Introduction : L’évaluation clinique du contrôle neuromusculaire des muscles du tronc est criante en réhabilitation et en entraînement. L’objectif principal de cette étude a été d’évaluer la reproductibilité intra et inter-évaluateur d’un test clinique le soulèvement actif de la jambe tendue (SAJT) chez une population active et saine. Méthode : Chaque sujet (18 joueurs de tennis) a été testé à deux reprises par 2 physiothérapeutes avec le SAJT. Résultats : La reproductibilité intra-évaluateur s’est avérée élevée à très élevée (ICC = 0.81 à 0.93) tandis la reproductibilité inter-évaluateur s’est avérée cliniquement non viable. Conclusion : À notre connaissance, le SAJT est le premier test clinique reproductible évaluant le contrôle neuromusculaire du tronc avec des compensations musculaires et cinétiques chez des sujets actifs et sains. Une formation plus importante des évaluateurs aurait certainement amélioré la reproductibilité inter-évaluateur. / Introduction: The clinical assessment of the trunk muscles neuromuscular control is lacking in rehabilitation and in conditioning. The main goal of this study was to assess the intra and inter-rater reliability of a clinical test, the active straight leg raise (ASLR), on an active and healthy population. Method: Each subject (18 tennis players) was tested twice by 2 physiotherapists with the ASLR. Results: The intra-rater reliability turned out to be high to very high (ICC = 0.81 à 0.93) while the inter-rater reliability came out clinically unsustainable. Conclusion: To our knowledge, the ASLR is the first reliable clinical test to assess the core neuromuscular control based on muscular and kinetic compensation observations with active and healthy subjects. A more exhaustive training of the assessors would definitely improve the inter-rater reliability.

<p>An objective measure of muscular low back pain (LBP) symptoms eludes clinicians. This study assessed efficacy of magnetic resonance imaging (MRI) of the lumbar multifidus using diffusion tensor imaging (DTI), blood oxygen level dependent (BOLD) signal fractal dimension (FD) analysis and muscle cross sectional area (CSA) in LBP assessment. MRI results were compared to two questionnaires, the Oswestry disability index (ODI) and visual analog score (VAS).</p> <p>Right-left asymmetry in both DTI metrics and T2-weighted (T2W) CSA were greater in the injured. Also, asymmetry measures were correlated with body mass index (BMI) but not age, height, or level of physical activity (measured via Godin activity questionnaire). The relationship between asymmetry and LBP symptoms in T2W and DTI scans increased for subjects with BMI below 35kg/m².</p> <p>BOLD FD did not scale with LBP symptoms. However, FD analysis showed promise following therapeutic Swedish massage, hypothesized as being related to local perfusion changes, indicating that FD is sensitive to changes in the lumbar muscle, just not LBP symptoms. Thus the BOLD FD does change with treatment, just not with the symptoms of LBP.</p> <p>When combining data from multiple scan types, the symptoms of LBP correlated best with the unweighted mean of DTI fractional anisotropy (FA) and T2W CSA asymmetry, and the correlation was greatest (R²=0.88) when only <em>symptomatic (not both symptomatic and control)</em> subjects with BMIs from 18-25kg/m² were considered. From these results there appears to be clinical utility in characterizing the symptoms of non-acute LBP using DTI and CSA.</p> / Doctor of Philosophy (PhD)