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Oranchuk DJ, Bodkin SG, Boncella KL, Harris-Love MO. Exploring the associations between skeletal muscle echogenicity and physical function in aging adults: A systematic review with meta-analyses. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:820-840. [PMID: 38754733 PMCID: PMC11336328 DOI: 10.1016/j.jshs.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/18/2024] [Accepted: 04/01/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Assessment and quantification of skeletal muscle within the aging population is vital for diagnosis, treatment, and injury/disease prevention. The clinical availability of assessing muscle quality through diagnostic ultrasound presents an opportunity to be utilized as a screening tool for function-limiting diseases. However, relationships between muscle echogenicity and clinical functional assessments require authoritative analysis. Thus, we aimed to (a) synthesize the literature to assess the relationships between skeletal muscle echogenicity and physical function in older adults (≥60 years), (b) perform pooled analyses of relationships between skeletal muscle echogenicity and physical function, and (c) perform sub-analyses to determine between-muscle relationships. METHODS CINAHL, Embase, MEDLINE, PubMed, and Web of Science databases were systematically searched to identify articles relating skeletal muscle echogenicity to physical function in older adults. Risk-of-bias assessments were conducted along with funnel plot examination. Meta-analyses with and without sub-analyses for individual muscles were performed utilizing Fisher's Z transformation for the most common measures of physical function. Fisher's Z was back-transformed to Pearson's r for interpretation. RESULTS Fifty-one articles (n = 5095, female = ∼2759, male = ∼2301, 72.5 ± 5.8 years, mean ± SD (1 study did not provide sex descriptors)) were extracted for review, with previously unpublished data obtained from the authors of 13 studies. The rectus femoris (n = 34) and isometric knee extension strength (n = 22) were the most accessed muscle and physical qualities, respectively. The relationship between quadriceps echogenicity and knee extensor strength was moderate (n = 2924, r = -0.36 (95% confidence interval: -0.38 to -0.32), p < 0.001), with all other meta-analyses (grip strength, walking speed, sit-to-stand, timed up-and-go) resulting in slightly weaker correlations (r: -0.34 to -0.23, all p < 0.001). Sub-analyses determined minimal differences in predictive ability between muscle groups, although combining muscles (e.g., rectus femoris + vastus lateralis) often resulted in stronger correlations with maximal strength. CONCLUSION While correlations are modest, the affordable, portable, and noninvasive ultrasonic assessment of muscle quality is a consistent predictor of physical function in older adults. Minimal between-muscle differences suggest that echogenicity estimates of muscle quality are systemic. Therefore, practitioners may be able to scan a single muscle to estimate full-body skeletal muscle quality/composition, while researchers should consider combining multiple muscles to strengthen the model.
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Affiliation(s)
- Dustin J Oranchuk
- Muscle Morphology, Mechanics, and Performance Laboratory, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - Stephan G Bodkin
- Muscle Morphology, Mechanics, and Performance Laboratory, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT 84108, USA
| | - Katie L Boncella
- Muscle Morphology, Mechanics, and Performance Laboratory, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Michael O Harris-Love
- Muscle Morphology, Mechanics, and Performance Laboratory, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
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Lateef S, Addison O, Zhang LQ, Gray V, Lanza MB. Exploring discrepancies in muscle analysis with ImageJ: understanding the impact of tool selection on echo intensity and muscle area measurements. J Ultrasound 2024:10.1007/s40477-024-00934-4. [PMID: 39060718 DOI: 10.1007/s40477-024-00934-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 06/06/2024] [Indexed: 07/28/2024] Open
Abstract
PURPOSE The aim was to compare the use of different tools within the ImageJ program (polygon vs. segmented line) and their impact on the calculation of muscle area and echo intensity (EI) values in ultrasound imaging of the vastus lateralis muscle. METHODS Thirteen volunteers participated in this study. Ultrasound images of the vastus lateralis muscle were acquired using 2D B-mode ultrasonography and analyzed using both the polygon and segmented line tools by the same evaluator. The intraclass correlation coefficient (ICC) and coefficient of variation (CV) assessed the tools' reliability. Bland-Altman plots were employed to verify the agreement between measurements, and linear regression analysis determined proportional bias. A paired t-test was conducted to analyze differences between the tools. RESULTS The reliability between tools for muscle area calculation was weak (r = 0.000; CV = 138.03 ± 0.34%), while it was excellent for EI (r = 0.871; CV = 15.19 ± 2.96%). The Bland-Altman plots indicated a large bias for muscle area (d = 195.2%) with a proportional bias (p < 0.001). For EI, the bias was (d = 15.2) with proportional bias (p = 0.028). The paired t-test revealed significant differences between the tools for area (p < 0.001) but not for EI (p = 0.060). CONCLUSION The study found significant differences in measurements obtained with the polygon and segmented line tools in ImageJ, with the polygon tool showing higher values for muscle area and lower values for EI.
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Affiliation(s)
- Shabnam Lateef
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, 100 Penn Street, Baltimore, MD, 20201, USA
| | - Odessa Addison
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, 100 Penn Street, Baltimore, MD, 20201, USA
| | - Li-Qun Zhang
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, 100 Penn Street, Baltimore, MD, 20201, USA
| | - Vicki Gray
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, 100 Penn Street, Baltimore, MD, 20201, USA
| | - Marcel B Lanza
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, 100 Penn Street, Baltimore, MD, 20201, USA.
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Takahashi M, Tamura Y, Tsurumi T, Terashima M, Takahashi H, Tamiya H, Furuya T, Nakatani Y, Otani N, Yasu T. Skeletal Muscle Quality Assessment in Patients With Cardiac Disease Associated With Type 2 Diabetes Mellitus: A Pilot Study. Cureus 2024; 16:e51897. [PMID: 38333459 PMCID: PMC10849938 DOI: 10.7759/cureus.51897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) is associated with changes in skeletal muscle quantity and quality, such as increased ectopic fat. Cardiac rehabilitation (CR) aims to improve the exercise capacity and muscle strength. This study aimed to determine the relationship between qualitative changes in the skeletal muscles and exercise function in patients with and without diabetes mellitus. Methods The study included patients with cardiovascular diseases who entered CR. Of 72 CR patients (68.1±9.0 years) who underwent a cardiopulmonary exercise test and skeletal muscle assessment at discharge, 15 patients with T2DM and 15 without DM were selected using propensity score matching by age and gender. Results No significant differences in the skeletal muscle echo intensity (EI) (T2DM: 58.4, Non-DM: 53.4, p=0.32), skeletal muscle index (T2DM: 7.5 kg/m2, Non-DM: 7.2 kg/m2, p=0.36), or the weight-bearing index (WBI)(T2DM: 0.44, Non-DM: 0.50, p=0.35) existed between the two groups. The phase angle (PhA) (T2DM: 3.67°, Non-DM: 4.49°, p<0.05) and peak oxygen uptake (T2DM: 12.3 mL/kg/min, Non-DM: 14.8 mL/kg/min, p<0.05) were significantly lower in the T2DM group. PhA values showed a significant correlation with the WBI, a parameter of lower limb muscle strength (r=0.50, p<0.05). Conclusion The coexistence of cardiovascular disease and T2DM resulted in a decrease in the PhA, indicating a qualitative decrease in skeletal muscle mass. The PhA is also associated with lower limb muscle strength.
