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Hare MM, Wohlgemuth KJ, Blue MNM, Mota JA. Reliability and Validity of Muscle Size and Quality Analysis Techniques. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1188-1193. [PMID: 38697896 DOI: 10.1016/j.ultrasmedbio.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVE This study investigated reliability and validity of muscle cross-sectional area and echo intensity using an automatic image analysis program. METHODS Twenty-two participants completed two data collection trials consisting of ultrasound imaging of the vastus lateralis (VL) at 10 and 12 MHz. Images were analyzed manually and with Deep Anatomical Cross-Sectional Area (DeepACSA). Reliability statistics (i.e., intraclass correlation coefficient [ICC] model 2,1, standard error of measure expressed as a percentage of the mean [SEM%], minimal differences [MD] values needed to be considered real) and validity statistics (i.e., constant error [CE], total error [TE], standard error of the estimate [SEE]) were calculated. RESULTS Automatic analyses of ACSA and EI demonstrated good reliability (10 MHz: ICC2,1 = 0.83 - 0.90; 12 MHz: ICC2,1 = 0.87-0.88), while manual analyses demonstrated moderate to excellent reliability (10 MHz: ICC2,1 = 0.82-0.99; 12 MHz: ICC2,1 = 0.73-0.99). Automatic analyses of ACSA presented greater error at 10 (CE = -0.76 cm2, TE = 4.94 cm2, SEE = 3.65 cm2) than 12 MHz (CE = 0.17 cm2, TE = 3.44 cm2, SEE = 3.11 cm2). Analyses of EI presented greater error at 10 (CE = 3.35 a.u., TE = 2.70 a.u., SEE = 2.58 a.u.) than at 12 MHz (CE = 3.21 a.u., TE = 2.61 a.u., SEE = 2.34 a.u.). CONCLUSION The results suggest the DeepACSA program may be less reliable compared to manual analysis for VL ACSA but displayed similar reliability for EI. In addition, the results demonstrated the automatic program had low error for 10 and 12 MHz.
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Affiliation(s)
- McKenzie M Hare
- Neuromuscular and Occupational Performance Laboratory, Texas Tech University, Lubbock, TX, USA
| | - Kealey J Wohlgemuth
- Neuromuscular and Occupational Performance Laboratory, Texas Tech University, Lubbock, TX, USA
| | - Malia N M Blue
- Health Exercise and Lifestyle Laboratory, University of North Carolina, Chapel Hill, NC, USA
| | - Jacob A Mota
- Neuromuscular and Occupational Performance Laboratory, Texas Tech University, Lubbock, TX, USA.
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Voskuil CC, Dudar MD, Carr JC. Exploring the Relationship between Ultrasonographic Measures of the Quadriceps and Knee Extensor Muscle Fitness in Endurance-Trained Individuals. TRANSLATIONAL SPORTS MEDICINE 2024; 2024:3415740. [PMID: 38654724 PMCID: PMC11023727 DOI: 10.1155/2024/3415740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/04/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024]
Abstract
Background B-mode ultrasonography is an accessible and cost-effective method to assess muscle size and quality through muscle thickness (MT) and echo intensity (EI), respectively. Muscle thickness and EI have demonstrated relationships with maximal strength and local muscle endurance, providing a noninvasive and efficient modality to examine muscle fitness. However, these relationships have not been quantified in the individual quadriceps muscles of habitually endurance-trained populations, which may provide information to practitioners regarding rehabilitation and performance. Methods Twenty-three participants (males: N = 10; females: N = 13) underwent B-mode ultrasonography to assess MT, EI, and adipose tissue thickness-corrected echo intensity (cEI) in the vastus intermedius (VI), vastus lateralis (VL), and rectus femoris (RF). Muscle fitness was evaluated through maximal strength (1RM) and local muscle endurance (4 sets to failure at 50% 1RM) during dynamic knee extension. Relationships between ultrasonography outcomes and muscle fitness were examined through stepwise multiple linear regression. Results The results indicate that VI cEI is the strongest predictor of 1RM strength (r = -0.643), while no ultrasonography-derived measures significantly predicted local muscle endurance. Conclusion The study demonstrates that ultrasonography, specifically measures of cEI in the VI, has the greatest association with maximal strength in endurance-trained individuals. These findings suggest monitoring VI muscle size and quality may benefit practitioners who aim to improve knee extension strength for performance or following injury. In addition, the findings support the use of EI examinations in trained populations.
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Affiliation(s)
- Caleb C. Voskuil
- Texas Christian University, Department of Kinesiology, Fort Worth, TX, USA
| | - Monique D. Dudar
- Texas Christian University, Department of Kinesiology, Fort Worth, TX, USA
| | - Joshua C. Carr
- Texas Christian University, Department of Kinesiology, Fort Worth, TX, USA
- Department of Medical Education, Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, TX, USA
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Shoemaker ME, Smith CM, Gillen ZM, Cramer JT. Sex Differences in Test-Retest Reliability of Near-Infrared Spectroscopy During Postocclusive Reactive Hyperemia of the Vastus Lateralis. J Strength Cond Res 2024; 38:e40-e48. [PMID: 37815266 DOI: 10.1519/jsc.0000000000004619] [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: 10/11/2023]
Abstract
ABSTRACT Shoemaker, ME, Smith, CM, Gillen, ZM, and Cramer, JT. Sex differences in test-retest reliability of near-infrared spectroscopy during postocclusive reactive hyperemia of the vastus lateralis. J Strength Cond Res 38(2): e40-e48, 2024-The purpose of this study was to determine test-retest reliability for vascular reactivity measures and ranges for normalization of near-infrared spectroscopy (NIRS) variables from the vastus lateralis using postocclusive reactive hyperemia (PORH) procedure in male subjects, female subjects, and combined. Concentrations of oxygenated hemoglobin (Hb) + myoglobin (Mb) (O 2 Hb) and deoxygenated Hb + Mb (HHb) to derive total Hb + Mb (THb), difference in Hb + Mb signal (Hbdiff), and muscle tissue oxygen saturation (StO 2 ) from the vastus lateralis were measured during the PORH in 12 male subjects (age: 23.17 ± 1.77 years; stature: 180.88 ± 4.59 cm; and mass: 81.47 ± 9.68 kg) and 10 female subjects (age: 23.80 ± 2.07 years; stature: 165.95 ± 4.92 cm; and mass: 70.93 ± 10.55 kg) on 2 separate days. Adipose tissue thickness at the NIRS site was measured with ultrasonography. There were no significant differences between the mean values from visit 1 to visit 2 ( p > 0.076-0.985). In the composite sample, intraclass correlation coefficient (ICC) and coefficient of variation (CV) ranged from 0.35 to 0.91 and 4.74 to 39.18%, respectively. In male subjects, ICC and CV values ranged from 0.57 to 0.89 and 2.44 to 28.55%, respectively. In female subjects, ICC and CV values ranged from -0.05 to 0.75 and 7.83 to 61.19%, respectively. Although NIRS variables were overall reliable during PORH, when separated by sex, reliability in male subjects generally increased, whereas female subjects were not reliable, suggesting adipose tissue thickness may be a contributing factor. Understanding sex differences in reliability is important when using this technique for normalization or examining vascular reactivity during athletic performance. With greater utilization of NIRS monitoring in athletes to examine training adaptations, it is important for practitioners to understand the capabilities and potential limitations of the tool.
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Affiliation(s)
- Marni E Shoemaker
- College of Education and Human Sciences, South Dakota State University, Brookings, South Dakota
| | - Cory M Smith
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas
| | - Zachary M Gillen
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi
| | - Joel T Cramer
- College of Health Professions and Sciences, University of Central Florida, Orlando, Florida
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Javanshir K, Ghafouri-Rouzbehani P, Zohrehvand A, Naeimi A, Fernández-de-las-Peñas C, Nikbakht HA, Mousavi-Khatir SR, Valera-Calero JA. Cervical Multifidus and Longus Colli Ultrasound Differences among Patients with Cervical Disc Bulging, Protrusion and Extrusion and Asymptomatic Controls: A Cross-Sectional Study. J Clin Med 2024; 13:624. [PMID: 38276132 PMCID: PMC10816935 DOI: 10.3390/jcm13020624] [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: 11/08/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
The aim of this study was to analyze the differences in morphological and histological features of the cervical multifidus (CM) and longus colli (LC) muscles among patients with cervical disc bulging, protrusion, or extrusion. Fifteen patients with cervical disc bulging (20% male, mean age: 48.5, standard deviation (SD) 7.5 years), fifteen with cervical disc protrusion (6% male, mean age: 43, SD 7.8 years), and fifteen with cervical disc extrusion (40% male, mean age: 44, SD 8 years) diagnosed via clinical and imaging findings participated in this study. Additionally, fifteen asymptomatic controls (40% male, mean age: 40.4, SD 9.7 years) were also included. The following ultrasound measurements, cross-sectional area (CSA), anterior-posterior distance (APD), lateral dimension (LD), and mean echo-intensity (EI) of the CM and LC at C5-C6 level were examined by an assessor blinded to the subject's condition. The results revealed no group ×side significant differences among the groups (p > 0. 00625). However, group effects were found for APD and MEI of the CM (p = 0.006 and p < 0.001, respectively) and CSA, APD and MEI of the LC (all, p < 0.001). The LD of the LC muscle and the APD and LD of the CM were negatively associated with related disability (p < 0.01; p < 0.05 and p < 0.01, respectively), and pain intensity was negatively associated with LC APD and LD (both p < 0.05). These results suggest that US can be used to detect bilateral morphological changes in deep cervical flexors and extensors to discriminate patients with cervical disc alterations.
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Affiliation(s)
- Khodabakhsh Javanshir
- Department of Physical Therapy, School of Rehabilitation, Babol University of Medical Science, Babol 47176-47745, Iran; (K.J.); (P.G.-R.); (S.R.M.-K.)
| | - Payam Ghafouri-Rouzbehani
- Department of Physical Therapy, School of Rehabilitation, Babol University of Medical Science, Babol 47176-47745, Iran; (K.J.); (P.G.-R.); (S.R.M.-K.)
| | - Amirhossein Zohrehvand
- Department of Neurosurgery, School of Medicine, Babol University of Medical Sciences, Babol 47176-47745, Iran;
| | - Arvin Naeimi
- Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht 41446-66949, Iran;
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
| | - Hossein-Ali Nikbakht
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47176-47745, Iran;
| | - Seyedeh Roghayeh Mousavi-Khatir
- Department of Physical Therapy, School of Rehabilitation, Babol University of Medical Science, Babol 47176-47745, Iran; (K.J.); (P.G.-R.); (S.R.M.-K.)
