{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T05:16:17Z","timestamp":1766639777381,"version":"3.48.0"},"reference-count":45,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Background: Objective, reproducible assessment of deep cervical muscle mechanics is clinically relevant, yet the reliability of shear-wave elastography (SWE) for the longus colli (LC) has not been established. Therefore, the aim of this study was to determine intra- and inter-examiner reliability of LC stiffness measured by SWE under a tightly standardized protocol in patients with mechanical neck pain. Methods: A longitudinal reliability study was conducted. Adults suffering from neck pain for \u22656 months were recruited. Two examiners (with different levels of experience) acquired bilateral LC images using fixed presets. The SWE region of interest covered the full muscle thickness (excluding fascia) to measure the LC shear-wave speed and Young\u2019s modulus. Intraclass correlation coefficients (ICCs), standard error of measurement and minimal detectable changes were computed. Results: Nineteen participants with neck pain completed imaging (left and right sides analyzed). Inter-examiner agreement was good to excellent for single measurements (ICC3,2 &gt; 0.818) and improved when averaging two acquisitions (ICC3,2 &gt; 0.866). Intra-examiner repeatability was good to excellent for the novel examiner (ICC3,1 &gt; 0.891) and excellent for the experienced examiner (ICC3,1 &gt; 0.973). No meaningful stiffness differences by sex or side were observed in this sample (p &gt; 0.05). Conclusions: A standardized SWE workflow yields reproducible LC stiffness measurements in mechanical neck pain. For longitudinal use, keep a single operator when feasible; in multi-examiner settings, average at least two acquisitions per side to enhance sensitivity to true change.<\/jats:p>","DOI":"10.3390\/s26010065","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T12:22:27Z","timestamp":1766578947000},"page":"65","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Testing the Reliability of a Procedure Using Shear-Wave Elastography for Measuring Longus Colli Muscle Stiffness"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7234-641X","authenticated-orcid":false,"given":"Juan","family":"Izquierdo-Garc\u00eda","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain"},{"name":"InveCuid, Instituto de Investigaci\u00f3n Sanitaria Hospital 12 de Octubre, 28041 Madrid, Spain"},{"name":"Department of Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3379-8392","authenticated-orcid":false,"given":"Juan Antonio","family":"Valera-Calero","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Grupo InPhysio, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6065-9283","authenticated-orcid":false,"given":"Marcos Jos\u00e9","family":"Navarro-Santana","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Grupo InPhysio, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibai","family":"L\u00f3pez-de-Uralde-Villanueva","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Grupo InPhysio, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6798-4487","authenticated-orcid":false,"given":"Gabriel","family":"Rabanal-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Grupo InPhysio, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4340-1907","authenticated-orcid":false,"given":"Mar\u00eda Paz","family":"Sanz-Ay\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain"},{"name":"Department of Radiology and Rehabilitation, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Ignacio","family":"Castillo-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain"},{"name":"Department of Radiology and Rehabilitation, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1596-5027","authenticated-orcid":false,"given":"Gustavo","family":"Plaza-Manzano","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Grupo InPhysio, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bakkum, B.W., and Cramer, G.D. (2014). Muscles That Influence the Spine. Clinical Anatomy of the Spine, Spinal Cord, and ANS, Mosby.","DOI":"10.1016\/B978-0-323-07954-9.00004-9"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"968","DOI":"10.3349\/ymj.2016.57.4.968","article-title":"Surgical Anatomy of the Longus Colli Muscle and Uncinate Process in the Cervical Spine","volume":"57","author":"Park","year":"2016","journal-title":"Yonsei Med. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s12565-015-0280-3","article-title":"Fibre Type Composition of Female Longus Capitis and Longus Colli Muscles","volume":"91","author":"Miller","year":"2016","journal-title":"Anat. Sci. Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.msksp.2017.10.005","article-title":"Do Longus Capitis and Colli Really Stabilise the Cervical Spine? A Study of Their Fascicular Anatomy and Peak Force Capabilities","volume":"32","author":"Kennedy","year":"2017","journal-title":"Musculoskelet. Sci. Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S1356-689X(03)00086-9","article-title":"Impairment in the Cervical Flexors: A Comparison of Whiplash and Insidious Onset Neck Pain Patients","volume":"9","author":"Jull","year":"2004","journal-title":"Man. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.jmpt.2008.08.003","article-title":"Clinical Assessment of the Deep Cervical Flexor Muscles: The Craniocervical Flexion Test","volume":"31","author":"Jull","year":"2008","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e6365","DOI":"10.1097\/MD.0000000000006365","article-title":"Does the Longus Colli Have an Effect on Cervical Vertigo?: A Retrospective Study of 116 Patients","volume":"96","author":"Liu","year":"2017","journal-title":"Medicine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e20230841","DOI":"10.1590\/1806-9282.20230841","article-title":"Pain Sensitization and Atrophy of Deep Cervical Muscles in Patients with Chronic Tension-Type Headache","volume":"69","author":"Balmaseda","year":"2023","journal-title":"Rev. Assoc. Medica Bras. (1992)"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1590\/bjpt-rbf.2014.0093","article-title":"Analysis of Dimensions, Activation and Median Frequency of Cervical Flexor Muscles in Young Women with Migraine or Tension-Type Headache","volume":"19","author":"Wanderley","year":"2015","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.math.2011.02.013","article-title":"Functional Reorganization of Cervical Flexor Activity Because of Induced Muscle Pain Evaluated by Muscle Functional Magnetic Resonance Imaging","volume":"16","author":"Cagnie","year":"2011","journal-title":"Man. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1097\/AJP.0b013e31823e9378","article-title":"The Change in Deep Cervical Flexor Activity after Training Is Associated with the Degree of Pain Reduction in Patients with Chronic Neck Pain","volume":"28","author":"Falla","year":"2012","journal-title":"Clin. J. Pain."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/S1388-2457(02)00418-2","article-title":"Myoelectric Manifestations of Sternocleidomastoid and Anterior Scalene Muscle Fatigue in Chronic Neck Pain Patients","volume":"114","author":"Falla","year":"2003","journal-title":"Clin. Neurophysiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1002\/ejp.1073","article-title":"Cervical Stability Training with and without Core Stability Training for Patients with Cervical Disc Herniation: A Randomized, Single-Blind Study","volume":"21","author":"Buyukturan","year":"2017","journal-title":"Eur. J. Pain"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Javanshir, K., Ghafouri-Rouzbehani, P., Zohrehvand, A., Naeimi, A., Fern\u00e1ndez-de-Las-Pe\u00f1as, C., Nikbakht, H.-A., Mousavi-Khatir, S.R., and Valera-Calero, J.A. (2024). Cervical Multifidus and Longus Colli Ultrasound Differences among Patients with Cervical Disc Bulging, Protrusion and Extrusion and Asymptomatic Controls: A Cross-Sectional Study. J. Clin. Med., 13.","DOI":"10.3390\/jcm13020624"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.bjorl.2020.10.018","article-title":"Acute Longus Colli Tendinitis and Otolaryngology","volume":"88","author":"Siag","year":"2022","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1186\/s13018-024-04605-2","article-title":"The Influence of Anterior Cervical Discectomy and Fusion Surgery on Cervical Muscles and the Correlation between Related Muscle Changes and Surgical Efficacy","volume":"19","author":"Sun","year":"2024","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1093\/pm\/pnx331","article-title":"The Relevance of Proprioception to Chronic Neck Pain: A Correlational Analysis of Flexor Muscle Size and Endurance, Clinical Neck Pain Characteristics, and Proprioception","volume":"19","author":"Ghamkhar","year":"2018","journal-title":"Pain Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"102220","DOI":"10.1016\/j.msksp.2020.102220","article-title":"Motor Control Training of Deep Neck Flexors with Pressure Biofeedback Improves Pain and Disability in Patients with Neck Pain: A Systematic Review and Meta-Analysis","volume":"50","author":"Tsiringakis","year":"2020","journal-title":"Musculoskelet. Sci. Pract."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.apmr.2015.09.021","article-title":"Prevalence of Myofascial Trigger Points in Spinal Disorders: A Systematic Review and Meta-Analysis","volume":"97","author":"Chiarotto","year":"2016","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Ribeiro, D.C., Belgrave, A., Naden, A., Fang, H., Matthews, P., and Parshottam, S. (2018). The Prevalence of Myofascial Trigger Points in Neck and Shoulder-Related Disorders: A Systematic Review of the Literature. BMC Musculoskelet. Disord., 19.","DOI":"10.1186\/s12891-018-2157-9"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1002\/mus.28377","article-title":"Myofascial Pain Syndrome: An Update on Clinical Characteristics, Etiopathogenesis, Diagnosis, and Treatment","volume":"71","author":"Steen","year":"2025","journal-title":"Muscle Nerve"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1093\/pm\/pnx207","article-title":"International Consensus on Diagnostic Criteria and Clinical Considerations of Myofascial Trigger Points: A Delphi Study","volume":"19","author":"Dommerholt","year":"2018","journal-title":"Pain Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1093\/rheumatology\/keu471","article-title":"A Critical Evaluation of the Trigger Point Phenomenon","volume":"54","author":"Quintner","year":"2015","journal-title":"Rheumatology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.math.2014.06.001","article-title":"Criterion Validity of Manual Assessment of Spinal Stiffness","volume":"19","author":"Koppenhaver","year":"2014","journal-title":"Man. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"E413","DOI":"10.1097\/01.brs.0000141178.98157.8e","article-title":"Reliability of Spinal Palpation for Diagnosis of Back and Neck Pain: A Systematic Review of the Literature","volume":"29","author":"Seffinger","year":"2004","journal-title":"Spine"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Moncl\u00fas-D\u00edez, G., D\u00edaz-Arribas, M.J., Fern\u00e1ndez-de-Las-Pe\u00f1as, C., Kosson, D., Ko\u0142acz, M., Kobylarz, M.D., S\u00e1nchez-Jorge, S., and Valera-Calero, J.A. (2025). Prevalence of Myofascial Trigger Points in Patients with Radiating and Non-Radiating Low Back Pain: A Systematic Review. Biomedicines, 13.","DOI":"10.3390\/biomedicines13061453"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"179","DOI":"10.2519\/jospt.2020.8821","article-title":"Neck Muscle Stiffness Measured With Shear Wave Elastography in Women With Chronic Nonspecific Neck Pain","volume":"50","author":"Dieterich","year":"2020","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3390\/biomedinformatics3010002","article-title":"Ultrasound Elastography: Basic Principles and Examples of Clinical Applications with Artificial Intelligence\u2014A Review","volume":"3","author":"Danesini","year":"2023","journal-title":"BioMedInformatics"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"027","DOI":"10.1055\/s-0042-1742575","article-title":"Physical Principles of Elastography: A Primer for Radiologists","volume":"01","author":"Patra","year":"2022","journal-title":"Indographics"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.7150\/thno.18650","article-title":"Ultrasound Elastography: Review of Techniques and Clinical Applications","volume":"7","author":"Sigrist","year":"2017","journal-title":"Theranostics"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1007\/s00261-018-1475-6","article-title":"Principles of Ultrasound Elastography","volume":"43","author":"Ozturk","year":"2018","journal-title":"Abdom. Radiol."},{"key":"ref_32","first-page":"1238","article-title":"Association among Clinical Severity Indicators, Psychological Health Status and Elastic Properties of Neck Muscles in Patients with Chronic Mechanical Neck Pain","volume":"13","author":"Varol","year":"2025","journal-title":"Eur. Spine J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.jclinepi.2010.03.002","article-title":"Guidelines for Reporting Reliability and Agreement Studies (GRRAS) Were Proposed","volume":"64","author":"Kottner","year":"2011","journal-title":"J. Clin. Epidemiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"5415","DOI":"10.1080\/09638288.2024.2304644","article-title":"Psychometric Properties of Neck Disability Index\u2014A Systematic Review and Meta-Analysis","volume":"46","author":"Saltychev","year":"2024","journal-title":"Disabil. Rehabil."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1016\/j.jpainsymman.2010.08.016","article-title":"Studies Comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for Assessment of Pain Intensity in Adults: A Systematic Literature Review","volume":"41","author":"Hjermstad","year":"2011","journal-title":"J. Pain Symptom Manag."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1002\/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E","article-title":"Sample Size and Optimal Designs for Reliability Studies","volume":"17","author":"Walter","year":"1998","journal-title":"Stat. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research","volume":"15","author":"Koo","year":"2016","journal-title":"J. Chiropr. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1097\/PHM.0b013e31820173e5","article-title":"Ultrasound Assessment of Bilateral Longus Colli Muscles in Subjects with Chronic Bilateral Neck Pain","volume":"90","author":"Javanshir","year":"2011","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s12998-016-0132-9","article-title":"Musculoskeletal Diagnostic Ultrasound Imaging for Thickness Measurement of Four Principal Muscles of the Cervical Spine\u2014A Reliability and Agreement Study","volume":"25","author":"Myhrvold","year":"2017","journal-title":"Chiropr. Man. Ther."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"F\u00e1vero, L.P., and Belfiore, P. (2019). Hypotheses Tests. Data Science for Business and Decision Making, Academic Press.","DOI":"10.1016\/B978-0-12-811216-8.00009-4"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1148\/rg.2017160116","article-title":"Shear-Wave Elastography: Basic Physics and Musculoskeletal Applications","volume":"37","author":"Taljanovic","year":"2017","journal-title":"Radiographics"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3579","DOI":"10.1589\/jpts.27.3579","article-title":"Reliability of Ultrasonography Measurement for the Longus Colli According to Inward Probe Pressure","volume":"27","author":"Jeong","year":"2015","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"282","DOI":"10.4085\/1062-6050-482-18","article-title":"Sex Differences in Ultrasound-Based Muscle Size and Mechanical Properties of the Cervical-Flexor and -Extensor Muscles","volume":"55","author":"Nagai","year":"2020","journal-title":"J. Athl. Train."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.jbmt.2023.11.008","article-title":"Reliability of Ultrasonography to Measure Cervical Multifidus, Semispinalis Cervicis and Longus Colli Muscles Dimensions in Patients with Unilateral Cervical Disc Herniation: An Observational Cross-Sectional Test-Retest Study","volume":"37","author":"Mohseni","year":"2024","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.2519\/jospt.2017.0302","article-title":"Neck Pain: Revision 2017","volume":"47","author":"Blanpied","year":"2017","journal-title":"J. Orthop. Sports Phys. Ther."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/1\/65\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T05:13:40Z","timestamp":1766639620000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/1\/65"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,22]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["s26010065"],"URL":"https:\/\/doi.org\/10.3390\/s26010065","relation":{},"ISSN":["1424-8220"],"issn-type":[{"type":"electronic","value":"1424-8220"}],"subject":[],"published":{"date-parts":[[2025,12,22]]}}}