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Affiliation(s)
- Momo Takahashi
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Yuma Tamura
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Tomoki Tsurumi
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Masato Terashima
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Harunori Takahashi
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Hajime Tamiya
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, JPN
| | - Tomoki Furuya
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Yuki Nakatani
- Department of Diabetes and Endocrinology, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Naoyuki Otani
- Department of Cardiology, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Takanori Yasu
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
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Akagi R, Miyokawa Y, Shiozaki D, Yajima Y, Yamada K, Kano K, Hashimoto Y, Okamoto T, Ando S. Eight-week neuromuscular electrical stimulation training produces muscle strength gains and hypertrophy, and partial muscle quality improvement in the knee extensors. J Sports Sci 2023; 41:2209-2228. [PMID: 38390833 DOI: 10.1080/02640414.2024.2318540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 02/07/2024] [Indexed: 02/24/2024]
Abstract
This study investigated the effect of an 8-week neuromuscular electrical stimulation (NMES) training programme (3 days/week) on muscle quantity and quality and single-joint performance in the knee extensors. Thirty-nine untrained young male participants were randomly assigned to NMES training (n = 21) and control (n = 18) groups. The 8-week NMES training induced significant increase in the isometric maximal voluntary contraction (MVC) torque of the knee extensors (≈9.3%), muscle volume of the individual and entire quadriceps muscles determined by magnetic resonance imaging (≈3.3%-6.4%), and a significant decrease in the ultrasound echo intensity of the vastus lateralis (≈-4.0%); however, hypertrophy of the vastus intermedius (i.e., the deep muscle) was limited (≈3.3%). In the NMES training group, the repeated measures correlations of the isometric MVC torque with the muscle volume of the entire quadriceps muscle and each quadriceps muscle were significant (rrm (20) = 0.551-0.776), whereas that of the isometric MVC torque with the ultrasound echo intensity of the vastus lateralis was not significant. These findings suggest that NMES training produces muscle strength gains, muscle hypertrophy, and partial muscle quality improvement and that the NMES training-induced muscle strength gains is caused by muscle hypertrophy in the knee extensors.
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Affiliation(s)
- Ryota Akagi
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Yusuke Miyokawa
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Daigo Shiozaki
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Yoshinari Yajima
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Koki Yamada
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Kosuke Kano
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Yuto Hashimoto
- Department of Exercise Physiology, Nippon Sport Science University, Tokyo, Japan
| | - Takanobu Okamoto
- Department of Exercise Physiology, Nippon Sport Science University, Tokyo, Japan
| | - Soichi Ando
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
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Kitagawa T, Nakamura M, Fukumoto Y. Usefulness of muscle echo intensity for evaluating functional performance in the older population: A scoping review. Exp Gerontol 2023; 182:112301. [PMID: 37776985 DOI: 10.1016/j.exger.2023.112301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/16/2023] [Accepted: 09/27/2023] [Indexed: 10/02/2023]
Abstract
Muscle echo intensity, as measured by ultrasonography, could be used as a new marker of functional performance in older populations. This scoping review aimed to present evidence on the utility of muscle echo intensity as determined by ultrasonography for assessing functional performance in older adults. The eligibility criterion included observational studies that investigated the associations between muscle echo intensity and functional performance in older adults. Terms, such as "echo intensity" and "older adults", were searched for in databases, such as PubMed, Web of Science, the Cochrane database of systematic reviews, and the Cumulative Index of Nursing and Allied Health Literature, in April 2021. Two independent reviewers screened and extracted the data; 46 papers, of which almost one-third were Japanese, were subsequently identified for inclusion. The representative functional performances included in this review were muscle strength, gait speed, sit-to-stand test results, and timed up-and-go test results. Poor to moderate associations were found between muscle echo intensity and functional performance; however, heterogeneities were observed in the characteristics of study participants. Moreover, the accurate effect size and causal inferences between muscle echo intensity and functional performance remained unclear. Further longitudinal studies are needed to determine these causal inferences.
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Affiliation(s)
- Takashi Kitagawa
- Department of Physical Therapy, School of Health Sciences, Shinshu University, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
| | - Masatoshi Nakamura
- Faculty of Rehabilitation Sciences, Nishi Kyushu University, 4490-9 Ozaki, Kanzaki 842-8585, Japan.
| | - Yoshihiro Fukumoto
- Department of Physical Therapy, Faculty of Rehabilitation, Kansai Medical University, 2-5-1 Shin-machi, Hirakata 573-1010, Japan.
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Vasilevska Nikodinovska V, Ivanoski S. Sarcopenia, More Than Just Muscle Atrophy: Imaging Methods for the Assessment of Muscle Quantity and Quality. ROFO-FORTSCHR RONTG 2023; 195:777-789. [PMID: 37160148 DOI: 10.1055/a-2057-0205] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Sarcopenia, a progressive reduction of muscle mass and function, is associated with adverse outcomes in the elderly. Sarcopenia and muscle atrophy are not equal processes. Low muscle strength in association with muscle quantity/quality reduction is currently the optimal method for assessing sarcopenia. There is a practical need for indirect measurement of muscle strength using state-of-the-art imaging techniques. METHODS The following provides a narrative, broad review of all current imaging techniques for evaluating muscles and identifying sarcopenia, including DEXA, CT, MRI, and high-resolution ultrasound, their main strengths, weaknesses, and possible solutions to problems regarding each technique. RESULTS AND CONCLUSION Well-recognized imaging methods for the assessment of muscle mass are explained, including evaluation with DEXA, CT, and MRI muscle quantity assessment, ultrasound evaluation of muscle thickness and CSA, and their correlations with established muscle mass calculation methods. A special focus is on imaging methods for muscle quality evaluation. Several innovative and promising techniques that are still in the research phase but show potential in the assessment of different properties of muscle quality, including MRI DIXON sequences, MRI spectroscopy, Diffusion Tensor Imaging, ultrasound echo intensity, ultrasound elastography, and speed-of-sound ultrasound imaging are briefly mentioned. KEY POINTS · Sarcopenia definition includes low muscle strength and low muscle quantity/quality.. · DEXA is a low-radiation method for whole-body composition measurement in a single image.. · CT has established cut-off values for muscle quality/quantity evaluation and sarcopenia diagnosis.. · MRI is the most sophisticated muscle quality assessment method capable of evaluating myosteatosis, myofibrosis, and microstructure.. · Ultrasound can evaluate muscle quality, including tissue architecture, and elasticity with excellent spatial resolution.. CITATION FORMAT · Vasilevska Nikodinovska V, Ivanoski S, . Sarcopenia, More Than Just Muscle Atrophy: Imaging Methods for the Assessment of Muscle Quantity and Quality. Fortschr Röntgenstr 2023; 195: 777 - 789.
