Quantitative estimation of muscle shear elastic modulus of the upper trapezius with supersonic shear imaging during arm positioning

Hio-Teng Leong, Gabriel Yin-Fat Ng, Vivian Yee-Fong Leung, Siu Ngor Fu, Hio-Teng Leong, Gabriel Yin-Fat Ng, Vivian Yee-Fong Leung, Siu Ngor Fu

Abstract

Pain and tenderness of the upper trapezius are the major complaints among people with chronic neck and shoulder disorders. Hyper-activation and increased muscle tension of the upper trapezius during arm elevation will cause imbalance of the scapular muscle force and contribute to neck and shoulder disorders. Assessing the elasticity of the upper trapezius in different arm positions is therefore important for identifying people at risk so as to give preventive programmes or for monitoring the effectiveness of the intervention programmes for these disorders. This study aimed to establish the reliability of supersonic shear imaging (SSI) in quantifying upper trapezius elasticity/shear elastic modulus and its ability to measure the modulation of muscle elasticity during arm elevation. Twenty-eight healthy adults (15 males, 13 females; mean age = 29.6 years) were recruited to participate in the study. In each participant, the shear elastic modulus of the upper trapezius while the arm was at rest and at 30° abduction was measured by two operators and twice by operator 1 with a time interval between the measurements. The results showed excellent within- and between-session intra-operator (ICC = 0.87-0.97) and inter-observer (ICC = 0.78-0.83) reliability for the upper trapezius elasticity with the arm at rest and at 30° abduction. An increase of 55.23% of shear elastic modulus from resting to 30° abduction was observed. Our findings demonstrate the possibilities for using SSI to quantify muscle elasticity and its potential role in delineating the modulation of upper trapezius elasticity, which is essential for future studies to compare the differences in shear elastic modulus between normal elasticity and that of individuals with neck and shoulder disorders.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Subject position for the measurement…
Figure 1. Subject position for the measurement of upper trapezius muscle elasticity with arm at rest.
Figure 2. Subject position for the measurement…
Figure 2. Subject position for the measurement of upper trapezius muscle elasticity with arm at 30° abduction.
(A) Front view; (B) Back view.
Figure 3. The probe was placed mid-way…
Figure 3. The probe was placed mid-way (marked with a ‘x’) between the angle of the acromion and the seventh cervical vertebra.
Figure 4. Measurement of elasticity of the…
Figure 4. Measurement of elasticity of the upper trapezius muscle (UT) in longitudinal view.
(A) Color-coded box presentations of the UT elasticity (stiffer areas were coded in red and softer areas in blue) superimposed on a longitudinal grey scale sonogram of the UT, with the circle representing the region of interest (ROI), and were adjusted according to the thickness of the muscle. The shear elastic modulus of the ROI is shown in the Q-box™ on the image. (B) Longitudinal grey scale sonograms of UT on the identical scan planes.
Figure 5. Measurement of elasticity of the…
Figure 5. Measurement of elasticity of the upper trapezius muscle (UT) in longitudinal view with arm at 30° abduction.
(A) Color-coded box presentations of the UT elasticity (stiffer areas were coded in red and softer areas in blue) superimposed on a longitudinal grey scale sonogram of the UT, with the circle representing the region of interest (ROI), and were adjusted according to the thickness of the muscle. The shear elastic modulus of the ROI is shown in the Q-box™ on the image. (B) Longitudinal grey scale sonograms of UT on the identical scan planes.

