Quantitative ultrasound to assess efficacy of treatment for neck somatic dysfunctions: a feasibility study

Abstract

Context: Neck pain is a common complaint in healthcare clinics. Although the pathogenesis of neck pain is often multifactorial, trapezius muscle dysfunction has been commonly linked to neck pain. Osteopathic manipulative treatment (OMT) has been demonstrated to be an effective treatment modality in treating trapezius muscle dysfunction and neck pain. However, there is a current lack of objective, quantitative measures to assess the effectiveness of OMT. Through previous research, ultrasound technology has been shown to be promising in its ability to quantify tissue changes both pre- and post-OMT.

Objectives: The objectives of this study are to evaluate the feasibility of shear wave elastography (SWE) in assessing upper trapezius muscles with pain and hypertonicity, as well as the changes in these muscles post-OMT for cervical somatic dysfunctions.

Methods: After obtaining approval from the Rocky Vista University Institutional Review Board and written informed consent from participants, SWE and osteopathic assessments were performed on 22 adult participants with and without cervical spine somatic dysfunction. Participants with positive osteopathic assessments of tissue texture, asymmetry, restricted motion, and/or tenderness (TART) were treated utilizing OMT. Shear wave velocity (SWV, m/s) and shear wave velocity rate [SWVR = (SWV _contraction - SWV _relaxation)/ SWV _relaxation] of the upper trapezius muscles with and without pain and hypertonicity, and before and after OMT, were examined utilizing a two-tailed t-test.

Results: SWV in muscle contraction and SWVR were significantly lower in muscles with pain compared to muscles without pain (p≤0.01). SWV in muscle contraction was also significantly lower in hypertonic muscles compared to normotonic muscles (p<0.01). Following OMT, SWV in muscle contraction and SWVR in muscles with pain and hypertonic increased significantly (p≤0.01). Overall TART score of all muscles with somatic dysfunction (SD) after OMT significantly decreased (p<0.01). SWV in muscle contraction and SWVR in hypertonic muscles were also significantly increased (p≤0.03), with an improvement index of 0.11 and 0.20.

Conclusions: This study's results demonstrate the feasibility of utilizing SWE to evaluate somatic dysfunctions of the upper trapezius musculature and the efficacy of OMT for neck somatic dysfunctions.

Keywords: muscle; osteopathic assessment; osteopathic manipulative treatment; shear wave elastography; ultrasound.