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Nhat PTH, Van Hao N, Yen LM, Anh NH, Khiem DP, Kerdegari H, Phuong LT, Hoang VT, Ngoc NT, Thu LNM, Trung TN, Pisani L, Razavi R, Yacoub S, Van Vinh Chau N, King AP, Thwaites L, Denehy L, Gomez A. Clinical evaluation of AI-assisted muscle ultrasound for monitoring muscle wasting in ICU patients. Sci Rep 2024; 14:14798. [PMID: 38926427 PMCID: PMC11208490 DOI: 10.1038/s41598-024-64564-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Muscle ultrasound has been shown to be a valid and safe imaging modality to assess muscle wasting in critically ill patients in the intensive care unit (ICU). This typically involves manual delineation to measure the rectus femoris cross-sectional area (RFCSA), which is a subjective, time-consuming, and laborious task that requires significant expertise. We aimed to develop and evaluate an AI tool that performs automated recognition and measurement of RFCSA to support non-expert operators in measurement of the RFCSA using muscle ultrasound. Twenty patients were recruited between Feb 2023 and July 2023 and were randomized sequentially to operators using AI (n = 10) or non-AI (n = 10). Muscle loss during ICU stay was similar for both methods: 26 ± 15% for AI and 23 ± 11% for the non-AI, respectively (p = 0.13). In total 59 ultrasound examinations were carried out (30 without AI and 29 with AI). When assisted by our AI tool, the operators showed less variability between measurements with higher intraclass correlation coefficients (ICCs 0.999 95% CI 0.998-0.999 vs. 0.982 95% CI 0.962-0.993) and lower Bland Altman limits of agreement (± 1.9% vs. ± 6.6%) compared to not using the AI tool. The time spent on scans reduced significantly from a median of 19.6 min (IQR 16.9-21.7) to 9.4 min (IQR 7.2-11.7) compared to when using the AI tool (p < 0.001). AI-assisted muscle ultrasound removes the need for manual tracing, increases reproducibility and saves time. This system may aid monitoring muscle size in ICU patients assisting rehabilitation programmes.
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Affiliation(s)
- Phung Tran Huy Nhat
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK.
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
| | - Nguyen Van Hao
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Lam Minh Yen
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | - Hamideh Kerdegari
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK
| | - Le Thanh Phuong
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Vo Tan Hoang
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | | | | | - Reza Razavi
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK
| | - Sophie Yacoub
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | | | - Andrew P King
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK
| | - Louise Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | | | - Alberto Gomez
- School of Biomedical Engineering Imaging Sciences, King's College London, London, UK
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Chen L, Zhou H, Gong Y, Tang Y, Su H, Jin Z, Chen G, Tong P. How Do Muscle Function and Quality Affect the Progression of KOA? A Narrative Review. Orthop Surg 2024; 16:802-810. [PMID: 38438160 PMCID: PMC10984828 DOI: 10.1111/os.14022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/26/2024] [Accepted: 02/03/2024] [Indexed: 03/06/2024] Open
Abstract
Knee osteoarthritis (KOA) is widely recognized as a chronic joint disease characterized by degeneration of knee cartilage and subsequent bone hyperplasia. However, it is important to acknowledge the significant role of muscles in the development and progression of KOA. Muscle function (MF) and muscle quality (MQ) are key factors in understanding the involvement of muscles in KOA. Quantitative indices such as muscle mass, muscle strength, muscle cross-sectional area, muscle thickness, and muscle fatigue are crucial in assessing MF and MQ. Despite the growing interest in KOA, there is a scarcity of studies investigating the relationship between muscles and this condition. This review aims to examine the commonly used indices and measurement methods for assessing MF and MQ in clinical settings, while also exploring the association between muscles and KOA. Furthermore, this article highlights the importance of restoring MF and MQ to enhance symptom management and improve the quality of life for patients with KOA.
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Affiliation(s)
- Lei Chen
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Haojing Zhou
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Yichen Gong
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Yi Tang
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Hai Su
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Zhaokai Jin
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Guoqian Chen
- Department of Orthopaedics and TraumatologyThe First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Peijian Tong
- Department of Orthopaedics and TraumatologyThe First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouChina
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Ben-Menachem E, Ashes C, Lepar G, Deacon J, Glavan N, Molan V, Watson A. Smaller rectus femoris size measured by ultrasound is associated with poorer outcomes after cardiac surgery. J Thorac Cardiovasc Surg 2024; 167:1115-1122.e5. [PMID: 35995604 DOI: 10.1016/j.jtcvs.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 06/17/2022] [Accepted: 07/03/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE We sought to evaluate the association of low rectus femoris cross-sectional area (RFCSA) with hospital length of stay and poorer outcomes in patients undergoing cardiac surgery. METHODS A single right-leg RFCSA was measured with ultrasound preoperatively and baseline characteristics, clinical data, and outcomes recorded. Patients were categorized as low rectus femoris muscle size (lowRF) or normal rectus femoris muscle size (normalRF), if they were in the lowest quartile or not, respectively. All analyses were performed on both body surface area (BSA)- and sex-adjusted RFCSA. RESULTS One hundred eight-four patients had a RFCSA measured with a mean of 5.01 cm2 (1.41 cm2), and range of 0.71 to 8.77 cm2. When analyzing the BSA-adjusted RFCSA, we found the lowRF group had a longer hospital stay, 11.0 days [7.0-16.3] versus 8.0 days [6.0-10.0] for the normalRF group (P < .001), and a greater proportion of extended hospital stay (≥18.5 days) of 19.6% compared with 6.2% (P = .010). When the RFCSA was adjusted for sex, the lowRF group had a greater length of hospital stay, 9.0 days [7.0-14.5] versus 8.0 days [6.0-11.0] (P = .049). In both the BSA- and sex-adjusted RFCSA, the lowRF group suffered greater morbidity and were more likely discharged to a destination other than home. In multivariate analyses adjusting for European System for Cardiac Operative Risk Evaluation II, BSA-adjusted lowRF but not sex-adjusted lowRF was independently associated with log-transformed hospital length of stay. LowRF was not independently associated with increased major morbidity and death for both BSA and sex-adjusted RFCSA. CONCLUSIONS Low RFCSA has a significant association with increased hospital length of stay, morbidity, and nonhome discharge in patients undergoing cardiac procedures. TRIAL REGISTRY NUMBER ACTRN12620000678998.
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Affiliation(s)
- Erez Ben-Menachem
- Department of Anaesthesia, St Vincent's Hospital, Sydney, Australia; Notre Dame School of Medicine, Sydney, Australia; St Vincent's Clinical School, University of New South Wales Sydney, Sydney, Australia.
| | - Catherine Ashes
- Department of Anaesthesia, St Vincent's Hospital, Sydney, Australia; St Vincent's Clinical School, University of New South Wales Sydney, Sydney, Australia
| | - Gila Lepar
- Department of Anaesthesia, St Vincent's Hospital, Sydney, Australia
| | - James Deacon
- Department of Anaesthesia, St Vincent's Hospital, Sydney, Australia; St Vincent's Clinical School, University of New South Wales Sydney, Sydney, Australia
| | - Nicole Glavan
- Department of Anaesthesia, St Vincent's Hospital, Sydney, Australia
| | - Veronique Molan
- Department of Anaesthesia, St Vincent's Hospital, Sydney, Australia
| | - Alasdair Watson
- St Vincent's Clinical School, University of New South Wales Sydney, Sydney, Australia; Department of Cardiothoracic Surgery, St Vincent's Hospital, Sydney, Australia
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Liu W, Wu HD, Ling YT, Shea QTK, Nazari V, Zheng YP, Ma CZH. Reliability and validity of assessing lower-limb muscle architecture of patients with cerebral palsy (CP) using ultrasound: A systematic review. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1212-1222. [PMID: 37334435 DOI: 10.1002/jcu.23498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023]
Abstract
AIMS To investigate the reliability, validity, and level of evidence of applying ultrasound in assessing the lower-limb muscles of patients with cerebral palsy (CP). METHOD Publications in Medline, PubMed, Web of Science, and Embase were searched on May 10, 2023, to identify and examine relevant studies investigating the reliability/validity of ultrasound in evaluating the architecture of CP lower-limb muscles systematically, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines. RESULTS Out of 897 records, 9 publications with 111 CP participants aged 3.8-17.0 years were included (8 focused on intra-rater and inter-rater reliability, 2 focused on validity, and 4 were with high quality). The ultrasound-based measurements of muscle thickness (intra-rater only), muscle length, cross-sectional area, muscle volume, fascicle length, and pennation angle showed high reliability, with the majority of intraclass correlation coefficient (ICC) values being larger than 0.9. Moderate-to-good correlations between ultrasound and magnetic resonance imaging measurements existed in muscle thickness and cross-sectional area (0.62 ≤ ICC ≤ 0.82). INTERPRETATION Generally, ultrasound has high reliability and validity in evaluating the CP muscle architecture, but this is mainly supported by moderate and limited levels of evidence. More high-quality future studies are needed.
