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Marín Baselga R, Teigell-Muñoz FJ, Porcel JM, Ramos Lázaro J, García Rubio S. Ultrasound for body composition assessment: a narrative review. Intern Emerg Med 2024:10.1007/s11739-024-03756-8. [PMID: 39240412 DOI: 10.1007/s11739-024-03756-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 08/21/2024] [Indexed: 09/07/2024]
Abstract
Ultrasound has become an increasingly valuable tool for the assessment of body composition, offering several applications and indications in clinical practice. Ultrasound allows bedside evaluation of muscle mass, fat compartments, and extravascular water, providing a cost-effective, portable, and accessible alternative to traditional methods, such as Dual-energy X-ray Absorptiometry (DEXA), Bioelectrical Impedance Analysis (BIA), Computed Tomography (CT), and Magnetic Resonance Imaging (MRI). It is particularly useful in evaluating conditions, such as malnutrition, sarcopenia, and sarcopenic obesity, which require poor muscle mass to establish a diagnosis. The potential uses of ultrasound in body composition assessment include measurement of muscle thickness, cross-sectional area, pennation angle, and echo-intensity, which are indicative of muscle health. Additionally, ultrasound can be used to evaluate various fat compartments, including visceral, subcutaneous, and ectopic fat, which are important for understanding metabolic health and cardiovascular risk. However, the widespread adoption of ultrasound is challenged by the lack of standardized measurements and the absence of ultrasound measures in the validated diagnostic criteria. This article reviews the current applications of ultrasound in body composition assessment, highlighting the recent advancements and the correlation between ultrasound parameters and clinical outcomes. It discusses the advantages of ultrasound while also addressing its limitations, such as the need for standardized protocols and cut-off points. By providing a comprehensive update based on recent publications, this article aims to enhance the clinical utility of ultrasound in assessing and monitoring body composition and pave the way for future research in this field.
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Affiliation(s)
| | | | - José M Porcel
- Internal Medicine Department, Hospital Universitario Arnau Vilanova, IRBLleida, Lleida, Spain
| | - Javier Ramos Lázaro
- Internal Medicine Department, Hospital Universitario de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Samuel García Rubio
- Internal Medicine Department, Hospital Santa Marina, ISS BioBizkaia, Bilbao, Spain.
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Beausejour JP, Knowles KS, Wilson AT, Mangum LC, Hill EC, Hanney WJ, Wells AJ, Fukuda DH, Stout J, Stock MS. Innovations in the Assessment of Skeletal Muscle Health: A Glimpse into the Future. Int J Sports Med 2024; 45:659-671. [PMID: 38198822 DOI: 10.1055/a-2242-3226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Skeletal muscle is the largest organ system in the human body and plays critical roles in athletic performance, mobility, and disease pathogenesis. Despite growing recognition of its importance by major health organizations, significant knowledge gaps remain regarding skeletal muscle health and its crosstalk with nearly every physiological system. Relevant public health challenges like pain, injury, obesity, and sarcopenia underscore the need to accurately assess skeletal muscle health and function. Feasible, non-invasive techniques that reliably evaluate metrics including muscle pain, dynamic structure, contractility, circulatory function, body composition, and emerging biomarkers are imperative to unraveling the complexities of skeletal muscle. Our concise review highlights innovative or overlooked approaches for comprehensively assessing skeletal muscle in vivo. We summarize recent advances in leveraging dynamic ultrasound imaging, muscle echogenicity, tensiomyography, blood flow restriction protocols, molecular techniques, body composition, and pain assessments to gain novel insight into muscle physiology from cellular to whole-body perspectives. Continued development of precise, non-invasive tools to investigate skeletal muscle are critical in informing impactful discoveries in exercise and rehabilitation science.
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Affiliation(s)
- Jonathan P Beausejour
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Kevan S Knowles
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Abigail T Wilson
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - L Colby Mangum
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Ethan C Hill
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - William J Hanney
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Adam J Wells
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - David H Fukuda
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - JeffreyR Stout
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Matt S Stock
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
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Rosahl SC, Rauschendorfer P, Arndt L, Voigtmann T, Mittag U, Rittweger J. Ex-vivo validation of spatial gain sonography for the quantification of echo intensity in fascicle-aligned ultrasound images in ten anatomical muscles in Bos taurus. Sci Rep 2024; 14:3808. [PMID: 38360989 PMCID: PMC10869723 DOI: 10.1038/s41598-024-53852-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/06/2024] [Indexed: 02/17/2024] Open
Abstract
This study aimed to validate the concept of spatial gain sonography for quantifying texture-related echo intensity in B-mode ultrasound of skeletal muscle. Fifty-one bovine muscles were scanned postmortem using B-mode ultrasonography at varying fascicle probe angles (FPA). The relationship between mean gray values (MGV) and FPA was fitted with a sinusoidal and a linear function, the slope of which was defined as tilt echo gain (TEG). Macroscopic muscle cross sections were optically analyzed for intramuscular connective tissue (IMCT) content which was plotted against MGV at 0° FPA (MGV_00). MGV peaked at FPA 0°. Sine fits were superior to linear fits (adjusted r2-values 0.647 vs. 0.613), especially for larger FPAs. In mixed models, the pennation angle was related to TEG (P < 0.001) and MGV_00 (P = 0.035). Age was relevant for MGV_00 (P < 0.001), but not TEG (P > 0.10). The correlation between the IMCT percentage and MGV_00 was significant but weak (P = 0.026; adjusted r2 = 0.103). The relationship between fascicle probe angle and echo intensity in B-mode ultrasound can be modeled more accurately with a sinusoidal but more practically for clinical use with a linear fit. The peak mean gray value MGV_00 can be used to compare echo intensity across muscles without the bias of pennation angle.
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Affiliation(s)
- Sophie C Rosahl
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.
| | | | - Lukas Arndt
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Thomas Voigtmann
- Institute of Material Physics in Space, German Aerospace Center (DLR), Cologne, Germany
- Institute of Theoretical Physics, Heinrich-Heine-Universität, Düsseldorf, Germany
| | - Uwe Mittag
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
- Department of Pediatrics and Adolescent Medicine, University Hospital Cologne, Cologne, Germany
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Lee JW, Hong SU, Lee JH, Park SY. Estimation of Validity of A-Mode Ultrasound for Measurements of Muscle Thickness and Muscle Quality. Bioengineering (Basel) 2024; 11:149. [PMID: 38391635 PMCID: PMC10886028 DOI: 10.3390/bioengineering11020149] [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: 01/16/2024] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
This study aimed to determine whether amplitude modulation (A-mode) ultrasound (US) provides accurate and reliable measurements comparable to those obtained using brightness modulation (B-mode) US under diverse conditions. Thirty healthy participants (15 women and 15 men) underwent measurements of subcutaneous fat thickness (SFT), muscle thickness (MT), and muscle quality (MQ) in the trapezius and biceps brachii muscles using both US modes before and after exercises designed to stimulate the respective muscles. Among the three key indices, the results demonstrated the high validity of the A-mode, with minimal mean differences (MDs) between the two devices less than 0.91 mm and intra-class correlation coefficients (ICCs) exceeding 0.95 for all measures. In addition, the correlation coefficients between the error scores and average scores for the trapezius and biceps brachii suggested no evidence of systematic error. The trapezius MT and MQ significantly increased, and the biceps brachii MT significantly increased after the exercises (p < 0.05). Notably, both the A- and B-modes exhibited the same trend in these post-exercise changes in the muscle. This study suggests that low-cost and low-resolution A-mode US provides measurements of SFT, MT, and MQ similar to the more expensive, high-resolution B-mode imaging. A-mode US is an affordable and portable alternative for muscle assessment.
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Affiliation(s)
- Ji-Won Lee
- Department of Korean Medicine, Graduate School, Dongguk University, Goyang 10326, Republic of Korea
| | - Seung-Ug Hong
- Department of Ophthalmology, Otolaryngology and Dermatology, College of Korean Medicine, Dongguk University, Goyang 10326, Republic of Korea
| | - Ju-Hee Lee
- College of Korean Medicine, Dongguk University, Goyang 10326, Republic of Korea
| | - Sung-Yun Park
- Department of Diagnostics, College of Korean Medicine, Dongguk University, Goyang 10326, Republic of Korea
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Hänni O, Ruby L, Paverd C, Frauenfelder T, Rominger MB, Martin A. Confounders of Ultrasound Attenuation Imaging in a Linear Probe Using the Canon Aplio i800 System: A Phantom Study. Diagnostics (Basel) 2024; 14:271. [PMID: 38337786 PMCID: PMC10855333 DOI: 10.3390/diagnostics14030271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
There have been studies showing attenuation imaging (ATI) with ultrasound as an approach to diagnose liver diseases such as steatosis or cirrhosis. So far, this technique has only been used on a convex probe. The goal of the study was to investigate the feasibility of ATI measurements using the linear array on a canon Aplio i800 scanner on certified phantoms. Three certified liver tissue attenuation phantoms were measured in five different positions using a linear probe. The effects of positioning and depth were explored and compared. The values were compared to the certified expected value for each phantom as well as the different measurement values for each measurement position. The ATI measurements on phantoms showed significant effect for the different probe positions and region of interest (ROI) depths. Values taken in the center with the probe perpendicular to the phantom were closest to certified values. Median values at 2.5-4.5 cm depth for phantoms 1 and 2 and 0.5-2.5 cm for phantom 3 were comparable with certified values. Measurements taken at a depth greater than 6 cm in any position were the least representative of the certified values (p-value < 0.01) and had the widest range throughout the different sessions. ATI measurements can be performed with the linear probe in phantoms; however, careful consideration should be given to depth dependency, as it can significantly affect measurement values. Remaining measurements at various depths within the 0.5-6.0 cm range showed deviation from the certified values of approximately 25%.
