Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 6 , Pages 1048-1054, June 2009

Assessment of Gluteus Maximus Muscle Area With Different Image Analysis Programs

  • Gary A. Wu, MS

      Affiliations

    • Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH
    • Cleveland Functional Electrical Stimulation Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH
    • ,
  • Kath Bogie, DPhil

      Affiliations

    • Department of Orthopaedics, Case Western Reserve University, Cleveland, OH
    • Cleveland Functional Electrical Stimulation Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH
    • Corresponding Author InformationReprint requests to Kath Bogie, DPhil, Dept of Orthopaedics, Case Western Reserve University, 2109 Adelbert Rd, BRB 336, Cleveland, OH 44106

Abstract 

Wu GA, Bogie K. Assessment of gluteus maximus muscle area with different image analysis programs.

Objective

To determine the effectiveness of a percutaneous gluteal stimulation system (GSTIM) by comparing assessments of axial computed tomography (CT) scans for the pelvic area.

Design

Comparing the measurements of the cross-sectional area (CSA) of the gluteus maximus muscle between raters and 2 image analysis programs.

Setting

Retrospective axial CT scans of the pelvic area.

Participants

Men (N=9) with complete (below T6) spinal cord injury (SCI) and at least 2 years postinjury participated in the study (range, 29–75y; mean age, 51.8y).

Intervention

Comparing gluteus maximus CSA before and after a period of GSTIM.

Main Outcome Measure

Measurements made by 2 expert and 2 nonexpert raters were used to compare the repeatability and reliability of measuring muscle CSA. The longitudinal study presented is from repeated CT scans obtained over a 2-year period for 1 representative participant who received a GSTIM system.

Results

For repeatability, nonexpert raters measured a mean CSA of 35.2cm2 (range, 20–45cm2), while experts measured 21cm2 (range, 10–35cm2). A composite of all raters using the same program had SDs of 2.5 to 2.6cm2 for a program available through the National Institutes of Health and 2.5 to 4.4cm2 for a commercially available program. For reliability, differences between the 2 programs had mean differences in SD between 2.2 and 3.7cm2.

Conclusions

The same rater and program (preferably the more reliable ImageJ) is recommended for the course of a longitudinal study. Otherwise, significant error would be introduced. Furthermore, significant increases in the CSA of gluteal muscle compared with preintervention (baseline) measurements were observed for the participant receiving GSTIM.

Key Words: Electric stimulation, Rehabilitation, Spinal cord injuries

List of Abbreviations: CSA, cross-sectional area, CT, computed tomography, GSTIM, percutaneous gluteal stimulation system, MRI, magnetic resonance imaging, SCI, spinal cord injury

 

 Supported by the Veterans Administration Rehabilitation Research and Development Service (grant no. B4664).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(09)00141-5

doi:10.1016/j.apmr.2008.12.009

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 6 , Pages 1048-1054, June 2009

Article Tools

* Image Usage & Resolution