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Buffet-García J, Plaza-Manzano G, Varol U, Ríos-León M, Díaz-Arribas MJ, Álvarez-González J, Sánchez-Jorge S, Valera-Calero JA. Reliability of Panoramic Ultrasound in Assessing Rectus Femoris Size, Shape, and Brightness: An Inter-Examiner Study. Bioengineering (Basel) 2024; 11:82. [PMID: 38247959 PMCID: PMC10813357 DOI: 10.3390/bioengineering11010082] [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: 12/05/2023] [Revised: 01/02/2024] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
Extended field-of-view ultrasound (US) imaging, also known as panoramic US, represents a technical advance that allows for complete visualization of large musculoskeletal structures, which are often limited in conventional 2D US images. Currently, there is no evidence examining whether the experience of examiners influences muscle shape deformations that may arise during the glide of the transducer in panoramic US acquisition. As no studies using panoramic US have analyzed whether two examiners with differing levels of experience might obtain varying scores in size, shape, or brightness during the US assessment of the rectus femoris muscle, our aim was to analyze the inter-examiner reliability of panoramic US imaging acquisition in determining muscle size, shape, and brightness between two examiners. Additionally, we sought to investigate whether the examiners' experience plays a significant role in muscle deformations during imaging acquisition by assessing score differences. Shape (circularity, aspect ratio, and roundness), size (cross-sectional area and perimeter), and brightness (mean echo intensity) were analyzed in 39 volunteers. Intraclass correlation coefficients (ICCs), standard error of measurements (SEM), minimal detectable changes (MDC), and coefficient of absolute errors (CAE%) were calculated. All parameters evaluated showed no significant differences between the two examiners (p > 0.05). Panoramic US proved to be reliable, regardless of examiner experience, as no deformations were observed. Further research is needed to corroborate the validity of panoramic US by comparing this method with gold standard techniques.
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Affiliation(s)
- Jorge Buffet-García
- Department of Physiotherapy, Faculty of Health, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain; (J.B.-G.); (J.Á.-G.)
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (G.P.-M.); (M.J.D.-A.); (J.A.V.-C.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - Umut Varol
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
| | - Marta Ríos-León
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Servicio de Salud de Castilla-La Mancha (SESCAM), 45004 Toledo, Spain;
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45004 Toledo, Spain
| | - María José Díaz-Arribas
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (G.P.-M.); (M.J.D.-A.); (J.A.V.-C.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - Javier Álvarez-González
- Department of Physiotherapy, Faculty of Health, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain; (J.B.-G.); (J.Á.-G.)
| | - Sandra Sánchez-Jorge
- Department of Physiotherapy, Faculty of Health, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain; (J.B.-G.); (J.Á.-G.)
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (G.P.-M.); (M.J.D.-A.); (J.A.V.-C.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
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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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Van den Broeck J, Héréus S, Cattrysse E, Raeymaekers H, De Maeseneer M, Scafoglieri A. Reliability of Muscle Quantity and Quality Measured With Extended-Field-of-View Ultrasound at Nine Body Sites. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1544-1549. [PMID: 37002153 DOI: 10.1016/j.ultrasmedbio.2023.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/01/2023] [Accepted: 02/27/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Measuring muscle quantity and quality is very important because the loss of muscle quantity and quality is associated with several adverse effects specifically in older people. Ultrasound is a method widely used to measure muscle quantity and quality. One problem with ultrasound is its limited field of view, which makes it impossible to measure the muscle quantity and quality of certain muscles. In this study, we aimed to evaluate the intra- and inter-rater reliability of extended-field-of-view (EFOV) ultrasound for the measurement of muscle quantity and quality in nine muscles of the limbs and trunk. METHODS Two examiners took two ultrasound EFOV images with a linear probe from each of the muscle sites. The intraclass correlation coefficient (ICC) was used, and the standard error of measurement and coefficient of variation were calculated. RESULTS Intra-rater reliability was good to excellent (ICC = 0.2-1.00) for all muscle measurements. The inter-rater reliability for most of the muscle measurements was good to excellent (ICC = 0.82-0.98). Inter-rater reliability was moderate (0.58-0.72) for some muscle quantity measurements of the tibialis anterior, gastrocnemius, rectus femoris, biceps femoris and triceps brachii muscles. CONCLUSION Muscle quantity and quality can be measured reliably using EFOV US.
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Affiliation(s)
- Jona Van den Broeck
- Experimental Anatomy Research Group, Department of Physiotherapy and Human Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Savanah Héréus
- Experimental Anatomy Research Group, Department of Physiotherapy and Human Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Erik Cattrysse
- Experimental Anatomy Research Group, Department of Physiotherapy and Human Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Hubert Raeymaekers
- Department of Radiology, University Hospital Brussels, Brussels, Belgium
| | | | - Aldo Scafoglieri
- Experimental Anatomy Research Group, Department of Physiotherapy and Human Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Karademir F, Ayhan Kuru C, Arın G, Soylu R. Morphometry of thenar muscles by water bath ultrasonography in trapeziometacarpal osteoarthritis: intra- and inter-rater reliability. J Hand Surg Eur Vol 2023; 48:115-122. [PMID: 36281061 DOI: 10.1177/17531934221130669] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We studied the intra- and inter-rater reliability of muscle thickness and cross-sectional area measurements of thenar muscles with a water bath ultrasonography technique in eight healthy volunteers and 16 patients with trapeziometacarpal osteoarthritis. Thickness and cross-sectional area of the opponens pollicis, abductor pollicis brevis, flexor pollicis brevis, first dorsal interosseous and adductor pollicis muscle were measured. The results showed changes in the morphometric properties of the thenar muscles in patients with trapeziometacarpal osteoarthritis (TMC OA) compared with the healthy volunteers. In the dominant-sided patients (n = 14), there were lower cross-sectional area values for the abductor pollicis brevis and opponens pollicis muscles. In the non-dominant-sided patients (n = 10), there were lower cross-sectional area values for the abductor pollicis brevis and flexor pollicis brevis and lower muscle thickness of the abductor pollicis brevis. The water bath ultrasonography technique could be used to diagnose and treat diseases where changes in thenar muscle thickness and cross-sectional area can be expected.Level of evidence: III.
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Affiliation(s)
- Feray Karademir
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Cigdem Ayhan Kuru
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Gamze Arın
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ruhi Soylu
- Department of Biophysics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Ueki H, Kanto R, DiNenna M, Linde MA, Fu FH, Smolinski P. Arthroscopic centralization reduces extrusion of the medial meniscus with posterior root defect in the ACL reconstructed knee. Knee Surg Sports Traumatol Arthrosc 2023; 31:543-550. [PMID: 36114341 DOI: 10.1007/s00167-022-07160-7] [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: 05/11/2022] [Accepted: 09/06/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the effects of arthroscopic meniscal centralization reinforcement for a medial meniscus (MM) posterior root defect on knee kinematics and meniscal extrusion in the anterior cruciate ligament reconstructed (ACLR) knee. The hypothesis was that the medial meniscus centralization would reduce extrusion and anterior laxity in ACLR knee with a medical meniscal defect. METHODS Fourteen fresh-frozen human cadaveric knees were tested using a six-degrees-of-freedom robotic system under the following loading conditions: (a) an 89.0 N anterior tibial load, (b) 5.0 Nm internal and external rotational torques, (c) a 10.0 Nm valgus and varus loadings, and (d) a combined 7.0 Nm valgus moment and then a 5.0 Nm internal rotation torque as a static simulated pivot shift. The tested knee states included: (1) anatomic single-bundle cruciate ligament reconstruction with intact medial meniscus (MM Intact), (2) anatomic single-bundle cruciate ligament reconstruction with medial meniscus posterior root defect (MM Defect), (3) Anatomic single-bundle cruciate ligament reconstruction with medial meniscus arthroscopic centralization (MM Centralization). Medial meniscus arthroscopic centralization was performed using 1.4 mm anchors with #2 suture. The MM extrusion (MME) was measured using ultrasound under unloaded and varus loading conditions at 0° and 30° of flexion. RESULTS Anterior tibial translation (ATT) increased significantly with MM posterior root defect compared to MM intact at all flexion angles. With MM centralization, ATT was not significantly different from the intact meniscus at 15° and 30° of flexion. Meniscus extrusion increased significantly with the root defect compared to intact meniscus and decreased significantly with meniscal centralization compared to the root defect at both flexion angles. CONCLUSIONS In ACL reconstruction, cases involving irreparable medial meniscal posterior root tears, applying arthroscopic centralization for avoiding the meniscal extrusion should be considered. Clinically, in ACL reconstruction cases with irreparable medial meniscal posterior root tears, applying arthroscopic meniscal centralization for avoiding the meniscal extrusion should be considered. Meniscal centralization decreases the extrusion of the MM and offers improvements in knee laxity.
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Affiliation(s)
- Hiroko Ueki
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryo Kanto
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael DiNenna
- Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Monica A Linde
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Freddie H Fu
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Patrick Smolinski
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA. .,Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
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11
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Antonio Valera-Calero J, Plaza-Manzano G, Ortega-Santiago R, Fernández-de-Las-Peñas C, Varol U. Panoramic ultrasound imaging does not produce muscle morphology deformation during imaging acquisition: A validity study. Phys Med 2023; 106:102530. [PMID: 36634596 DOI: 10.1016/j.ejmp.2023.102530] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/30/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Despite panoramic ultrasound imaging (US) is a promising advance for the morphological and histological assessment of large musculature which cannot be entirely assessed using B-mode, there is no evidence assessing if this technology produces muscle deformation during imaging acquisition. We aimed to analyze differences in size, shape and brightness descriptors between B-mode and panoramic US images and to assess the concordance between both methods. Methods We analyzed size (cross-sectional area and perimeter), shape (circularity, aspect ratio and roundness) and brightness (mean echo-intensity) features of cervical multifidus (CM) and short rotators (SR) in 46 healthy volunteers. Images were acquired in B-mode and extended field-of-view mode. For validity analysis, mean differences between methods were calculated. For agreement analysis, intraclass correlation coefficients (ICCs), standard error of measurements (SEM), minimal detectable changes (MDC) and coefficient of variation (CV%) were calculated. RESULTS All parameters showed no significant differences between both methods for either CM or SR (P > 0.05). Panoramic US showed excellent concordance with B-mode for assessing all CM parameters (all ICCs > 0.9), while for SR the agreement ranged from good-to-excellent (ICC from 0.861 to 0.978). CONCLUSION Panoramic US seems to be a valid tool for assessment of muscle size, shape and brightness as no deformation in comparison with B-mode images was seen. Further research is needed to corroborate these findings comparing panoramic US imaging with Gold Standard methods.
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Affiliation(s)
- Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, Spain; Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, Spain; Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Umut Varol
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28933 Alcorcón, Spain
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12
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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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13
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Davies TB, Halaki M, Orr R, Mitchell L, Helms ER, Clarke J, Hackett DA. Effect of Set-Structure on Upper-Body Muscular Hypertrophy and Performance in Recreationally-Trained Male and Female. J Strength Cond Res 2022; 36:2176-2185. [PMID: 35916746 DOI: 10.1519/jsc.0000000000003971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
ABSTRACT Davies, TB, Halaki, M, Orr, R, Mitchell, L, Helms, ER, Clarke, J, and Hackett, DA. Effect of set structure on upper-body muscular hypertrophy and performance in recreationally trained men and women. J Strength Cond Res 36(8): 2176-2185, 2022-This study explored the effect of volume-equated traditional-set and cluster-set structures on muscular hypertrophy and performance after high-load resistance training manipulating the bench press exercise. Twenty-one recreationally trained subjects (12 men and 9 women) performed a 3-week familiarization phase and were then randomized into one of two 8-week upper-body and lower-body split programs occurring over 3 and then progressing to 4 sessions per week. Subjects performed 4 sets of 5 repetitions at 85% one repetition maximum (1RM) using a traditional-set structure (TRAD, n = 10), which involved 5 minutes of interset rest only, or a cluster-set structure, which included 30-second inter-repetition rest and 3 minutes of interset rest (CLUS, n = 11). A 1RM bench press, repetitions to failure at 70% 1RM, regional muscle thickness, and dual-energy x-ray absorptiometry were used to estimate changes in muscular strength, local muscular endurance, regional muscular hypertrophy, and body composition, respectively. Velocity loss was assessed using a linear position transducer at the intervention midpoint. TRAD demonstrated a significantly greater velocity loss magnitude (g = 1.50) and muscle thickness of the proximal pectoralis major (g = -0.34) compared with CLUS. There were no significant differences between groups for the remaining outcomes, although a small effect size favoring TRAD was observed for the middle region of the pectoralis major (g = -0.25). It seems that the greater velocity losses during sets observed in traditional-set compared with cluster-set structures may promote superior muscular hypertrophy within specific regions of the pectoralis major in recreationally trained subjects.
