and their consent was obtained before the study was conducted. This study was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of the affiliated institution (Approval number: 1858-210218, Approval date: 2/18/2021).

Figure 1.

Method for measuring muscle thickness. Ultrasound short-axis images of the right rectus abdominis muscle (A), right oblique muscle group (B), and right lumbar multifidus muscle (C).

2.2 Experimental protocol

Ultrasound imaging was performed using an ultrasound imaging system (Aplio 500, Toshiba Medical Systems) with a 10 MHz linear probe. The instrument settings were B mode, focus point of 2 cm, and gain of 100 dB, which were kept consistent during the measurements. The target muscles included the rectus abdominis, external oblique, internal oblique, transverse abdominis, and lumbar multifidus. Measurements were obtained from the sprinters on the right side, while volleyball and basketball players were measured on both sides. Because volleyball and basketball involve many asymmetrical movements, bilateral imaging was performed. The abdominal muscles were measured in the supine position, the lumbar multifidus was measured in the prone position, and the upper limbs were positioned on the side of the body. Additionally, the participants were instructed to breathe quietly while resting during the measurements [11]. One image was taken for each exhalation, and all measurements were performed by the same examiner (C.S.). The rectus abdominis (RA) was measured 3 cm lateral to the umbilicus [11]. The transversus abdominis (TrA) internal oblique (IO), and external oblique (EO) muscles were measured 2.5 cm anterior to the mid-axillary line at the midpoint between the inferior rib and iliac crest [11]. Furthermore, the lumbar multifidus (MF) was measured 2 cm lateral to the L4 spinous process [11]. The probe was applied perpendicular to the skin with minimal pressure, and two short-axis ultrasound images were obtained for each muscle [12].

2.3 Measurement of muscle thickness (Fig. 1)

Table 2
Intraclass correlation coefficients (ICC) and Minimal detectable change (MDC)

	ICC (1,2)	MDC₉₅
Muscle thickness (mm)
Right RA	0.99	0.68
Right TrA	0.966	0.55
Right IO	0.98	0.79
Right EO	0.987	0.84
Right MF	0.971	2.66
Muscle brightness (0–255)
Right RA	0.975	6.11
Right TrA	0.960	9.09
Right IO	0.978	8.08
Right EO	0.938	7.88
Right MF	0.948	9.57

Abbreviations: rectus abdominis (RA), transversus abdominis (TrA), internal oblique (IO), external oblique (EO), lumbar multifidus (MF).

Muscle thickness was calculated at 0.1 mm intervals using calipers on the ultrasound image. The locations of the fascia and vertebral arch were identified on ultrasound images. The maximum muscle thickness was used as the measurement for the RA. For the TrA, IO, and EO, the muscle thickness was measured at 2 cm from the TrA intersection [13]. The line connecting the vertebral arch to the subcutaneous tissue was measured for obtaining MF, and the maximum value was considered as the MF measurement. Two images were analyzed once, and the average value was calculated [12]. All analyses were performed by the same examiner (C.S.).