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Affiliation(s)
| | - Slavcho Ivanoski
- Diagnostic Radiology, St. Erasmo Hospital, Ohrid, North Macedonia
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Belzunce MA, Henckel J, Di Laura A, Horga LM, Hart AJ. Gender similarities and differences in skeletal muscle and body composition: an MRI study of recreational cyclists. BMJ Open Sport Exerc Med 2023; 9:e001672. [PMID: 37637483 PMCID: PMC10450064 DOI: 10.1136/bmjsem-2023-001672] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2023] [Indexed: 08/29/2023] Open
Abstract
Objectives This study aims to quantitatively evaluate whether there are muscle mass differences between male and female recreational cyclists and compare muscle quality and body composition in the pelvis region between two well-matched groups of fit and healthy male and female adults. Methods This cross-sectional study involved 45 female and 42 male recreational cyclists. The inclusion criteria for both groups were to have cycled more than 7000 km in the last year, have an absence of injuries and other health problems, have no contraindication to MRI, and be 30-65 years old. Our main outcome measures were fat fraction, as a measure of intramuscular fat (IMF) content, and volume of the gluteal muscles measured using Dixon MRI. The gluteal subcutaneous adipose tissue (SAT) volume was evaluated as a secondary measure. Results We found that there were no gender differences in the IMF content of gluteus maximus (GMAX, p=0.42), gluteus medius (GMED, p=0.69) and gluteus minimus (GMIN, p=0.06) muscles, despite women having more gluteal SAT (p<0.01). Men had larger gluteal muscles than women (p<0.01), but no differences were found when muscle volume was normalised by body weight (GMAX, p=0.54; GMED, p=0.14; GMIN, p=0.19). Conclusions Our study shows that despite the recognised hormonal differences between men and women, there is gender equivalence in the muscle mass and quality of the gluteal muscles when matched for exercise and body weight. This new MRI study provides key information to better understand gender similarities and differences in skeletal muscle and body composition.
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Affiliation(s)
- Martin Alberto Belzunce
- Royal National Orthopaedic Hospital, Stanmore, UK
- Center for Complex Systems and Brain Sciences (CEMSC3), Centro Universitario de Imágenes Médicas (CEUNIM), Instituto de Ciencias Físicas (ICIFI) UNSAM--CONICET, Escuela de Ciencia y Tecnología, Universidad Nacional de Gral. San Martín, San Martín, Buenos Aires, Argentina
| | | | - Anna Di Laura
- Royal National Orthopaedic Hospital, Stanmore, UK
- Department of Mechanical Engineering, University College London, London, UK
| | - Laura Maria Horga
- Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK
| | - Alister James Hart
- Royal National Orthopaedic Hospital, Stanmore, UK
- Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK
- Cleveland Clinic London, London, UK
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Quadriceps Muscle Morphology Is an Important Determinant of Maximal Isometric and Crank Torques of Cyclists. Sports (Basel) 2023; 11:sports11020022. [PMID: 36828307 PMCID: PMC9958782 DOI: 10.3390/sports11020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/26/2022] [Accepted: 12/30/2022] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to determine if quadriceps morphology [muscle volume (MV); cross-sectional area (CSA)], vastus lateralis (VL) muscle architecture, and muscle quality [echo intensity (ECHO)] can explain differences in knee extensor maximal voluntary isometric contraction (MVIC), crank torque (CT) and time-to-exhaustion (TTE) in trained cyclists. Twenty male competitive cyclists performed a maximal incremental ramp to determine their maximal power output (POMAX). Muscle morphology (MV; CSA), muscle architecture of VL and muscle quality (ECHO) of both quadriceps muscles were assessed. Subsequently, cyclists performed three MVICs of both knee extensor muscles and finally performed a TTE test at POMAX with CT measurement during TTE. Stepwise multiple regression results revealed right quadriceps MV determined right MVIC (31%) and CT (33%). Left MV determined CT (24%); and left VL fascicle length (VL-FL) determined MVIC (64%). However, quadriceps morphological variables do not explain differences in TTE. No significant differences were observed between left and right quadriceps muscle morphology (p > 0.05). The findings emphasize that quadriceps MV is an important determinant of knee extensor MVIC and CT but does not explain differences in TTE at POMAX. Furthermore, quadriceps morphological variables were similar between the left and right quadriceps in competitive cyclists.
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Yun DH, Jung IY, Moon CW, Cho KH. Correlation of Femoral Muscle Volume Using Three-Dimensional Modeling and Locomotor Function After Unilateral Trans-femoral Amputation. Ann Rehabil Med 2022; 46:303-311. [PMID: 36588445 PMCID: PMC9810655 DOI: 10.5535/arm.22110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/11/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between femoral muscle volume (FMV) and physiological outcomes after trans-femoral amputations (TFAs) affecting overall locomotor function in patients. METHODS Seven individuals who underwent TFA and had been using a prosthesis participated in this cross-sectional study. Gait and balance were assessed using clinical tests, such as 10-m walk test, 6-minute walk test, Berg Balance Scale, and automatic balance system. Respiratory gas analysis was performed to check oxygen consumption rate. Five participants were evaluated for bilateral FMV by MR imaging and FMV was reconstructed using three-dimentional remodeling. RESULTS In five participants, significant differences were found between the non-involved and involved sides in femur length, total FMV, and functional muscle volume (all p<0.01) in all groups except for the hip adductor volume. The %mean difference between the non-involved and involved sides was 30% for femur length, 52.55% for hip flexor volume, 26.55% for hip adductor volume, 51.86% for hip extensor volume, and 60.21% for knee extensor volume. The hip flexor volume to hip extensor volume ratio in the involved limb and oxygen consumption rate during comfortable gait were negatively correlated (r=-0.96, p=0.04). CONCLUSION In individuals who underwent unilateral TFA, hip girdle muscle imbalance in the involved limbs may be associated with oxygen consumption rate while using a prosthesis.
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Affiliation(s)
- Dong Hyuk Yun
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Il-Young Jung
- Department of Rehabilitation Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Chang Won Moon
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Kang Hee Cho
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, Daejeon, Korea,Corresponding author: Kang Hee Cho Department of Rehabilitation Medicine, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea. Tel: +82-42-338-2460, Fax: +82-42-338-2461, E-mail:
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Factors of Muscle Quality and Determinants of Muscle Strength: A Systematic Literature Review. Healthcare (Basel) 2022; 10:healthcare10101937. [PMID: 36292384 PMCID: PMC9601777 DOI: 10.3390/healthcare10101937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/14/2022] [Accepted: 09/26/2022] [Indexed: 11/04/2022] Open
Abstract
Muscle quality defined as the ratio of muscle strength to muscle mass disregards underlying factors which influence muscle strength. The aim of this review was to investigate the relationship of phase angle (PhA), echo intensity (EI), muscular adipose tissue (MAT), muscle fiber type, fascicle pennation angle (θf), fascicle length (lf), muscle oxidative capacity, insulin sensitivity (IS), neuromuscular activation, and motor unit to muscle strength. PubMed search was performed in 2021. The inclusion criteria were: (i) original research, (ii) human participants, (iii) adults (≥18 years). Exclusion criteria were: (i) no full-text, (ii) non-English or -German language, (iii) pathologies. Forty-one studies were identified. Nine studies found a weak−moderate negative (range r: [−0.26]−[−0.656], p < 0.05) correlation between muscle strength and EI. Four studies found a weak−moderate positive correlation (range r: 0.177−0.696, p < 0.05) between muscle strength and PhA. Two studies found a moderate-strong negative correlation (range r: [−0.446]−[−0.87], p < 0.05) between muscle strength and MAT. Two studies found a weak-strong positive correlation (range r: 0.28−0.907, p < 0.05) between θf and muscle strength. Muscle oxidative capacity was found to be a predictor of muscle strength. This review highlights that the current definition of muscle quality should be expanded upon as to encompass all possible factors of muscle quality.