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Affiliation(s)
- Wei Liu
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Department of Prosthetic and Orthotic Engineering, School of Rehabilitation, Kunming Medical University, Kunming, China
| | - Hui Dong Wu
- Department of Prosthetic and Orthotic Engineering, School of Rehabilitation, Kunming Medical University, Kunming, China
| | - Yan To Ling
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Queenie Tsung Kwan Shea
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Vaheh Nazari
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Christina Zong-Hao Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China
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Kaur G, Lalwani R, Khan MM, Athavale SA. Muscle Architecture of Leg Muscles: Functional and Clinical Significance. Acta Med Litu 2023; 30:194-205. [PMID: 38516510 PMCID: PMC10952421 DOI: 10.15388/amed.2023.30.2.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/24/2023] [Accepted: 08/30/2023] [Indexed: 03/23/2024] Open
Abstract
Background Architectural properties of the muscles are the prime predictors of functional attributes and force-generating capacity of the muscles. This data is vital for musculoskeletal modelling and selecting the appropriate muscle-tendon units for tendon transfers.Cadaveric data for architectural properties is the gold standard and primary input for musculoskeletal modelling. There is a paucity of these datasets, especially in the leg muscles. Methods Sixty muscles of the anterior and lateral compartments from twelve formalin-fixed lower limbs were studied for gross architecture, including the peculiar fibre arrangements and architectural properties of muscles. Muscle weight, muscle length, fibre length, pennation angle and sarcomere length were measured. Normalised fibre length, fibre length to muscle length ratio (FL/ML ratio), and the physiological cross-sectional area (PCSA) were calculated from the obtained data. Results Muscles displayed a combination of architectural strategies and were partly fusiform and partly pennate. The tibialis anterior and peroneus longus were the heaviest muscles in their respective compartments and showed more extensive origin from the nearby deep facial sheets.Long fibre length and less pennation angle were seen in muscles of the extensor compartment. Potential muscle power was highest in the tibialis anterior and peroneus longus and least in the extensor hallucis longus. Conclusions Arching of the foot and eversion are peculiar to humans and recent in evolution. Due to the functional demand of maintaining the medial longitudinal arch and eversion, the tibialis anterior and peroneus longus have more muscle weight and larger physiological cross-sectional area and are potentially more powerful.Extensor compartment muscles were architecturally more suited for excursions because of the long fibre length and less pennation angle.This study contributes baseline normative data for musculoskeletal modelling platforms and simulation tools - an emerging area in biomechanics and tendon transfers.
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Affiliation(s)
| | - Rekha Lalwani
- All India Institute of Medical Sciences, Bhopal, India
| | - Manal M. Khan
- All India Institute of Medical Sciences, Bhopal, India
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De Rosa S, Umbrello M, Pelosi P, Battaglini D. Update on Lean Body Mass Diagnostic Assessment in Critical Illness. Diagnostics (Basel) 2023; 13:diagnostics13050888. [PMID: 36900032 PMCID: PMC10000858 DOI: 10.3390/diagnostics13050888] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Acute critical illnesses can alter vital functions with profound biological, biochemical, metabolic, and functional modifications. Despite etiology, patient's nutritional status is pivotal to guide metabolic support. The assessment of nutritional status remains complex and not completely elucidated. Loss of lean body mass is a clear marker of malnutrition; however, the question of how to investigate it still remains unanswered. Several tools have been implemented to measure lean body mass, including a computed tomography scan, ultrasound, and bioelectrical impedance analysis, although such methods unfortunately require validation. A lack of uniform bedside measurement tools could impact the nutrition outcome. Metabolic assessment, nutritional status, and nutritional risk have a pivotal role in critical care. Therefore, knowledge about the methods used to assess lean body mass in critical illnesses is increasingly required. The aim of the present review is to update the scientific evidence regarding lean body mass diagnostic assessment in critical illness to provide the diagnostic key points for metabolic and nutritional support.
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Affiliation(s)
- Silvia De Rosa
- Centre for Medical Sciences—CISMed, University of Trento, Via S. Maria Maddalena 1, 38122 Trento, Italy
- Anesthesia and Intensive Care, Santa Chiara Regional Hospital, APSS, 38123 Trento, Italy
| | - Michele Umbrello
- S.C. Anestesia e Rianimazione II, Ospedale San Carlo Borromeo, ASST dei Santi Paolo e Carlo, 20142 Milano, Italy
| | - Paolo Pelosi
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università degli Studi di Genova, 16132 Genova, Italy
| | - Denise Battaglini
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Correspondence:
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Wohlann T, Warneke K, Hillebrecht M, Petersmann A, Ferrauti A, Schiemann S. Effects of daily static stretch training over 6 weeks on maximal strength, muscle thickness, contraction properties, and flexibility. Front Sports Act Living 2023; 5:1139065. [PMID: 37139297 PMCID: PMC10149921 DOI: 10.3389/fspor.2023.1139065] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/06/2023] [Indexed: 05/05/2023] Open
Abstract
Purpose Static stretch training (SST) with long stretching durations seems to be sufficient to increase flexibility, maximum strength (MSt) and muscle thickness (MTh). However, changes in contraction properties and effects on muscle damage remain unclear. Consequently, the objective of the study was to investigate the effects of a 6-week self-performed SST on MSt, MTh, contractile properties, flexibility, and acute response of creatine kinase (CK) 3 days after SST. Methods Forty-four participants were divided into a control (CG, n = 22) and an intervention group (IG, n = 22), who performed a daily SST for 5 min for the lower limb muscle group. While isometric MSt was measured in leg press, MTh was examined via sonography and flexibility by functional tests. Muscle stiffness and contraction time were measured by tensiomyography on the rectus femoris. Additionally, capillary blood samples were taken in the pretest and in the first 3 days after starting SST to measure CK. Results A significant increase was found for MSt (p < 0.001, η 2 = 0.195) and flexibility in all functional tests (p < 0.001, η 2 > 0.310). Scheffé post hoc test did not show significant differences between the rectus femoris muscle inter- and intragroup comparisons for MTh nor for muscle stiffness and contraction time (p > 0.05, η 2 < 0.100). Moreover, CK was not significantly different between IG and CG with p > 0.05, η 2 = 0.032. Discussion In conclusion, the increase in MSt cannot be exclusively explained by muscular hypertrophy or the increased CK-related repair mechanism after acute stretching. Rather, neuronal adaptations have to be considered. Furthermore, daily 5-min SST over 6 weeks does not seem sufficient to change muscle stiffness or contraction time. Increases in flexibility tests could be attributed to a stretch-induced change in the muscle-tendon complex.
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Affiliation(s)
- Tim Wohlann
- Institute for Exercise, Sport and Health, Leuphana University, Lüneburg, Germany
- Correspondence: Tim Wohlann
| | - Konstantin Warneke
- Institute for Exercise, Sport and Health, Leuphana University, Lüneburg, Germany
| | - Martin Hillebrecht
- University Sports Centre, Carl von University of Oldenburg, Oldenburg, Germany
| | - Astrid Petersmann
- University Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Oldenburg, Oldenburg, Germany
- Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | | | - Stephan Schiemann
- Institute for Exercise, Sport and Health, Leuphana University, Lüneburg, Germany
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Paolo F, Valentina DG, Silvia C, Tommaso P, Elena C, Martin D, Marini John J, Davide C. The possible predictive value of muscle ultrasound in the diagnosis of ICUAW in long-term critically ill patients. J Crit Care 2022; 71:154104. [DOI: 10.1016/j.jcrc.2022.154104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/09/2022] [Accepted: 06/20/2022] [Indexed: 12/25/2022]
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Canever JB, Lanferdini FJ, de Moura BM, Diefenthaeler F, Lima KMME. Influence of subcutaneous adipose thickness and dominance on reliability of quadriceps muscle quality in healthy young individuals. J Ultrasound 2022; 25:513-519. [PMID: 34519999 PMCID: PMC9402827 DOI: 10.1007/s40477-021-00615-6] [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: 05/06/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Echo intensity (EI) can be useful to check muscle quality and has been widely used to identify tissue damage. In the clinical and sports context, it has been used to identify metabolic disorders and training muscle performance. OBJECTIVE To determine whether subcutaneous adipose thickness (SAT) influences the inter-session EI reliability of the quadriceps femoris and whether EI is influenced by dominance in young healthy subjects. DESIGN All procedures were approved by the local Institutional Research Ethics Committee (project number 2.620.204). This is a cross-sectional study where 19 healthy young individuals volunteered. METHOD The individuals were assessed at two time points by an experienced examiner. Imaging of the rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM) muscles were performed bilaterally by ultrasonography. EI and SAT analysis was performed using ImageJ®software. RESULTS/FINDINGS Inter-session intraclass correlation coefficient (ICC) for EImeasured showed moderate reliability for RF (R = 0.578; P = 0.038) and VL (R = 0.735; P = 0.004) and low for VM (R = 0.402; P = 0.142). When corrected by SAT, inter-session (EIcorrected), ICC values showed good reliability for RF (R = 0.826; P < 0.001) and VM (R = 0.765; P = 0.002) and excellent for VL (R = 0.909; P < 0.001). Considering inter-side reliability, Student's paired t-test demonstrated no difference for EImeasured (P > 0.283), EIcorrected (P > 0.127), and SAT (P > 0.356). CONCLUSIONS SAT influenced the inter-session reliability values of EI in all muscles evaluated. Although they showed similarity, EI values were not influenced by dominance in young healthy subjects.