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Affiliation(s)
- Timothy B Davies
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Mark Halaki
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Rhonda Orr
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Lachlan Mitchell
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Eric R Helms
- Sport Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand; and
| | - Jillian Clarke
- Discipline of Medical Imaging Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW Australia
| | - Daniel A Hackett
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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14
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Colantuono VM, Oakley R, Hatfield DL, Penailillo L, Lateef S, Earp JE. Contrast With Compression Therapy Enhances Muscle Function Recovery and Attenuates Glycogen Disruption After Exercise. Sports Health 2022; 15:234-243. [PMID: 35343332 PMCID: PMC9950996 DOI: 10.1177/19417381221080172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Exercise-associated muscle damage (EAMD) temporally impairs muscle function and intramuscular glycogen storage. Contrast with compression (CwC) therapy provides localized EAMD treatment with minimal changes in core/tissue temperature that can impair glycogen resynthesis. HYPOTHESIS CwC will enhance the recovery of strength, power, and joint mobility, reduce markers of EAMD, and attenuate the disruption of glycogen storage observed after damaging exercise. STUDY DESIGN Randomized controlled trial with crossover design. LEVEL OF EVIDENCE Level 2. METHODS Ten men completed 2 bouts of eccentric elbow flexor exercise, separated by 1 week, using contralateral arms. After each bout, participants received either CwC therapy (at 0, 24, and 48 h postexercise) or no therapy with intervention order and limb randomly assigned. Prior to (pre-exercise) and 1, 24, 48, and 72 h after each exercise bout, muscular strength, muscular power, intramuscular glycogen, creatine kinase, muscle thickness, muscle soreness, pressure pain threshold, active elbow flexion, passive elbow extension, and dietary intake were assessed. Comparisons were made between conditions over time (interaction effects) using separate repeated-measures analyses of variance/multivariate analyses of variance and effect sizes (Cohen d) to describe treatment effect at each time point. RESULTS Significant interaction effects were observed for muscular strength (d = 0.67-1.12), muscular power (d = 0.20-0.65), intramuscular glycogen (d = 0.29-0.81), creatine kinase (d = 0.01-0.96), muscle thickness (d = 0.35-0.70), muscle soreness (d = 0.18-0.85), and active elbow flexion (d = 0.65-1.17) indicating a beneficial effect of CwC over time (P ≤ 0.05). In contrast, no significant interaction effect was observed for pressure pain threshold or passive elbow extension (P > 0.05). CONCLUSION These results support the use of CwC for the recovery of muscle function after damaging exercise in male patients and indicate that CwC attenuates, but does not remove, the disruption of intramuscular glycogen stores observed after intense eccentric exercise. CLINICAL RELEVANCE Glycolysis-dependent athletes may benefit from CwC therapy after training/competition that causes EAMD.
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Affiliation(s)
| | - Ryan Oakley
- University of Rhode Island,
Department of Kinesiology, Kingston, Rhode Island
| | - Disa L. Hatfield
- University of Rhode Island,
Department of Kinesiology, Kingston, Rhode Island
| | - Luis Penailillo
- Universidad Andrés Bello, School
of Physical Therapy, Santiago, Chile
| | - Shabnam Lateef
- University of Rhode Island,
Department of Kinesiology, Kingston, Rhode Island
| | - Jacob E. Earp
- University of Rhode Island,
Department of Kinesiology, Kingston, Rhode Island,University of Connecticut, Sports
Optimization & Rehabilitation Lab, Storrs, Connecticut,Jacob E. Earp, PhD,
CSCS, Assistant Professor of Kinesiology, University of Connecticut,
2095 Hillside Rd, U-1110, Storrs, CT 06269 (
)
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15
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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: 10] [Impact Index Per Article: 3.3] [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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16
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Miller T, Ying MTC, Chung RCK, Pang MYC. Convergent Validity and Test-Retest Reliability of Multimodal Ultrasonography and Related Clinical Measures in People With Chronic Stroke. Arch Phys Med Rehabil 2021; 103:459-472.e4. [PMID: 34695388 DOI: 10.1016/j.apmr.2021.09.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/18/2021] [Accepted: 09/22/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the test-retest reliability of diagnostic ultrasonography measurements of the bilateral biceps brachii (BB), brachial artery, medial gastrocnemius (MG), and popliteal artery in survivors of stroke and their convergent validity with related clinical comparators. DESIGN Cross-sectional study. SETTING All procedures were conducted in a university laboratory. PARTICIPANTS Sixty-five community dwelling adults (N=65; 26 women, 39 men) with an average age of 60.9±7.7 years and stroke duration of 5.7±3.9 years participated in this study. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Measures of muscle structure (ie, thickness, cross-sectional area, fascicle length, pennation angle), stiffness, and intramuscular blood perfusion were conducted using B-mode, elastography and color flow Doppler ultrasonography modes, respectively. Convergent validity was assessed by examining correlations between ultrasonography measures and assessments of related constructs (ie, dynamic stiffness, isometric peak torque, spasticity, and systemic vascular function using myotonometry, dynamometry, the Composite Spasticity Scale, and the Ankle-Brachial Index, respectively). A 2-way random-effects intraclass correlation coefficient (ICC) model (ICC2,3) was used to determine agreement between intersession measures among a smaller cohort of participants with stroke (n=20). RESULTS ICC estimates ranged from moderate to excellent for muscle stiffness (paretic: ICC=0.74-0.89; nonparetic: ICC=0.66-0.88), structure (paretic: ICC=0.87-0.99; nonparetic: ICC=0.81-0.98), and blood perfusion measures (paretic: ICC=0.74-0.84; nonparetic: ICC=0.73-0.88). Weak to moderate associations were found between myotonometry and elastography measures of the bilateral BB (r=0.29-0.52, P≤.05) and MG muscles (r=0.31-0.69, P≤.05). The correlations between elastography measures and spasticity scores for the paretic upper (r=0.35-0.63, P≤.05) and lower limbs (r=0.25-0.37, P≤.05) were also weak to moderate. CONCLUSIONS Elastography demonstrated mostly weak to moderate correlation with measures of stiffness using myotonometry as well as scores of paretic upper and lower limb spasticity. The results also indicate acceptable intersession reliability for muscle and vascular measures using several ultrasonography modalities among individuals with chronic stroke.
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Affiliation(s)
- Tiev Miller
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom
| | - Michael T C Ying
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR
| | - Raymond C K Chung
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom
| | - Marco Y C Pang
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom.
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17
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Varanoske AN, Coker NA, Johnson BADI, Belity T, Wells AJ. Influence of muscle depth and thickness on ultrasound echo intensity of the vastus lateralis. Acta Radiol 2021; 62:1178-1187. [PMID: 32996322 DOI: 10.1177/0284185120958405] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Ultrasonography is used to evaluate muscle quality (i.e. echo intensity [EI]), but an attenuation of ultrasound waves occurs in deeper tissues, potentially affecting these measures. PURPOSE To determine whether muscle thickness (MT) affects EI and if EI varies between the superficial and deep portions of the muscle. MATERIALS AND METHODS MT, EI, subcutaneous adipose tissue thickness (SAT), tissue depth (DISDEEP), and EI of the overall (EIFULL) as well as deep (EIDEEP) and superficial (EISUPF) portions of the vastus lateralis (VL) were assessed in 33 resistance-trained males using ultrasonography. The difference (EIDIFF) between EISUPF and EIDEEP was calculated. Mean differences between EIFULL, EISUPF, and EIDEEP were analyzed using a repeated-measures analysis of variance (ANOVA). Relationships between measures of muscle depth/ thickness and EI were examined using Pearson's r. RESULTS EISUPF was greater than EIDEEP (P < 0.001) and EIFULL (P < 0.001). MT was negatively correlated with EIFULL (P < 0.001) and positively correlated with EIDIFF (P < 0.001). SAT was not correlated with any EI measure, but DISDEEP was positively correlated with EIDIFF (P < 0.001). CONCLUSION EI of the VL is heterogeneous, as the deeper portion produces lower values than the superficial portion. Thicker muscles present lower EI but have greater discrepancies in EI between the superficial and deep portions. Although SAT was not correlated with EI, DISDEEP was related to EIDIFF, demonstrating that the combination of MT and SAT should be considered when evaluating muscle quality. Future research is necessary to determine if changes in EI following resistance training are driven by increases in MT.
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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 DI 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
| | - 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
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18
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Trivisonno AJ, Laffan MR, Giuliani HK, Mota JA, Gerstner GR, Smith-Ryan AE, Ryan ED. The influence of age on the recovery from worksite resistance exercise in career firefighters. Exp Gerontol 2021; 152:111467. [PMID: 34237392 DOI: 10.1016/j.exger.2021.111467] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 12/13/2022]
Abstract
Resistance exercise is an important strategy to reduce injuries and improve performance in the fire service. However, given the large age range of firefighters, it is important to determine if age influences their recovery following an acute bout of resistance exercise. PURPOSE To examine the changes in indirect markers of muscle damage in young and older firefighters following a feasible worksite resistance exercise routine. METHODS Nineteen young (25.5 ± 3.4 years) and 19 older male career firefighters (50.3 ± 3.5 years) completed pre-testing, an acute bout of resistance exercise, and post-testing at 24, 48, and 72 h post-exercise at their fire station. Prior to all testing, firefighters completed a work-related fatigue (WRF) questionnaire to account for potential unanticipated differences in previous shift workloads. Testing included perceived muscle soreness, ultrasonography to quantify muscle size and echo intensity (EI) of the vastus lateralis (VL) and biceps brachii (BB), countermovement jump (CMJ) height and velocity, upper body (UB) peak force (PF), lower body (LB) PF and rapid force, and electromyographic (EMG) amplitude of the VL. The resistance training session included 3 sets of 8-10 repetitions of a deadlift, shoulder press, lunge, and upright row exercise at 80% 1-RM. All recovery variables were analyzed using a linear mixed model, controlling for WRF. RESULTS There was no interaction (age × time) for any of the variables and a similar training volume were completed between groups (P ≥ 0.171). Muscle soreness, CMJ height and velocity, UB PF, LB rapid force and EMG amplitude at later time intervals (100-200 ms), and VL and BB muscle size were altered from baseline (P ≤ 0.044) for 48, 24, 48, 72, and 72 h post-exercise, respectively. Young firefighters exhibited greater CMJ height and velocity, LB PF, LB rapid force (200 ms), and lower VL EI values than the older firefighters (P ≤ 0.047). CONCLUSIONS Age did not influence the recovery from an acute bout of worksite resistance exercise in firefighters. However, UB muscle strength, CMJ performance, and LB rapid force production were reduced 24-72 h post-exercise. Appropriately scheduled and chronic on-duty resistance training may mitigate these decrements.