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Hirata K, Ito M, Nomura Y, Yoshida T, Yamada Y, Akagi R. Can phase angle from bioelectrical impedance analysis associate with neuromuscular properties of the knee extensors? Front Physiol 2022; 13:965827. [PMID: 36035485 PMCID: PMC9403265 DOI: 10.3389/fphys.2022.965827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022] Open
Abstract
Maintenance and improvement of neuromuscular functions is crucial for everyone regardless of age. An easy way to assess neuromuscular properties without muscle contraction is useful especially for those who cannot perform strenuous muscular force production, such as older adults and patients with orthopedic or cognitive disorders. Bioelectrical impedance analysis (BIA) can assess body electrical properties e.g., phase angle (PhA) which is regarded as muscle quantity/quality index. The purpose of this study was to investigate associations of PhA with neuromuscular properties of the knee extensors in 55 young (n = 23) and older (n = 32) adults. The values of PhA of the right thigh and whole-body were determined with BIA at 50 kHz. The participants performed 4-s maximal voluntary isometric contraction (MVIC) to measure peak torque (PTMVIC), and 1-s brief MVIC to assess rate of torque development (RTD) over the time interval of 0–200 ms. As markers of physiological mechanisms of muscle force production, twitch contractile properties (peak twitch torque, rate of twitch torque development, and time-to-peak twitch torque) of the knee extensors obtained by femoral nerve electrical stimulation, and muscle activity assessed as root mean square values of electromyographic activity (EMG-RMS) during PTMVIC and RTD measurements were measured. Thigh and whole-body PhA significantly correlated with PTMVIC (r ≥ 0.555, p < 0.001) and electrically evoked twitch parameters (peak twitch torque, rate of twitch torque development, and time-to-peak twitch torque; |r| ≥ 0.420, p ≤ 0.001), but not RTD (r ≤ 0.237, p ≥ 0.081) or EMG-RMSs (|r| ≤ 0.214, p ≥ 0.117). Stepwise multiple linear regression analysis revealed that thigh PhA was selected as a significant variable to predict PTMVIC but not RTD. Whole-body PhA was not selected as a significant variable to predict PTMVIC or RTD. In conclusion, both thigh and whole-body PhA can associate with maximal voluntary muscle strength of the knee extensors, and this association may be due to intrinsic contractile properties but not neural aspects. Regarding prediction of the knee extensor strength, thigh PhA is preferable as the predictor rather than whole-body PhA which is used as a widely acknowledged indicator of sarcopenia.
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Affiliation(s)
- Kosuke Hirata
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- *Correspondence: Kosuke Hirata, ; Ryota Akagi,
| | - Mari Ito
- Airweave Inc., Aichi, Japan
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Yuta Nomura
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Tsukasa Yoshida
- Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Yosuke Yamada
- Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Ryota Akagi
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
- *Correspondence: Kosuke Hirata, ; Ryota Akagi,
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12
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Yamada Y, Hirata K, Iida N, Kanda A, Shoji M, Yoshida T, Myachi M, Akagi R. Membrane capacitance and characteristic frequency are associated with contractile properties of skeletal muscle. Med Eng Phys 2022; 106:103832. [PMID: 35926956 DOI: 10.1016/j.medengphy.2022.103832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 06/07/2022] [Indexed: 12/13/2022]
Abstract
The cell membrane capacitance (Cm) and characteristic frequencies (fc) of tissues can be obtained using segmental bioelectrical impedance spectroscopy (S-BIS). Higher Cm and lower fc are associated with a larger surface area of skeletal muscle fibers with T-tubules in the tissues. Muscle fiber membrane is one of the major physiological factors that influence surface electromyograms (EMGs) as well as the number of recruited motor units so that the amplitude of surface EMG may be correlated with Cm and fc. The aim of the current study was to examine the association of fc or Cm in the lower leg with contractile and neuromuscular properties in the plantar flexors. We analyzed data from 59 participants (29 women) aged 21-83 years. The Cm, fc, and intracellular water (ICW) in the lower leg were obtained using S-BIS. We measured electrical-evoked torque, maximal voluntary contraction (MVC) torque, and amplitude of EMG normalized by the M wave during MVC contraction. The high Cm group had a significantly lower fc and significantly higher MVC torque, estimated maximum torque, twitch torque, and root mean square (RMS) of EMG normalized by the M wave (EMG:M) in the musculus triceps surae compared to the low Cm group (P < 0.05). Cm was positively and fc was negatively correlated with the nRMS of EMG:M in the triceps surae (P < 0.05). S-BIS recordings can be used to detect changes in skeletal muscle membrane capacitance, which may provide insights into the number of T-tubules. The muscle capacitance measured with S-BIS can be predictive of muscle force generation.
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Affiliation(s)
- Yosuke Yamada
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan; Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Shinjuku-ku, Tokyo, Japan.
| | - Kosuke Hirata
- Faculty of Sport Sciences, Waseda University, Tokorozawa-shi, Saitama, Japan
| | - Natsuki Iida
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama-shi, Saitama, Japan
| | - Akihiro Kanda
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama-shi, Saitama, Japan; Mizuno Corporation, Suminoe-ku, Osaka, Japan
| | - Mikio Shoji
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama-shi, Saitama, Japan
| | - Tsukasa Yoshida
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan; Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Shinjuku-ku, Tokyo, Japan
| | - Motohiko Myachi
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Shinjuku-ku, Tokyo, Japan; Faculty of Sport Sciences, Waseda University, Tokorozawa-shi, Saitama, Japan
| | - Ryota Akagi
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama-shi, Saitama, Japan; Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama-shi, Saitama, Japan.