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Affiliation(s)
- Olivia Hänni
- Faculty of Medicine, University of Zurich, Dekanat Pestalozzistrasse 3, 8032 Zurich, Switzerland
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (M.B.R.)
| | - Lisa Ruby
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (M.B.R.)
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Catherine Paverd
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (M.B.R.)
| | - Thomas Frauenfelder
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (M.B.R.)
| | - Marga B. Rominger
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (M.B.R.)
| | - Alexander Martin
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (M.B.R.)
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Pimenta R, Coelho F, Correia JP, Vaz JR. Influence of transducer pressure and examiner experience on muscle active shear modulus measured by shear wave elastography. Radiography (Lond) 2024; 30:185-192. [PMID: 38035432 DOI: 10.1016/j.radi.2023.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/19/2023] [Accepted: 11/08/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION This study examined the effects of ultrasound transducer pressure and examiner experience on the biceps femoris long head and semitendinosus muscle active shear modulus in healthy individuals (n = 28). METHODS Active shear modulus was assessed using shear wave elastography at 20% of knee flexor maximal voluntary isometric contraction. Examiners with different experience levels measured the muscles' shear modulus with three pressure levels: mild, moderate, and hard. RESULTS A main effect of transducer pressure was found for both biceps femoris long head (p < 0.001; η2p = 0.314) and semitendinosus muscles (p < 0.001; η2p = 0.280), whereas differences were found between mild-moderate (biceps femoris long head: p = 0.013, d = 0.23; semitendinosus: p = 0.024, d = 0.25), and mild-hard pressures (biceps femoris long head: p = 0.001, d = 0.47; semitendinosus: p = 0.002, d = 0.47). Examiners performed similar shear modulus measurements in the biceps femoris long head (p = 0.299; η2p = 0.041) and semitendinosus (p = 0.177; η2p = 0.066), although the experienced examiner showed a higher measurement repeatability (biceps femoris long head: ICC = 0.86-0.95, semitendinosus: ICC = 0.89-0.96; vs. biceps femoris long head: ICC = 0.78-0.87, semitendinosus: ICC = 0.66-0.87). CONCLUSION Transducer pressure influences the active shear modulus measurement between mild and moderate or hard pressures. Additionally, examiner experience seems to have no influence on muscle active shear modulus measurement when assessed at the same site (using casts). IMPLICATIONS FOR PRACTICE Future studies assessing active muscle shear modulus should use mild transducer pressure and having experienced examiners in order to improve measurement reliability.
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Affiliation(s)
- R Pimenta
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal; Research Center of the Polytechnic Institute of Maia (N2i), Maia Polytechnic Institute (IPMAIA), Castêlo da Maia, 4475-690 Maia, Portugal; Futebol Clube Famalicão - Futebol SAD, Department of Rehabilitation and Performance, Famalicão, Portugal.
| | - F Coelho
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - J P Correia
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - J R Vaz
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal; Egas Moniz - Cooperativa de Ensino Superior, Monte da Caparica, Portugal
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Baer TD, Rice KA, Urbina E, Whitener DV, Dankel SJ. Assessing the effectiveness of Compare Assistant for improving intra-rater reliability of ultrasound-measured muscle thickness. J Med Ultrason (2001) 2024; 51:117-123. [PMID: 37804405 DOI: 10.1007/s10396-023-01367-y] [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: 03/24/2023] [Accepted: 08/07/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE Muscle thickness measured via ultrasound is commonly used to assess muscle size. The purpose of this study was to determine if the reliability of this measurement will improve if using the Compare Assistant tool, and whether this depends on technician experience and the muscle being assessed. METHODS Individuals came to the laboratory for two visits each separated by 24 h. On day 1, two ultrasound images were taken on the individual's anterior upper arm (elbow flexors) and anterior lower leg (tibialis anterior) by two inexperienced and one experienced ultrasound technician. On day 2, three images were taken: (1) without looking at the previous images taken on day 1; (2) after re-examining the images taken on day 1, and (3) side-by-side with the images taken on day 1 via Compare Assistant. Bayes Factors (BF10) were used to provide evidence for the null (< 0.33) or alternative (> 3) hypotheses. RESULTS There was no rater by measurement technique interaction (upper body: BF10 = 0.04, lower body: BF10 = 0.138), nor was there a main effect of measurement technique (upper body: BF10 = 0.052, lower body: BF10 = 0.331), indicating that reliability measures were not improved for either the upper body (CV%, no look: 2.92 vs. Compare Assistant: 2.87) or lower body (CV%, no look: 1.81 vs. Compare Assistant: 1.34) as a result of using Compare Assistant. CONCLUSION The results of this study suggest that day-to-day reliability of muscle thickness measurement may be limited by random biological variability as opposed to technician error.
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Affiliation(s)
- Tyler D Baer
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, James Hall Room 1044, 201 Mullica Hill Rd, Glassboro, NJ, 08028, USA
| | - Kevin A Rice
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, James Hall Room 1044, 201 Mullica Hill Rd, Glassboro, NJ, 08028, USA
| | - Emely Urbina
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, James Hall Room 1044, 201 Mullica Hill Rd, Glassboro, NJ, 08028, USA
| | - Dominic V Whitener
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, James Hall Room 1044, 201 Mullica Hill Rd, Glassboro, NJ, 08028, USA
| | - Scott J Dankel
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, James Hall Room 1044, 201 Mullica Hill Rd, Glassboro, NJ, 08028, USA.
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Helms ER, Spence AJ, Sousa C, Kreiger J, Taylor S, Oranchuk DJ, Dieter BP, Watkins CM. Effect of Small and Large Energy Surpluses on Strength, Muscle, and Skinfold Thickness in Resistance-Trained Individuals: A Parallel Groups Design. SPORTS MEDICINE - OPEN 2023; 9:102. [PMID: 37914977 PMCID: PMC10620361 DOI: 10.1186/s40798-023-00651-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Many perform resistance training (RT) to increase muscle mass and strength. Energy surpluses are advised to support such gains; however, if too large, could cause unnecessary fat gain. We randomized 21 trained lifters performing RT 3 d/wk for eight weeks into maintenance energy (MAIN), moderate (5% [MOD]), and high (15% [HIGH]) energy surplus groups to determine if skinfold thicknesses (ST), squat and bench one-repetition maximum (1-RM), or biceps brachii, triceps brachii, or quadriceps muscle thicknesses (MT) differed by group. COVID-19 reduced our sample, leaving 17 completers. Thus, in addition to Bayesian ANCOVA comparisons, we analyzed changes in body mass (BM) with ST, 1-RM, and MT changes via regression. We reported Bayes factors (BF10) indicating odds ratios of the relative likelihood of hypotheses (e.g., BF10 = 2 indicates the hypothesis is twice as likely as another) and coefficients of determination (R2) for regressions. RESULTS ANCOVAs provided no evidence supporting the group model for MT or squat 1-RM. However, moderate (BF10 = 9.9) and strong evidence (BF10 = 14.5) indicated HIGH increased bench 1-RM more than MOD and MAIN, respectively. Further, there was moderate evidence (BF10 = 4.2) HIGH increased ST more than MAIN and weak evidence (BF10 = 2.4) MOD increased ST more than MAIN. Regression provided strong evidence that BM change predicts ST change (BF10 = 14.3, R2 = 0.49) and weak evidence predicting biceps brachii MT change (BF10 = 1.4, R2 = 0.24). CONCLUSIONS While some group-based differences were found, our larger N regression provides the most generalizable evidence. Therefore, we conclude faster rates of BM gain (and by proxy larger surpluses) primarily increase rates of fat gain rather than augmenting 1-RM or MT. However, biceps brachii, the muscle which received the greatest stimulus in this study, may have been positively impacted by greater BM gain, albeit slightly. Our findings are limited to the confines of this study, where a group of lifters with mixed training experience performed moderate volumes 3 d/wk for 8 weeks. Thus, future work is needed to evaluate the relationship between BM gains, increases in ST and RT adaptations in other contexts.
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Affiliation(s)
- Eric R Helms
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, 17 Antares Place, Rosedale, Auckland, 0632, New Zealand.