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Affiliation(s)
- Abigail J Trivisonno
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Megan R Laffan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hayden K Giuliani
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jacob A Mota
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
| | - Gena R Gerstner
- Neuromechanics Laboratory, Department of Human Movement Sciences, Old Dominion University, Norfolk, VA, USA; North Carolina Occupational Safety and Health Education and Research Center, Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Abbie E Smith-Ryan
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eric D Ryan
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Valera-Calero JA, Arias-Buría JL, Fernández-de-Las-Peñas C, Cleland JA, Gallego-Sendarrubias GM, Cimadevilla-Fernández-Pola E. Echo-intensity and fatty infiltration ultrasound imaging measurement of cervical multifidus and short rotators in healthy people: A reliability study. Musculoskelet Sci Pract 2021; 53:102335. [PMID: 33531271 DOI: 10.1016/j.msksp.2021.102335] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/16/2021] [Accepted: 01/20/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND In addition to muscle morphology, ultrasound imaging (US) could be a potential tool to determine muscle quality assessing the echo-intensity and using offline software to quantify the percentage of intramuscular fatty infiltration. OBJECTIVE To investigate intra- and inter-rater image measurement reliability of morphological (i.e., cross-sectional area, perimeter) and echo intensity features (i.e., mean muscular echo intensity, fat echo intensity cut-offs, fatty infiltrates percentage estimation) of deep neck extensors in asymptomatic subjects. METHODS Brightness-mode images of the cervical spine at C4/C5 were acquired in 25 asymptomatic subjects (40%women, age: 24 years) by an experienced examiner. Cross-sectional area, perimeter and echo-intensity measures of cervical multifidus and short rotators were measured on two separate days (one-week apart) in a randomized order by two assessors. Intra-class correlation coefficients (ICC), standard error of measurement, minimal detectable change, and mean, absolute and percent errors were calculated. RESULTS Intra- (ICC3,1 0.800-0.989) and inter- (ICC3,2 0.841-0.948) examiner reliability of echo-intensity measures ranged from good to excellent. Women exhibited higher echo-intensity features than men. Intra-examiner reliability of morphological measures was excellent (ICC3,1 0.917-0.974) for multifidus and good-excellent (ICC3,1 0.868-0.987) for short rotators. Inter-examiner reliability of morphological measures also ranged from good to excellent (ICC3,2 0.765-0.965). Men exhibited higher CSA and perimeter than women. No side-to-side differences were observed in any ultrasound measure. CONCLUSION This study found that intra- and inter-rater image analysis reliability of muscle morphology, mean echo intensity, and fatty infiltration quantification of cervical multifidus and short rotators at C4/C5 level was good-to-excellent in healthy subjects.
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Affiliation(s)
- Juan Antonio Valera-Calero
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de La Cañada, Madrid, Spain; International Doctoral School, Universidad Rey Juan Carlos, Alcorcón, Spain.
| | - José Luis Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Joshua A Cleland
- Doctor of Physical Therapy Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Mass, USA
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Smith RW, Harty PS, Stratton MT, Rafi Z, Rodriguez C, Dellinger JR, Benavides ML, Johnson BA, White SJ, Williams AD, Tinsley GM. Predicting Adaptations to Resistance Training Plus Overfeeding Using Bayesian Regression: A Preliminary Investigation. J Funct Morphol Kinesiol 2021; 6:36. [PMID: 33919267 PMCID: PMC8167794 DOI: 10.3390/jfmk6020036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 01/05/2023] Open
Abstract
Relatively few investigations have reported purposeful overfeeding in resistance-trained adults. This preliminary study examined potential predictors of resistance training (RT) adaptations during a period of purposeful overfeeding and RT. Resistance-trained males (n = 28; n = 21 completers) were assigned to 6 weeks of supervised RT and daily consumption of a high-calorie protein/carbohydrate supplement with a target body mass (BM) gain of ≥0.45 kg·wk-1. At baseline and post-intervention, body composition was evaluated via 4-component (4C) model and ultrasonography. Additional assessments of resting metabolism and muscular performance were performed. Accelerometry and automated dietary interviews estimated physical activity levels and nutrient intake before and during the intervention. Bayesian regression methods were employed to examine potential predictors of changes in body composition, muscular performance, and metabolism. A simplified regression model with only rate of BM gain as a predictor was also developed. Increases in 4C whole-body fat-free mass (FFM; (mean ± SD) 4.8 ± 2.6%), muscle thickness (4.5 ± 5.9% for elbow flexors; 7.4 ± 8.4% for knee extensors), and muscular performance were observed in nearly all individuals. However, changes in outcome variables could generally not be predicted with precision. Bayes R2 values for the models ranged from 0.18 to 0.40, and other metrics also indicated relatively poor predictive performance. On average, a BM gain of ~0.55%/week corresponded with a body composition score ((∆FFM/∆BM)*100) of 100, indicative of all BM gained as FFM. However, meaningful variability around this estimate was observed. This study offers insight regarding the complex interactions between the RT stimulus, overfeeding, and putative predictors of RT adaptations.
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Affiliation(s)
- Robert W. Smith
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA; (R.W.S.); (P.S.H.); (M.T.S.); (C.R.); (J.R.D.); (M.L.B.); (B.A.J.); (S.J.W.); (A.D.W.)
| | - Patrick S. Harty
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA; (R.W.S.); (P.S.H.); (M.T.S.); (C.R.); (J.R.D.); (M.L.B.); (B.A.J.); (S.J.W.); (A.D.W.)
| | - Matthew T. Stratton
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA; (R.W.S.); (P.S.H.); (M.T.S.); (C.R.); (J.R.D.); (M.L.B.); (B.A.J.); (S.J.W.); (A.D.W.)
| | - Zad Rafi
- NYU Langone Medical Center, New York, NY 10016, USA;
| | - Christian Rodriguez
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA; (R.W.S.); (P.S.H.); (M.T.S.); (C.R.); (J.R.D.); (M.L.B.); (B.A.J.); (S.J.W.); (A.D.W.)
| | - Jacob R. Dellinger
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA; (R.W.S.); (P.S.H.); (M.T.S.); (C.R.); (J.R.D.); (M.L.B.); (B.A.J.); (S.J.W.); (A.D.W.)
| | - Marqui L. Benavides
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA; (R.W.S.); (P.S.H.); (M.T.S.); (C.R.); (J.R.D.); (M.L.B.); (B.A.J.); (S.J.W.); (A.D.W.)
| | - Baylor A. Johnson
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA; (R.W.S.); (P.S.H.); (M.T.S.); (C.R.); (J.R.D.); (M.L.B.); (B.A.J.); (S.J.W.); (A.D.W.)
| | - Sarah J. White
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA; (R.W.S.); (P.S.H.); (M.T.S.); (C.R.); (J.R.D.); (M.L.B.); (B.A.J.); (S.J.W.); (A.D.W.)
| | - Abegale D. Williams
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA; (R.W.S.); (P.S.H.); (M.T.S.); (C.R.); (J.R.D.); (M.L.B.); (B.A.J.); (S.J.W.); (A.D.W.)
| | - Grant M. Tinsley
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA; (R.W.S.); (P.S.H.); (M.T.S.); (C.R.); (J.R.D.); (M.L.B.); (B.A.J.); (S.J.W.); (A.D.W.)
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Sobolewski EJ, Wein LD, Crow JM, Carpenter KM. Intra-rater and inter-rater reliability of the process of obtaining cross-sectional area and echo intensity measurements of muscles from ultrasound images. J Ultrason 2021; 21:7-11. [PMID: 33791111 PMCID: PMC8008133 DOI: 10.15557/jou.2021.0002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/16/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction: The use of ultrasound images for analyzing muscle quality and size is continuing to grow in the literature. However, many of these manuscripts fail to properly describe their measurement techniques and steps involved in analyzing ultrasound images. Aim of this study: To evaluate the intra- and inter-rater reliability of the steps involved when analyzing ultrasound images to measure cross-sectional area and echo intensity. Material and methods: Twenty ultrasound images of the rectus femoris and vastus lateralis images were blinded and replicated, and then analyzed by experienced raters. The raters then were asked to analyze the images using open-source software for scaling measurements, subcutaneous fat thickness, cross-sectional area, and echo intensity. Matched image values for each measurement where compared for intra- and inter-rater reliability. Results: Intra-rater reliability ranged from fair (ICC3,1 = 0.32) to high (0.98), with echo intensity values being the least reliable (>0.55), and scaling and depth measurements being the most reliable (<0.85). Inter-rater reliability ranged from good (0.77) to high (0.97). Conclusion: Ultrasound-derived measures of cross-sectional area and echo intensity can be measured reliably, with echo intensity being the most difficult to replicate. However, reliability measures are unique to the rater and study and, therefore, should be clearly reported in every paper.
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Affiliation(s)
| | - Leah D Wein
- Molnar Human Performance Lab, Furman University, Greenville SC, USA
| | - Jacquelyn M Crow
- Molnar Human Performance Lab, Furman University, Greenville SC, USA
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22
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Tanaka NI, Ogawa M, Yoshiko A, Akima H. Validity of Extended-Field-of-View Ultrasound Imaging to Evaluate Quantity and Quality of Trunk Skeletal Muscles. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:376-385. [PMID: 33267963 DOI: 10.1016/j.ultrasmedbio.2020.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 10/29/2020] [Accepted: 11/05/2020] [Indexed: 06/12/2023]
Abstract
This study examined the validity of extended-field-of-view (EFOV) ultrasound imaging for evaluating the quantity (cross-sectional area [CSA]) and quality (accumulation of intramuscular fat) of trunk skeletal muscles (rectus abdominis, abdominal oblique and erector spinae) using magnetic resonance imaging (MRI) as a reference. Thirty healthy young men participated in this study. Cross-sectional images of the trunk at the height of the third lumbar vertebra were acquired and compared by EFOV ultrasound imaging and MRI. No significant differences were observed in CSAs between the two methods (0.74 ≤ R2 ≤ 0.85). Echo intensities significantly correlated with MRI-derived accumulation of intramuscular fat in each skeletal muscle group. However, the correlation coefficients were relatively low (0.37 ≤ r ≤0.47; p < 0.05). These results indicate that EFOV ultrasound imaging is a reliable method for assessing trunk skeletal muscle CSA. Further research is warranted to find the optimal ultrasound setting for evaluating muscle quality.
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Affiliation(s)
- Noriko I Tanaka
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan; Graduate School of Education & Human Development, Nagoya University, Nagoya, Japan.
| | - Madoka Ogawa
- Department of Exercise Physiology, Nippon Sport Science University, Tokyo, Japan
| | - Akito Yoshiko
- School of International Liberal Studies, Chukyo University, Toyota-shi, Japan
| | - Hiroshi Akima
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan; Graduate School of Education & Human Development, Nagoya University, Nagoya, Japan
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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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Garrett J, Keller J, Anders JP, Hergenrader K, Neltner T, Housh T, Schmidt R, Johnson G. Echo intensity is weakly associated with muscular strength and endurance in young, healthy adults. Res Sports Med 2021; 30:371-382. [PMID: 33573413 DOI: 10.1080/15438627.2021.1888109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of this study was to evaluate the relationships between echo intensity (EI) and muscular strength (maximal voluntary isometric contraction [MVIC]) and endurance (time-to task-failure [TTF]) in young adults. Ultrasonography was used to examine the dominant vastus lateralis of 15 young men and 15 young women. The participants completed an MVIC to assess muscular strength and sustained a bilateral, leg extension at 45% MVIC to assess muscular endurance. There was a significant (r = -0.354, p = 0.028) correlation between EI and normalized MVIC force for the combined sample (n = 30). There was also a significant (r = -0.520, p = 0.002) correlation between EI and absolute MVIC force for the combined sample. The correlation between EI and TTE was significant for the men (r = -0.449, p = 0.047) and the combined sample (r = -0.477, p = 0.004). Overall, muscle quality as assessed by EI does not appear to be strongly related to muscular strength, but there may be a modest correlation with muscular endurance.
