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Reliability of lumbar multifidus ultrasound assessment during the active straight leg raise test Plaza Manzano, Gustavo Navarro Santana, Marcos José Valera Calero, Juan Antonio Fabero Garrido, Raúl Fernández de las Peñas, César López De Uralde Villanueva, Ibai Julio Background: Previous evidence showed altered lumbar multifidus (LM) activa-tion in populations with chronic nonspecific low back pain (LBP). We aimed toinvestigate the test–retest and inter-examiner reliability of ultrasound imaging(US) for assessing LM thickness at rest and activation during the active straightleg raise test (ASLR) and the association between thickness changes with clinicaloutcomes.Methods: Fifty- two patients with LBP and two examiners (one experienced andone novice) participated in this study. A total of 18 B- mode images at L4–L5 orL5–S1 level (both sides, 3 at rest and 6 during ASLR) were collected. For assess-ing test–retest reliability, the experienced examiner repeated the procedure after7 days. Intraclass correlation coefficients (ICC), standard error of measurements(SEM) and minimal detectable changes (MDC) were calculated.Results: Inter-examiner agreement was good to excellent (ICC3,2 = 0.71–0.92)and test–retest reliability was excellent (ICC3,1 = 0.91–0.98). Mean average ofmultiple measurements improved the agreement. Greater LM thickness at rest(p < .05) and greater thickness change after 3 s (p < .01) and 10 s (homolateralside, p < .01; contralateral side, p < .05) were associated with less pain intensity.Conclusions: US is a reliable method to assess the LM thickness at rest andcontracted during the ASLR in patients with LBP. The measurement at 3 s aftermaintaining ASLR, as well as the use of the mean of three measurements, hasbeen shown to be the most reliable method for measuring LM muscle thicknessduring ASLR.K E Y W O R D Slow back pain, lumbar multifidus, lumbar spine, reliability, stabilization, ultrasound imaging 2024-06-10T15:11:47Z 2024-06-10T15:11:47Z 2021-12-09 journal article Plaza‐Manzano, G., Navarro‐Santana, M. J., Valera‐Calero, J. A., Fabero‐Garrido, R., Fernández‐de‐las‐Peñas, C., & López‐de‐Uralde‐Villanueva, I. (2022). Reliability of lumbar multifidus ultrasound assessment during the active straight leg raise test. European Journal of Clinical Investigation, 52(5), e13728. 0014-2972 1365-2362 10.1111/eci.13728 https://hdl.handle.net/20.500.14352/104814 https://doi.org/10.1111/eci.13728 https://onlinelibrary.wiley.com/doi/10.1111/eci.13728 eng http://creativecommons.org/licenses/by-nc/4.0/ open access Attribution-NonCommercial 4.0 International Wiley