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Affiliation(s)
- Jaquelini Betta Canever
- Department of Health Sciences, Federal University of Santa Catarina (UFSC), Campus Jardim das Avenidas, Rod. Governador Jorge Lacerda, 3201, Araranguá, SC 88906-072 Brazil
| | - Fábio Juner Lanferdini
- Department of Physical Education, Biomechanics Laboratory (BIOMEC), Sports Center, Federal University of Santa Catarina (UFSC), Florianopolis, SC 88036-800 Brazil
| | - Bruno Monteiro de Moura
- Department of Physical Education, Biomechanics Laboratory (BIOMEC), Sports Center, Federal University of Santa Catarina (UFSC), Florianopolis, SC 88036-800 Brazil
| | - Fernando Diefenthaeler
- Department of Physical Education, Biomechanics Laboratory (BIOMEC), Sports Center, Federal University of Santa Catarina (UFSC), Florianopolis, SC 88036-800 Brazil
| | - Kelly Mônica Marinho e Lima
- Department of Health Sciences, Federal University of Santa Catarina (UFSC), Campus Jardim das Avenidas, Rod. Governador Jorge Lacerda, 3201, Araranguá, SC 88906-072 Brazil
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Alharthi S, Meakin J, Wright C, Fulford J. The impact of altering participant MRI scanning position on back muscle volume measurements. BJR Open 2022; 4:20210051. [PMID: 36105428 PMCID: PMC9459950 DOI: 10.1259/bjro.20210051] [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] [Received: 08/04/2021] [Revised: 02/17/2022] [Accepted: 03/20/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives Muscle volume may reflect both strength and functional capability and hence is a parameter often measured to assess the effect of various interventions. The aim of the current study was to determine the sensitivity of muscle volume calculations on participant postural position and hence gauge possible errors that may arise in longitudinal studies, especially those where an intervention leads to large muscle changes and potentially the degree of spinal curvature. Methods Twenty healthy participants (22-49 years, 10 male and 10 female), were recruited and MRI images acquired with them lying in four different positions; neutral spine (P1), decreased lordosis (P2), increased lordosis (P3) and neutral spine repeated (P4). Images were analysed in Simpleware ScanIP, and lumbar muscle volume and Cobb's angle, as an indicator of spine curvature, determined. Results After comparing volume determinations, no statistically significant differences were found for P1 - P2 and P1 - P4, whereas significant changes were determined for P2 - P3 and P1 - P3. P2 and P3 represent the two extremes of spinal curvature with a difference in Cobb's angle of 17°. However, the mean difference between volume determinations was only 29 cm3. These results suggest the differences in muscle volume determinations are generally greater with increasing differences in curvature between measurements, but that overall the effects are small. Conclusions Thus, generally, spinal muscle volume determinations are robust in terms of participant positioning. Advances in knowledge Differences in muscle volume calculations appear to become larger the greater the difference in spinal curvature between positions. Thus, spinal curvature should not have a major impact on the results of spinal muscle volume determinations following interventions in longitudinal studies.
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Affiliation(s)
| | - Jude Meakin
- Physics and Astronomy Department, University of Exeter, Exeter, United Kingdom
| | - Chris Wright
- Medical Imaging Department, Medical School, University of Exeter, Exeter, United Kingdom
| | - Jonathan Fulford
- NIHR Exeter Clinical Research Facility, University of Exeter, Exeter, United Kingdom
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Abiko T, Ohmae K, Murata S, Shiraiwa K, Horie J. Reliability of muscle thickness and echo intensity measurements of the quadriceps: A novice examiner. J Bodyw Mov Ther 2022; 31:164-168. [DOI: 10.1016/j.jbmt.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 12/06/2021] [Accepted: 03/14/2022] [Indexed: 11/17/2022]
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Leitão BFM, Franchi MV, da Matta TT. Letter to the editor concerning the article "The role of exercise selection in regional Muscle Hypertrophy: A randomized controlled trial" by Zabaleta-Korta et al. (2021). J Sports Sci 2021; 40:655-657. [PMID: 34930094 DOI: 10.1080/02640414.2021.2013596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Thiago Torres da Matta
- Laboratório de Biomecânica Muscular, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Palmieri-Smith RM, Garcia SA, Rodriguez KM, Krishnan C. Electrically Evoked Torque at Rest is Strongly Related to Quadriceps Muscle Size in Individuals with Anterior Cruciate Ligament Reconstruction. MEASUREMENT IN PHYSICAL EDUCATION AND EXERCISE SCIENCE 2021; 26:199-206. [PMID: 36060895 PMCID: PMC9439261 DOI: 10.1080/1091367x.2021.2005602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Electrically evoked torque at rest (i.e., the torque produced from supramaximal stimul applied to a resting muscle) has been shown to be related to muscle size in healthy adults, but this relationship has not been evaluated in pathological populations where atrophy is present. This study aimed to evaluate the relationship between the electrically evoked torque at rest and vastus lateralis cross-sectional area (CSA) in individuals with anterior cruciate ligament (ACL) reconstruction. Eighteen individuals with ACL reconstruction participated. Quadriceps electrically evoked torque at rest was elicited bilaterally via sex-specific, standardized supramaximal triplet stimulations. Vastus lateralis CSA was measured at 50% of thigh length using ultrasound. Pearson's r and partial correlations were used to evaluate associations between outcomes. Evoked torque at rest was positively associated with vastus lateralis CSA in the ACL reconstructed limb (r=0.865, partial r=0.816, P<0.01), non-reconstructed limb (r=0.628, partial r=0.575, P<0.05), and side-to-side ratios (r=0.670, partial r=0.659, P<0.01). These results indicate that electrically evoked torque at rest may indirectly assess side-to-side differences in quadriceps muscle size after ACL reconstruction.
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Affiliation(s)
- Riann M. Palmieri-Smith
- School of Kinesiology, University of Michigan; Ann Arbor, MI
- Orthopedic Rehabilitation and Biomechanics Laboratory, University of Michigan, Ann Arbor, MI
- Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor, MI
| | - Steven A Garcia
- Orthopedic Rehabilitation and Biomechanics Laboratory, University of Michigan, Ann Arbor, MI
- Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor, MI
| | - Kazandra M. Rodriguez
- Orthopedic Rehabilitation and Biomechanics Laboratory, University of Michigan, Ann Arbor, MI
- Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor, MI
| | - Chandramouli Krishnan
- Department of Physical Medicine and Rehabilitation, University of Michigan; Ann Arbor, MI
- Neuromuscular and Rehabilitation Robotics Laboratory, University of Michigan; Ann Arbor, MI
- Robotics Institute, University of Michigan, Ann Arbor, MI
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14
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Rotator cuff strength is not augmented by blood flow restriction training. Phys Ther Sport 2021; 52:305-311. [PMID: 34742029 DOI: 10.1016/j.ptsp.2021.10.013] [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] [Received: 07/03/2021] [Revised: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Blood flow restriction (BFR) training utilizes a tourniquet applied to the upper or lower extremities (UE or LE) to occlude blood flow while exercising. BFR training may help augment strength in muscles that are proximal to BFR cuff application. However, prior studies have failed to demonstrate augmented strength gains in the rotator cuff when the tourniquet is applied to the UE. The purpose of this study was to evaluate if a protocol consisting of LE exercises, performed with BFR, followed by rotator cuff exercises was superior in augmenting strength, and cross-sectional area (CSA) of the rectus femoris, in untrained subjects when compared to a non-BFR training group. DESIGN Randomized controlled trial. SETTING University. PARTICIPANTS Thirty-five subjects (mean age 25.8 ± 1.6 y) randomized to a BFR or non-BFR group. MAIN OUTCOME MEASURES Muscular strength measured via hand held dynamometer and the CSA of the dominant rectus femoris was measured by diagnostic ultrasound. RESULTS Both groups experienced significant gains in LE and rotator cuff strength. Strength increased in the BFR group by 11.6% for the supraspinatus, 34.1% for shoulder ER, 23.4% for the quadriceps, and 17.1% for the hamstrings. Strength increased in the non-BFR group by 7.3% for the supraspinatus, 20% for shoulder ER, 12.8% for the quadriceps, and 10.7% for the hamstrings. However, there were no differences in strength gains between groups. Neither group experienced a significant increase in CSA for the rectus femoris. CONCLUSION The BFR protocol used in this study did not augment strength for the rotator cuff in subjects who also performed LE exercises under occlusion.
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El‐Ansary D, Marshall CJ, Farragher J, Annoni R, Schwank A, McFarlane J, Bryant A, Han J, Webster M, Zito G, Parry S, Pranata A. Architectural anatomy of the quadriceps and the relationship with muscle strength: An observational study utilising real-time ultrasound in healthy adults. J Anat 2021; 239:847-855. [PMID: 34458993 PMCID: PMC8450473 DOI: 10.1111/joa.13497] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 01/26/2021] [Accepted: 06/09/2021] [Indexed: 11/27/2022] Open
Abstract
Quadriceps atrophy and morphological change is a known phenomenon that can impact significantly on strength and functional performance in patients with acute or chronic presentations conditions. Real-time ultrasound (RTUS) imaging is a noninvasive valid and reliable method of quantifying quadriceps muscle anatomy and architecture. To date, there is a paucity of normative data on the architectural properties of superficial and deep components of the quadriceps muscle group to inform assessment and evaluation of intervention programs. The aims of this study were to (1) quantify the anatomical architectural properties of the quadriceps muscle group (rectus femoris, vastus intermedius, and vastus lateralis) using RTUS in healthy older adults and (2) to determine the relationship between RTUS muscle parameters and measures of quadriceps muscle strength. Thirty middle aged to older males and females (age range 55-79 years; mean age =59.9 ± 7.08 years) were recruited. Quadriceps muscle thickness, cross-sectional area, pennation angle, and echogenicity were measured using RTUS. Quadriceps strength was measured using hand-held dynamometry. For the RTUS-derived quadriceps morphological data, rectus femoris mean results; circumference 9.3 cm; CSA 4.6 cm2 ; thickness 1.5 cm; echogenicity 100.2 pixels. Vastus intermedius mean results; thickness 1.8 cm; echogenicity 99.1 pixels. Vastus lateralis thickness 1.9 cm; pennation angle 17.3°; fascicle length 7.0 cm. Quadriceps force was significantly correlated only with rectus femoris circumference (r = 0.48, p = 0.007), RF echogenicity (r = 0.38, p = 0.037), VI echogenicity (r = 0.43, p = 0.018), and VL fascicle length (r = 0.43, p = 0.019). Quadriceps force was best predicted by a three-variable model (adjusted R2 = 0.46, p < 0.001) which included rectus femoris echogenicity (B = 0.43, p = 0.005), vastus lateralis fascicle length (B = 0.33, p = 0.025) and rectus femoris circumference (B = 0.31, p = 0.041). Thus respectively, rectus femoris echogenicity explains 43%, vastus lateralis fascicle length explains 33% and rectus femoris circumference explains 31% of the variance of quadriceps force. The study findings suggest that RTUS measures were reliable and further research is warranted to establish whether these could be used as surrogate measures for quadriceps strength in adults to inform exercise and rehabilitation programs.