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Affiliation(s)
- Jayden Garrett
- University of Nebraska Medical Center, Division of Physical Therapy Education, Omaha, USA
| | - Joshua Keller
- University of South Alabama, Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, Mobile, USA
| | - John Paul Anders
- University of Nebraska - Lincoln, Human Performance Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Science, Lincoln, USA
| | - Kipp Hergenrader
- University of Nebraska - Lincoln, Human Performance Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Science, Lincoln, USA
| | - Tyler Neltner
- University of Nebraska - Lincoln, Human Performance Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Science, Lincoln, USA
| | - Terry Housh
- University of Nebraska - Lincoln, Human Performance Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Science, Lincoln, USA
| | - Richard Schmidt
- University of Nebraska - Lincoln, Human Performance Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Science, Lincoln, USA
| | - Glen Johnson
- University of Nebraska - Lincoln, Human Performance Laboratory, Department of Nutrition and Health Sciences, College of Education and Human Science, Lincoln, USA
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Valera-Calero JA, Ojedo-Martín C, Fernández-de-Las-Peñas C, Cleland JA, Arias-Buría JL, Hervás-Pérez JP. Reliability and Validity of Panoramic Ultrasound Imaging for Evaluating Muscular Quality and Morphology: A Systematic Review. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:185-200. [PMID: 33189413 DOI: 10.1016/j.ultrasmedbio.2020.10.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/12/2020] [Accepted: 10/17/2020] [Indexed: 06/11/2023]
Abstract
Panoramic ultrasound (US) is a novel method used to assess linear dimensions, cross-sectional area, fatty infiltrate and echo-intensity features of muscles that cannot be measured with B-mode US. However, a structured overview of its validity and reliability is lacking. MEDLINE, PubMed, SCOPUS and Web of Science databases were systematically searched for studies evaluating reliability or validity data on panoramic US imaging to determine the muscular morphology and/or quality of skeletal muscles. Most studies had acceptable methodological quality. Seventeen studies analyzing reliability (n = 16) or validity (n = 5) were included. Twelve studies assessed cross-sectional area, seven studies assessed echo-intensity, five assessed linear dimensions (fascicle/tendon length, muscle/subcutaneous adipose thickness or between-structure distance) and one assessed intramuscular fat. Panoramic US seems to be a reliable and valid tool for the assessment of muscle morphology and quality in healthy populations at specific locations, particularly the lower extremities. Studies including scanning procedures are needed to confirm these findings in locations not included in this revision and in both clinical and healthy populations.
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Affiliation(s)
- Juan Antonio Valera-Calero
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, Spain; Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Alcorcón, Spain.
| | - Cristina Ojedo-Martín
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Joshua A Cleland
- Doctor of Physical Therapy Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - José Luis Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Juan Pablo Hervás-Pérez
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, Spain
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Hill EC, Housh TJ, Smith CM, Keller JL, Schmidt RJ, Johnson GO. High- vs. Low-Intensity Fatiguing Eccentric Exercise on Muscle Thickness, Strength, and Blood Flow. J Strength Cond Res 2021; 35:33-40. [DOI: 10.1519/jsc.0000000000002632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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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: 75] [Impact Index Per Article: 18.8] [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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Dankel SJ, Abe T, Bell ZW, Jessee MB, Buckner SL, Mattocks KT, Mouser JG, Loenneke JP. The Impact of Ultrasound Probe Tilt on Muscle Thickness and Echo-Intensity: A Cross-Sectional Study. J Clin Densitom 2020; 23:630-638. [PMID: 30454951 DOI: 10.1016/j.jocd.2018.10.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/19/2018] [Accepted: 10/22/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION/BACKGROUND To determine the influence of ultrasound probe tilt on reliability and overall changes in muscle thickness and echo-intensity. MATERIALS AND METHODS Thirty-six individuals had a total of 15 images taken on both the biceps brachii and tibialis anterior muscles. These images were taken in 2° increments with the probe tilted either upward (U) or downward (D) from perpendicular (0°) to the muscle (U6°, U4°, U2°, 0°, D2°, D4°, and D6°). All images were then saved, stored, and analyzed using Image-J software for echo-intensity and muscle thickness measures. Mean values (2-3 measurements within each probe angle) were compared across each probe angle, and reliability was assessed as if the first measure was taken perpendicular to the muscle, but the second measure was taken with the probe tilted to a different angle (to assume unintentional adjustments in reliability from probe tilt). RESULTS Tilting the probe as little as 2° produced a significant 4.7%, and 10.5% decrease in echo-intensity of the tibialis anterior and biceps brachii muscles, respectively, while changes in muscle thickness were negligible (<1%) at all probe angles. The reliability for muscle thickness was greater than that of echo-intensity when the probe was held perpendicular at both measurements (∼1% vs 3%), and the impact that probe tilt had on reliability was exacerbated for echo-intensity measurements (max coefficient of variation: 24.5%) compared to muscle thickness (max coefficient of variation: 1.5%). CONCLUSION While muscle thickness is less sensitive to ultrasound probe tilt, caution should be taken to ensure minimal probe tilt is present when taking echo-intensity measurements as this will alter mean values and reduce reliability. Echo-intensity values should be interpreted cautiously, particularly when comparing values across technicians/studies where greater alterations in probe tilt is likely.
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Affiliation(s)
- Scott J Dankel
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Zachary W Bell
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Matthew B Jessee
- School of Kinesiology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Samuel L Buckner
- Division of Exercise Science, University of South Florida, Tampa, FL, USA
| | - Kevin T Mattocks
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - J Grant Mouser
- Department of Kinesiology and Health Promotion, Troy University, Troy, AL, USA
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA.
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Valera-Calero JA, Gallego-Sendarrubias GM, Fernández-de-las-Peñas C, Cleland JA, Ortega-Santiago R, Arias-Buría JL. Panoramic Ultrasound Examination of Posterior Neck Extensors in Healthy Subjects: Intra-Examiner Reliability Study. Diagnostics (Basel) 2020; 10:diagnostics10100740. [PMID: 32987741 PMCID: PMC7598691 DOI: 10.3390/diagnostics10100740] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/03/2022] Open
Abstract
Previous studies analyzing morphometry of posterior cervical muscles with ultrasound (US) imaging have mainly used Brightness mode (B-mode). Our aim was to investigate the intra-examiner reliability of panoramic US imaging for assessing posterior-lateral cervical muscle layers. Panoramic US images of the neck at C4/C5 level were acquired in 25 asymptomatic subjects (40% women; mean age: 24 years) by an experienced assessor. The cross-sectional area (CSA) of the upper trapezius, splenius, semispinalis, multifidi, rotators, and levator scapulae was measured from panoramic US scans on two separate days. Intra-class correlation coefficients (ICC3,1), standard error of measurement (SEM), minimal detectable change (MDC) and mean, absolute and percent errors were calculated. In general, intra-examiner reliability was excellent with ICC3,1 ranging from 0.978 (trapezius) to 0.993 (semispinalis). The SEM ranged from 0.02 (multifidus) to 0.07 (semispinalis/levator), whereas the MDC ranged from 0.05 (cervical multifidus) to 0.19 (levator/semispinalis). Absolute error was lower than 0.11 cm2 (levator/semispinalis). No differences between males and females were found. This study found that intra-examiner/rater reliability of panoramic US imaging was excellent for assessing the CSA of the posterior-lateral neck extensor muscles in asymptomatic subjects. The current findings suggest that panoramic US may be a reliable technique for examining the size of the cervical extensor muscles in both males and females.
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Affiliation(s)
- Juan Antonio Valera-Calero
- Department of Physical Therapy, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain;
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28933 Alcorcón, Spain
- Correspondence: ; Tel.: +34-653-766-841
| | | | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (C.F.-d.-l.-P.); (R.O.-S.); (J.L.A.-B.)
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Madrid, Spain
| | - Joshua A. Cleland
- Doctor of Physical Therapy Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02155, USA;
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (C.F.-d.-l.-P.); (R.O.-S.); (J.L.A.-B.)
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Madrid, Spain
| | - José Luis Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (C.F.-d.-l.-P.); (R.O.-S.); (J.L.A.-B.)
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Madrid, Spain
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Enhancing Trigger Point Dry Needling Safety by Ultrasound Skin-to-Rib Measurement: An inter-Rater Reliability Study. J Clin Med 2020; 9:jcm9061958. [PMID: 32585845 PMCID: PMC7356170 DOI: 10.3390/jcm9061958] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/10/2020] [Accepted: 06/19/2020] [Indexed: 01/01/2023] Open
Abstract
Dry needling (DN) is a minimally invasive treatment technique widely used by physical therapists to treat myofascial trigger points (MTrP). Even if its safety has been commonly declared and the majority of adverse events are considered mild, serious adverse events cannot be excluded and DN treatments of several trunk muscles can potentially result in pneumothorax. Ultrasound imaging (US) skin-to-rib measurement could ensure the safety of this treatment procedure. Therefore, the aim of this study was to determine the inter-rater reliability of depth measurement of different trunk muscles (i.e., rhomboid, lower trapezius, iliocostalis, and pectoralis major) between an expert and two novice physiotherapists. Skin-to-rib distance of 26 asymptomatic and normal weights subjects was consecutively, independently, and randomly measured for each muscle by the three examiners (1 expert and 2 novice physical therapists) with a handheld US wireless probe. Intraclass correlation coefficient (ICC3,k) and standard error of measurement (SEM) were used to assess inter-rater reliability. Inter-rater reliability of skin-to-rib measurements between the three examiners was good to excellent or excellent for every muscle, with an ICC3,k ranging from 0.92 and 0.98 (95% CI 0.86–0.99). The SEM never exceeded 10% of the skin-to-rib distance. In conclusion, skin-to-rib US measurements of the trunk muscles can be reliably performed by novice physical therapists using a handheld US device. These measures could be used as an innovative and reliable technique to improve the safety of some potential dangerous DN treatments.
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Four Weeks of Time-Restricted Feeding Combined with Resistance Training Does Not Differentially Influence Measures of Body Composition, Muscle Performance, Resting Energy Expenditure, and Blood Biomarkers. Nutrients 2020; 12:nu12041126. [PMID: 32316561 PMCID: PMC7231047 DOI: 10.3390/nu12041126] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/12/2020] [Accepted: 04/16/2020] [Indexed: 01/05/2023] Open
Abstract
Recently, interest in time-restricted feeding (TRF) has increased from reports highlighting improvements in body composition and muscular performance measures. Twenty-six recreationally active males were randomly assigned to either TRF (n = 13; ~22.9 years; 82.0 kg; 178.1 cm; 8 h eating window, 25% caloric deficit, 1.8 g/kg/day protein) or normal diet (ND; n = 13; ~22.5 years; 83.3 kg; 177.5 cm; normal meal pattern; 25% caloric deficit, 1.8 g/kg/day protein) groups. Participants underwent 4-weeks of supervised full body resistance training. Changes in body composition (fat mass (FM), fat free mass (FFM), and body fat percentage (BF%)), skeletal muscle cross sectional area (CSA) and muscle thickness (MT) of the vastus lateralis (VL), rectus femoris, (RF), and biceps brachii (BB) muscles, resting energy expenditure (REE), muscular performance, blood biomarkers, and psychometric parameters were assessed. Significant (p < 0.05) decreases were noted in BM, FM, BF%, testosterone, adiponectin, and REE, along with significant increases in BP1RM, LP1RM, VJHT, VJPP, VLCSA, BBCSA, and BBMT in both groups. Plasma cortisol levels were significantly elevated at post (p = 0.018) only in ND. Additionally, FFM was maintained equally between groups. Thus, a TRF style of eating does not enhance reductions in FM over caloric restriction alone during a 4-week hypocaloric diet.