- Muscle Physiology Laboratory, Department of Exercise Science and Health Promotion, Florida Atlantic University, Boca Raton, FL, USA.
| | - Alyssa-Joy Spence
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, 17 Antares Place, Rosedale, Auckland, 0632, New Zealand
| | - Colby Sousa
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, 17 Antares Place, Rosedale, Auckland, 0632, New Zealand
| | | | | | - Dustin J Oranchuk
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, 17 Antares Place, Rosedale, Auckland, 0632, New Zealand
| | | | - Casey M Watkins
- Department of Kinesiology, Seattle University, Seattle, WA, USA
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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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Martin A, Lepers R, Vasseur M, Julliand S. Effect of high-starch or high-fibre diets on the energy metabolism and physical performance of horses during an 8-week training period. Front Physiol 2023; 14:1213032. [PMID: 37745248 PMCID: PMC10514361 DOI: 10.3389/fphys.2023.1213032] [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: 04/27/2023] [Accepted: 08/16/2023] [Indexed: 09/26/2023] Open
Abstract
Large amounts of high-starch concentrates are traditionally fed to horses in training. However, this has been associated with digestive or muscle diseases and behavioural modifications. In parallel, it has been demonstrated that horses fed high-fibre, low-starch diets achieve the same performance over an exercise test as the ones fed high-starch diets. However, whether the same performance level can be maintained over a longer training cycle is still being determined. This study aimed to compare the evolution in physical performance and cardiorespiratory responses of two groups of French Trotters fed either a control high-starch (15.0 g dry matter hay/kg body mass/day + 6.6 g dry matter oats/kg body mass/day) or a high-fibre diet (75% of oats replaced by dehydrated alfalfa) over an 8-week training period. The horses that entered the trial were untrained for ≥4 months and previously fed hay only. Track training with speed monitoring included interval training sessions and 2400 m performance tests from week 1 to week 8 (W8). Before (week 0, W0) and after (week 9, W9) the training period, horses performed an incremental continuous exercise test during which cardiorespiratory parameters were measured. Both groups progressed to the same extent regarding physical performance measured during interval training sessions (acceleration: 0.16 m.s-2 at W0 and 0.40 m.s-2 at W8; p < 0.0001), the 2400 m performance test (average speed: 8.88 m.s-1 at W0 and 10.55 m.s-1 at W8; p < 0.0001), and the incremental continuous exercise test (speed during the fastest stage: 9.57 m.s-1 at W0 and 10.53 m.s-1 at W9; p = 0.030). Although oxygen consumption increased with training (p = 0.071), it was not influenced by the diet. On the contrary, carbon dioxide production increased in the high-starch group only (high-starch group: 84.0 vs. high-fibre group: 77.7 mL.kg-1.min-1 at W9; p = 0.031). The results illustrate that horses in both groups progressed similarly but did not use the same metabolic pathways during exercise. This hypothesis is supported by carbohydrate oxidation, which tended to increase in the high-starch group at W9 but decreased in the high-fibre group (p = 0.061). In conclusion, the substitution of high-starch by high-fibre diets enabled similar performance over an 8-week training period and altered energy metabolism in a way that could be beneficial during high-intensity exercise.
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Affiliation(s)
| | - Romuald Lepers
- INSERM UMR 1093-CAPS, Université de Bourgogne, UFR des Sciences du Sport, Dijon, France
| | - Maximilien Vasseur
- Lab To Field, Dijon, France
- INSERM UMR 1093-CAPS, Université de Bourgogne, UFR des Sciences du Sport, Dijon, France
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Bunout D, Gonzalez S, Canales M, Barrera G, Hirsch S. Ultrasound assessment of rectus femoris pennation angle and echogenicity. Their association with muscle functional measures and fat infiltration measured by CT scan. Clin Nutr ESPEN 2023; 55:420-424. [PMID: 37202077 DOI: 10.1016/j.clnesp.2023.04.015] [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: 02/22/2023] [Revised: 04/08/2023] [Accepted: 04/17/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND & AIMS Ultrasound can be used to measure the pennation angle between muscle fiver and the presumed axis of force generation and muscle echogenicity as an indicator of muscle fat infiltration. We aimed to assess the association of the rectus femoris pennation angle and echogenicity with muscle functional measures. Also, to assess the concordance of rectus femoris echogenicity with muscle fat infiltration as determined by CT scan. METHODS Rectus femoris ultrasound pennation angle and thickness were measured in 78 participants aged 69 (65,73) years (37 women). Also hand grip strength, gait speed in 4 m, the 12 min' walk and body composition by DEXA were measured. In a different group of 114 participants aged 44 (31,52) years (80 females), non-dominant rectus femoris echogenicity and thickness were measured by ultrasound and muscle fat infiltration was assessed by CT scan. Handgrip strength and quadriceps torque were also measured. RESULTS There was a weak correlation between the pennation angle and rectus femoris thickness in men (r = 0.31 p = 0.05) but not in women (r = 0.29 NS). Women, but not men with a low pennation angle covered a longer distance during the 12 min' walk. The concordance between the z scores of rectus femoris echogenicity and CT radiological density was 0.43 (p < 0.01) and 0.01 (NS) in men and women, respectively. Men and women with an echogenicity below the 25th percentile had a higher quadriceps torque. Men with an echogenicity 25th percentile below 25th percentile had also a higher handgrip strength. CONCLUSIONS Rectus femoris pennation angle had a weak or absent association with muscle performance. Rectus femoris echogenicity had a moderate overall concordance with radiological density by CT scan and was inversely associated with quadriceps torque. Therefore, echogenicity was associated with muscle strength, but pennation angle measurement did not contribute to the assessment of muscle function.
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Affiliation(s)
- Daniel Bunout
- Institute of Nutrition and Food Technology (INTA), University of Chile, Chile.
| | - Sonya Gonzalez
- Institute of Nutrition and Food Technology (INTA), University of Chile, Chile
| | - Marcela Canales
- Institute of Nutrition and Food Technology (INTA), University of Chile, Chile
| | - Gladys Barrera
- Institute of Nutrition and Food Technology (INTA), University of Chile, Chile
| | - Sandra Hirsch
- Institute of Nutrition and Food Technology (INTA), University of Chile, Chile
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12
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de Lucena Alves CP, de Almeida SB, Lima DP, Neto PB, Miranda AL, Manini T, Vlietstra L, Waters DL, Bielemann RM, Correa-de-Araujo R, Trussardi Fayh AP, Costa EC. Muscle Quality in Older Adults: A Scoping Review. J Am Med Dir Assoc 2023; 24:462-467.e12. [PMID: 36963436 DOI: 10.1016/j.jamda.2023.02.012] [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: 01/26/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE This scoping review aimed to map out currently available definitions and assessment methods of muscle quality in older adults. DESIGN Scoping review. SETTING AND PARTICIPANTS All available studies. METHODS Four databases (PubMed, EMBASE, Web of Science, and Cochrane Library) were searched from inception to May 2022. Title, abstract, and full-text screening were undertaken by 2 reviewers independently. Observational and experimental studies were eligible for inclusion if there was a clear description of muscle quality assessment in individuals aged 60+ years. RESULTS A total of 96 articles were included. Several definitions and assessment methods of muscle quality were identified and divided into 2 main domains: (1) functional domain, and (2) morphological domain. A total of 70% and 30% of the included studies assessed muscle quality in the functional and morphological domains, respectively. In the functional domain, most studies defined muscle quality as the ratio of knee extension strength by leg lean mass (45.9%). In the morphological domain, most studies defined muscle quality as the echo intensity of quadriceps femoris by ultrasound (50.0%). CONCLUSIONS AND IMPLICATIONS There is a substantial heterogeneity of definitions and assessment methods of muscle quality in older adults. Herein, we propose a standardized definition of muscle quality to include terminology, domain, and assessment methods (tests, tools, and body sites). Such standardization may help researchers, clinicians, and decision makers use muscle quality as a potential marker of "skeletal muscle health" in older adults.
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Affiliation(s)
| | - Samuel Brito de Almeida
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza, CE, Brazil; Division of Geriatrics, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Danielle Pessoa Lima
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza, CE, Brazil; Division of Geriatrics, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Medical School, University of Fortaleza, Fortaleza, CE, Brazil
| | - Pedro Braga Neto
- Medical School, University of Fortaleza, Fortaleza, CE, Brazil; Division of Neurology, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, CE, Brazil; Center of Health Sciences, State University of Ceará, Fortaleza, Brazil
| | - Ana Lúcia Miranda
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil
| | - Todd Manini
- Institute on Aging, Department of Health Outcomes and Biomedical Informatics, University of Florida, USA
| | - Lara Vlietstra
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Debra L Waters
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza, CE, Brazil; Department of Medicine and School of Physiotherapy, University of Otago, Dunedin, New Zealand; Department of Internal Medicine/Geriatrics, University of New Mexico, Albuquerque, NM, USA
| | - Renata Moraes Bielemann
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza, CE, Brazil; Graduate Program in Nutrition and Food, Faculty of Nutrition, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Rosaly Correa-de-Araujo
- Division of Geriatrics and Clinical Gerontology, National Institute on Aging, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Ana Paula Trussardi Fayh
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza, CE, Brazil; Department of Nutrition, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Eduardo Caldas Costa
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza, CE, Brazil; ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
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13
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Cronin K, Foley S, Cournane S, De Vito G, Kerin F, Farrell G, Delahunt E. The architectural characteristics of the hamstring muscles do not differ between male and female elite-level rugby union players. Front Physiol 2023; 14:1129061. [PMID: 36776970 PMCID: PMC9911870 DOI: 10.3389/fphys.2023.1129061] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/18/2023] [Indexed: 01/28/2023] Open
Abstract
Purpose: To determine whether differences exist in the architectural characteristics of the hamstring muscles of elite-level male and female rugby union players. Methods: Forty elite-level rugby union players (male n = 20, female n = 20) participated in this cross-sectional study. A sonographer acquired static ultrasound images using a 92 mm linear transducer to quantify (via a semi-automated tracing software tool) the architectural characteristics (muscle length, fascicle length, pennation angle, and muscle thickness) of the biceps femoris long head and semimembranosus muscles of participants' left limb. Muscle length and muscle thickness of the biceps femoris short head and semitendinosus muscles of participants' left limb were also quantified. Bonferroni adjusted independent samples t-tests were performed to evaluate whether differences exist in the architectural characteristics of the hamstring muscles of elite-level male and female rugby union players. Results: There were no significant differences in fascicle length or pennation angle of the hamstring muscles of elite-level male and female rugby union players. Some significant differences in muscle thickness (biceps femoris short head, and semimembranosus) and muscle length (biceps femoris short head, biceps femoris long head, semitendinosus, and semimembranosus) were observed; in all cases the male players had thicker and longer muscles. Conclusion: At a group level, hamstring muscle fascicle length and pennation angle are unlikely to be a sex-specific intrinsic risk factor for Hamstring strain injuries.
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Affiliation(s)
- Kevin Cronin
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Shane Foley
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Seán Cournane
- School of Physics, University College Dublin, Dublin, Ireland
| | - Giuseppe De Vito
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Fearghal Kerin
- Leinster Rugby, Dublin, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | | | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
- Institute for Sport and Health, University College Dublin, Dublin, Ireland
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14
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Bürkle F, Doll J, Neide A, Gantz S, Tsitlakidis S, Fischer C. New perspectives for investigating muscular perfusion response after dietary supplement intake: an exploratory, randomized, double-blind, placebo-controlled crossover trial in healthy young athletes using contrast-enhanced ultrasound (CEUS). J Int Soc Sports Nutr 2022; 19:397-416. [PMID: 35859621 PMCID: PMC9291664 DOI: 10.1080/15502783.2022.2097018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Various dietary supplements have been reported to enhance muscular perfusion in athletes practicing resistance training, especially through modulation of nitric oxide signaling. Objectives The aim of this study was therefore to investigate selected ‘NO-boosting’ supplements in a real-life setting i) to generate novel hypotheses and perfusion estimates for power calculation in view of a definitive trial and ii) to assess the feasibility of the study design with particular focus on the use of contrast-enhanced ultrasound (CEUS) for perfusion quantification. Methods Thirty young male athletes (24 ± 4 years) regularly practicing resistance training were enrolled in this three-arm, placebo(PL)-controlled crossover trial with ingestion of two commercially available supplements: an amino acid combination (AA) (containing 3 g of L-arginine-hydrochloride and 8 g of L-citrulline-malate) and 300 mg of a specific green tea extract (GTE). After intake, CEUS examinations of the dominant biceps brachii muscle were performed under resting conditions and following standardized resistance exercising. Quantitative parameters of biceps perfusion (peak enhancement, PE; wash-in perfusion index, WiPI) and caliber were derived from corresponding CEUS video files. Additionally, subjective muscle pump was determined after exercise. Results For PE, WiPI, and biceps caliber, the standard deviation (SD) of the within-subject differences between PL, AA, and GTE was determined, thereby allowing future sample size calculations. No significant differences between PL, AA, and GTE were observed for biceps perfusion, caliber, or muscle pump. When comparing resting with post-exercise measurements, the increase in biceps perfusion significantly correlated with the caliber increase (PE: r = 0.266, p = 0.0113; WiPI: r = 0.269, p = 0.0105). Similarly, the biceps perfusion correlated with muscle pump in the post-exercise conditions (PE: r = 0.354, p = 0.0006; WiPI: r = 0.350, p = 0.0007). A high participant adherence was achieved, and the acquisition of good quality CEUS video files was feasible. No adverse events occurred. Conclusion Based on our novel examination protocol, CEUS seems to be feasible following higher-load resistance exercising and may be used as a new method for high-resolution perfusion quantification to investigate the effects of pre-exercise dietary supplementation on muscle perfusion and related muscle size dynamics.
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Affiliation(s)
- Franziska Bürkle
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Ultrasound Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Julian Doll
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Ultrasound Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Arndt Neide
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Ultrasound Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Simone Gantz
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Ultrasound Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefanos Tsitlakidis
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Ultrasound Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Fischer
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Ultrasound Center, Heidelberg University Hospital, Heidelberg, Germany
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15
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Fukumoto Y, Taniguchi M, Hirono T, Yagi M, Yamagata M, Nakai R, Asai T, Yamada Y, Kimura M, Ichihashi N. Influence of ultrasound focus depth on the association between echo intensity and intramuscular adipose tissue. Muscle Nerve 2022; 66:568-575. [PMID: 35822539 DOI: 10.1002/mus.27677] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/08/2022]
Abstract
INTRODUCTION/AIMS Attenuation of the US wave is a serious limitation of echo intensity (EI) on B-mode ultrasound (US). The aim of this study was to determine if the focus depth of US images influences the depth-dependent attenuation of EI and the relationship between EI and intramuscular adipose tissues (IntraMAT). METHODS The rectus femoris (RF) and vastus intermedius (VI) of the right thigh were studied in 135 adults (92 older, 43 younger). The EI on US images was measured at three focus depth conditions: top of the image, center of the RF, and center of the VI. The depth of the region of interest (ROI) was measured. Using water and fat images based on the two-point Dixon technique with 3.0 T MRI scanner, IntraMAT was calculated. RESULTS The correlation between EI and IntraMAT was stronger in the focus RF and VI conditions than in the focus top condition and stronger for RF than for VI. The depth of the ROI influenced the IntraMAT-adjusted residual EI more in the focus top condition than in the focus RF and VI conditions, and influenced VI more strongly than it did RF. DISCUSSION This study showed that by mitigating EI attenuation, EI with a focus depth adjusted to the ROI reflected IntraMAT more accurately than that without adjustment. However, it may not completely prevent the potential influence of depth-dependent attenuation of EI, especially for deeper muscles such as the VI. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | - Masashi Taniguchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University
| | | | - Masahide Yagi
- Human Health Sciences, Graduate School of Medicine, Kyoto University
| | - Momoko Yamagata
- Human Development, Graduate School of Human Development and Environment, Kobe university
| | | | - Tsuyoshi Asai
- Faculty of Rehabilitation, Kansai Medical University
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University
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16
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Ruple BA, Smith MA, Osburn SC, Sexton CL, Godwin JS, Edison JL, Poole CN, Stock MS, Fruge AD, Young KC, Roberts MD. Comparisons between skeletal muscle imaging techniques and histology in tracking midthigh hypertrophic adaptations following 10 weeks of resistance training. J Appl Physiol (1985) 2022; 133:416-425. [PMID: 35771220 DOI: 10.1152/japplphysiol.00219.2022] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
This study had two aims. AIM1 was to determine the agreement between mid-thigh vastus lateralis (VL) cross-sectional area measured by ultrasound (mCSAUS) versus magnetic resonance imaging (mCSAMRI) at a single time point, and the ability of each to detect hypertrophic changes. AIM2 was to assess the relationships between pre-to-post training changes in thigh lean mass determined by DXA, VL mCSAUS, ultrasound-determined VL thickness (VLThick), and VL mean myofiber cross-sectional area (fCSA) with changes in VL mCSAMRI. Twelve untrained males (Age: 20±1 y, BMI: 26.9±5.4 kg/m2; n=12) engaged in a 10-week resistance training program (2x/week) where right mid-thigh images and VL biopsies were obtained prior to and 72-hours following the last training bout. Participants' VL mCSAMRI (p=0.005), DXA thigh lean mass (p=0.015), and VLThick (p=0.001) increased following training, whereas VL mCSAUS and fCSA did not. For AIM1, mCSAUS demonstrated excellent concordance (CCC = 0.830) with mCSAMRI, albeit mCSAUS values were systematically lower compared to mCSAMRI (mean bias: -2.29 cm2). Additionally, PRE-to-POST VL mCSA changes between techniques exhibited good agreement (CCC = 0.700; mean bias: -1.08 cm2). For AIM2, moderate, positive correlations existed for PRE-to-POST changes in VL mCSAMRI and DXA thigh lean mass (r=0.580, p=0.048), mCSAUS (r=0.622, p=0.031), and VLThick (r=0.520, p=0.080). A moderate, negative correlation existed between mCSAMRI and fCSA (r=-0.569, p=0.054). Our findings have multiple implications: i) resistance training-induced hypertrophy was dependent on the quantification method, ii) ultrasound-determined mCSA shows good agreement with MRI, and iii) tissue-level changes poorly agreed with mean fCSA changes and this requires further research.
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Affiliation(s)
- Bradley A Ruple
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Morgan A Smith
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Shelby C Osburn
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Casey L Sexton
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Joshua S Godwin
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Joseph L Edison
- Edward Via College of Osteopathic Medicine, Auburn, AL, United States
| | - Christopher N Poole
- Department of Educational Leadership and Human Development, Texas A&M University-Central Texas, Killeen, Texas, United States
| | - Matt S Stock
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL, United States
| | - Andrew D Fruge
- Dietetics and Hospitality, Auburn University, Auburn, AL, United States
| | - Kaelin C Young
- School of Kinesiology, Auburn University, Auburn, AL, United States.,Edward Via College of Osteopathic Medicine, Auburn, AL, United States
| | - Michael D Roberts
- School of Kinesiology, Auburn University, Auburn, AL, United States.,Edward Via College of Osteopathic Medicine, Auburn, AL, United States
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17
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Lynch DH, Spangler HB, Franz JR, Krupenevich RL, Kim H, Nissman D, Zhang J, Li YY, Sumner S, Batsis JA. Multimodal Diagnostic Approaches to Advance Precision Medicine in Sarcopenia and Frailty. Nutrients 2022; 14:1384. [PMID: 35405997 PMCID: PMC9003228 DOI: 10.3390/nu14071384] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 12/12/2022] Open
Abstract
Sarcopenia, defined as the loss of muscle mass, strength, and function with aging, is a geriatric syndrome with important implications for patients and healthcare systems. Sarcopenia increases the risk of clinical decompensation when faced with physiological stressors and increases vulnerability, termed frailty. Sarcopenia develops due to inflammatory, hormonal, and myocellular changes in response to physiological and pathological aging, which promote progressive gains in fat mass and loss of lean mass and muscle strength. Progression of these pathophysiological changes can lead to sarcopenic obesity and physical frailty. These syndromes independently increase the risk of adverse patient outcomes including hospitalizations, long-term care placement, mortality, and decreased quality of life. This risk increases substantially when these syndromes co-exist. While there is evidence suggesting that the progression of sarcopenia, sarcopenic obesity, and frailty can be slowed or reversed, the adoption of broad-based screening or interventions has been slow to implement. Factors contributing to slow implementation include the lack of cost-effective, timely bedside diagnostics and interventions that target fundamental biological processes. This paper describes how clinical, radiographic, and biological data can be used to evaluate older adults with sarcopenia and sarcopenic obesity and to further the understanding of the mechanisms leading to declines in physical function and frailty.
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Affiliation(s)
- David H. Lynch
- Division of Geriatric Medicine, Center for Aging and Health, University of North Carolina, Chapel Hill, NC 27599, USA;
| | - Hillary B. Spangler
- Division of Medicine and Pediatrics, University of North Carolina, Chapel Hill, NC 27599, USA;
| | - Jason R. Franz
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, North Carolina State University, Chapel Hill, NC 27599, USA; (J.R.F.); (R.L.K.); (H.K.)
| | - Rebecca L. Krupenevich
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, North Carolina State University, Chapel Hill, NC 27599, USA; (J.R.F.); (R.L.K.); (H.K.)
| | - Hoon Kim
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, North Carolina State University, Chapel Hill, NC 27599, USA; (J.R.F.); (R.L.K.); (H.K.)
| | - Daniel Nissman
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA; (D.N.); (J.Z.)
| | - Janet Zhang
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA; (D.N.); (J.Z.)
| | - Yuan-Yuan Li
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (Y.-Y.L.); (S.S.)
| | - Susan Sumner
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (Y.-Y.L.); (S.S.)
| | - John A. Batsis
- Division of Geriatric Medicine, Center for Aging and Health, University of North Carolina, Chapel Hill, NC 27599, USA;
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; (Y.-Y.L.); (S.S.)
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18
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Abdelnaby R, Mohamed KA, Elgenidy A, Sonbol YT, Bedewy MM, Aboutaleb AM, Ebrahim MA, Maallem I, Dardeer KT, Heikal HA, Gawish HM, Zschüntzsch J. Muscle Sonography in Inclusion Body Myositis: A Systematic Review and Meta-Analysis of 944 Measurements. Cells 2022; 11:600. [PMID: 35203250 PMCID: PMC8869828 DOI: 10.3390/cells11040600] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/28/2022] [Accepted: 02/04/2022] [Indexed: 01/14/2023] Open
Abstract
Inclusion body myositis (IBM) is a slowly progressive muscle weakness of distal and proximal muscles, which is diagnosed by clinical and histopathological criteria. Imaging biomarkers are inconsistently used and do not follow international standardized criteria. We conducted a systematic review and meta-analysis to investigate the diagnostic value of muscle ultrasound (US) in IBM compared to healthy controls. A systematic search of PubMed/MEDLINE, Scopus and Web of Science was performed. Articles reporting the use of muscle ultrasound in IBM, and published in peer-reviewed journals until 11 September 2021, were included in our study. Seven studies were included, with a total of 108 IBM and 171 healthy controls. Echogenicity between IBM and healthy controls, which was assessed by three studies, demonstrated a significant mean difference in the flexor digitorum profundus (FDP) muscle, which had a grey scale value (GSV) of 36.55 (95% CI, 28.65-44.45, p < 0.001), and in the gastrocnemius (GC), which had a GSV of 27.90 (95% CI 16.32-39.48, p < 0.001). Muscle thickness in the FDP showed no significant difference between the groups. The pooled sensitivity and specificity of US in the differentiation between IBM and the controls were 82% and 98%, respectively, and the area under the curve was 0.612. IBM is a rare disease, which is reflected in the low numbers of patients included in each of the studies and thus there was high heterogeneity in the results. Nevertheless, the selected studies conclusively demonstrated significant differences in echogenicity of the FDP and GC in IBM, compared to controls. Further high-quality studies, using standardized operating procedures, are needed to implement muscle ultrasound in the diagnostic criteria.
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Affiliation(s)
- Ramy Abdelnaby
- Department of Neurology, RWTH Aachen University, Pauwels Street 30, 52074 Aachen, Germany;
| | - Khaled Ashraf Mohamed
- Faculty of Medicine, Cairo University, 1 Gamaa Street, Cairo 12613, Egypt; (K.A.M.); (A.E.); (Y.T.S.); (M.M.B.); (M.A.E.); (K.T.D.); (H.A.H.); (H.M.G.)
| | - Anas Elgenidy
- Faculty of Medicine, Cairo University, 1 Gamaa Street, Cairo 12613, Egypt; (K.A.M.); (A.E.); (Y.T.S.); (M.M.B.); (M.A.E.); (K.T.D.); (H.A.H.); (H.M.G.)
| | - Yousef Tarek Sonbol
- Faculty of Medicine, Cairo University, 1 Gamaa Street, Cairo 12613, Egypt; (K.A.M.); (A.E.); (Y.T.S.); (M.M.B.); (M.A.E.); (K.T.D.); (H.A.H.); (H.M.G.)
| | - Mahmoud Mostafa Bedewy
- Faculty of Medicine, Cairo University, 1 Gamaa Street, Cairo 12613, Egypt; (K.A.M.); (A.E.); (Y.T.S.); (M.M.B.); (M.A.E.); (K.T.D.); (H.A.H.); (H.M.G.)
| | | | - Mohamed Ayman Ebrahim
- Faculty of Medicine, Cairo University, 1 Gamaa Street, Cairo 12613, Egypt; (K.A.M.); (A.E.); (Y.T.S.); (M.M.B.); (M.A.E.); (K.T.D.); (H.A.H.); (H.M.G.)
| | - Imene Maallem
- Faculty of Medicine, Pharmacy Department, University Badji Mokhtar Annaba, Zaafrania Street, Annaba 23000, Algeria;
| | - Khaled Tarek Dardeer
- Faculty of Medicine, Cairo University, 1 Gamaa Street, Cairo 12613, Egypt; (K.A.M.); (A.E.); (Y.T.S.); (M.M.B.); (M.A.E.); (K.T.D.); (H.A.H.); (H.M.G.)
| | - Hamed Amr Heikal
- Faculty of Medicine, Cairo University, 1 Gamaa Street, Cairo 12613, Egypt; (K.A.M.); (A.E.); (Y.T.S.); (M.M.B.); (M.A.E.); (K.T.D.); (H.A.H.); (H.M.G.)
| | - Hazem Maher Gawish
- Faculty of Medicine, Cairo University, 1 Gamaa Street, Cairo 12613, Egypt; (K.A.M.); (A.E.); (Y.T.S.); (M.M.B.); (M.A.E.); (K.T.D.); (H.A.H.); (H.M.G.)
| | - Jana Zschüntzsch
- Clinic for Neurology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany
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19
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Wong V, Song JS, Abe T, Spitz RW, Yamada Y, Bell ZW, Kataoka R, Kang M, Loenneke JP. Muscle thickness assessment of the forearm via ultrasonography: is experience level important? Biomed Phys Eng Express 2022; 8. [PMID: 35051910 DOI: 10.1088/2057-1976/ac4d42] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/20/2022] [Indexed: 11/11/2022]
Abstract
It is suggested that experience is needed in order to capture valid estimates of muscle size with ultrasound. However, it is unknown whether there is a large degree of skill needed to analyze the images once they are captured.Objective:To determine if less experienced raters could accurately analyze ultrasound images of the forearm by comparing their estimates with those of a very experienced ultrasonographer (criterion).Approach:50 muscle thickness images were captured by one experienced ultrasonographer (also Rater 1). Those images were saved and were then measured by four raters with different levels of experience. The rater who captured the images was very experienced (criterion), the second rater was also experienced and provided 5 minutes of instruction for Rater 3 (minimal experience) and Rater 4 (no experience). Test-retest reliability was also determined for Rater 3 and 4.Main Results:The average muscle thickness value for the criterion was 3.73 cm. The constant error for Rater 2, 3, and 4 was -0.003 (0.02) cm (p=0.362), -0.07 (0.04) cm (p<0.001), and 0.02 (0.09) cm (p=0.132), respectively. The SD for Rater 4 was greater, resulting in wider limits of agreement compared to Rater 2 and 3. Absolute error was 0.01 cm for Rater 2, whilst it was 0.07 cm and 0.03 cm for the two inexperienced raters (Rater 3 and 4). The error for Rater 3 was systematic and post-hoc assessment found that this rater was using a different border than the other three raters (but consistent across time). For the test-retest reliability, the minimal difference for Rater 3 was 0.08 cm (relative minimal difference of 2%) and 0.17 cm (relative minimal difference of 4%) for Rater 4.Significance:Less experienced raters were able to accurately and reliably analyze already captured muscle thickness images of the forearm with low absolute errors.
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Affiliation(s)
- Vickie Wong
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, PO Box 1848, University Park, Mississippi, 38677, UNITED STATES
| | - Jun Seob Song
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, PO Box 1848, University Park, Mississippi, 38677, UNITED STATES
| | - Takashi Abe
- Juntendo University, Japan, Bunkyo-ku, Tokyo, NA, JAPAN
| | - Robert W Spitz
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, PO Box 1848, University Park, Mississippi, 38677, UNITED STATES
| | - Yujiro Yamada
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, PO Box 1848, University Park, Mississippi, 38677, UNITED STATES
| | - Zachary W Bell
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, PO Box 1848, University Park, Mississippi, 38677, UNITED STATES
| | - Ryo Kataoka
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, PO Box 1848, University Park, Mississippi, 38677, UNITED STATES
| | - Minsoo Kang
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, PO Box 1848, University Park, Mississippi, 38677, UNITED STATES
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, PO Box 1848, University Park, Mississippi, 38677, UNITED STATES
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Tang X, Yang Y, Huang L, Qiu L. The Application of Texture Feature Analysis of Rectus Femoris Based on Local Binary Pattern (LBP) Combined With Gray-Level Co-Occurrence Matrix (GLCM) in Sarcopenia. JOURNAL OF ULTRASOUND IN MEDICINE 2021; 41:2169-2179. [PMID: 34825723 DOI: 10.1002/jum.15896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/01/2021] [Accepted: 11/11/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES In order to detect the changes in muscle texture of sarcopenia and to explore a new method of ultrasound assessment of muscle changes in sarcopenia. METHODS we used the local binary pattern (LBP) combined with gray-level co-occurrence matrix (GLCM) method to extract and quantitatively analyze the texture information of the rectus femoris of different people, and initially verified the robustness of this method to image gain changes. We recruited young volunteers, elderly volunteers without sarcopenia, and elderly volunteers with sarcopenia in this cross-sectional study. We scanned the rectus femoris and extracted their muscle texture features. RESULTS We found that when ultrasonographic gain varied from 40% to 70%, the intraclass correlation coefficient (ICC) of contrast, entropy, and homogeneity were 0.989, 0.973, and 0.989, respectively. Body mass index was significantly related to contrast (r = 0.285, P < .05), and age had a significant correlation with contrast and homogeneity (r = -0.259 and r = 0.269, P < .05). The elderly volunteers with sarcopenia had the highest entropy (0.363 [0.342-0.403]) and homogeneity (2.203 [2.162-2.277]) in the texture of the rectus femoris among the three groups, and at the same time had the lowest contrast (44.583 [43.492-47.399]), and all P < .05. CONCLUSION LBP combined with GLCM can be a stable method for extracting muscle texture features. At the same time, the contrast, entropy, and homogeneity of the rectus femoris of the elderly with sarcopenia were significantly different from those of the young volunteers and the elderly without sarcopenia, suggesting the texture features of rectus femoris are potential parameters for evaluating muscle function and pathological changes.
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Affiliation(s)
- Xinyi Tang
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Yujia Yang
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Li Huang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Li Qiu
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, China
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21
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Carr JC, Gerstner GR, Voskuil CC, Harden JE, Dunnick D, Badillo KM, Pagan JI, Harmon KK, Girts RM, Beausejour JP, Stock MS. The Influence of Sonographer Experience on Skeletal Muscle Image Acquisition and Analysis. J Funct Morphol Kinesiol 2021; 6:91. [PMID: 34842750 PMCID: PMC8628927 DOI: 10.3390/jfmk6040091] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 01/05/2023] Open
Abstract
The amount of experience with ultrasonography may influence measurement outcomes while images are acquired or analyzed. The purpose of this study was to identify the interrater reliability of ultrasound image acquisition and image analysis between experienced and novice sonographers and image analysts, respectively. Following a brief hands-on training session (2 h), the experienced and novice sonographers and analysts independently performed image acquisition and analyses on the biceps brachii, vastus lateralis, and medial gastrocnemius in a sample of healthy participants (n = 17). Test-retest reliability statistics were computed for muscle thickness (transverse and sagittal planes), muscle cross-sectional area, echo intensity and subcutaneous adipose tissue thickness. The results show that image analysis experience generally has a greater impact on measurement outcomes than image acquisition experience. Interrater reliability for measurements of muscle size during image acquisition was generally good-excellent (ICC2,1: 0.82-0.98), but poor-moderate for echo intensity (ICC2,1: 0.43-0.77). For image analyses, interrater reliability for measurements of muscle size for the vastus lateralis and biceps brachii was poor-moderate (ICC2,1: 0.48-0.70), but excellent for echo intensity (ICC2,1: 0.90-0.98). Our findings have important implications for laboratories and clinics where members possess varying levels of ultrasound experience.
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Affiliation(s)
- Joshua C. Carr
- Neuromuscular Physiology Laboratory, Texas Christian University, Fort Worth, TX 76129, USA; (J.C.C.); (C.C.V.)
- Department of Medical Education, TCU & UNTHSC School of Medicine, Fort Worth, TX 76129, USA
| | - Gena R. Gerstner
- Neuromechanics Laboratory, Department of Human Movement Sciences, Old Dominion University, Norfolk, VA 23529, USA; (G.R.G.); (J.E.H.)
| | - Caleb C. Voskuil
- Neuromuscular Physiology Laboratory, Texas Christian University, Fort Worth, TX 76129, USA; (J.C.C.); (C.C.V.)
| | - Joel E. Harden
- Neuromechanics Laboratory, Department of Human Movement Sciences, Old Dominion University, Norfolk, VA 23529, USA; (G.R.G.); (J.E.H.)
| | - Dustin Dunnick
- Department of Health and Physical Education, Arkansas Tech University, Russellville, AR 72801, USA;
| | - Kristin M. Badillo
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (K.M.B.); (J.I.P.); (K.K.H.); (R.M.G.); (J.P.B.)
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
| | - Jason I. Pagan
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (K.M.B.); (J.I.P.); (K.K.H.); (R.M.G.); (J.P.B.)
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
| | - Kylie K. Harmon
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (K.M.B.); (J.I.P.); (K.K.H.); (R.M.G.); (J.P.B.)
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
| | - Ryan M. Girts
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (K.M.B.); (J.I.P.); (K.K.H.); (R.M.G.); (J.P.B.)
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
| | - Jonathan P. Beausejour
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (K.M.B.); (J.I.P.); (K.K.H.); (R.M.G.); (J.P.B.)
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
| | - Matt S. Stock
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (K.M.B.); (J.I.P.); (K.K.H.); (R.M.G.); (J.P.B.)
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
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22
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Naimo MA, Varanoske AN, Hughes JM, Pasiakos SM. Skeletal Muscle Quality: A Biomarker for Assessing Physical Performance Capabilities in Young Populations. Front Physiol 2021; 12:706699. [PMID: 34421645 PMCID: PMC8376973 DOI: 10.3389/fphys.2021.706699] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/09/2021] [Indexed: 12/28/2022] Open
Abstract
Muscle quality (MQ), defined as the amount of strength and/or power per unit of muscle mass, is a novel index of functional capacity that is increasingly relied upon as a critical biomarker of muscle health in low functioning aging and pathophysiological adult populations. Understanding the phenotypical attributes of MQ and how to use it as an assessment tool to explore the efficacy of resistance exercise training interventions that prioritize functional enhancement over increases in muscle size may have implications for populations beyond compromised adults, including healthy young adults who routinely perform physically demanding tasks for competitive or occupational purposes. However, MQ has received far less attention in healthy young populations than it has in compromised adults. Researchers and practitioners continue to rely upon static measures of lean mass or isolated measures of strength and power, rather than using MQ, to assess integrated functional responses to resistance exercise training and physical stress. Therefore, this review will critically examine MQ and the evidence base to establish this metric as a practical and important biomarker for functional capacity and performance in healthy, young populations. Interventions that enhance MQ, such as high-intensity stretch shortening contraction resistance exercise training, will be highlighted. Finally, we will explore the potential to leverage MQ as a practical assessment tool to evaluate function and enhance performance in young populations in non-traditional research settings.
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Affiliation(s)
- Marshall A Naimo
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
| | - Alyssa N Varanoske
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States.,Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States
| | - Julie M Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
| | - Stefan M Pasiakos
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
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23
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Varanoske AN, Coker NA, Johnson BADI, Belity T, Wells AJ. Muscle Quality, Measured by Ultrasound-Derived Corrected Echo Intensity, Does not Affect Changes in Cross-sectional Area of the Vastus Lateralis Following Recumbent Rest. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2021. [DOI: 10.1177/8756479320967277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Recumbent rest elicits a decrease in muscle size of the lower extremity, but the extent of decrease may be related to differences in muscle quality. This could have implications for ultrasound-derived measures of muscle size, particularly in individuals with a large proportion of intramuscular contractile elements. The research objective was to determine whether decreases in muscle size following recumbent rest are related to ultrasound-derived corrected echo intensity in resistance-trained males. Methods: Cross-sectional area (CSA), echo intensity (EI), subcutaneous fat thickness (SFT), and EI corrected for SFT (EICor) of the vastus lateralis (VL) were measured via ultrasonography in 30 resistance-trained males. Measures were obtained immediately following recumbency (T0) and 15 minutes after recumbency (T15). The association between EICor and percentage change in CSA (%ΔCSA) from T0 to T15 was examined. Comparisons of morphological characteristics were examined between a subset of participants with the lowest (LO; n = 10; <33rd percentile) and highest (HI; n = 10; >66th percentile) EICor. Results: EICor was not correlated with %ΔCSA ( P = .151), and the decrease in CSA from T0 to T15 did not differ between the LO and HI groups. Conclusions: Muscle quality (EICor) is not related to the decrease in CSA of the VL following recumbent rest among resistance-trained, young males. The time frame of muscle CSA acquisition should not differ based solely on differences in muscle quality.
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Affiliation(s)
- Alyssa N. Varanoske
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Nicholas A. Coker
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Bri-Ana D. I. Johnson
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Tal Belity
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Adam J. Wells
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
- Exercise Physiology Intervention and Collaboration (EPIC) Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL
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24
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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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25
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Bell ZW, Abe T, Wong V, Spitz RW, Viana RB, Chatakondi RN, Dankel SJ, Yamada Y, Loenneke JP. Muscle swelling following blood flow-restricted exercise does not differ between cuff widths in the proximal or distal portions of the upper leg. Clin Physiol Funct Imaging 2020; 40:269-276. [PMID: 32319156 DOI: 10.1111/cpf.12635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/31/2020] [Accepted: 04/14/2020] [Indexed: 12/01/2022]
Abstract
The purpose was to understand how wider cuffs, covering larger portions of the limb, may affect acute muscle swelling when used during low-load knee extension exercise with blood flow restriction. A total of 96 individuals (53 females and 43 males) completed two visits, with visit one used for measuring maximal strength and arterial occlusion pressure (AOP), and visit two to compare between a narrow (5 cm) and a wide (12 cm) cuff for acute changes in muscle thickness and echo intensity following exercise. Ultrasound measurements were completed at a proximal and distal site within both legs, with the proximal site located beneath the cuff within the leg exercising using the wide cuff. Study findings indicate that the difference in acute changes for muscle thickness [median difference (95% credible interval) of 0.009 (-0.03, 0.05) cm] and echo intensity [median difference (95% credible interval) of 0.79 (-0.28, 1.89) AU] between cuff widths did not differ between proximal and distal sites. Additionally, acute changes in muscle thickness did not differ between cuff widths, sexes or participants who had AOP measured and those who were estimated. Lastly, acute changes in echo intensity did not differ between cuff widths and those who had AOP measured and those who were estimated. However, there was evidence showing how there might be greater reductions in echo intensity for females at the distal site. The previously observed attenuation of muscle growth under the cuff is unlikely to be related to differences in the acute muscle swelling response.
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Affiliation(s)
- Zachary W Bell
- Kevser Ermin Applied Physiology Laboratory, Department of Health, & Recreation Management, The University of Mississippi, University, MS, USA
| | - Takashi Abe
- Kevser Ermin Applied Physiology Laboratory, Department of Health, & Recreation Management, The University of Mississippi, University, MS, USA
| | - Vickie Wong
- Kevser Ermin Applied Physiology Laboratory, Department of Health, & Recreation Management, The University of Mississippi, University, MS, USA
| | - Robert W Spitz
- Kevser Ermin Applied Physiology Laboratory, Department of Health, & Recreation Management, The University of Mississippi, University, MS, USA
| | - Ricardo B Viana
- Kevser Ermin Applied Physiology Laboratory, Department of Health, & Recreation Management, The University of Mississippi, University, MS, USA.,Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Raksha N Chatakondi
- Kevser Ermin Applied Physiology Laboratory, Department of Health, & Recreation Management, The University of Mississippi, University, MS, USA
| | - Scott J Dankel
- Exercise Physiology Laboratory, Department of Health and Exercise Science, Rowan University, Glassboro, NJ, USA
| | - Yujiro Yamada
- Kevser Ermin Applied Physiology Laboratory, Department of Health, & Recreation Management, The University of Mississippi, University, MS, USA
| | - Jeremy P Loenneke
- Kevser Ermin Applied Physiology Laboratory, Department of Health, & Recreation Management, The University of Mississippi, University, MS, USA
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26
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Yitzchaki N, Zhu WG, Kuehne TE, Vasenina E, Dankel SJ, Buckner SL. An examination of changes in skeletal muscle thickness, echo intensity, strength and soreness following resistance exercise. Clin Physiol Funct Imaging 2020; 40:238-244. [PMID: 32187417 DOI: 10.1111/cpf.12630] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/11/2020] [Accepted: 03/13/2020] [Indexed: 11/30/2022]
Abstract
It is suggested that changes in echo intensity (EI) measured through ultrasound can detect muscle swelling. However, changes in EI have never been examined relative to a non-exercise control following naïve exposure to exercise. PURPOSE Examine the changes in muscle thickness (MT), EI and isometric strength (ISO) before, immediately after, and 24, and 48 hr following biceps curls. METHODS Twenty-seven non-resistance-trained individuals visited the laboratory four times. During visit 1, paperwork was completed and strength was measured. During visit 2, MT and ISO were measured before four sets of curls. Additional measures were taken immediately after exercise, as well as 24 and 48 hr post. Results are displayed as means (SD). RESULTS For MT, there was an interaction (p < .001). For the experimental condition, MT increased from pre [2.88(0.64) cm] to post [3.27(0.67) cm] and remained elevated 48 hr post. There were no changes for MT in the control arm. In the experimental arm, EI increased from pre [22.9(9.6) AU] to post [29.1(12.3) AU] exercise and returned to baseline by 24 hr. For the control condition, EI was different between pre [24.8(10.2) AU] and 48 hr [21.5(10.7) AU]. The change in EI in the experimental condition was greater than the control condition immediately post (p = .039) and at 48 hr (p = .016). For ISO, there was an interaction (p < .001). In the experimental condition, ISO decreased from pre [40.6(14.7) Nm)] to post [24.8(9.4) Nm] and remained depressed. CONCLUSIONS Exercise produced a swelling response, which was elevated 48 hr post. Despite a sustained increase in MT, EI was only elevated immediately post exercise.
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Affiliation(s)
- Noam Yitzchaki
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, FL, USA
| | - Wenyuan G Zhu
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, FL, USA
| | - Tayla E Kuehne
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, FL, USA
| | - Ecaterina Vasenina
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, FL, USA
| | - Scott J Dankel
- Exercise Physiology Laboratory, Department of Health and Exercise Science, Rowan University, Glassboro, NJ, USA
| | - Samuel L Buckner
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, FL, USA
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27
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Exercise induced changes in echo intensity within the muscle: a brief review. J Ultrasound 2020; 23:457-472. [PMID: 31925731 DOI: 10.1007/s40477-019-00424-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/19/2019] [Indexed: 02/07/2023] Open
Abstract
Echo intensity is the mean pixel intensity of a specific region of interest from an ultrasound image. This variable has been increasingly used in the literature as a physiological marker. Although there has been an increased interest in reporting changes in echo intensity in response to exercise, little consensus exists as to what a change in echo intensity represents physiologically. The purpose of this paper is to review some of the earliest, as well as the most up to date literature regarding the changes in echo intensity in response to exercise. Echo intensity has been used to measure muscle quality, muscle damage, acute swelling, and intramuscular glycogen. The changes in echo intensity, however, are not consistent throughout the literature and often times lead to conclusions that seem contrary to the physiologic effects of exercise. For example, echo intensity increases in conjunction with increases in strength, contrary to what would be expected if echo intensity was a marker of muscle quality/muscle damage. It is conceivable that a change in echo intensity represents a range of physiologic effects at different time points. We recommend that these effects should be determined experimentally in order to rule out what echo intensity might and might not represent. Until this is done, caution should be employed when interpreting changes in echo intensity with acute and chronic exercise.
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Oranchuk DJ, Stock MS, Nelson AR, Storey AG, Cronin JB. Variability of regional quadriceps echo intensity in active young men with and without subcutaneous fat correction. Appl Physiol Nutr Metab 2020; 45:745-752. [PMID: 31917597 DOI: 10.1139/apnm-2019-0601] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Quantifying echo intensity (EI), a proposed measure of muscle quality, is becoming increasingly popular. Additionally, much attention has been paid to regional differences in other ultrasonically evaluated measures of muscle morphology and architecture. However, the variability of regional (proximal, middle, distal) EI of the vastus lateralis, rectus femoris, and lateral and anterior vastus intermedius has yet to be determined. Twenty participants (40 limbs), were evaluated on 3 occasions, separated by 7 days. Intersession variability of EI with and without subcutaneous fat correction was quantified. Furthermore, the interchangeability of corrected EI across regions was evaluated. Variability of regional quadriceps EI was substantially lower with subcutaneous fat correction (intraclass correlation coefficient (ICC) = 0.81-0.98, coefficient of variation (CV) = 4.5%-16.8%, typical error of measure (TEM) = 0.13-0.49) versus raw values (ICC = 0.69-0.98, CV = 7.7%-42.7%, TEM = 0.14-0.68), especially when examining the vastus intermedius (ICC = 0.81-0.95, CV = 7.1%-16.8%, TEM = 0.23-0.49 vs. ICC = 0.69-0.92, CV = 22.9%-42.7%, TEM = 0.31-0.68). With the exception of the rectus femoris and vastus intermedius (p ≥ 0.143, effect size (ES) ≤ 0.18), corrected EI was greater for proximal and distal regions when compared with the midpoint (p ≤ 0.038, ES = 0.38-0.82). Researchers and practitioners should utilize subcutaneous fat thickness correction to confidently evaluate EI at all regions of the quadriceps. Regional EI cannot be used interchangeably for the vastus muscles, likely because of an increase in fibrous content towards the myotendinous junctions. Novelty Regional quadriceps echo intensity was reliable with and without correction for subcutaneous fat thickness. Intersession variability of regional quadriceps echo intensity was substantially improved following subcutaneous fat correction. Quadriceps echo intensity increased towards myotendinous junctions in the vastus muscles.