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13
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Association of age-related decrease in intracellular-to-total water ratio with that in explosive strength of the plantar flexors: a cross-sectional study. J Physiol Anthropol 2022; 41:10. [PMID: 35346376 PMCID: PMC8962585 DOI: 10.1186/s40101-022-00284-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/18/2022] [Indexed: 12/12/2022] Open
Abstract
Background We aimed to investigate the association of age-related differences in the intracellular-to-total water ratio with explosive strength of the plantar flexors. Methods A total of 60 young (21–33 years) and older (64–83 years) individuals were recruited. Intracellular- (ICW) and total-water (TW) content within the right leg was evaluated by bioelectrical impedance spectroscopy as indicators of muscle cell mass and whole muscle mass within the segment, respectively. ICW divided by TW (ICW/TW) was calculated as an index of the occupancy of muscle cells within whole muscle. Rate of torque development (RTD) and electromyography (EMG) activity during maximal voluntary isometric plantar flexion were measured as indicators of explosive muscle strength and neuromuscular activity, respectively. RTD was calculated from three time windows of 0–50, 50–100, and 100–200 ms. Time-to-peak torque (TPT) was assessed from evoked twitch contraction. Results Compared with young participants, older participants showed lower ICW/TW (−7%, P < 0.001), RTD (−25 to −40%, P = 0.003 to 0.001), and longer TPT (+11%, P < 0.001). ICW/TW associated positively with RTD (r = 0.377 to 0.408, P = 0.004 to 0.001) and negatively with TPT (r = −0.392, P = 0.002), but not with EMG activity. RTD was associated positively with EMG for each time window (r = 0.527 to 0.607, P < 0.001). Conclusions These results indicate that ICW/TW may be a useful predictor of the age-related decrease in RTD, and that the decrease in ICW/TW with age may reflect age-associated changes in intrinsic contractile properties.
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14
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Reddy C, Zhou Y, Wan B, Zhang X. Sex and posture dependence of neck muscle size-strength relationships. J Biomech 2021; 127:110660. [PMID: 34364186 DOI: 10.1016/j.jbiomech.2021.110660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 07/21/2021] [Accepted: 07/25/2021] [Indexed: 11/18/2022]
Abstract
Neck muscle size and strength have been linked to lower injury risk and reduced pain. However, prior findings have been inconclusive and have failed to clarify whether there are sex differences in neck muscle size-strength relationships. Such differences may point to an underlying cause for the reported sex difference in neck pain prevalence. Thirty participants (13 males, 17 females) who underwent neck strength testing and MR imaging were analyzed. Strength was measured in three conditions that differed in posture and exertion direction. Muscle size was quantified by three metrics: anatomical cross-sectional area (ACSA), muscle volume (MV), and an estimate of physiological cross-sectional area-reconstruction-based cross-sectional area (RCSA). Inter-posture strength correlations, muscle size-strength correlations, and sex differences were analyzed with linear regression. Males were approximately 65% stronger and had significantly larger muscles. Strength varied significantly across postures, but only female strength values for different postures were significantly correlated. Observed in males only, the sternocleidomastoid (SCM) was a strong predictor of flexion strength in the neutral posture while the anterior scalene (AS) was more involved in the extended. No extensor's size was significantly linked to extension strength. A greater amount of force variation is unexplained by muscle size alone in females than in males. Males and females exhibited distinct size-strength relationships, highlighting the need for sex-specific models and analyses and the greater potential effect of non-morphometric factors on force generating capacity in females. No advantage of one muscle size metric over another in strength prediction was evidenced.
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Affiliation(s)
- Curran Reddy
- Department of Biomedical Engineering, Texas A&M University
| | - Yu Zhou
- Department of Industrial and Systems Engineering, Texas A&M University
| | - Bocheng Wan
- Department of Industrial and Systems Engineering, Texas A&M University
| | - Xudong Zhang
- Department of Biomedical Engineering, Texas A&M University; Department of Industrial and Systems Engineering, Texas A&M University; Department of Mechanical Engineering, Texas A&M University.
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15
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Application of ultrasound for muscle assessment in sarcopenia: 2020 SARCUS update. Eur Geriatr Med 2021; 12:45-59. [PMID: 33387359 DOI: 10.1007/s41999-020-00433-9] [Citation(s) in RCA: 129] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/13/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE In 2018, the SARCUS working group published a first article on the standardization of the use of ultrasound to assess muscle. Recommendations were made for patient positioning, system settings and components to be measured. Also, shortcomings in knowledge were mentioned. An important issue that still required standardization was the definition of anatomical landmarks for many muscles. METHODS A systematic search was performed in Medline, SCOPUS and Web of Sciences looking for all articles describing the use of ultrasound in the assessment of muscle not described in the first recommendations, published from 01/01/2018 until 31/01/2020. All relevant terms used for older people, ultrasound and muscles were used. RESULTS For 39 muscles, different approaches for ultrasound assessment were found that likely impact the values measured. Standardized anatomical landmarks and measuring points were proposed for all muscles/muscle groups. Besides the five already known muscle parameters (muscle thickness, cross-section area, pennation angle, fascicle length and echo-intensity), four new parameters are discussed (muscle volume, stiffness, contraction potential and microcirculation). The former SARCUS article recommendations are updated with this new information that includes new muscle groups. CONCLUSIONS The emerging field of ultrasound assessment of muscle mass only highlights the need for a standardization of measurement technique. In this article, guidelines are updated and broadened to provide standardization instructions for a large number of muscles.
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16
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Stock MS, Thompson BJ. Echo intensity as an indicator of skeletal muscle quality: applications, methodology, and future directions. Eur J Appl Physiol 2020; 121:369-380. [PMID: 33221942 DOI: 10.1007/s00421-020-04556-6] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/07/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE This narrative review provides an overview of the current knowledge of B-mode ultrasound-derived echo intensity (EI) as an indicator of skeletal muscle quality. METHOD PubMed and Google Scholar were used to search the literature. Advanced search functions were used to find original studies with the terms 'echo intensity' and/or 'muscle quality' in the title and/or abstract. Publications that conceptually described muscle quality but did not include measurement of EI were not a focus of the review. RESULT Importantly, the foundational premise of EI remains unclear. While it is likely that EI reflects intramuscular adiposity, data suggesting that these measurements are influenced by fibrous tissue is limited to diseased muscle and animal models. EI appears to show particular promise in studying muscular aging. Studies have consistently reported an association between EI and muscle function, though not all chronic interventions have demonstrated improvements. Based on the existing literature, it is unclear if EI can be used as a marker of muscle glycogen following exercise and nutritional interventions, or if EI is influenced by hydration status. Inconsistent methodological approaches used across laboratories have made comparing EI studies challenging. Image depth, rest duration, participant positioning, probe tilt, and the decision to correct for subcutaneous adipose tissue thickness are all critical considerations when interpreting the literature and planning studies. CONCLUSION While some areas show conflicting evidence, EI shows promise as a novel tool for studying muscle quality. Collaborative efforts focused on methodology are necessary to enhance the consistency and quality of the EI literature.