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Wells E, Eustace D, Gupton CS, Dedrick GS, Bunn J. Eccentric and blood flow restriction exercises in women induce hypertrophy. J Sports Med Phys Fitness 2020; 59:1968-1974. [PMID: 31933343 DOI: 10.23736/s0022-4707.19.09573-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of the study was to assess the mechanical and metabolic effects of eccentric (ECC) resistance training and blood flow restriction (BFR) exercise on the elbow flexors in recreationally trained females. METHODS Seventeen females (ECC: 30.0±7.6 years, 165.6±5.4 cm, 67.1±8.5 kg; ECC+BFR: 24.4±2.2 years, 163.7±9.3 cm, 67.6±12.2 kg) were randomized to two groups and trained twice weekly for four weeks. The ECC+BFR group trained at 30% 1-rep max (1-RM), 3x20 repetitions, and the ECC group trained at 60% 1-RM, 3×10 repetitions. The BFR cuff was pressurized to 60% of maximal occlusion. Both groups performed the ECC portion of a bicep curl with assistance to return the arm back to starting position. Rate of perceived exertion (RPE) and blood lactate were measured each week. Testing was conducted at baseline and post-training and included: body composition, thickness and cross-sectional area (CSA) of the elbow flexors, arm circumference, bicep curl 1-RM, and inverted rows to exhaustion. RESULTS There was no significant group difference for any of the variables (P>0.05). A training effect was shown with both groups increasing right arm circumference (P=0.004), muscle thickness (P<0.001), CSA (P=0.001), 1-RM for the right (P=0.001) and left arms (P=0.014), and inverted rows (P=0.001). Both groups showed significant decreases in lactate (P=0.047) and RPE (P<0.001). CONCLUSIONS Females can produce muscular gains with ECC and BFR training similar to previous results seen in males.
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Affiliation(s)
- Elizabeth Wells
- Department of Physical Therapy, Campbell University, Buies Creek, NC, USA
| | - Danielle Eustace
- Department of Physical Therapy, Campbell University, Buies Creek, NC, USA
| | - C Stuart Gupton
- Department of Physical Therapy, Campbell University, Buies Creek, NC, USA
| | - Gregory S Dedrick
- Department of Physical Therapy, Campbell University, Buies Creek, NC, USA
| | - Jennifer Bunn
- Department of Physical Therapy, Campbell University, Buies Creek, NC, USA -
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Low-load blood flow restriction elicits greater concentric strength than non-blood flow restriction resistance training but similar isometric strength and muscle size. Eur J Appl Physiol 2019; 120:425-441. [DOI: 10.1007/s00421-019-04287-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 12/10/2019] [Indexed: 12/11/2022]
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Ruas CV, Pinto RS, Haff GG, Lima CD, Brown LE. Effects of Different Combinations of Concentric and Eccentric Resistance Training Programs on Traditional and Alternative Hamstrings-to-Quadriceps Ratios. Sports (Basel) 2019; 7:E221. [PMID: 31614760 PMCID: PMC6835643 DOI: 10.3390/sports7100221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 11/17/2022] Open
Abstract
Resistance training is often recommended for combined increases in traditional and alternative hamstrings-to-quadriceps (H:Q) ratios in order to reduce knee strength imbalance and associated hamstrings and knee ligament injury risk. The aim of this study was to investigate the effect of different concentric and eccentric resistance training programs on traditional and alternative H:Q ratios. Forty male volunteers were assigned to one of 4 groups: concentric quadriceps and concentric hamstrings (CON/CON, n = 10), eccentric quadriceps and eccentric hamstrings (ECC/ECC, n = 10), concentric quadriceps and eccentric hamstrings (CON/ECC, n = 10), or no training (control (CNTRL), n = 10). Traditional conventional (CR) and functional (FR), alternative rate of torque development (RTD), muscle size (MS), and muscle activation (MA) H:Q ratios were measured before and after six weeks of unilateral nondominant knee extension-flexion resistance training performed on an isokinetic dynamometer. The ECC/ECC training significantly increased FR (pre = 0.75 ± 0.11; post = 0.85 ± 0.15), whereas the lack of training (CNTRL) decreased the RTD H:Q ratio (pre = 1.10 ± 0.67; post = 0.73 ± 0.33). There were no differences between groups for the other traditional and alternative ratios following resistance training protocols. These findings suggest eccentric exercise for quadriceps and hamstrings as the most beneficial training program for inducing increases in the traditional FR. However, different resistance training strategies may be needed to also elicit increases in the alternative RTD, MS, and MA H:Q ratios for fully restoring muscle balance and reducing potential hamstrings and knee ligament injury risk.
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Affiliation(s)
- Cassio V Ruas
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup 6027, Australia.
- Exercise Research Laboratory, School of Physical Education, Physioteraphy and Dance, Universidade Federal do Rio Grande do Sul, Rua Felizardo 750, Porto Alegre 90690-200, Brazil.
| | - Ronei S Pinto
- Exercise Research Laboratory, School of Physical Education, Physioteraphy and Dance, Universidade Federal do Rio Grande do Sul, Rua Felizardo 750, Porto Alegre 90690-200, Brazil.
| | - Guy G Haff
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup 6027, Australia.
| | - Camila D Lima
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup 6027, Australia.
| | - Lee E Brown
- Center for Sport Performance and Human Performance Lab, Department of Kinesiology, California State University, Fullerton, 800 N State College Blvd, Fullerton, CA 92831, USA.
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Tinsley GM, Moore ML, Graybeal AJ, Paoli A, Kim Y, Gonzales JU, Harry JR, VanDusseldorp TA, Kennedy DN, Cruz MR. Time-restricted feeding plus resistance training in active females: a randomized trial. Am J Clin Nutr 2019; 110:628-640. [PMID: 31268131 PMCID: PMC6735806 DOI: 10.1093/ajcn/nqz126] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/10/2019] [Accepted: 05/31/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND A very limited amount of research has examined intermittent fasting (IF) programs, such as time-restricted feeding (TRF), in active populations. OBJECTIVE Our objective was to examine the effects of TRF, with or without β-hydroxy β-methylbutyrate (HMB) supplementation, during resistance training (RT). METHODS This study employed a randomized, placebo-controlled, reduced factorial design and was double-blind with respect to supplementation in TRF groups. Resistance-trained females were randomly assigned to a control diet (CD), TRF, or TRF plus 3 g/d HMB (TRFHMB). TRF groups consumed all calories between 1200 h and 2000 h, whereas the CD group ate regularly from breakfast until the end of the day. All groups completed 8 wk of supervised RT and consumed supplemental whey protein. Body composition, muscular performance, dietary intake, physical activity, and physiological variables were assessed. Data were analyzed prior to unblinding using mixed models and both intention-to-treat (ITT) and per protocol (PP) frameworks. RESULTS Forty participants were included in ITT, and 24 were included in PP. Energy and protein intake (1.6 g/kg/d) did not differ between groups despite different feeding durations (TRF and TRFHMB: ∼7.5 h/d; CD: ∼13 h/d). Comparable fat-free mass (FFM) accretion (+2% to 3% relative to baseline) and skeletal muscle hypertrophy occurred in all groups. Differential effects on fat mass (CD: +2%; TRF: -2% to -4%; TRFHMB: -4% to -7%) were statistically significant in the PP analysis, but not ITT. Muscular performance improved without differences between groups. No changes in physiological variables occurred in any group, and minimal side effects were reported. CONCLUSIONS IF, in the form of TRF, did not attenuate RT adaptations in resistance-trained females. Similar FFM accretion, skeletal muscle hypertrophy, and muscular performance improvements can be achieved with dramatically different feeding programs that contain similar energy and protein content during RT. Supplemental HMB during fasting periods of TRF did not definitively improve outcomes. This study was prospectively registered at clinicaltrials.gov as NCT03404271.
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Affiliation(s)
- Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA,Address correspondence to GMT (e-mail: )
| | - M Lane Moore
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Austin J Graybeal
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Youngdeok Kim
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Joaquin U Gonzales
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - John R Harry
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Trisha A VanDusseldorp
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Devin N Kennedy
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Megan R Cruz
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
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Ferrer-Peña R, Calvo-Lobo C, Gómez M, Muñoz-García D. Prediction Model for Choosing Needle Length to Minimize Risk of Median Nerve Puncture With Dry Needling of the Pronator Teres. J Manipulative Physiol Ther 2019; 42:366-371. [PMID: 31262581 DOI: 10.1016/j.jmpt.2018.11.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 11/07/2018] [Accepted: 11/07/2018] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this study was to relate forearm anthropometric measures to ultrasound pronator teres depth to determine the necessary needle length to prevent median nerve (MN) injury during pronator teres dry needling. METHODS We conducted a study employing a diagnostic accuracy prediction model (NCT03308279) at a Spanish university center. The study recruited 65 participants to predict the depth of the MN (measured with ultrasound) in the pronator teres using a decision tree algorithm to reduce the risk of MN puncture using 2 needle lengths (13 mm or 25 mm). The decision tree was developed by automatically selecting a cutoff for body mass index, forearm length and circumference, and pronator teres thickness. RESULTS For forearm circumferences ≤27.5 cm, the predictive value for the 13-mm needle was 92%. For forearm circumferences >27.5 cm and forearm lengths ≤26.75 cm, the predictive value for the 25-mm needle was 100%. CONCLUSION Based upon the findings of this study, we suggest that needle length should be selected according to forearm anthropometric measures to prevent MN injury during pronator teres dry needling.
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Affiliation(s)
- Raúl Ferrer-Peña
- Departamento de Fisioterapia and Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - César Calvo-Lobo
- Nursing and Physical Therapy Department, Faculty of Health Sciences, Universidad de León, Ponferrada, León, Spain.
| | - Miguel Gómez
- Departamento de Fisioterapia and Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Daniel Muñoz-García
- Departamento de Fisioterapia and Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
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Rabello R, Fröhlich M, Bueno AF, Marcolino MAZ, De Bona Bernardi T, Sbruzzi G, Aurélio Vaz M. Echo intensity reliability between two rectus femoris probe sites. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2019; 27:233-240. [PMID: 31762472 DOI: 10.1177/1742271x19853859] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/08/2019] [Indexed: 12/14/2022]
Abstract
Introduction The ultrasound technique has been extensively used to measure echo intensity, with the goal of measuring muscle quality, muscle damage, or to detect neuromuscular disorders. However, it is not clear how reliable the technique is when comparing different days, raters, and analysts, or if the reliability is affected by the muscle site where the image is obtained from. The goal of this study was to compare the intra-rater, inter-rater, and inter-analyst reliability of ultrasound measurements obtained from two different sites at the rectus femoris muscle. Methods Muscle echo intensity was quantified from ultrasound images acquired at 50% [RF50] and at 70% [RF70] of the thigh length in 32 healthy subjects. Results Echo intensity values were higher (p = 0.0001) at RF50 (61.08 ± 12.04) compared to RF70 (57.32 ± 12.58). Reliability was high in both RF50 and RF70 for all comparisons: intra-rater (ICC = 0.89 and 0.94), inter-rater (ICC = 0.89 and 0.89), and inter-analyst (ICC = 0.98 and 0.99), respectively. However, there were differences (p < 0.05) between raters and analysts when obtaining/analyzing echo intensity values in both rectus femoris sites. Conclusions The differences in echo intensity values between positions suggest that rectus femoris's structure is not homogeneous, and therefore measurements from different muscle regions should not be used interchangeably. Both sites showed a high reliability, meaning that the measure is accurate if performed by the same experienced rater in different days, if performed by different experienced raters in the same day, and if analyzed by different well-trained analysts, regardless of the evaluated muscle site.
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Affiliation(s)
- Rodrigo Rabello
- Escola de Educação Física, Fisioterapia e Dança Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Brazil
| | - Matias Fröhlich
- Escola de Educação Física, Fisioterapia e Dança Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Brazil
| | - Aline Felicio Bueno
- Escola de Educação Física, Fisioterapia e Dança Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Brazil
| | - Miriam Allein Zago Marcolino
- Escola de Educação Física, Fisioterapia e Dança Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Brazil
| | - Thainá De Bona Bernardi
- Escola de Educação Física, Fisioterapia e Dança Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Brazil
| | - Graciele Sbruzzi
- Escola de Educação Física, Fisioterapia e Dança Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Brazil
| | - Marco Aurélio Vaz
- Escola de Educação Física, Fisioterapia e Dança Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Brazil
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Muddle TW, Magrini MA, Colquhoun RJ, Luera MJ, Tomko PM, Jenkins ND. Impact of Fatiguing, Submaximal High- vs. Low-Torque Isometric Exercise on Acute Muscle Swelling, and Echo Intensity in Resistance-Trained Men. J Strength Cond Res 2019; 33:1007-1019. [DOI: 10.1519/jsc.0000000000003033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Hill EC, Housh TJ, Keller JL, Smith CM, Schmidt RJ, Johnson GO. The validity of the EMG and MMG techniques to examine muscle hypertrophy. Physiol Meas 2019; 40:025009. [PMID: 30736032 DOI: 10.1088/1361-6579/ab057e] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The purpose of this investigation was to examine the ability of the electromyographic (EMG) and mechanomyographic (MMG) amplitude versus torque relationships to track group and individual changes in muscle hypertrophy as a result of resistance training. APPROACH Twelve women performed four weeks of forearm flexion blood flow restriction (BFR) resistance training at a frequency of three times per week. The training was performed at an isokinetic velocity of 120° · s-1 with a training load that corresponded to 30% of concentric peak torque. Muscle hypertrophy was determined using ultrasound-based assessments of muscle cross-sectional area from the biceps brachii. Training-induced changes in the slope coefficients of the EMG amplitude and MMG amplitude versus torque relationships were determined from the biceps brachii during incremental (10%-100% of maximum) isometric muscle actions. MAIN RESULTS There was a significant (p < 0.001; d = 2.15) mean training-induced increase in muscle cross-sectional area from 0 week (mean ± SD = 5.86 ± 0.65 cm2) to 4 weeks (7.42 ± 0.80 cm2), a significant (p = 0.023; d = 0.36) decrease in the EMG amplitude versus torque relationship (50.70 ± 20.41 to 43.82 ± 17.76 µV · Nm-1), but no significant (p = 0.192; d = 0.17) change in the MMG amplitude versus torque relationship (0.018 ± 0.009 to 0.020 ± 0.009 m · s-2 · Nm-1). There was, however, great variability for the individual responses for the EMG and MMG amplitude versus torque relationships. SIGNIFICANCE The results of the present study indicated that the EMG amplitude, but not the MMG amplitude versus torque relationship was sensitive to mean changes in muscle cross-sectional area during the early-phase of resistance training. There was, however, great variability for the individual EMG amplitude versus torque relationships that limits its application for identifying individual changes in muscle hypertrophy as a result of BFR.
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Affiliation(s)
- Ethan C Hill
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, 110 Ruth Leverton Hall, Lincoln, NE 68583-0806, United States of America. Author to whom any correspondence should be addressed
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Hill EC, Housh TJ, Smith CM, Keller JL, Schmidt RJ, Johnson GO. The Contributions of Arterial Cross-Sectional Area and Time-Averaged Flow Velocity to Arterial Blood Flow. J Med Ultrasound 2019; 26:186-193. [PMID: 30662149 PMCID: PMC6314092 DOI: 10.4103/jmu.jmu_20_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/02/2018] [Indexed: 11/09/2022] Open
Abstract
Background: Ultrasound has been used for noninvasive assessments of endothelial function in both clinical and athletic settings and to identify changes in muscle blood flow in response to exercise, nutritional supplementation, and occlusion. The purposes of the present study were to examine the reliability and relative contributions of arterial cross-sectional area and time-averaged flow velocity to predict muscle blood flow as a result of fatiguing exercise in men and women. Methods: Eighteen healthy men and 18 healthy women performed 50 consecutive eccentric repetitions of the elbow flexors at 60% of their pretest eccentric peak torque at a velocity of 180° s−1. Test-retest reliability and stepwise linear regression analyses were performed to determine the ability of arterial cross-sectional area and time-averaged flow velocity to predict brachial artery muscle blood flow for the men, women, and combined sample. Results: There was no systematic test versus retest mean differences (P > 0.05) for any of the ultrasound determined variables. The two-variable regression models significantly improved the ability to predict muscle blood flow and were associated with smaller standard error of the estimates (3.7%–10.1% vs. 16.8%–37.0% of the mean baseline muscle blood flow values) compared to the one-variable models. Conclusions: The findings of the present study supported the use of ultrasound for reliable assessments of arterial diameter, arterial cross-sectional area, time-averaged flow velocity, and muscle blood flow from the brachial artery in men and women. Furthermore, time-averaged flow velocity was a more powerful predictor of muscle blood flow than arterial cross-sectional area.
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Affiliation(s)
- Ethan C Hill
- Department of Nutrition and Health Sciences, Human Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE 68505, USA
| | - Terry J Housh
- Department of Nutrition and Health Sciences, Human Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE 68505, USA
| | - Cory M Smith
- Department of Nutrition and Health Sciences, Human Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE 68505, USA
| | - Joshua L Keller
- Department of Nutrition and Health Sciences, Human Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE 68505, USA
| | - Richard J Schmidt
- Department of Nutrition and Health Sciences, Human Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE 68505, USA
| | - Glen O Johnson
- Department of Nutrition and Health Sciences, Human Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE 68505, USA
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Tarantino G, Costantini S, Citro V, Conforti P, Capone F, Sorice A, Capone D. Interferon-alpha 2 but not Interferon-gamma serum levels are associated with intramuscular fat in obese patients with nonalcoholic fatty liver disease. J Transl Med 2019; 17:8. [PMID: 30602382 PMCID: PMC6317208 DOI: 10.1186/s12967-018-1754-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/21/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Intramuscular triglycerides (IMTGs) represent an important energy supply and a dynamic fat-storage depot that can expand during periods of elevated lipid availability and a fatty acid source. Ultrasonography (US) of human skeletal muscles is a practical and reproducible method to assess both IMTG presence and entity. Although a crosstalk between cytokines in skeletal muscle and adipose tissue has been suggested in obesity, condition leading to hepatic steatosis (HS) or better defined as nonalcoholic fatty liver disease and cancer, there are still questions to be answered about the role of interferons (IFNs), alpha as well as gamma, and IMTG in obesity. We aimed at discovering any correlation between IFNs and IMTG. METHODS We analysed anthropometric data, metabolic parameters and imaging features of a population of 80 obese subjects with low-prevalence of co-morbidities but HS in relation to IFNs serum levels. A population of 38 healthy subjects (21 males) served as controls. The levels of serum IFNs were detected by a magnetic bead-based multiplex immunoassays. RESULTS Serum concentrations of IFN-alpha 2 were increased, while serum levels of IFN-gamma were decreased confronted with those of controls; the severity of IMTG, revealed at US as Heckmatt scores, was inversely predicted by IFN-alpha 2 serum concentrations; IMTG scores were not predicted by serum levels of IFN-gamma; IMTG scores were predicted by HS severity, ascertained at US; HS severity was predicted by visceral adipose tissue, assessed by US, but the latter was not instrumental to IMTG. DISCUSSION AND CONCLUSION This study has added some pieces of observation about the cytokine network regulating the interplay between IMTG and obesity in obese patients with HS.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, "Federico II" University Medical School of Naples, Naples, Italy.
| | - Susan Costantini
- Oncology Research Center of Mercogliano (CROM), Istituto Nazionale Tumori-IRCSS-Fondazione G. Pascale, Naples, Italy
| | - Vincenzo Citro
- Department of General Medicine, "Umberto I" Hospital, Nocera Inferiore, SA, Italy
| | - Paolo Conforti
- "Federico II" University Medical School of Naples, Naples, Italy
| | - Francesca Capone
- Oncology Research Center of Mercogliano (CROM), Istituto Nazionale Tumori-IRCSS-Fondazione G. Pascale, Naples, Italy
| | - Angela Sorice
- Oncology Research Center of Mercogliano (CROM), Istituto Nazionale Tumori-IRCSS-Fondazione G. Pascale, Naples, Italy
| | - Domenico Capone
- Integrated Care Department of Public Health and Drug-Use, Section of Medical Pharmacology and Toxicology, "Federico II" University, Naples, Italy
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Assessing sarcopenia with vastus lateralis muscle ultrasound: an operative protocol. Aging Clin Exp Res 2018; 30:1437-1443. [PMID: 29700758 DOI: 10.1007/s40520-018-0958-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 04/20/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Muscle ultrasound (MUS) has so far not been implemented for sarcopenia assessment in clinical geriatric practice due to allegedly low reproducibility of results in the absence of standardization of procedures. However, rigorous and standardized application of this technique yields highly reproducible results. Its application, especially if integrated with clinical evaluation and comprehensive geriatric assessment, proofs very useful for rapidly obtaining information on muscle mass and architecture. OBJECTIVE Here, we present a standardized protocol for performing right vastus lateralis (RVL) MUS and measuring parameters of muscle size and architecture. METHODS RVL muscle thickness (MT), fascicle length (FL), pennation angle (PA), echo-intensity (EI) and cross-sectional area (CSA) can be assessed with this protocol. A portable instrument equipped with a 5-cm long 3-11 mHz linear probe should be used with both B-mode real-time and extended-field-of-view (EFOV) techniques. Longitudinal B-mode and transverse EFOV images should be acquired during each exam, and analyzed with NIH-ImageJ software. CONCLUSIONS This operative protocol represents a good compromise between the feasibility of MUS in clinical settings and the need of obtaining precise measurements of muscle parameters. Future studies should verify the reproducibility of the proposed technique, and its correlation with appendicular lean mass and parameters of muscle function.