References

    1. Strom V, Roe C, Knardahl S (2009) Work-induced pain, trapezius blood flux, and muscle activity in workers with chronic shoulder and neck pain. Pain 144: 147–155.
    1. Chester R, Smith TO, Hooper L, Dixon J (2010) The impact of subacromial impingement syndrome on muscle activity patterns of the shoulder complex: a systematic review of electromyographic studies. BMC Musculoskel Disord 11: 45–57.
    1. Lin JJ, Hsieh SC, Cheng WC, Chen WC, Lai Y (2011) Adaptive patterns of movement during arm elevation test in patients with shoulder impingement syndrome. J Orthop Res 29: 653–657.
    1. Bercoff J, Tanter M, Fink M (2004) Supersonic shear imaging: a new technique for soft tissue elasticity mapping. IEEE Trans Ultrason Ferroelectr Freq Control 51: 396–409.
    1. Bouillard K, Nordez A, Hug F (2011) Estimation of individual muscle force using elastography. PLoS One 6(12): e29261–e29267.
    1. Greenleaf JF, Fatemi M, Insana M (2003) Selected methods for imaging elastic properties of biological tissues. Annu Rev Biomed Eng 5: 57–78.
    1. Shinohara M, Sabra K, Gennisson JL, Fink M, Tanter M (2010) Real-time visualization of muscle stiffness distribution with ultrasound shear wave imaging during muscle contraction. Muscle Nerve 42: 438–41.
    1. Kot BCW, Zhang ZJ, Lee AWC, Leung VYF, Fu SN (2012) Elastic Modulus of Muscle and Tendon with Shear Wave Ultrasound Elastography: Variations with Different Technical Settings. PLoS ONE 7(8): e44348.
    1. Nordez A, Hug F (2010) Muscle shear elastic modulus measured using supersonic shear imaging is highly related to muscle activity level. J Appl Physiol 108: 1389–1394.
    1. Gennisson JL, Defieux T, Mace E, Montaldo G, Fink M, et al. (2010) Visoelastic and anisotropic mechanical properties of in vivo muscle tissue assessed by supersonic shear imaging. Ultrasound in Med & Biol 36(5): 789–801.
    1. Antony NT, Keir PJ (2010) Effects of posture, movement and hand load on shoulder muscle activity. J Electromyograph Kinesiol 20: 191–198.
    1. Wickham J, Pizzari T, Stansfeld K, Burnside A, Watson L (2010) Quantifying ‘normal’ shoulder muscle activity during abduction. J Electromyogr Kinesiol 20: 212–222.
    1. Cram JR (1998) Introduction to surface electromyography. Gaithersburg, Md: Aspen Publishers.
    1. Lv F, Tang J, Luo Y, Ban Y, Wu R, et al. (2012) Muscle crush injury of extremity: quantitative elastography with supersonic shear imaging. Ultrasound Med Bio 38(5): 795–802.
    1. Royer D, Gennisson LL, Deffieux T, Tanter M (2011) On the elasticity of transverse isotropic soft tissues (L). J Acoust Soc Am 129(5): 1257–1260.
    1. Fleiss JL (1986) The Design and Analysis of Clinical Experiments. NY: John Wiley and Sons.
    1. Portney LG, Watkins MP (2009) Foundations of clinical research: Application to practice. 3rd ed. Upper Saddle River, NJ: Pearson/Prentice Hall.
    1. Lacourpaille L, Hug F, Bouillard K, Hogrel JY, Nordez A (2012) Supersonic shear imaging provides a reliable measurement of resting muscle shear elastic modulus. Physiol Meas 33: N19–N28.
    1. Drakonaki EE, Allen GM, Wilson DJ (2009) Real-time ultrasound elastography of the normal Achilles tendon: reproducibility and pattern description. Clin Radiol 64: 1196–1202.
    1. Wu CH, Chang KV, Mio S, Chen WS, Wang TG (2011) Sonoelastography of the plantar fascia. Radiol 259(2): 502–7.
    1. Arda K, Ciledag N, Aktas E, Aribas BK, Kose K (2011) Quantitative assessment of normal soft-tissue elasticity using shear-wave ultrasound elastography. AJR Am J Roentgenol 197: 532–6.
    1. Klauser AS, Faschingbauer R, Jaschke WR (2010) Is sonoelastography of value in assessing tendons? Semin Musculoskelet Radiol 14: 323–33.
    1. Lin JJ, Hsieh SC, Cheng WC, Chen WC, Lai Y (2011) Adaptive patterns of movement during arm elevation test in patients with shoulder impingement syndrome. J Orthop Res 29: 653–657.
    1. Ludewig PM, Cook TM (2000) Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther 80: 276–291.
    1. Cools AM, Witvrouw EE, Declercq GA, Danneels LD, Cambier DC (2003) Scapular muscle recruitment patterns: trapezius muscle latency with and without impingement symptoms. Am J Sports Med 31: 542–549.
    1. Chen Q, Bensamoun S, Basford JR, Thompson JM, An KN (2007) Identification and quantification of myofascial taut bands with magnetic resonance elastography. Arch Phys Med Rehabil 88: 1658–61.
    1. Viir R, Virkus A, Laiho K, Rajaleid K, Selart A, et al. (2007) Trapezius muscle tone and viscoelastic properties in sitting and supine positions. SJWEH (3): 76–80.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe