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Physiotherapy Theory and Practice
An International Journal of Physical Therapy
Volume 30, 2014 - Issue 6
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Research Article

Separate assessment of gluteus medius and minimus: B-mode or M-mode ultrasound?

, PhD, , AMS, , PhD, , MPE & , PhD
Pages 438-443 | Received 26 Jul 2013, Accepted 18 Dec 2013, Published online: 26 Feb 2014
 

Abstract

The hip abductors gluteus medius (Gmed) and minimus (Gmin) differ slightly in function and how they are affected by hip joint pathology. A separate assessment of Gmed and Gmin is feasible by ultrasound (US) imaging. B-mode and M-mode US can be used to measure muscle thickness. Two B- and two M-mode scans of Gmed and Gmin thickness were taken in relaxation on 16 asymptomatic volunteers, repeated within 4 days on 11 subjects. Three types of intra-rater reliability of muscle thickness measurements were examined: (1) within-session reliability comparing two scans from the same session, (2) between-days reliability comparing thickness from two scanning occasion within 4 days and (3) reliability of taking thickness measurements by re-measuring the same US scans after 1 week. Thickness measurements on B- and M-mode images provided ICC3,1 >0.96 for within-session reliability. ICC3,k >0.89 for between-days reliability and ICC3,1 >0.85 for re-reading the same scans were estimated. Minimal detectable changes >1.0 mm within-session, >2.4 mm between-days and >1.7 mm for re-reading scans indicated that small thickness changes are not detectable. The investigation suggests a slight advantage for fascia recognition in B-mode and the advantage of visual control of muscle relaxation in M-mode.

Acknowledgements

We thankfully acknowledge the loan of the US system by Siemens Medical Systems, Western Australia, expert advice on hip muscle anatomy by John Owens and technical support by Paul Davey.

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