Table 3

Muscle thickness

	Muscle thickness (mm)
	LBP group	Healthy group	p-value
Sprinters
Right RA	12.96 $\pm$ 1.88	12.29 $\pm$ 2.48	0.558
Right TrA	3.39 $\pm$ 0.58	3.64 $\pm$ 0.80	0.486
Right IO	9.74 $\pm$ 1.97	9.10 $\pm$ 2.25	0.568
Right EO	8.48 $\pm$ 1.07	9.70 $\pm$ 1.55	0.094^†
Right MF	24.66 $\pm$ 2.98	28.13 $\pm$ 2.84	0.039^*
Volleyball players
Right RA	12.05 $\pm$ 2.08	11.99 $\pm$ 1.68	0.947
Right TrA	3.08 $\pm$ 0.73	3.65 $\pm$ 0.66	0.071^†
Right IO	8.65 $\pm$ 2.28	8.75 $\pm$ 1.83	0.903
Right EO	8.82 $\pm$ 1.01	8.70 $\pm$ 1.44	0.826
Right MF	26.10 $\pm$ 3.56	27.80 $\pm$ 4.05	0.309
Left RA	12.56 $\pm$ 1.66	12.77 $\pm$ 2.39	0.718
Left TrA	3.05 $\pm$ 0.70	3.52 $\pm$ 0.82	0.161
Left IO	8.07 $\pm$ 1.81	8.79 $\pm$ 2.29	0.424
Left EO	9.25 $\pm$ 2.14	8.77 $\pm$ 1.16	0.522
Left MF	26.99 $\pm$ 3.16	28.45 $\pm$ 3.91	0.349
Basketball players
Right RA	11.03 $\pm$ 1.02	11.36 $\pm$ 0.94	0.485
Right TrA	3.50 $\pm$ 0.95	3.32 $\pm$ 0.50	0.6
Right IO	9.21 $\pm$ 1.75	9.51 $\pm$ 1.86	0.741
Right EO	9.13 $\pm$ 1.62	9.25 $\pm$ 1.76	0.881
Right MF	26.50 $\pm$ 2.08	26.71 $\pm$ 2.66	0.863
Left RA	11.50 $\pm$ 1.12	11.06 $\pm$ 1.32	0.481
Left TrA	3.36 $\pm$ 0.84	3.05 $\pm$ 0.76	0.427
Left IO	8.24 $\pm$ 1.75	8.10 $\pm$ 2.04	0.881
Left EO	10.01 $\pm$ 1.62	9.48 $\pm$ 1.94	0.341
Left MF	27.46 $\pm$ 3.01	27.12 $\pm$ 2.99	0.818

Muscle thickness is expressed as the mean $\pm$ standard deviation. Abbreviations: rectus abdominis (RA), transversus abdominis (TrA), internal oblique (IO), external oblique (EO), lumbar multifidus (MF). ^{*p <} 0.05 and ^{†p <} 0.1.

2.4 Measurement of muscle echo intensity

Muscle brightness was evaluated by computer-assisted 8-bit grayscale analysis using the standard histogram function in Image J (U.S. National Institutes of Health, Bethesda, MD, USA). Muscle brightness indicates muscle quality. High muscle brightness (high value) indicates a high amount of adipose tissue and intramuscular fibrous. The region of interest for muscle brightness was selected for each muscle to include the maximum part of muscle possible without the bone or surrounding fascia [11]. The mean muscle brightness in the region of interest was calculated and expressed as a value ranging from 0 (black) to 255 (white). Two images were analyzed once, and the average value was calculated [12]. All analyses were performed by the same examiner (C.S.).

Figure 2.

Muscle thickness. Mean and standard deviation of trunk muscle thickness in sprinters, volleyball players, and basketball players. Sprinters: right side, Volleyball, and Basket players: right and left side ^{* p <} 0.05 and ^†p < 0.1.

2.5 Intraclass correlation coefficients (ICC) and Minimal detectable change (MDC)

ICC (1,2) was used to examine the intra-rater reliability of muscle thickness and brightness measurements. Eight female university students were included in the ICC measurements performed by the examiner, and the measurements were identical to those used in the main experiment. The right side of the trunk was measured. We calculated the MDC with a 95% confidence interval (MDC₉₅) using the following equation: MDC ${}_{95}=$ 1.96 $\times\sqrt{2}\times$ standard error of measurement (SEM); SEM was calculated as SEM $=\frac{\textit{SD}^{d}}{\sqrt{2}}$ [14]. SD^d is the standard deviation (SD) of the difference between two measurements (d).

2.6 Statistical analyses

Figure 3.

Muscle brightness. Means and standard deviations of trunk muscle brightness in sprinters, volleyball players, and basketball players. Sprinters: right side, Volleyball, and Basket players: right and left side.