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Affiliation(s)
- Doa El‐Ansary
- Department of Nursing and Allied Health, School of Health SciencesSwinburne University of TechnologyHawthornVicAustralia
- Department of SurgerySchool of MedicineUniversity of MelbourneParkvilleVicAustralia
- Faculty of Physiotherapy and Sports RehabilitationShanghai University of SportShanghaiChina
| | - Charlotte J. Marshall
- Department of Nursing and Allied Health, School of Health SciencesSwinburne University of TechnologyHawthornVicAustralia
| | - Joshua Farragher
- Department of Nursing and Allied Health, School of Health SciencesSwinburne University of TechnologyHawthornVicAustralia
- Department of PhysiotherapyThe University of MelbourneSchool of Health SciencesMelbourneVicAustralia
| | - Raquel Annoni
- Department of Applied PhysiotherapyFederal University of Triangulo MineiroUberabaMinas GeraisBrazil
| | - Ariane Schwank
- Institute for PhysiotherapyKantonsspital WinterhurWinterhurSwitzerland
| | | | - Adam Bryant
- Department of PhysiotherapyThe University of MelbourneSchool of Health SciencesMelbourneVicAustralia
| | - Jia Han
- Department of Nursing and Allied Health, School of Health SciencesSwinburne University of TechnologyHawthornVicAustralia
- Faculty of Physiotherapy and Sports RehabilitationShanghai University of SportShanghaiChina
- Research Institute for Sport and ExerciseUniversity of CanberraCanberraACTAustralia
| | - Marilyn Webster
- Department of PhysiotherapyThe University of MelbourneSchool of Health SciencesMelbourneVicAustralia
| | - Guy Zito
- Department of PhysiotherapyThe University of MelbourneSchool of Health SciencesMelbourneVicAustralia
| | - Selina Parry
- Department of PhysiotherapyThe University of MelbourneSchool of Health SciencesMelbourneVicAustralia
| | - Adrian Pranata
- Department of Nursing and Allied Health, School of Health SciencesSwinburne University of TechnologyHawthornVicAustralia
- Faculty of Physiotherapy and Sports RehabilitationShanghai University of SportShanghaiChina
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Reliability of knee extensor neuromuscular structure and function and functional tests' performance. J Bodyw Mov Ther 2021; 27:584-590. [PMID: 34391291 DOI: 10.1016/j.jbmt.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/13/2021] [Accepted: 05/07/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the intra and inter-rater and inter-analyzer reliability of neuromuscular variables and functional tests. METHODS Cross-sectional crossover design. Two independent raters and analyzers evaluated twenty-two healthy subjects. Knee-extensor strength was assessed from three maximal voluntary isometric contractions. Muscle activation was obtained from the vastus lateralis (VL), rectus femoris (RF), and vastus medialis (VM) muscles. VL and RF muscles' architecture [fascicle length (FL), pennation angle (PA), muscle thickness (MT)] was obtained at rest by ultrasound. The time from five sit-to-stand (STS) trials, and the distance from the 6-min walk test (6MWT) were obtained. Intraclass correlation coefficient was determined and classified as strong (r = 0.75-1.00), moderate (r = 0.40-0.74), and weak (r < 0.40). RESULTS Strong intra-rater reliability values were observed for strength (r = 0.97), muscle activation [VL (r = 0.91); RF (r = 0.92); VM (r = 0.80)], VL [FL (r = 0.90); PA (r = 0.94); MT (r = 0.99)] and RF [MT (r = 0.85)] muscle architecture, STS (r = 0.95), and 6MWT (r = 0.98). Inter-rater reliability also presented strong values for strength (r = 0.97), muscle activation [VL (r = 0.94); RF (r = 0.79); VM (r = 0.78)], muscle architecture VL [PA (r = 0.81) and MT (r = 0.88)] and RF [MT (r = 0.80)], STS (r = 0.93), and 6MWT (r = 0.98). A moderate correlation VL muscle architecture [FL (r = 0.69)]. Inter-analyzer muscle architecture reliability presented strong VL [FL (r = 0.77); PA (r = 0.76); MT (r = 0.91)] and RF [MT (r = 0.99)]. CONCLUSION The high intra and inter-rater and inter-analyzer reliability values for most variables is evidence that they can be used for clinical evaluation. Muscle architecture might need a longer training period by different raters and analyzers to increase reliability.
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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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Geneen LJ, Kinsella J, Zanotto T, Naish PF, Mercer TH. Validity and reliability of high-resolution ultrasound imaging for the assessment of regional body composition in stage 5 chronic kidney disease patients undergoing continuous ambulatory peritoneal dialysis. Perit Dial Int 2021; 42:57-64. [PMID: 33783265 DOI: 10.1177/08968608211002384] [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] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Accurate measurement of muscle mass is an important research and clinical tool. High-resolution ultrasound (US) has shown potential as a method to assess muscle and fat mass at specific anatomical sites. However, there is limited evidence for the reliability of US to measure muscle size in patients receiving continuous ambulatory peritoneal dialysis (CAPD). Therefore, we examined the validity and reliability of an US method compared to a gold standard comparison for the assessment of a quadriceps muscle in this clinical population. METHODS Twenty people receiving CAPD (mean age = 56.5 ± 16.7 years) at a single dialysis unit were assessed on two occasions, 7 days apart. Measures of the mid-thigh, such as vastus lateralis (VL) anatomical cross-sectional area (ACSA), VL muscle thickness and subcutaneous fat thickness were compared for US reliability and validity compared to magnetic resonance imaging (MRI) measures. RESULTS US had high validity against gold standard MRI measures, with intraclass correlation coefficients (ICC) equating to VL ACSA of 0.95, VL thickness of 0.99 and fat thickness of 0.98. The US measurements also exhibited high intra-rater reliability (ICCs: VL thickness = 0.98, total muscle thickness = 0.97 and fat thickness = 0.99) in measuring body composition at the mid-VL site in the study population. CONCLUSIONS Valid assessment of regional body composition can be achieved via high-resolution US in patients receiving CAPD. The validity and reliability of the US in repeated measures (in comparison to the gold standard MRI) warrant further investigation in the wider chronic kidney disease population.
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Affiliation(s)
- Louise J Geneen
- Centre of Health, Activity and Rehabilitation Research, School of Health Sciences, 3122Queen Margaret University, Edinburgh, UK
| | - Jodie Kinsella
- Department of Renal Medicine, 105646University of North Staffordshire, Stoke-on-Trent, UK
| | - Tobia Zanotto
- Centre of Health, Activity and Rehabilitation Research, School of Health Sciences, 3122Queen Margaret University, Edinburgh, UK
| | - Patrick F Naish
- Department of Renal Medicine, 105646University of North Staffordshire, Stoke-on-Trent, UK
| | - Thomas H Mercer
- Centre of Health, Activity and Rehabilitation Research, School of Health Sciences, 3122Queen Margaret University, Edinburgh, UK
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Nakanishi N, Okura K, Okamura M, Nawata K, Shinohara A, Tanaka K, Katayama S. Measuring and Monitoring Skeletal Muscle Mass after Stroke: A Review of Current Methods and Clinical Applications. J Stroke Cerebrovasc Dis 2021; 30:105736. [PMID: 33756264 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105736] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/16/2021] [Accepted: 02/28/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Muscle mass at admission is important to survive stroke, and stroke-induced sarcopenia is a serious problem because of its poor prognosis. Muscle mass measurement and monitoring are essential for appropriate rehabilitation and nutrition management. However, few reviews are available about the muscle mass measurement and monitoring after stroke. MATERIAL AND METHODS Several methods are used to assess skeletal muscle mass in stroke, such as computed tomography (CT), ultrasound, bioelectrical impedance analysis, dual-energy X-ray absorptiometry, biomarkers, and anthropometrics. We summarized the current methods and clinical applications in stroke. RESULTS In stroke, a head CT is used to estimate muscle mass by measuring the temporal muscle. However, it can be conducted retrospectively due to radiation exposure. After stroke, limb muscle atrophy and diaphragm dysfunction are observed using ultrasound. However, ultrasound requires an understanding of the methods and skill. A bioelectrical impedance analysis can be used to assess muscle mass in patients after a stroke unless they have dynamic fluid changes. Dual-energy X-ray absorptiometry is used for follow-up after hospital discharge. Urinary titin N-fragment and serum C-terminal agrin fragment reflect muscle atrophy after stroke. Anthropometrics may be useful with limited resources. CONCLUSIONS We summarized the features of each measurement and proved the recent evidence to properly measure and monitor skeletal muscle mass after stroke.