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Affiliation(s)
- Matt S Stock
- School of Kinesiology and Physical Therapy, University of Central Florida, 12805 Pegasus Drive, HPA 1, Room 258, Orlando, FL, 32816-2205, USA. .,Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, USA.
| | - Brennan J Thompson
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, USA.,Sorenson Legacy Foundation Center for Clinical Excellence, Movement Research Clinic, Utah State University, Logan, UT, USA
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17
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Bali AU, Harmon KK, Burton AM, Phan DC, Mercer NE, Lawless NW, Stock MS. Muscle strength, not age, explains unique variance in echo intensity. Exp Gerontol 2020; 139:111047. [DOI: 10.1016/j.exger.2020.111047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
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18
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Duan K, Gao X, Zhu D. The clinical relevance and mechanism of skeletal muscle wasting. Clin Nutr 2020; 40:27-37. [PMID: 32788088 DOI: 10.1016/j.clnu.2020.07.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/15/2020] [Accepted: 07/21/2020] [Indexed: 02/08/2023]
Abstract
Skeletal muscle wasting occurs in both chronic and acute diseases. Increasing evidence has shown this debilitating process is associated with short- and long-term outcomes in critical, cancer and surgical patients. Both muscle quantity and quality, as reflected by the area and density of a given range of attenuation in CT scan, impact the patient prognosis. In addition, ultrasound and bioelectrical impedance analysis (BIA) are also widely used in the assessment of body composition due to their bedside viability and no radioactivity. Mechanism researches have revealed complicated pathways are involved in muscle wasting, which include altered IGF1-Akt-FoxO signaling, elevated levels of myostatin and activin A, activation of NF-κB pathway and glucocorticoid effects. Particularly, central nervous system (CNS) has been proven to participate in regulating muscle wasting in various conditions, such as infection and tumor. Several promising therapeutic agents have been under developing in the treatment of muscle atrophy, such as myostatin antagonist, ghrelin analog, non-steroidal selective androgen receptor modulators (SARMs). Notably, nutritional therapy is still the fundamental support in combating muscle wasting. However, the optimizing and tailored nutrition regimen relies on accurate metabolism measurement and large clinical trials in the future. Here, we will discuss the current understanding of muscle wasting and potential treatment in clinical practice.
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Affiliation(s)
- Kaipeng Duan
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, PR China
| | - Xin Gao
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, PR China
| | - Dongming Zhu
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, PR China.
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19
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Stock MS, Oranchuk DJ, Burton AM, Phan DC. Age-, sex-, and region-specific differences in skeletal muscle size and quality. Appl Physiol Nutr Metab 2020; 45:1253-1260. [PMID: 32450045 DOI: 10.1139/apnm-2020-0114] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ultrasonography-derived cross-sectional area (CSA) and echo intensity (EI) are increasingly utilized by investigators to study muscle size and quality, respectively. We sought to examine age, sex, and region (proximal, middle, distal) differences in vastus lateralis and rectus femoris CSA and EI, and determine whether correction for subcutaneous fat thickness influences the magnitude of EI differences. Fifteen younger men (mean age = 23 years), 15 younger women (aged 21 years), 11 older men (aged 74 years), and 15 older women (aged 70 years) participated. Clear differences were observed among age, sex, and region for vastus lateralis CSA (p ≤ 0.013, d = 0.38-0.73), whereas rectus femoris CSA was only different between younger and older participants at the proximal region (p = 0.017, d = 0.65). Uncorrected EI was greatest at the distal region of both muscles (p < 0.001, d = 0.59-1.38), with only the younger men having significantly lower EI values than the other groups (p ≤ 0.043, d = 0.37-0.63). Subcutaneous fat correction resulted in a marked increase in the magnitude of sex-specific EI differences (p ≤ 0.032, d ≥ 0.42). Additionally, subcutaneous fat correction increased the uniformity of EI throughout the thigh. These findings highlight considerable region-specific differences in muscle size and quality among younger and older men and women and highlight the need to correct for subcutaneous fat thickness when examining EI. Novelty Rectus femoris CSA is similar between younger and older adults except at the most proximal site evaluated. Age- and sex-specific differences in uncorrected EI are nonuniform across the thigh. Correction for subcutaneous fat thickness substantially increased EI in women, resulting in greater sex differences.
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Affiliation(s)
- Matt S Stock
- Neuromuscular Plasticity Laboratory, School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816-2205, USA.,Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA
| | - Dustin J Oranchuk
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland 0632, New Zealand
| | - Adam M Burton
- Miller School of Medicine, University of Miami, Miami, FL 33124, USA
| | - David C Phan
- Neuromuscular Plasticity Laboratory, School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816-2205, USA
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20
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Bokaee F, Rezasoltani A, Manshadi FD, Naimi SS. Ultrasound echo intensity of cervical muscles in women with and without forward head posture. Cranio 2020; 40:232-238. [DOI: 10.1080/08869634.2020.1750806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Fateme Bokaee
- Physiotherapy Department, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Asghar Rezasoltani
- Physiotherapy Department, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farideh Dehghan Manshadi
- Physiotherapy Department, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedigheh Sadat Naimi
- Physiotherapy Department, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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21
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Automated multi-atlas segmentation of gluteus maximus from Dixon and T1-weighted magnetic resonance images. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 33:677-688. [PMID: 32152794 DOI: 10.1007/s10334-020-00839-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/02/2020] [Accepted: 02/18/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To design, develop and evaluate an automated multi-atlas method for segmentation and volume quantification of gluteus maximus from Dixon and T1-weighted images. MATERIALS AND METHODS The multi-atlas segmentation method uses an atlas library constructed from 15 Dixon MRI scans of healthy subjects. A non-rigid registration between each atlas and the target, followed by majority voting label fusion, is used in the segmentation. We propose a region of interest (ROI) to standardize the measurement of muscle bulk. The method was evaluated using the dice similarity coefficient (DSC) and the relative volume difference (RVD) as metrics, for Dixon and T1-weighted target images. RESULTS The mean(± SD) DSC was 0.94 ± 0.01 for Dixon images, while 0.93 ± 0.02 for T1-weighted. The RVD between the automated and manual segmentation had a mean(± SD) value of 1.5 ± 4.3% for Dixon and 1.5 ± 4.8% for T1-weighted images. In the muscle bulk ROI, the DSC was 0.95 ± 0.01 and the RVD was 0.6 ± 3.8%. CONCLUSION The method allows an accurate fully automated segmentation of gluteus maximus for Dixon and T1-weighted images and provides a relatively accurate volume measurement in shorter times (~ 20 min) than the current gold-standard manual segmentations (2 h). Visual inspection of the segmentation would be required when higher accuracy is needed.