Table 4

Muscle brightness

	Muscle brightness (0–255)
	LBP group	Healthy group	p-value
Sprinters
Right RA	90.51 $\pm$ 8.01	88.66 $\pm$ 7.52	0.653
Right TrA	55.48 $\pm$ 5.53	52.54 $\pm$ 7.08	0.384
Right IO	68.73 $\pm$ 3.90	66.34 $\pm$ 6.15	0.38
Right EO	80.38 $\pm$ 6.55	80.01 $\pm$ 6.15	0.915
Right MF	80.74 $\pm$ 11.42	74.21 $\pm$ 9.58	0.256
Volleyball players
Right RA	87.98 $\pm$ 7.04	90.31 $\pm$ 6.61	0.433
Right TrA	54.81 $\pm$ 11.08	53.55 $\pm$ 8.20	0.766
Right IO	61.92 $\pm$ 10.34	65.19 $\pm$ 9.20	0.442
Right EO	75.66 $\pm$ 5.90	79.55 $\pm$ 8.26	0.219
Right MF	80.92 $\pm$ 10.18	76.85 $\pm$ 7.84	0.306
Left RA	85.47 $\pm$ 7.57	88.31 $\pm$ 6.30	0.351
Left TrA	53.33 $\pm$ 11.11	55.43 $\pm$ 8.54	0.625
Left IO	64.56 $\pm$ 10.79	70.65 $\pm$ 9.77	0.181
Left EO	81.48 $\pm$ 6.11	85.42 $\pm$ 7.72	0.2
Left MF	76.94 $\pm$ 11.05	73.97 $\pm$ 5.70	0.14
Basketball players
Right RA	86.99 $\pm$ 9.52	89.55 $\pm$ 8.68	0.565
Right TrA	52.89 $\pm$ 12.29	50.25 $\pm$ 9.33	0.611
Right IO	68.50 $\pm$ 7.22	65.80 $\pm$ 10.81	0.57
Right EO	80.00 $\pm$ 5.82	78.97 $\pm$ 10.43	0.816
Right MF	75.64 $\pm$ 9.42	75.27 $\pm$ 8.40	0.932
Left RA	87.76 $\pm$ 9.71	90.39 $\pm$ 8.17	0.544
Left TrA	49.67 $\pm$ 10.39	48.42 $\pm$ 10.51	0.808
Left IO	65.87 $\pm$ 5.17	63.13 $\pm$ 12.58	0.594
Left EO	79.43 $\pm$ 5.83	78.51 $\pm$ 7.15	0.78
Left MF	68.94 $\pm$ 11.64	71.35 $\pm$ 10.70	0.658

Muscle brightness is expressed as the mean $\pm$ standard deviation. Abbreviations: rectus abdominis (RA), transversus abdominis (TrA), internal oblique (IO), external oblique (EO), lumbar multifidus (MF), low back pain (LBP).

The Kolmogorov-Smirnov test was used to confirm data normality. Data on participants, muscle thickness, and brightness were compared between the LBP and healthy groups for each sport. Normally distributed items were compared between the two groups using an unpaired $t$ -test. Items that were not normally distributed were compared using the Mann-Whitney $U$ test. SPSS Statistics 29.0 (IBM Corp., USA) was used for all the statistical analyses. The level of significance was set at $p=$ 0.05.

3. Results

3.1 Participant characteristics (Table 1)

Eight sprinters were classified into the LBP group and seven sprinters into the healthy group. Both LBP and healthy groups had eleven volleyball players each. Furthermore, 7 and 11 basketball players were classified into the LBP and the healthy group, respectively. There were no significant differences in age, height, weight, Body Mass Index, or athletic career between the two groups in any sport.

3.2 ICC and MDC₉₅ (Table 2)

Table 2 shows the results of ICC and MDC₉₅. The ICC (1,2) values of muscle thickness and muscle brightness measurements were $>$ 0.81 for all muscles, indicating a high degree of reliability for both types of assessments [15].

3.3 Muscle thickness (Table 3) (Fig. 2)

In sprinters, the right MF thickness was 24.66 $\pm$ 2.98 mm and 28.13 $\pm$ 2.84 mm in the LBP and the healthy groups, respectively. It was significantly thinner in the LBP group than in the healthy group ( $p<$ 0.05, $d$ $=$ 1.19). The right EO thickness was 8.48 $\pm$ 1.07 mm and 9.7 $\pm$ 1.55 mm in the LBP and healthy groups, respectively, with a tendency toward thinness in the LBP group ( $p=$ 0.094, $d=$ 0.93). In other muscles, there were no significant differences in thickness between the two groups. In volleyball players, no significant differences were observed in muscle thickness between the groups for any muscle type. The right TrA thickness was 3.08 $\pm$ 0.73 mm and 3.65 $\pm$ 0.66 mm in the LBP and healthy groups, respectively, with a tendency toward thinness in the LBP group ( $p=$ 0.071, $d=$ 0.81). In basketball players, there was no significant difference in muscle thickness between the groups for all muscles.

3.4 Muscle brightness (Table 4) (Fig. 3)

In all sports, there was no significant difference in muscle brightness between the two groups for all muscles.

4. Discussion

In this study, we examined the relationship between the history of LBP, trunk muscle thickness, and brightness in female college athletes. The results revealed a relationship between a history of LBP and trunk muscle thickness in sprinters.

Sprinters exhibited a significant decrease in right MF thickness in the LBP group compared with the healthy group. Previous studies reported that LBP is related to MF thickness, and the results were similar in sprinters. For instance, the cross-sectional area of the lumbar MF is decreased in patients with chronic LBP compared with healthy participants [16], and the lumbar MF thickness changes during voluntary contraction are reduced compared with healthy participants [17]. Voluntary contraction of the MF muscle inhibits lumbar spine movement and increases lumbar spine stiffness in the neutral zone [18]. Thus, lumbar spinal stability may be reduced in sprinters with a history of LBP. A reduced MF thickness causes instability of the lumbar spine, which may lead to an increased risk of intervertebral disc and facet joint disorders. Furthermore, it has been reported that 100 m sprinting time is related to MF thickness [19], hence, competitive performance may be reduced in sprinters with low values of muscle thickness in the multifidus muscle.

In volleyball players, right TrA muscle thickness tended to be lower in the LBP group than in the healthy group, but there was no significant difference between the two groups. In this study, expect for one participant, the volleyball players were right-handed during the serving and spiking tasks, and those with a history of LBP tended to have lower TrA muscle thickness on the dominant side. However, there was no significant difference in TrA muscle thickness between the two groups. A study investigating the relationship between head and neck and upper extremity injuries and trunk muscle thickness in volleyball players revealed that TrA muscle thickness did not differ with varying histories of injury of the player, and these results were consistent with those in our study [20]. Alternatively, some reports indicate that adolescent female volleyball players with more than two years of experience have greater TrA muscle thickness than other women of the same age [21]. As the TrA was higher in volleyball players, the TrA may be used frequently in volleyball movements. However, the present study did not find a relationship between LBP and muscle thickness, and further investigations are mandated because TrA muscle thickness may be important in volleyball.

In this study, only the sprinter’s multifidus muscle thickness was related to a history of LBP. Previous studies have failed to reach a consensus on the relationship between LBP and muscle thickness. For example, in young soccer players, the cross-sectional area of the lumbar MF and TrA thickness does not change in the presence or absence of LBP [3, 22]. Conversely, it has been established that the cross-sectional area of the lumbar MF and TrA thickness is significantly lower in cyclists with LBP than in healthy participants [6]. The results of this study suggest that there may be no relationship between a history of LBP and trunk muscle thickness in female athletes, but further investigation is needed to make a definitive conclusion.

Additionally, changes in the TrA muscle thickness during voluntary contraction from rest were investigated. For example, the change in TrA muscle thickness during draw-in is smaller in patients with pre-existing LBP than in those without preexisting LBP [10]. In ballet dancers, it has been reported that the slide of the TrA during draw-in is smaller in those with a history of LBP than in healthy individuals [23]. Future studies, including studies investigating changes in muscle thickness during voluntary contractions, may clarify the relationship between LBP and trunk muscle thickness in female athletes.

No difference was found in muscle brightness between the healthy and LBP groups in any of the muscles in all sports. Based on the results of the present study, trunk muscle brightness may not be associated with LBP in collegiate athletes. It has been reported that trunk muscle brightness in healthy women aged 20–60 years is higher in women aged 40 years than in those in their twenties [11]. Since trunk muscle brightness increases with age, the presence or absence of a history of LBP may not cause differences in muscle brightness in collegiate athletes. However, reports indicate that the brightness of the peroneus longus muscle in individuals with chronic ankle instability is higher on the affected side than on the healthy side, even in young individuals [9]; therefore, further investigation is needed.

This study has several limitations. First, LBP severity was not assessed in this study. Differences in the severity of LBP may have affected the results. Second, the sample size was small. As this study was conducted on young female athletes, it was difficult to recruit a large number of participants. Therefore, it is desirable to recruit a larger number of participants and conduct further studies.

The results of this study suggest that LBP in female college athletes may not be related to trunk muscle thickness and brightness. Therefore, future research should focus not only on muscle morphology but also on muscle function and muscle activity during sports activities. The results of this study suggest that increasing the muscle thickness of the MF in sprinters may help prevent LBP.