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Affiliation(s)
- Nobuto Nakanishi
- Emergency and Critical Care Medicine, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
| | - Kazuki Okura
- Department of Rehabilitation, Akita University Hospital, 44-2 Hasunuma, Aza, Hiroomote, Akita 010-8543, Japan
| | - Masatsugu Okamura
- Department of Rehabilitation, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan
| | - Keishi Nawata
- Department of Rehabilitation, University Hospital of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, Fukuoka 807-8556, Japan
| | - Ayato Shinohara
- Department of Rehabilitation, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan
| | - Kohei Tanaka
- Department of Rehabilitation Medicine, Osaka Police Hospital, 10-31 Kitayama, Tennouji, Osaka 543-0035, Japan
| | - Sho Katayama
- Department of Rehabilitation Medicine, Okayama University Hospital, 2-5-1 shikata, Kitaku, Okayama 700-8558, Japan
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Wilkinson TJ, Gore EF, Vadaszy N, Nixon DGD, Watson EL, Smith AC. Utility of Ultrasound as a Valid and Accurate Diagnostic Tool for Sarcopenia: Sex-Specific Cutoff Values in Chronic Kidney Disease. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:457-467. [PMID: 32780522 DOI: 10.1002/jum.15421] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/11/2020] [Accepted: 06/19/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Patients with chronic kidney disease (CKD) have aberrant changes in body composition, including low skeletal muscle mass, a feature of "sarcopenia." The measurement of the (quadriceps) rectus femoris (RF) cross-sectional area (CSA) is widely used as a marker of muscle size. Cutoff values are needed to help discriminate the condition of an individual's muscle (eg, presence of sarcopenia) quickly and accurately. This could help distinguish those at greater risk and aid in targeted treatment programs. METHODS Transverse images of the RF were obtained by B-mode 2-dimensional ultrasound imaging. Sarcopenic levels of muscle mass were defined by established criteria (1, appendicular skeletal muscle mass [ASM]; 2, ASM/height2 ; and 3, ASM/body mass index) based on the ASM and total muscle mass measured by a bioelectrical impedance analysis. The discriminative power of RF-CSA was assessed by receiver operating characteristic curves, and optimal cutoffs were determined by the maximum Youden index (J). RESULTS One hundred thirteen patients with CKD (mean age [SD], 62.0 [14.1] years; 48% male; estimated glomerular filtration rate, 38.0 [21.5] mL/min/1.73m2 ) were included. The RF-CSA was a moderate predictor of ASM (R2 = 0.426; P < .001) and total muscle mass (R2 = 0.438; P < .001). With a maximum J of 0.47, in male patients, an RF-CSA cutoff of less than 8.9 cm2 was deemed an appropriate cutoff for detecting sarcopenic muscle mass. In female patients, an RF-CSA cutoff of less than 5.7 cm2 was calculated on the basis of ASM/height2 (J = 0.71). CONCLUSIONS Ultrasound may provide a low-cost and simple means to diagnose sarcopenia in patients with CKD. This would allow for early management and timely intervention to help mitigate the effects in this group.
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Affiliation(s)
| | - Eleanor F Gore
- Departments of Health Sciences, University of Leicester, Leicester, UK
| | - Noemi Vadaszy
- Departments of Health Sciences, University of Leicester, Leicester, UK
| | - Daniel G D Nixon
- Departments of Health Sciences, University of Leicester, Leicester, UK
| | - Emma L Watson
- Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Alice C Smith
- Departments of Health Sciences, University of Leicester, Leicester, UK
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Grant D, Tomlinson D, Tsintzas K, Kolić P, Onambélé-Pearson G. Minimizing sedentary behavior (without increasing medium-to-vigorous exercise) associated functional improvement in older women is somewhat dependent on a measurable increase in muscle size. Aging (Albany NY) 2020; 12:24081-24100. [PMID: 33276345 PMCID: PMC7762509 DOI: 10.18632/aging.202265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/19/2020] [Indexed: 12/17/2022]
Abstract
The optimal pattern of sedentarism displacement and mechanisms underlying its health effects are poorly understood. Therefore, the aim of this study was to quantify muscle-tendon adaptation in response to two different sedentarism displacement interventions and relate any adaptations to functional outcomes. Thirty-four older women (73±5yrs) underwent skeletal muscle-tendon size and functional assessments. Participants were randomly allocated to: Sedentary behavior fragmentation (SBF), Light intensity physical activity (LIPA), or Control groups. Measures were taken at weeks 0 and 8. Gait speed significantly increased (p=0.003), in both experimental groups (SBF: 0.06 ± 0.08m/s, 6±10%, LIPA: 0.06 ± 0.07m/s, 6±6%), but not control (-0.02 ± 0.12m/s, -2±9%). Accordingly, the relative change in Vastus Lateralis muscle volume, accounted for 30% (p=0.027), and 45% (p=0.0006) of the explained variance in the relative change in gait speed, for SBF and LIPA respectively. Gastrocnemius Medialis fascicle length changes were positively associated with gait speed changes, following LIPA exclusively (R2= 0.50, p=0.009). This is the first study to show SBF and LIPA are adequate loading in older women, with related muscle adaptation and clinically relevant gait speed improvements. Such adaptations appear similar irrespective of whether sedentarism displacement is prescribed in a single bout (LIPA) or in frequent micro-bouts (SBF).
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Affiliation(s)
- Dale Grant
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sports and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - David Tomlinson
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sports and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - Kostas Tsintzas
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, Faculty of Medicine and Health Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Petra Kolić
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sports and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - Gladys Onambélé-Pearson
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sports and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
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Gould DW, Watson EL, Wilkinson TJ, Wormleighton J, Xenophontos S, Viana JL, Smith AC. Ultrasound assessment of muscle mass in response to exercise training in chronic kidney disease: a comparison with MRI. J Cachexia Sarcopenia Muscle 2019; 10:748-755. [PMID: 31054219 PMCID: PMC6711420 DOI: 10.1002/jcsm.12429] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 03/01/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a catabolic condition associated with muscle wasting and dysfunction, which associates with morbidity and mortality. There is a need for simple techniques capable of monitoring changes in muscle size with disease progression and in response to interventions aiming to increase muscle mass and function. Ultrasound is one such technique; however, it is unknown how well changes in muscle cross-sectional area (CSA) measured using ultrasound relate to changes in whole muscle volume measured using magnetic resonance imaging. We tested whether rectus femoris CSA (RF-CSA) could be used as a valid indication of changes in quadriceps muscle volume as a single measure of muscle size and following a 12 week exercise intervention that resulted in muscle hypertrophy. METHODS Secondary analysis of data was collected from the ExTra CKD study (ISRCTN 36489137). Quadriceps muscle size was assessed from 36 patients with non-dialysis CKD before and after 12 weeks of supervised exercise that resulted in muscle hypertrophy. RESULTS Strong positive correlations were observed between RF-CSA and quadriceps volume at baseline (r2 = 0.815, CI 0.661 to 0.903; P < 0.001) and following 12 week exercise (r2 = 0.845, CI 0.700 to 0.923; P < 0.001). A moderate positive association was also observed between changes in RF-CSA and quadriceps following exercise training (rho = 0.441, CI 0.085 to 0.697; P = 0.015). Bland-Altman analysis revealed a small bias (bias 0.6% ± 12.5) between the mean percentage changes in RF-CSA and quadriceps volume but wide limits of agreement from -24 to 25. CONCLUSIONS Rectus femoris CSA appears to be a reliable index of total quadriceps volume as a simple measure of muscle size, both as a single observation and in response to exercise training in non-dialysis CKD patients.
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Affiliation(s)
| | - Emma L. Watson
- Department of Cardiovascular SciencesUniversity of LeicesterLeicesterUK
| | | | | | | | - Joao L. Viana
- Research Center in Sports Sciences, Health Sciences and Human DevelopmentCIDESD, University Institute of MaiaISMAIMaiaPortugal
| | - Alice C. Smith
- Department of Health SciencesUniversity of LeicesterLeicesterUK
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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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Moutzouri M, Coutts F, Gliatis J, Billis E, Tsepis E, Gleeson N. Early initiation of home-based sensori-motor training improves muscle strength, activation and size in patients after knee replacement: a secondary analysis of a controlled clinical trial. BMC Musculoskelet Disord 2019; 20:231. [PMID: 31101039 PMCID: PMC6525469 DOI: 10.1186/s12891-019-2575-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 04/15/2019] [Indexed: 11/10/2022] Open
Abstract
Background There is accumulating evidence for the advantages of rehabilitation involving sensori-motor training (SMT) following total knee replacement (TKR). However, the best way in which to deliver SMT remains elusive because of potential interference effects amongst concurrent exercise stimuli for optimal neuromuscular and morphological adaptations. The aim of this study was to use additional outcomes (i.e. muscle strength, activation and size) from a published parent study to compare the effects of early-initiated home-based rehabilitative SMT with functional exercise training (usual care) in patients undergoing TKR. Methods A controlled clinical trial was conducted at the Orthopedic University Hospital of Rion, Greece involving allocation concealment to patients. Fifty-two patients electing to undergo TKR were randomised to either early-initiated SMT [experimental] or functional exercise training [control] in a home-based environment. Groups were prescribed equivalent duration of exercise during 12-weeks, 3–5 sessions of ~ 40 min per week of home-based programmes. Muscle strength and activation (peak force [PF]; peak amplitude [Peak Amp.] and root mean square of integrated electromyography [RMS iEMG]), muscular size (including rectus femoris muscle cross-sectional area [CSARF]), and knee ROM were assessed on three separate occasions (pre-surgery [0 weeks]; 8 weeks post-surgery; 14 weeks post-surgery). Results Patients undertaking SMT rehabilitation showed significantly greater improvements over the 14 weeks compared to control in outcomes including quadriceps PF (25.1 ± 18.5 N vs 12.4 ± 20.8 N); iPeak Amp. (188 ± 109.5% vs 25 ± 105.8%); CSARF (252.0 ± 101.0 mm2 vs 156.7 ± 76.2 mm2), respectively (p < 0.005); Knee ROM did not offer clinically relevant changes (p: ns) between groups over time. At 14 weeks post-surgery, the SMT group’s and control group’s performances differed by relative effect sizes (Cohen’s d) ranging between 0.64 and 1.06. Conclusion A prescribed equivalent time spent in SMT compared to usual practice, delivered within a home-based environment, elicited superior restoration of muscle strength, activation and size in patients following TKR. Trial registration ISRCTN12101643, December 2017 (retrospective registration). Electronic supplementary material The online version of this article (10.1186/s12891-019-2575-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria Moutzouri
- Department of Physiotherapy, Technological Educational Institute (TEI) of Western Greece, Aigion, Greece
| | - Fiona Coutts
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - John Gliatis
- Orthopedic Surgery Department, University Hospital of Patras, Patras, Greece.
| | - Evdokia Billis
- Department of Physiotherapy, Technological Educational Institute (TEI) of Western Greece, Aigion, Greece
| | - Elias Tsepis
- Department of Physiotherapy, Technological Educational Institute (TEI) of Western Greece, Aigion, Greece
| | - Nigel Gleeson
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
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Hanada M, Soyama A, Hidaka M, Nagura H, Oikawa M, Tsuji A, Kasawara KT, Mathur S, Reid WD, Takatsuki M, Eguchi S, Kozu R. Effects of quadriceps muscle neuromuscular electrical stimulation in living donor liver transplant recipients: phase-II single-blinded randomized controlled trial. Clin Rehabil 2019; 33:875-884. [PMID: 30607983 DOI: 10.1177/0269215518821718] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To evaluate the efficacy of neuromuscular electrical stimulation on quadriceps muscle strength and thickness in liver transplantation patients. DESIGN Phase-II, randomized, parallel-group, allocation-concealed, assessor-blinded, single-center controlled trial. SETTING Inpatient rehabilitation sector. SUBJECTS Patients following living donor liver transplantation. INTERVENTIONS The quadriceps muscle stimulation and the control groups received bilateral muscle electrical stimulation on the quadriceps and tibialis anterior muscles, respectively. Neuromuscular electrical stimulation sessions in both groups were conducted for 30 minutes per session, once per day for five weekdays over four weeks by a physical therapist. MAIN MEASURES Quadriceps muscle strength and quadriceps muscle thickness. RESULTS Neuromuscular electrical stimulation was applied to the quadriceps muscles group ( n = 23) or the tibialis anterior muscle in the control group ( n = 22). The decrease in quadriceps muscle thickness differed significantly between both groups on postoperative day 30 (median -3 vs -8, P < 0.01). The changes in predicted quadriceps strength and 6 minutes walking distance were not significantly different between groups (quadriceps strength median -12% vs -5%, P = 0.40; 6 minutes walking distance median -18 vs -21 m, P = 0.74). CONCLUSION Neuromuscular electrical stimulation of the quadriceps muscle for liver transplantation recipients was able to maintain the quadriceps muscle thickness after surgery. Future larger scale studies are needed to consider the effectiveness of neuromuscular electrical stimulation and how to incorporate this intervention in the overall strategy of the physical therapy program.
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Affiliation(s)
- Masatoshi Hanada
- 1 Cardiorespiratory Division, Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan.,2 Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Akihiko Soyama
- 3 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masaaki Hidaka
- 3 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroki Nagura
- 1 Cardiorespiratory Division, Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Masato Oikawa
- 1 Cardiorespiratory Division, Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Ayumi Tsuji
- 4 Department of Nurse, Nagasaki University Hospital, Nagasaki, Japan
| | | | - Sunita Mathur
- 2 Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.,5 Canadian National Transplant Research Program, University of Alberta, Edmonton, AB, Canada
| | - W Darlene Reid
- 2 Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Mitsuhisa Takatsuki
- 3 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- 3 Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryo Kozu
- 1 Cardiorespiratory Division, Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan.,6 Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Ultrasound assessment of rectus femoris muscle in rehabilitation patients with chronic obstructive pulmonary disease screened for sarcopenia: correlation of muscle size with quadriceps strength and fat-free mass. Eur Geriatr Med 2018; 10:89-97. [PMID: 32720275 DOI: 10.1007/s41999-018-0130-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/07/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE To determine the relationship of the size of the rectus femoris muscle, assessed by ultrasonography, with parameters of muscle strength and body composition that are commonly used in the case-finding of sarcopenia in rehabilitation patients with chronic obstructive pulmonary disease (COPD). METHODS Cross-sectional pilot study of 18 men with severe COPD and 17 healthy controls. MAIN OUTCOME VARIABLES cross-sectional area, thickness, and width of the non-dominant rectus femoris muscle obtained by ultrasound, muscle strength determined by voluntary maximum isometric contraction of the quadriceps muscle, and fat-free mass assessed by bioimpedance analysis. RESULTS Ultrasounds detected differences in the size of the rectus femoris muscle: cross-sectional area was 4.3 (SD 1.05) cm2 in patients, compared to 5.6 (SD 1.25) cm2 in controls; patients also presented lower quadriceps strength, and fat-free mass index. Cross-sectional area of the rectus femoris muscle showed a moderate correlation with quadriceps strength (R = 0.497, p = 0.036) and fat-free mass (R = 0.584, p = 0.011). In a multivariate linear model adjusted for age, body mass index, fat-free mass and muscle size, muscle strength was 7.44 kg lower (p value = 0.014) in patients, compared to controls. CONCLUSIONS A causal relationship was observed between the cross-sectional area of the rectus femoris muscle, assessed with ultrasonography, and maximum isometric strength of knee extension in COPD rehabilitation patients. Reduced cross-sectional area was also associated with loss of fat-free mass. Muscle ultrasound and bioimpedance analysis provide complementary and relevant information that could be useful in the case-finding of sarcopenia in COPD patients.
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Neuromuscular Adaptations Following Training and Protein Supplementation in a Group of Trained Weightlifters. Sports (Basel) 2018; 6:sports6020037. [PMID: 29910341 PMCID: PMC6026839 DOI: 10.3390/sports6020037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 04/11/2018] [Accepted: 04/16/2018] [Indexed: 11/21/2022] Open
Abstract
The purpose of this study was to examine the effects of a recovery supplement compared with a placebo on muscle morphology in trained weightlifters. Vastus lateralis and muscle fiber cross sectional area of type I and type II fibers were compared between groups using a series of 2 × 2 (group × time) repeated measure ANOVAs. Both groups on average improved cross-sectional area of the vastus lateralis, type I and type II muscle fibers from pre-to-post but individual response varied within both groups. Greater magnitude of changes in type I and type II muscle fibers were observed for the placebo group but not for vastus lateralis cross sectional area. Additionally, subjects were divided into large and small fiber groups based on combined fiber size at the start of the investigation. These findings indicate that the recovery supplement utilized provided no greater effect compared with a placebo in a 12-week block periodization protocol in trained weightlifters. The primary determinate of fiber size changes in the study was determined to be the initial fiber size of muscle fibers with larger practical changes observed in the small fiber group compared with the large fiber group in type I, II, and ultrasound cross-sectional area (CSA).
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Carlier PG, Marty B, Scheidegger O, Loureiro de Sousa P, Baudin PY, Snezhko E, Vlodavets D. Skeletal Muscle Quantitative Nuclear Magnetic Resonance Imaging and Spectroscopy as an Outcome Measure for Clinical Trials. J Neuromuscul Dis 2018; 3:1-28. [PMID: 27854210 PMCID: PMC5271435 DOI: 10.3233/jnd-160145] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Recent years have seen tremendous progress towards therapy of many previously incurable neuromuscular diseases. This new context has acted as a driving force for the development of novel non-invasive outcome measures. These can be organized in three main categories: functional tools, fluid biomarkers and imagery. In the latest category, nuclear magnetic resonance imaging (NMRI) offers a considerable range of possibilities for the characterization of skeletal muscle composition, function and metabolism. Nowadays, three NMR outcome measures are frequently integrated in clinical research protocols. They are: 1/ the muscle cross sectional area or volume, 2/ the percentage of intramuscular fat and 3/ the muscle water T2, which quantity muscle trophicity, chronic fatty degenerative changes and oedema (or more broadly, “disease activity”), respectively. A fourth biomarker, the contractile tissue volume is easily derived from the first two ones. The fat fraction maps most often acquired with Dixon sequences have proven their capability to detect small changes in muscle composition and have repeatedly shown superior sensitivity over standard functional evaluation. This outcome measure will more than likely be the first of the series to be validated as an endpoint by regulatory agencies. The versatility of contrast generated by NMR has opened many additional possibilities for characterization of the skeletal muscle and will result in the proposal of more NMR biomarkers. Ultra-short TE (UTE) sequences, late gadolinium enhancement and NMR elastography are being investigated as candidates to evaluate skeletal muscle interstitial fibrosis. Many options exist to measure muscle perfusion and oxygenation by NMR. Diffusion NMR as well as texture analysis algorithms could generate complementary information on muscle organization at microscopic and mesoscopic scales, respectively. 31P NMR spectroscopy is the reference technique to assess muscle energetics non-invasively during and after exercise. In dystrophic muscle, 31P NMR spectrum at rest is profoundly perturbed, and several resonances inform on cell membrane integrity. Considerable efforts are being directed towards acceleration of image acquisitions using a variety of approaches, from the extraction of fat content and water T2 maps from one single acquisition to partial matrices acquisition schemes. Spectacular decreases in examination time are expected in the near future. They will reinforce the attractiveness of NMR outcome measures and will further facilitate their integration in clinical research trials.
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Affiliation(s)
- Pierre G Carlier
- Institute of Myology, Pitie-Salpetriere University Hospital, Paris, France.,CEA, DSV, I2BM, MIRCen, NMR Laboratory, Paris, France.,National Academy of Sciences, United Institute for Informatics Problems, Minsk, Belarus
| | - Benjamin Marty
- Institute of Myology, Pitie-Salpetriere University Hospital, Paris, France.,CEA, DSV, I2BM, MIRCen, NMR Laboratory, Paris, France
| | - Olivier Scheidegger
- Institute of Myology, Pitie-Salpetriere University Hospital, Paris, France.,Support Center for Advanced Neuroimaging (SCAN), Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Switzerland
| | | | | | - Eduard Snezhko
- National Academy of Sciences, United Institute for Informatics Problems, Minsk, Belarus
| | - Dmitry Vlodavets
- N.I. Prirogov Russian National Medical Research University, Clinical Research Institute of Pediatrics, Moscow, Russian Federation
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Lima K, Martins N, Pereira W, Oliveira L. Triceps surae elasticity modulus measured by shear wave elastography is not correlated to the plantar flexion torque. Muscles Ligaments Tendons J 2017; 7:347-352. [PMID: 29264348 DOI: 10.11138/mltj/2017.7.2.347] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Supersonic Shear Imaging (SSI) is a technique which analyses quantitatively the tissue properties in real time. The relation between joint torque and Young's modulus (E) of the agonist muscles is important for obtaining stratification values and ranges of normality. The aim of this study was to evaluate the intra and intersessions reliability of the E values of the Achilles tendon and medial gastrocnemius muscle, bilaterally, during rest, and correlate them with the isometric plantarflexion peak torque. Methods Shear modulus maps were acquired bilaterally in Achilles tendon (AT) and medial gastrocnemius (MG) muscle of 24 healthy male volunteers. Two 5-second plantarflexion maximal voluntary contractions were performed with a 40-seconds interval and correlated with E values. Results a good intrasession reliability (intraclass correlation coefficient- ICC= 0.821-0.986) and a weak Pearson's correlation was found between E values and peak torque (r= 0.022 to -0.202) for both limbs (P > .05). Conclusion E values cannot be predictive of the triceps surae force production in untrained men. It could be helpful, otherwise, to monitor a chronic strength adaptation after an exercise intervention or rehabilitation program. Level of evidence IIb, individual cohort study.