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22
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Rozand V, Sundberg CW, Hunter SK, Smith AE. Age-related Deficits in Voluntary Activation: A Systematic Review and Meta-analysis. Med Sci Sports Exerc 2020; 52:549-560. [PMID: 31688647 PMCID: PMC8015244 DOI: 10.1249/mss.0000000000002179] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Whether there are age-related differences in neural drive during maximal effort contractions is not clear. This review determined the effect of age on voluntary activation during maximal voluntary isometric contractions. The literature was systematically reviewed for studies reporting voluntary activation quantified with the interpolated twitch technique (ITT) or central activation ratio (CAR) during isometric contractions in young (18-35 yr) and old adults (>60 yr; mean, ≥65 yr). Of the 2697 articles identified, 54 were eligible for inclusion in the meta-analysis. Voluntary activation was assessed with electrical stimulation and transcranial magnetic stimulation on five different muscle groups. Random-effects meta-analysis revealed lower activation in old compared with young adults (d = -0.45; 95% confidence interval, -0.62 to -0.29; P < 0.001), with moderate heterogeneity (52.4%). To uncover the sources of heterogeneity, subgroup analyses were conducted for muscle group, calculation method (ITT or CAR), and stimulation type (electrical stimulation or transcranial magnetic stimulation) and number (single, paired, or train stimulations). The age-related reduction in voluntary activation occurred for all muscle groups investigated except the ankle dorsiflexors. Both ITT and CAR demonstrated an age-related reduction in voluntary activation of the elbow flexors, knee extensors, and plantar flexors. ITT performed with paired and train stimulations showed lower activation for old than young adults, with no age difference for the single electrical stimulation. Together, the meta-analysis revealed that healthy older adults have a reduced capacity to activate some upper and lower limb muscles during maximal voluntary isometric contractions; however, the effect was modest and best assessed with at least paired stimulations to detect the difference.
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Affiliation(s)
- Vianney Rozand
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Christopher W Sundberg
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Ashleigh E Smith
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, SA, AUSTRALIA
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23
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Akagi R, Hinks A, Davidson B, Power GA. Differential contributions of fatigue-induced strength loss and slowing of angular velocity to power loss following repeated maximal shortening contractions. Physiol Rep 2020; 8:e14362. [PMID: 32034892 PMCID: PMC7007446 DOI: 10.14814/phy2.14362] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to investigate the relationship between fatigue-induced reductions in isometric torque and isotonic power and to quantify the extent to which the decreases in angular velocity and dynamic torque can explain the power loss immediately following an isotonic fatiguing task and throughout recovery in seven young males and six young females. All measurements were performed with both legs. For dorsiflexion, fatigue-related time-course changes in isometric maximal voluntary contraction (MVC) torque, angular velocity, dynamic torque, and power production following repeated maximal isotonic contractions (load: 20% MVC) were investigated before, immediately after, and 1, 2, 5 and 10 min after a fatiguing task. There were no relationships between the fatigue-related reductions in isometric MVC torque and peak power at any timepoint, suggesting that fatigue-induced reductions in isometric MVC torque does not entirely reflect fatigue-induced changes in dynamic performance. The relative contribution of fatigue-related reduction in dynamic torque on power loss was greater immediately following the task, and lower throughout recovery than the corresponding decrease in angular velocity. Thus, power loss immediately following the task was more strongly related to the decline in dynamic torque; however, this relationship shifted throughout recovery to a greater dependence on slowing of angular velocity for power loss.
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Affiliation(s)
- Ryota Akagi
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan.,Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, ON, Canada
| | - Avery Hinks
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, ON, Canada
| | - Brooke Davidson
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, ON, Canada
| | - Geoffrey A Power
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, ON, Canada
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24
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Hucteau E, Jubeau M, Cornu C, Cattagni T. Is there an intermuscular relationship in voluntary activation capacities and contractile kinetics? Eur J Appl Physiol 2020; 120:513-526. [PMID: 31925519 DOI: 10.1007/s00421-019-04299-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 12/30/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE The force-generating capacities of human skeletal muscles are interrelated, highlighting a common construct of limb strength. This study aimed to further determine whether there is an intermuscular relationship in maximal voluntary activation capacities and contractile kinetics of human muscles. METHODS Twenty-six young healthy individuals participated in this study. Isometric maximal voluntary contraction (MVC) torque, voluntary activation level (VAL), and doublet twitch contractile kinetics (contraction time and half-relaxation time) evoked by a paired supramaximal peripheral nerve stimulation at 100 Hz were obtained in elbow flexors, knee extensors, plantar flexors and dorsiflexors of the dominant limb. RESULTS Peak MVC torque had significant positive correlations between all muscle group pairs (all P values < 0.01). A significant positive correlation for VAL was found only between knee extensors and plantar flexors (r = 0.60, P < 0.01). There were no significant correlations between all muscle group pairs for doublet twitch contraction time and doublet twitch half-relaxation time. DISCUSSION These results show that there is a partial common construct of maximal voluntary activation capacities that only concerns muscle groups that have incomplete activation during MVC (i.e., knee extensors and plantar flexors). This suggests that the common construct of MVC strength between these two muscle groups is partly influenced by neural mechanisms. The lack of intermuscular relationship of contractile kinetics showed that there is no common construct of muscle contractile kinetics, as assessed in vivo by investigating the time-course of evoked doublet twitch contractions.
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Affiliation(s)
- Elyse Hucteau
- Laboratoire "Motricité, Interactions, Performance" EA 4334, Faculty of Sport Sciences, UFR STAPS, University of Nantes, 25 bis Boulevard Guy Mollet-BP 72206, 44 322, Nantes cedex 3, France
| | - Marc Jubeau
- Laboratoire "Motricité, Interactions, Performance" EA 4334, Faculty of Sport Sciences, UFR STAPS, University of Nantes, 25 bis Boulevard Guy Mollet-BP 72206, 44 322, Nantes cedex 3, France
| | - Christophe Cornu
- Laboratoire "Motricité, Interactions, Performance" EA 4334, Faculty of Sport Sciences, UFR STAPS, University of Nantes, 25 bis Boulevard Guy Mollet-BP 72206, 44 322, Nantes cedex 3, France
| | - Thomas Cattagni
- Laboratoire "Motricité, Interactions, Performance" EA 4334, Faculty of Sport Sciences, UFR STAPS, University of Nantes, 25 bis Boulevard Guy Mollet-BP 72206, 44 322, Nantes cedex 3, France.
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25
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Owen PJ, Rantalainen T, Scheuring RA, Belavy DL. Serratus Anterior Contraction During Resisted Arm Extension (GravityFit) Assessed by MRI. Front Physiol 2019; 10:1164. [PMID: 31572214 PMCID: PMC6749035 DOI: 10.3389/fphys.2019.01164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 08/28/2019] [Indexed: 12/04/2022] Open
Abstract
Background Scapular stabilization is a common focus of shoulder rehabilitation. Objective Examine contraction of serratus anterior during a bilateral arm extension exercise with axial compression using an exercise device (GravityFit) by magnetic resonance imaging (MRI). Methods MRI was performed under two conditions: rest and static arm extension with axial compression. Load was set at 20% of age, sex and weight estimated bench press one-repetition maximum. A T2-weighted sequence was used to collect 14 axial images of the upper thoracic spine and shoulder bilaterally. Mean muscle length and thickness were calculated for the whole muscle and in equidistant subregions of the muscle in its anterior (superficial), central and posterior (deep) portions. Adjustment of p-values to guard against false positives was performed via the false discovery rate method. Results Nine participants without a history of shoulder or spine pathology were included. When compared to rest, arm extension with the exercise device led to 11% increased overall muscle thickness (P = 0.038) and 6.1% decreased overall muscle length (P = 0.010). Regionally, thickness increased in anterior (superficial, +19%; P = 0.040) and central (+17%; P = 0.028) portions of the muscle more than posterior (deep, +3.9%, P = 0.542). Conclusion Contraction of serratus anterior occurred during static arm extension with axial compression produced by a novel exercise approach, as measured via MRI. The activation of serratus anterior differed across its length with greater contraction of the anterior and central portions. This may indicate compartmentalization of function within this muscle. Overall, the proof-of-principle findings justify the use of this exercise approach for the activation of serratus anterior.