5. Conclusions

Low back pain in female college athletes may not be related to trunk muscle thickness and brightness. In sprinters, MF thickness was significantly decreased in the LBP group compared to the healthy group, but no difference was observed between the two groups in the other sports. Regardless of the sport, muscle brightness was not associated with a history of LBP. Future research should focus not only on muscle morphology but also on muscle function and muscle activity during sports activities.

Author contributions

CONCEPTION: C.S. and M.E.

PERFORMANCE OF WORK: C.S.

INTERPRETATION OR ANALYSIS OF DATA: C.S.

PREPARATION OF THE MANUSCRIPT: C.S., H.Y., R.H., H.A., T.I., T.K. and M.E.

REVISION FOR IMPORTANT INTELLECTUAL CONTENT: C.S., H.Y., R.H., H.A., T.I., T.K. and M.E.

SUPERVISION: C.S.

Ethical approval

This study was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of the affiliated institution.

Funding

This study was supported by a Grant-in-Aid for Scientific Research (21K17556) from the Japanese Society for the Promotion of Science (JSPS) and a Grant-in-Aid from the Niigata University of Health and Welfare.

Footnotes

Acknowledgments

We would like to express our deepest gratitude to the team managers, coaches, and players who contributed to this study.

Conflict of interest

The authors declare that they have no competing interests.

References

Hangai

Kaneoka

Okubo

Miyakawa

Hinotsu

Mukai

, et al. Relationship between low back pain and competitive sports activities during youth. Am J Sports Med. 2010; 38(4): 791-96. doi: 10.1177/0363546509350297.

D’Souza

. Track and field athletics injuries – a one-year survey. Br J Sports Med. 1994; 28(3): 197-202. doi: 10.1136/bjsm.28.3.197.

Noormohammadpour

Rostami

Mansournia

Farahbakhsh

Pourgharib Shahi

MHP

Kordi

. Low back pain status of female university students in relation to different sport activities. Eur Spine J. 2016; 25(4): 1196-203. doi: 10.1007/s00586-015-4034-7.

Hides

Gilmore

Stanton

Bohlscheid

. Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects. Man Ther. 2008; 13(1): 43-9. doi: 10.1016/j.math..

Noormohammadpour

Mirzaei

Moghadam

Mansournia

Kordi

. Comparison of lateral abdominal muscle thickness in young male soccer players with and without low back pain. Int J Sports Phys Ther. 2019; 14(2): 273-81. doi: 10.26603/ijspt20190273.

Rostami

Ansari

Noormohammadpour

Mansournia

Kordi

. Ultrasound assessment of trunk muscles and back flexibility, strength and endurance in off-road cyclists with and without low back pain. J Back Musculoskelet Rehabil. 2015; 28(4): 635-44. doi: 10.3233/BMR-140559.

Pillen

Tak

Zwarts

Lammens

MMY

Verrijp

Arts

, et al. Skeletal muscle ultrasound: correlation between fibrous tissue and echo intensity. Ultrasound Med Biol. 2009; 35(3): 443-6. doi: 10.1016/j.ultrasmedbio.2008.09.016.

Fukumoto

Ikezoe

Yamada

Tsukagoshi

Nakamura

Mori

, et al. Skeletal muscle quality assessed from echo intensity is associated with muscle strength of middle-aged and elderly persons. Eur J Appl Physiol. 2012; 112(4): 1519-25. doi: 10.1007/s00421-011-2099-5.

Sakai

Urabe

Morikawa

Fujishita

Komiya

Sasadai

, et al. Quantity and quality of the peroneus longus assessed using ultrasonography in the leg with chronic ankle instability. J Phys Ther Sci. 2018; 30(12): 1396-400. doi: 10.1589/jpts.30.1396.

10.

Sutherlin

Gage

Mangum

Hertel

Russell

Saliba

et al. Changes in muscle thickness across positions on ultrasound imaging in participants with or without a history of low back pain. J Athl Train. 2018; 53(6): 553-9. doi: 10.4085/1062-6050-491-16.

11.

Ota

Ikezoe

Kato

Tateuchi

Ichihashi

. Age-related changes in muscle thickness and echo intensity of trunk muscles in healthy women: comparison of 20–60 s age groups. Eur J Appl Physiol. 2020; 120(8): 1805-14. doi: 10.1007/s00421-020-04412-7.

12.

Monjo

Fukumoto

Asai

Kubo

Ohshima

Tajitsu

, et al. Differences in muscle thickness and echo intensity between stroke survivors and age- and sex-matched healthy older adults. Phys Ther Res. 2020; 23(2): 188-94. doi: 10.1298/ptr.E10018.

13.

Briani

Waiteman

de Albuquerque

Gasoto

Segatti

Oliveira

, et al. Lower trunk muscle thickness is associated with pain in women with patellofemoral pain. J Ultrasound Med. 2019; 38(10): 2685-93. doi: 10.1002/jum.14973.

14.

Faber

Bosscher

van Wieringen

PCW

. Clinimetric properties of the performance-oriented mobility assessment. Phys Ther. 2006; 86(7): 944-54. doi: 10.1093/ptj/86.7.944.

15.

Landis

Koch

. The measurement of observer agreement for categorical data. Biometrics. 1977; 33(1): 159-74. doi: 10.2307/2529310.

16.

Danneels

Vanderstraeten

Cambier

Witvrouw

De Cuyper

. CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects. Eur Spine J. 2000; 9(4): 266-72. doi: 10.1007/s005860000190.

17.

Djordjevic

Konstantinovic

Miljkovic

. Difference between subjects in early chronic phase of low back pain with and without neuropathic component: observational cross-sectional study. Eur J Phys Rehabil Med. 2019; 55(2): 217-24. doi: 10.23736/S1973-9087.18.05226-7.

18.

Wilke

Wolf

Claes

Arand

Wiesend

. Stability increase of the lumbar spine with different muscle groups. A biomechanical in vitro study. Spine. 1995; 20(2): 192-8. doi: 10.1097/00007632-199501150-00011.

19.

Fujita

Kusano

Sugiura

Sakuraba

Kubota

Sakuma

, et al. A 100-m Sprint Time Is Associated with Deep Trunk Muscle Thickness in Collegiate Male Sprinters. Front Sports Act Living. 2019; 1: 32. doi: 10.3389/fspor.2019.00032.

20.

Hides

Leung

Watson

Trojman

Grantham

Mendis

. Trunk muscle size and function in volleyball players with and without injuries to the head, neck, and upper limb. Phys Ther Sport. 2022; 54: 1-7. doi: 10.1016/j.ptsp.2021.12.003.

21.

Pawel

Saulicz

Wolny

Myśliwiec

. Assessment of the abdominal muscles at rest and during the abdominal drawing-in maneuver in adolescents practicing volleyball: A case control study. J Sport Health Sci. 2017; 6: 118-24. doi: 10.1016/j.jshs.2015.10.002.

22.

Noormohammadpour

Aghaei-Afshar

Mansournia

Mirzashahi

Akbari-Fakhrabadi

Linek

, et al. The relationship between low back pain incidence and ultrasound assessment of trunk muscles in adult soccer players: A cohort study. Asian J Sports Med. 2020; 11(2): e102810. doi: 10.5812/asjsm.102810.

23.

Gildea

Hides

Hodges

. Morphology of the abdominal muscles in ballet dancers with and without low back pain: a magnetic resonance imaging study. J Sci Med Sport. 2014; 17(5): 452-6. doi: 10.1016/j.jsams.2013.09.002.

Comparison of trunk muscle thickness and brightness in collegiate female athletes with and without a history of low back pain

Abstract

BACKGROUND:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSIONS:

Keywords

Table 1 Participant characteristics based on the sport engaged

2. Methods

2.1 Participants

2.3 Measurement of muscle thickness (Fig. 1)

Table 2 Intraclass correlation coefficients (ICC) and Minimal detectable change (MDC)

2.6 Statistical analyses

3.1 Participant characteristics (Table 1)

3.2 ICC and MDC95 (Table 2)

3.3 Muscle thickness (Table 3) (Fig. 2)

3.4 Muscle brightness (Table 4) (Fig. 3)

4. Discussion

5. Conclusions

Author contributions

Ethical approval

Funding

Footnotes

Acknowledgments

Conflict of interest

References

Table 1
Participant characteristics based on the sport engaged

Table 2
Intraclass correlation coefficients (ICC) and Minimal detectable change (MDC)

3.2 ICC and MDC₉₅ (Table 2)