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Affiliation(s)
- Kelly Lima
- Laboratory of Biomechanics of the Biomedical Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Natália Martins
- Laboratory of Biomechanics of the Biomedical Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Wagner Pereira
- Laboratory of Ultrasound of the Biomedical Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Liliam Oliveira
- Laboratory of Biomechanics of the Biomedical Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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30
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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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31
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Strengthening of Quadriceps by Neuromuscular Magnetic Stimulation in Healthy Subjects. PM R 2017; 9:767-773. [DOI: 10.1016/j.pmrj.2016.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 12/13/2016] [Accepted: 12/23/2016] [Indexed: 11/16/2022]
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DAO TIENTUAN, HO BA THO MARIECHRISTINE. A CONSISTENT DATA FUSION APPROACH FOR UNCERTAINTY QUANTIFICATION IN RIGID MUSCULOSKELETAL SIMULATION. J MECH MED BIOL 2016. [DOI: 10.1142/s0219519417500622] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Uncertainty quantification in rigid musculoskeletal modeling is essential to analyze the risks related to the simulation outcomes. Data fusion from multiple sources is a potential solution to reduce data uncertainties. This present study aimed at proposing a new data fusion rule leading to a more consistent and coherent data for uncertainty quantification. Moreover, a new uncertainty representation was developed using imprecise probability approach. A biggest maximal coherent subsets (BMCS) operator was defined to fuse interval-valued data ranges from multiple sources. Fusion-based probability-box structure was developed to represent the data uncertainty. Case studies were performed for uncertainty propagation through inverse dynamics and static optimization algorithms. Hip joint moment and muscle force estimation were computed under effect of the uncertainties of thigh mass and muscle properties. Respective p-boxes of these properties were generated. Regarding the uncertainty propagation analysis, correlation coefficients showed a very good value ([Formula: see text]) for the proposed fusion operator according to classical operators. Muscle force variation of the rectus femoris was computed. Peak-to-peak (i.e., difference between maximal values) rectus femoris forces showed deviations of 55[Formula: see text]N and 40[Formula: see text]N for the first and second peaks, respectively. The development of the new fusion operator and fusion-based probability-box leads to a more consistent uncertainty quantification. This allows the estimation of risks associated with the simulation outcomes under input data uncertainties for rigid musculoskeletal modeling and simulation.
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Affiliation(s)
- TIEN TUAN DAO
- Sorbonne University, Université de technologie de Compiègne, CNRS, UMR 7338, Biomechanics and Bioengineering, Centre de recherche Royallieu, CS 60 319, 60203 Compiègne Cedex, France
| | - MARIE-CHRISTINE HO BA THO
- Sorbonne University, Université de technologie de Compiègne, CNRS, UMR 7338, Biomechanics and Bioengineering, Centre de recherche Royallieu, CS 60 319, 60203 Compiègne Cedex, France
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Oliveira VBD, Carneiro SP, Oliveira LFD. Reliability of biceps femoris and semitendinosus muscle architecture measurements obtained with ultrasonography. ACTA ACUST UNITED AC 2016. [DOI: 10.1590/2446-4740.04115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Kizilarslanoglu MC, Kuyumcu ME, Yesil Y, Halil M. Sarcopenia in critically ill patients. J Anesth 2016; 30:884-90. [PMID: 27376823 DOI: 10.1007/s00540-016-2211-4] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 06/26/2016] [Indexed: 12/25/2022]
Abstract
Sarcopenia occurring as a primary consequence of aging and secondary due to certain medical problems including chronic disease, malnutrition and inactivity is a progressive generalized loss of skeletal muscle mass, strength and function. The prevalence of sarcopenia increases with aging (approximately 5-13 % in the sixth and seventh decades). However, data showing the prevalence and clinical outcomes of sarcopenia in intensive care units (ICUs) are limited. A similar condition to sarcopenia in the ICU, called ICU-acquired weakness (ICU-AW), has been reported more frequently. Here, we aim to examine the importance of sarcopenia, especially ICU-AW, in ICU patients via related articles in Medline.
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Affiliation(s)
- Muhammet C Kizilarslanoglu
- Division of Geriatrics, Department of Internal Medicine, Hacettepe University School of Medicine, 06100, Ankara, Turkey.
| | - Mehmet E Kuyumcu
- Division of Geriatrics, Department of Internal Medicine, Hacettepe University School of Medicine, 06100, Ankara, Turkey
| | - Yusuf Yesil
- Division of Geriatrics, Department of Internal Medicine, Hacettepe University School of Medicine, 06100, Ankara, Turkey
| | - Meltem Halil
- Division of Geriatrics, Department of Internal Medicine, Hacettepe University School of Medicine, 06100, Ankara, Turkey
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Hacker ED, Peters T, Garkova M. Ultrasound Assessment of the Rectus Femoris Cross-Sectional Area: Subject Position Implications. West J Nurs Res 2016; 38:1221-30. [PMID: 27090872 DOI: 10.1177/0193945916644751] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Ultrasonic measurement of the rectus femoris (RF) is a novel, proxy measure for muscle strength. The impact of hip flexion/head of bed positioning on RF cross-sectional area (CSA) has not been fully explored. This study describes and compares differences in RF CSA across four degrees of hip flexion. This repeated-measures, comparative study enrolled healthy, pre-menopausal women (n = 20). RF CSA of the dominant leg was measured using the SonoSite M-Turbo ultrasound system with the head of bed at 0°, 20°, 30°, and 60°. One-way repeated measures indicated significant differences in RF CSA, F(3, 17) = 14.18, p < .001, with variation in hip flexion/head of bed elevation and significant RF CSA differences between: (a) 0° and 20°, (b) 0° and 30°, (c) 0° and 60°, and (d) 20° and 60°. Standardizing patient positioning when conducting ultrasonic measurement of RF CSA is vital for researchers who assess muscle mass.
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Dao TT, Tho MCHB. ASSESSMENT OF PARAMETER UNCERTAINTY IN RIGID MUSCULOSKELETAL SIMULATION USING A PROBABILISTIC APPROACH. ACTA ACUST UNITED AC 2016. [DOI: 10.1142/s021895771550013x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Experimental investigation coupled with numerical simulations is commonly used for solving multi-physical problems. In the field of biomechanics, in which the aim is to understand the mechanics of living system, the main difficulties are to provide experimental data reflecting the multi-physical behavior of the system of interest. These experimental data are used as input data for numerical simulations to quantify output responses through physical and/or biological laws expressed by constitutive mathematical equations. However, uncertainties on the experimentally available data exist from factors such as human variability and differences in protocols parameters and techniques. Thus, the true values of these data could never be experimentally measured. The objective of this study was to develop a modeling workflow to assess and account for the parameter uncertainty in rigid musculoskeletal simulation. A generic musculoskeletal model was used. Data uncertainties of the right thigh mass, physiological cross-sectional area (pCSA) and muscle tension coefficient of the rectus femoris were accounted to estimate their effect on the joint moment and muscle force computing, respectively. A guideline was developed to fuse data from multiple sources into a sample variation space leading to establish input data distribution. Uncertainty propagation was performed using Monte Carlo and most probable point methods. A high degree of sensitivity of 0.98 was noted for the effect of thigh mass uncertainty on the hip joint moment using inverse dynamics method. A strong deviation of rectus femoris muscle force (around 260 N) was found under effect of pCSA and muscle tension coefficient on the force estimation using static optimization method. Accounting parameter uncertainty into rigid musculoskeletal simulation plays an essential role in the evaluation of the confidence in the model outputs. Thus, simulation outcome may be computed and represented in a more reliable manner with a global range of plausible values.
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Affiliation(s)
- Tien Tuan Dao
- Université de Technologie de Compiègne, CNRS UMR 7338, Biomécanique et Bioingénierie, BP 20529, 60205 Compiègne cedex, France
| | - Marie-Christine Ho Ba Tho
- Sorbonne University, Université de technologie de Compiègne, CNRS, UMR 7338, Biomechanics and Bioengineering, BP 20529, 60205 Compiègne cedex, France
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Benavent-Caballer V, Sendín-Magdalena A, Lisón JF, Rosado-Calatayud P, Amer-Cuenca JJ, Salvador-Coloma P, Segura-Ortí E. Physical factors underlying the Timed “Up and Go” test in older adults. Geriatr Nurs 2016; 37:122-7. [DOI: 10.1016/j.gerinurse.2015.11.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/06/2015] [Accepted: 11/16/2015] [Indexed: 12/25/2022]
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Roelofs EJ, Smith-Ryan AE, Melvin MN, Wingfield HL, Trexler ET, Walker N. Muscle size, quality, and body composition: characteristics of division I cross-country runners. J Strength Cond Res 2016; 29:290-6. [PMID: 25330086 DOI: 10.1519/jsc.0000000000000729] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The primary purpose of this study was to identify the relationship between muscle cross-sectional area (mCSA), echo intensity (EI), and body composition of Division I cross-country runners. The secondary purpose was to examine differences in these variables in athletes stratified based on stress-fracture (SFx) history. Thirty-six athletes were stratified based on sex and SFx history. A panoramic scan vastus lateralis was performed using a GE Logiq-e B-mode ultrasound. Echo intensity and mCSA were determined from the scan using a grayscale imaging software (ImageJ). Body composition measures were determined using dual-energy x-ray absorptiometry. For females, mCSA was significantly correlated with left leg lean mass (LM; R = 0.54) and EI (R = -0.57). Lean mass was significantly correlated with bone mineral density (BMD; R = 0.58) and bone mineral content (BMC; R = 0.56), whereas BMC was also correlated with leg LM (R = 0.72). For males, mCSA was significantly correlated with leg LM (R = 0.66), BMD (R = 0.50), and BMC (R = 0.54). Leg LM was significantly correlated with BMD (R = 0.53) and BMC (R = 0.77). Personal best times for males were significantly correlated with fat mass (R = 0.489) and %fat (R = 0.556) for the 10- and 5-km races, respectively. Female and male athletes with a history of SFx were not significantly different across any variables when compared with athletes with no history. These correlations suggest that more muscle mass may associate with higher BMD and BMC for stronger bone structure. Modifications in training strategies to include heavy resistance training and plyometrics may be advantageous for preventing risk factors associated with SFx reoccurrence.