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Affiliation(s)
- Dustin J Oranchuk
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Mairangi Bay, Auckland, New Zealand
| | - Matt S Stock
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
| | - André R Nelson
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Adam G Storey
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Mairangi Bay, Auckland, New Zealand
| | - John B Cronin
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Mairangi Bay, Auckland, New Zealand
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Dankel SJ, Abe T, Spitz RW, Viana R, Bell ZW, Wong V, Chatakondi RN, Loenneke JP. Impact of Acute Fluid Retention on Ultrasound Echo Intensity. J Clin Densitom 2020; 23:149-150. [PMID: 30910401 DOI: 10.1016/j.jocd.2019.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 02/26/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Scott J Dankel
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Takashi Abe
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Robert W Spitz
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Ricardo Viana
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Zachary W Bell
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Vickie Wong
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Raksha N Chatakondi
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA.
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Dankel SJ, Bell ZW, Spitz RW, Wong V, Viana RB, Chatakondi RN, Buckner SL, Jessee MB, Mattocks KT, Mouser JG, Abe T, Loenneke JP. Assessing differential responders and mean changes in muscle size, strength, and the crossover effect to 2 distinct resistance training protocols. Appl Physiol Nutr Metab 2019; 45:463-470. [PMID: 31553889 DOI: 10.1139/apnm-2019-0470] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The objective of this study was to determine differences in 2 distinct resistance training protocols and if true variability can be detected after accounting for random error. Individuals (n = 151) were randomly assigned to 1 of 3 groups: (i) a traditional exercise group performing 4 sets to failure; (ii) a group performing a 1-repetition maximum (1RM) test; and (iii) a time-matched nonexercise control group. Both exercise groups performed 18 sessions of elbow flexion exercise over 6 weeks. While both training groups increased 1RM strength similarly (∼2.4 kg), true variability was only present in the traditional exercise group (true variability = 1.80 kg). Only the 1RM group increased untrained arm 1RM strength (1.5 kg), while only the traditional group increased ultrasound measured muscle thickness (∼0.23 cm). Despite these mean increases, no true variability was present for untrained arm strength or muscle hypertrophy in either training group. In conclusion, these findings demonstrate the importance of taking into consideration the magnitude of random error when classifying differential responders, as many studies may be classifying high and low responders as those who have the greatest amount of random error present. Additionally, our mean results demonstrate that strength is largely driven by task specificity, and the crossover effect of strength may be load dependent. Novelty Many studies examining differential responders to exercise do not account for random error. True variability was present in 1RM strength gains, but the variability in muscle hypertrophy and isokinetic strength changes could not be distinguished from random error. The crossover effect of strength may differ based on the protocol employed.
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Affiliation(s)
- Scott J Dankel
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Goassboro, NJ 08028, USA
| | - Zachary W Bell
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS 38677, USA
| | - Robert W Spitz
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS 38677, USA
| | - Vickie Wong
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS 38677, USA
| | - Ricardo B Viana
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS 38677, USA.,Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia 74000-000, Brazil
| | - Raksha N Chatakondi
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS 38677, USA
| | - Samuel L Buckner
- USF Muscle Laboratory, Exercise Science Program, University of South Florida, Tampa, FL 33606, USA
| | - Matthew B Jessee
- Department of Health, Exercise Science, & Recreation Management, The University of Mississippi, University, MS 38677, USA
| | - Kevin T Mattocks
- Department of Exercise Science, Lindenwood University - Belleville, Belleville, IL 63301, USA
| | - J Grant Mouser
- Department of Kinesiology and Health Promotion, Troy University, Troy, AL 36082, USA
| | - Takashi Abe
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS 38677, USA
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, & Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS 38677, USA
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Varanoske AN, Coker NA, Johnson BAD, Belity T, Mangine GT, Stout JR, Fukuda DH, Wells AJ. Effects of Rest Position on Morphology of the Vastus Lateralis and Its Relationship with Lower-Body Strength and Power. J Funct Morphol Kinesiol 2019; 4:jfmk4030064. [PMID: 33467379 PMCID: PMC7739298 DOI: 10.3390/jfmk4030064] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/16/2019] [Accepted: 08/20/2019] [Indexed: 11/16/2022] Open
Abstract
Ultrasonography of the lower body typically encompasses supine rest due to fluid shifts affecting tissue size and composition. However, vastus lateralis (VL) examination is completed in the lateral recumbent position, and this positional change may influence morphology and its ability to predict function. This study aimed to examine the effect of position on VL morphology and its relationship with lower-body performance. Cross-sectional area (CSA), muscle thickness (MT), pennation angle (PA), echo intensity (UnCorEI), subcutaneous adipose tissue thickness (SFT), and echo intensity corrected for SFT (CorEI) were assessed in 31 resistance-trained males (23.0 ± 2.1 yrs; 1.79 ± 0.08 m; 87.4 ± 11.7 kg) immediately after transitioning from standing to supine (IP), after 15 min of standing (ST), and after 15 min of rest in three recumbent positions: supine (SUP), dominant lateral recumbent (DLR), non-dominant lateral recumbent (NDLR). Participants also completed unilateral vertical jumps, isometric/isokinetic tests, and a one-repetition maximum leg press. CSA, MT, PA, and SFT were greater in ST compared to NDLR, DLR, and SUP (p < 0.05). CSA, UnCorEI, and CorEI were different between recumbent positions; however no differences were observed for MT, PA, and SFT. Different magnitudes of relationships were observed between muscle morphological characteristics measured after rest in different positions and performance variables. Muscle morphology in IP generally appears to be the best predictor of performance for most variables, although utilizing the NDLR and DLR positions may provide comparable results, whereas morphology measured in ST and SUP provide weaker relationships with physical performance. IP also requires less time and fewer requirements on the technician and subject, thus researchers should consider this positioning for VL examination.
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Affiliation(s)
- Alyssa N. Varanoske
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, University of Central Florida, 12494 University Blvd., Orlando, FL 32816, USA
| | - Nicholas A. Coker
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, University of Central Florida, 12494 University Blvd., Orlando, FL 32816, USA
| | - Bri-Ana D.I. Johnson
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, University of Central Florida, 12494 University Blvd., Orlando, FL 32816, USA
| | - Tal Belity
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, University of Central Florida, 12494 University Blvd., Orlando, FL 32816, USA
| | - Gerald T. Mangine
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA 30144, USA
| | - Jeffrey R. Stout
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, University of Central Florida, 12494 University Blvd., Orlando, FL 32816, USA
| | - David H. Fukuda
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, University of Central Florida, 12494 University Blvd., Orlando, FL 32816, USA
| | - Adam J. Wells
- Institute of Exercise Physiology and Rehabilitation Science, Division of Kinesiology, University of Central Florida, 12494 University Blvd., Orlando, FL 32816, USA
- Correspondence: ; Tel.: +1-407-823-3906
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Wong V, Abe T, Chatakondi RN, Bell ZW, Spitz RW, Dankel SJ, Loenneke JP. The influence of biological sex and cuff width on muscle swelling, echo intensity, and the fatigue response to blood flow restricted exercise. J Sports Sci 2019; 37:1865-1873. [PMID: 30945606 DOI: 10.1080/02640414.2019.1599316] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose was to determine if the muscle swelling, echo intensity, and fatigue responses to blood flow restriction differs based on cuff width (Experiment 1), applied pressure (Experiment 2), and sex. Ultrasound of muscle was taken before and after exercise. In Experiment 1 (n = 96), men swelled more than women and more with a narrow cuff than a wide cuff (0.60 cm vs. 0.52 cm). Expressed as a percentage change, there were no longer differences between cuffs (Narrow: 15% vs. Wide: 14%) or sex (Men: 14% vs. Women: 15%). Echo intensity remained unchanged. Women required more repetitions to reach task failure in sets 2, 3, and 4. In Experiment 2 (n = 87), men swelled more than women (Men: 0.46 cm vs. Women: 0.31 cm). Expressed as a percentage change, there were no differences. Echo intensity decreased in both conditions and to a greater extent with a higher applied pressure. If the acute muscle swelling response is important for initiating long term adaptation, then our results indicate that neither cuff width, sex, nor applied pressure will differentially impact the adaptation observed via this mechanism. Changes in echo intensity were inconsistent and the utility of this measurement may need to be reconsidered.
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Affiliation(s)
- Vickie Wong
- a Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory , The University of Mississippi , University , MS , USA
| | - Takashi Abe
- a Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory , The University of Mississippi , University , MS , USA
| | - Raksha N Chatakondi
- a Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory , The University of Mississippi , University , MS , USA
| | - Zachary W Bell
- a Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory , The University of Mississippi , University , MS , USA
| | - Robert W Spitz
- a Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory , The University of Mississippi , University , MS , USA
| | - Scott J Dankel
- a Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory , The University of Mississippi , University , MS , USA
| | - Jeremy P Loenneke
- a Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory , The University of Mississippi , University , MS , USA
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