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Colquhoun RJ, Tomko PM, Magrini MA, Muddle TWD, Jenkins NDM. The influence of input excitation on the inter- and intra-day reliability of the motor unit firing rate versus recruitment threshold relationship. J Neurophysiol 2018; 120:3131-3139. [PMID: 30355024 DOI: 10.1152/jn.00490.2018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Decomposition of the surface electromyographic (sEMG) signal is commonly used to examine motor unit (MU) firing behavior. However, the intra- and inter-day reliability of these measurements has yet to be quantified or reported. This investigation 1) examined the effect of input excitation on the mean firing rate (MFR) vs. recruitment threshold (RT) relationship and 2) determined the inter- and intra-day reliability of the MFR vs. RT relationship at 30%, 50%, and 70% of maximum voluntary isometric strength (MVIC). Twenty-eight healthy males (23 ± 3 yr) completed two experimental visits, during which they performed MVIC testing and isometric ramp contractions at 30%, 50%, and 70% MVIC. sEMG signals were recorded from the vastus lateralis during the ramp contractions and decomposed to establish the MFR vs. RT relationship for the detected MUs. Intra- and inter-day reliability was then established for the slopes and y-intercepts of the MFR vs. RT relationship at each contraction intensity. All participants displayed significant MFR vs. RT relationships ( r range: -0.662 to -0.999; P ≤ 0.001-0.006). Intra- and inter-day intraclass correlation coefficients (ICCs) ranged from 0.766-0.824 and 0.867-0.919 for the slopes and from 0.780-0.915 and 0.804-0.927 for the y-intercepts, respectively. Furthermore, the slope coefficient was significantly greater at 70% than at 30% MVIC, and the y-intercepts increased with increasing contraction intensities. Changes in input excitation to the MU pool alter the magnitude, but not the reliability, of the slopes and y-intercepts of the MFR vs. RT relationship. NEW & NOTEWORTHY The firing behavior of the motor unit (MU) pool is often characterized using the mean firing rate vs. recruitment threshold relationship of the active MUs. Although this relationship has been widely used, this is the first study to report the effects of input excitation (contraction intensity) on the intra- and inter-day reliability of this relationship. The criteria used for MU analysis and the model utilized in this study allow for generalization to outside investigators and laboratories.
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Affiliation(s)
- Ryan J Colquhoun
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University , Stillwater, Oklahoma
| | - Patrick M Tomko
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University , Stillwater, Oklahoma
| | - Mitchel A Magrini
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University , Stillwater, Oklahoma
| | - Tyler W D Muddle
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University , Stillwater, Oklahoma
| | - Nathaniel D M Jenkins
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University , Stillwater, Oklahoma
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Vigotsky AD, Schoenfeld BJ, Than C, Brown JM. Methods matter: the relationship between strength and hypertrophy depends on methods of measurement and analysis. PeerJ 2018; 6:e5071. [PMID: 29967737 PMCID: PMC6026459 DOI: 10.7717/peerj.5071] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 06/04/2018] [Indexed: 12/18/2022] Open
Abstract
Purpose The relationship between changes in muscle size and strength may be affected by both measurement and statistical approaches, but their effects have not been fully considered or quantified. Therefore, the purpose of this investigation was to explore how different methods of measurement and analysis can affect inferences surrounding the relationship between hypertrophy and strength gain. Methods Data from a previous study-in which participants performed eight weeks of elbow flexor training, followed by an eight-week period of detraining-were reanalyzed using different statistical models, including standard between-subject correlations, analysis of covariance, and hierarchical linear modeling. Results The associative relationship between strength and hypertrophy is highly dependent upon both method/site of measurement and analysis; large differences in variance accounted for (VAF) by the statistical models were observed (VAF = 0-24.1%). Different sites and measurements of muscle size showed a range of correlations coefficients with one another (r = 0.326-0.945). Finally, exploratory analyses revealed moderate-to-strong relationships between within-individual strength-hypertrophy relationships and strength gained over the training period (ρ = 0.36-0.55). Conclusions Methods of measurement and analysis greatly influence the conclusions that may be drawn from a given dataset. Analyses that do not account for inter-individual differences may underestimate the relationship between hypertrophy and strength gain, and different methods of assessing muscle size will produce different results. It is suggested that robust experimental designs and analysis techniques, which control for different mechanistic sources of strength gain and inter-individual differences (e.g., muscle moment arms, muscle architecture, activation, and normalized muscle force), be employed in future investigations.
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Affiliation(s)
- Andrew D Vigotsky
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, United States of America
| | - Brad J Schoenfeld
- Department of Health Sciences, City University of New York, Herbert H. Lehman College, Bronx, NY, United States of America
| | - Christian Than
- School of Biomedical Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - J Mark Brown
- School of Biomedical Sciences, University of Queensland, St. Lucia, Queensland, Australia
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Magrini MA, Colquhoun RJ, Barrera-Curiel A, Thiele RM, DeFreitas JM, Smith DB, Jenkins ND. Muscle size, strength, power, and echo intensity, but not specific tension, are affected by age in physically active adults. ISOKINET EXERC SCI 2018. [DOI: 10.3233/ies-172194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Mitchel A. Magrini
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, Stillwater, OK, USA
| | - Ryan J. Colquhoun
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, Stillwater, OK, USA
| | | | - Ryan M. Thiele
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS, USA
| | - Jason M. DeFreitas
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, Stillwater, OK, USA
| | - Doug B. Smith
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, Stillwater, OK, USA
| | - Nathaniel D.M. Jenkins
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, Stillwater, OK, USA
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Tomko PM, Muddle TW, Magrini MA, Colquhoun RJ, Luera MJ, Jenkins ND. Reliability and differences in quadriceps femoris muscle morphology using ultrasonography: The effects of body position and rest time. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2018; 26:214-221. [PMID: 30479636 DOI: 10.1177/1742271x18780127] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 04/09/2018] [Indexed: 12/28/2022]
Abstract
Introduction The purpose of this investigation was to: (1) to determine the reliability of rectus femoris muscle cross-sectional area and echo intensity obtained using panoramic ultrasound imaging during seated and supine lying positions before and after a 5-minute rest period and (2) to determine the influence of body position and rest period on the magnitude of rectus femoris muscle cross-sectional area and echo intensity measurements. Methods A total of 23 males and females (age = 21.5 ± 1.9 years) visited the laboratory on two separate occasions. During each visit, panoramic ultrasound images of the rectus femoris were obtained in both a seated and a supine position before (T1) and after a 5-minute (T2) rest period to quantify any potential changes in either muscle cross-sectional area and/or echo intensity. Results None of the muscle cross-sectional area or echo intensity measurements exhibited systematic variability, and the ICCs were 0.98-0.99 and 0.88-0.91, and the coefficients of variation were ≤ 3.9% and ≤ 8.2% for muscle cross-sectional area and echo intensity, respectively. Our results indicated that muscle cross-sectional area was greater in the seated than supine position, whereas echo intensity was greater in the supine position. Further, echo intensity increased in the seated position from T1 to T2. Conclusion Both rectus femoris muscle cross-sectional area and echo intensity may be reliably measured in either a seated or supine lying position before or after a 5-minute rest period. Aside from echo intensity in the seated position, rest period had no influence on the magnitude of muscle cross-sectional area or echo intensity. Comparison of muscle cross-sectional area values that are obtained in different body positions is ill-advised.
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Affiliation(s)
- Patrick M Tomko
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, USA
| | - Tyler Wd Muddle
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, USA
| | - Mitchel A Magrini
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, USA
| | - Ryan J Colquhoun
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, USA
| | - Micheal J Luera
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, USA
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Tanaka NI, Ogawa M, Yoshiko A, Ando R, Akima H. Reliability of size and echo intensity of abdominal skeletal muscles using extended field-of-view ultrasound imaging. Eur J Appl Physiol 2017; 117:2263-2270. [PMID: 28913554 DOI: 10.1007/s00421-017-3713-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 09/01/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE This study aimed to examine the reliability of extended field-of-view (EFOV) ultrasound imaging to evaluate the cross-sectional area (CSA) and echo intensity of abdominal skeletal muscles. METHODS Twenty-seven healthy young males (age 18.6 ± 1.0 years, body mass index 20.9 ± 2.8 kg/m2, waist circumference 75.0 ± 7.9 cm, body fat 16.6 ± 5.9%) visited the laboratory on 2 days. EFOV ultrasound images of the rectus abdominis, abdominal oblique, and erector spinae muscles were acquired at the height of the third lumbar vertebra with the subject lying on a bed. We then analyzed CSA and echo intensity using ImageJ software and calculated intra-class correlation coefficients (ICC) and the standard error of measurement (SEM). RESULTS No significant differences (p = 0.149-0.679) were observed in CSA or echo intensity values for each skeletal muscle between days. ICC and SEM values in CSA for each skeletal muscle ranged between 0.944 and 0.958 and 4.9% and 7.3%, respectively. The corresponding values for echo intensity were 0.851-0.945 for ICC and 5.3-9.7% for SEM. CONCLUSIONS The present results indicate that EFOV ultrasound imaging has high repeatability for measuring CSA and echo intensity of abdominal skeletal muscle groups in healthy college-aged males.
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Affiliation(s)
- Noriko I Tanaka
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan. .,Graduate School of Education and Human Development, Nagoya University, 1 Furo-cho, Chikusa-ku, Nagoya, Aichi, 464-8601, Japan.
| | - Madoka Ogawa
- Graduate School of Education and Human Development, Nagoya University, 1 Furo-cho, Chikusa-ku, Nagoya, Aichi, 464-8601, Japan.,Japan Society for the Promotion of Science, 5-3-1 Ko-jimachi, Chiyoda-ku, Tokyo, 102-0083, Japan
| | - Akito Yoshiko
- Graduate School of Medicine, Nagoya University, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Ryosuke Ando
- Department of Sports Science, Japan Institute of Sports Sciences, 3-15-1 Nishigaoka, Kita-ku, Tokyo, 115-0056, Japan
| | - Hiroshi Akima
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan.,Graduate School of Education and Human Development, Nagoya University, 1 Furo-cho, Chikusa-ku, Nagoya, Aichi, 464-8601, Japan
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Santos R, Armada-da-Silva P. Reproducibility of ultrasound-derived muscle thickness and echo-intensity for the entire quadriceps femoris muscle. Radiography (Lond) 2017; 23:e51-e61. [DOI: 10.1016/j.radi.2017.03.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 03/15/2017] [Accepted: 03/20/2017] [Indexed: 01/05/2023]
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Stock MS, Mota JA, DeFranco RN, Grue KA, Jacobo AU, Chung E, Moon JR, DeFreitas JM, Beck TW. The time course of short-term hypertrophy in the absence of eccentric muscle damage. Eur J Appl Physiol 2017; 117:989-1004. [DOI: 10.1007/s00421-017-3587-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 03/11/2017] [Indexed: 12/23/2022]
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Varanoske AN, Fukuda DH, Boone CH, Beyer KS, Stout JR, Hoffman JR. Homogeneity of echo intensity values in transverse ultrasound images. Muscle Nerve 2017; 56:93-98. [DOI: 10.1002/mus.25470] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/31/2016] [Accepted: 11/08/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Alyssa N. Varanoske
- Institute of Exercise Physiology and Wellness; University of Central Florida; 4000 University Blvd Orlando Florida USA 32816
| | - David H. Fukuda
- Institute of Exercise Physiology and Wellness; University of Central Florida; 4000 University Blvd Orlando Florida USA 32816
| | - Carleigh H. Boone
- Institute of Exercise Physiology and Wellness; University of Central Florida; 4000 University Blvd Orlando Florida USA 32816
| | - Kyle S. Beyer
- Institute of Exercise Physiology and Wellness; University of Central Florida; 4000 University Blvd Orlando Florida USA 32816
| | - Jeffrey R. Stout
- Institute of Exercise Physiology and Wellness; University of Central Florida; 4000 University Blvd Orlando Florida USA 32816
| | - Jay R. Hoffman
- Institute of Exercise Physiology and Wellness; University of Central Florida; 4000 University Blvd Orlando Florida USA 32816
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