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Affiliation(s)
- Patrick J Owen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Timo Rantalainen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.,Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Daniel L Belavy
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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Abstract
PURPOSE OF REVIEW To help guide metabolic support in critical care, an understanding of patients' nutritional status and risk is important. Several methods to monitor lean body mass are increasingly used in the ICU and knowledge about their advantages and limitations is essential. RECENT FINDINGS Computed tomography scan analysis, musculoskeletal ultrasound, and bioelectrical impedance analysis are emerging as powerful clinical tools to monitor lean body mass during ICU stay. Accuracy, expertise, ease of use at the bedside, and costs are important factors which play a role in determining which method is most suitable. Exciting new research provides an insight into not only quantitative measurements, but also qualitative measurements of lean body mass, such as infiltration of adipose tissue and intramuscular glycogen storage. SUMMARY Methods to monitor lean body mass in the ICU are under constant development, improving upon bedside usability and offering new modalities to measure. This provides clinicians with valuable markers with which to identify patients at high nutritional risk and to evaluate metabolic support during critical illness.
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Non-Linear Relation Between Upper Arm Volume and Maximal Effort Force Production. J Appl Biomech 2019; 35:353–357. [PMID: 31141451 DOI: 10.1123/jab.2018-0481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective of the present study was to examine the relationship between maximal effort force production and anthropometric measures of upper arm volume. Thirty healthy young participants (15 women) performed five isokinetic concentric and eccentric maximal-effort elbow flexor/extensor contractions, on separate days. Measures of arm length, circumference, and skinfold/subcutaneous fat thickness were used to obtain a measure of arm volume, modeled as two separate right-angle frustra. Single variable regression analyses demonstrated significant (p<0.001) second-order polynomial relationships between maximal effort elbow flexor and extensor force with arm volume (r2 = 0.63 - 0.86). The major findings demonstrated that strong and positive relations between maximal force production and estimates of limb volume can be observed using non-linear modeling and a closer geometric representation of the exercising limb.
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Yoshida T, Yamada Y, Tanaka F, Yamagishi T, Shibata S, Kawakami Y. Intracellular-to-total water ratio explains the variability of muscle strength dependence on the size of the lower leg in the elderly. Exp Gerontol 2018; 113:120-127. [DOI: 10.1016/j.exger.2018.09.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/22/2018] [Accepted: 09/24/2018] [Indexed: 12/25/2022]
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Bachasson D, Dubois GJR, Allenbach Y, Benveniste O, Hogrel JY. Muscle Shear Wave Elastography in Inclusion Body Myositis: Feasibility, Reliability and Relationships with Muscle Impairments. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:1423-1432. [PMID: 29706410 DOI: 10.1016/j.ultrasmedbio.2018.03.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 03/22/2018] [Accepted: 03/29/2018] [Indexed: 06/08/2023]
Abstract
Degenerative muscle changes may be associated with changes in muscle mechanical properties. Shear wave elastography (SWE) allows direct quantification of muscle shear modulus (MSM). The aim of this study was to evaluate the feasibility and reliability of SWE in the severely disordered muscle as observed in inclusion body myositis. To explore the clinical relevance of SWE, potential relationships between MSM values and level muscle impairments (weakness and ultrasound-derived muscle thickness and echo intensity) were investigated. SWE was performed in the biceps brachii at 100°, 90°, 70° and 10° elbow flexion in 34 patients with inclusion body myositis. MSM was assessed before and after five passive stretch-shortening cycles at 4°/s from 70° to 10° elbow angle and after three maximal voluntary contractions to evaluate potential effects of muscle pre-conditioning. Intra-class correlation coefficients and standard errors of measurements were >0.83 and <1.74 kPa and >0.64 and <1.89 kPa for within- and between-day values, respectively. No significant effect of passive loading-unloading and maximal voluntary contractions was found (all p values >0.18). MSM correlated to predicted muscle strength (all Spearman correlation coefficients (ρ) > 0.36; all p values < 0.05). A significant correlation was found between muscle echo intensity and muscle shear modulus at 70° only (ρ = 0.38, p <0.05). No correlation was found between muscle thickness and MSM (all ρ values > 0.23 and all p values > 0.25, respectively). Within- and between-day reliability of muscle SWE was satisfactory and moderate, respectively. SWE shows promise for assessing changes in mechanical properties of the severely disordered muscle. Further investigations are required to clarify these findings and to refine their clinical value.
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Affiliation(s)
| | | | - Yves Allenbach
- Institute of Myology, Paris, France; Inflammatory Muscle and Innovative Targeted Therapies, Department of Internal Medicine and Clinical Immunology, University Pierre et Marie Curie, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Paris, France
| | - Olivier Benveniste
- Institute of Myology, Paris, France; Inflammatory Muscle and Innovative Targeted Therapies, Department of Internal Medicine and Clinical Immunology, University Pierre et Marie Curie, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Paris, France
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Yamada Y. Muscle Mass, Quality, and Composition Changes During Atrophy and Sarcopenia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1088:47-72. [PMID: 30390247 DOI: 10.1007/978-981-13-1435-3_3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Skeletal muscle mass (SMM) and muscle strengh reach their peak in 20s to 40s of age in human life and then decrease with advancing age. The decrease rate of muscle strength or power was twice to four times as large as that of the SMM. Thus, the normalized muscle force (muscle strength divided by SMM) also decreases in aging. It depends on the number of factors in skeletal muscle tissues and neuromuscular system. In human study, SMM cannot be measured directly without dissection so that all of the methodologies are indirect methods to assess SMM, even computing tomography or magnetic resonance imaging. Dual-energy X-ray absorptiometry, ultrasonography, anthropometry, and bioelectrical impedance analysis (BIA) are used as secondary indirect methods to estimate SMM. Recent researches show muscle composition changes in aging, and in particular, the ratio of muscle cell mass (MCM) against SMM decrease and relative expansion of extracellular water (ECW) and extracellular space is observed with advancing age and/or decrease of physical function. The intracellular water (ICW) and ECW estimated by segmental bioelectrical impedance spectroscopy or multifrequency BIA are good biomarkers of the ratio of MCM against SMM in limbs. The BIS and other state-of-the-art technology for assessment of muscle mass, quality, and composition are useful to fully understand the muscle atrophy in a living organism.
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Affiliation(s)
- Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition Tokyo, Tokyo, Japan.
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