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Affiliation(s)
- Erica J Roelofs
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina
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Caballer VB, Lisón JF, Rosado-Calatayud P, Amer-Cuenca JJ, Segura-Orti E. Factors associated with the 6-minute walk test in nursing home residents and community-dwelling older adults. J Phys Ther Sci 2015; 27:3571-8. [PMID: 26696740 PMCID: PMC4681947 DOI: 10.1589/jpts.27.3571] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 08/24/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The main objective of this study was to determine the contributions and extent
to which certain physical measurements explain performance in the 6-minute walk test in
healthy older adults living in a geriatric nursing home and for older adults dwelling in
the community. [Subjects] The subjects were 122 adults aged 65 and older with no cognitive
impairment who were independent in their daily activities. [Methods] The 6-minute walk
test, age, body mass index, walking speed, chair stand test, Berg Balance Scale, Timed
Up-and-Go test, rectus femoris cross-sectional area, Short Physical Performance Battery,
and hand-grip strength were examined. [Results] Strong significant associations were found
between mobility, lower-limb function, balance, and the 6-minute walk test. A stepwise
multiple regression on the entire sample showed that lower-limb function was a significant
and independent predictor for the 6-minute walk test. Additionally, lower-limb function
was a strong predictor for the 6-minute walk test in our nursing home group, whereas
mobility was found to be the best predictor in our community-dwelling group. [Conclusion]
Better lower-limb function, balance, and mobility result in a higher distance covered by
healthy older adults. Lower-limb function and mobility appeared to best determine walking
performance in the nursing home and community-dwelling groups, respectively.
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Affiliation(s)
| | | | | | | | - Eva Segura-Orti
- Department of Physiotherapy, University Cardenal Herrera-CEU, Spain
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da Silva Pereira Júnior N, da Matta TT, Alvarenga AV, de Albuquerque Pereira WC, de Oliveira LF. Reliability of ultrasound texture measures of Biceps Brachialis and Gastrocnemius Lateralis muscles' images. Clin Physiol Funct Imaging 2015; 37:84-88. [PMID: 26235146 DOI: 10.1111/cpf.12257] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 04/07/2015] [Indexed: 11/28/2022]
Abstract
Ultrasound (US) is an important tool for diagnosing of many musculoskeletal tissue conditions. Image texture analysis can be used to characterize this tissue. The complexity curve (CC) is a technique commonly used to characterize the number of grey-level transitions in an image. Variability and reliability of US texture measures in the muscle tissue are unavailable in the literature. The aim of this study was to determine the variability and reliability of five CC texture parameters from US images of healthy Biceps Brachialis and Gastrocnemius Lateralis (GL) muscles, with longitudinal and transversal orientations of the probe. Eight images per subject were obtained for 30 men in 2 days. Mean, standard deviation, coefficient of variation and intraclass correlation coefficient for the five parameters were calculated for regions of interest. Results showed that the variability was similar for both muscles and most of the parameters showed satisfactory reliability (r > 0·7) for the Biceps Brachialis with the transverse scan and for the GL with the longitudinal scan.
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Affiliation(s)
| | - Thiago Torres da Matta
- Biomedical Engineering Program - COPPE/UFRJ, Federal University of Rio de Janeiro, Rio de Janeiro, Brasil.,Physical Education Post-Graduation Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brasil
| | - André Victor Alvarenga
- National Institute of Metrology, Quality and Technology - INMETRO, Rio de Janeiro, Brasil
| | | | - Liliam Fernandes de Oliveira
- Biomedical Engineering Program - COPPE/UFRJ, Federal University of Rio de Janeiro, Rio de Janeiro, Brasil.,Physical Education Post-Graduation Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brasil
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Kim MK, Ko YJ, Lee HJ, Ha HG, Lee WH. Ultrasound imaging for age-related differences of lower extremity muscle architecture. ACTA ACUST UNITED AC 2015. [DOI: 10.14474/ptrs.2015.4.1.38] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Min Kyu Kim
- Department of Physical Therapy, The Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Young Jun Ko
- Department of Physical Therapy, The Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Hwang Jae Lee
- Department of Physical Therapy, The Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Hyun Geun Ha
- Department of Physical Therapy, The Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Wan Hee Lee
- Department of Physical Therapy, The Graduate School, Sahmyook University, Seoul, Republic of Korea
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42
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Wojda TR, Cardone MS, Lo WD, Stawicki SPA, Evans DC. Ultrasound and Computed Tomography Imaging Technologies for Nutrition Assessment in Surgical and Critical Care Patient Populations. CURRENT SURGERY REPORTS 2015. [DOI: 10.1007/s40137-015-0099-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Assessment of muscle architecture of the biceps femoris and vastus lateralis by ultrasound after a chronic stretching program. Clin J Sport Med 2015; 25:55-60. [PMID: 24451696 DOI: 10.1097/jsm.0000000000000069] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the chronic effects of a static stretching program on the muscle architecture of biceps femoris (BF) and vastus lateralis (VL) muscles in ultrasound (US) images. DESIGN Randomized controlled longitudinal trial. SETTING Biomechanics Laboratory of Physical Education School of the Army, Rio de Janeiro, Brazil. PARTICIPANTS The study included 24 healthy and physically active male volunteers (19.05 ± 1.40 years, 1.73 ± 0.07 m, and 73.15 ± 8.33 kg), randomly allocated to 1 of 2 groups: stretching group (SG, n = 12) and control group (n = 12). INTERVENTIONS The SG was submitted to 3 sets of 30 seconds of static stretching 3 times a week during 8 weeks. MAIN OUTCOME MEASURES Ultrasound equipment (7.5 MHz) was used for the evaluation of BF and VL muscle architecture variables (pennation angle, fiber length, muscle thickness, and fascicle displacement) before and after training. Knee range of motion (ROM) and isometric flexion and extension torque (TQ) were also measured. RESULTS There were no significant changes in muscle architecture, TQ, and maximum knee flexion angle (P > 0.05). However, maximum knee extension angle (MEA) increased significantly in the SG (pretraining: 159.37 ± 7.27 degrees and posttraining: 168.9 ± 3.7 degrees; P < 0.05). CONCLUSIONS Volume or intensity (or both) of the stretching protocol was insufficient to cause structural changes in the VL and BF muscles. The increase in MEA could not be explained by muscle architecture changes. CLINICAL RELEVANCE To describe changes in the VL and BF muscle tendon unit using US after a long-term stretching program to identify which structures are responsible for ROM increase.
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McCormack WP, Stout JR, Wells AJ, Gonzalez AM, Mangine GT, Fragala MS, Hoffman JR. Predictors of high-intensity running capacity in collegiate women during a soccer game. J Strength Cond Res 2014; 28:964-70. [PMID: 24378664 DOI: 10.1519/jsc.0000000000000359] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this investigation was to determine which physiological assessments best predicted high-intensity running (HIR) performance during a women's collegiate soccer game. A secondary purpose was to examine the relationships among physiological performance measures including muscle architecture on soccer performance (distance covered, HIR, and sprints during the game) during a competitive collegiate women's soccer game. Ten National Collegiate Athletic Association (NCAA) Division I women soccer players performed physiological assessments within a 2-week period before a competitive regulation soccer game performed during the spring season. Testing consisted of height, body mass, ultrasound measurement of dominant (DOMleg), and nondominant leg (NDOMleg) vastus lateralis for muscle thickness (MT) and pennation angle (PA), VO2max, running economy, and Wingate anaerobic test (WAnT) for peak power (PP), mean power (MP), and fatigue rate (FR). During the game, distance run, HIR, and sprints were measured using a 10-Hz global positioning system. Stepwise regression revealed that VO2max, dominant leg thickness, and dominant leg PA were the strongest predictors of HIR distance during the game (R = 0.989, SEE = 115.5 m, p = 0.001). V[Combining Dot Above]O2max was significantly correlated with total distance run (r = 0.831; p = 0.003), HIR (r = 0.755; p = 0.012), WAnTPP (r = -0.737; p = 0.015), WAnTPP·kg (r = -0.706; p = 0.022), and WAnTFR (r = -0.713; p = 0.021). DOMlegMT was significantly correlated with WAnTFR (r = 0.893; p = 0.001). DOMlegPA was significantly correlated with WAnTFR (r = 0.740; p = 0.023). The NDOMlegPA was significantly correlated to peak running velocity (r = 0.781; p = 0.013) and WAnT MP·kg (r = 0.801; p = 0.01). Results of this study indicate that V[Combining Dot Above]O2max and muscle architecture are important characteristics of NCAA Division I women soccer players and may predict HIR distance during a competitive contest.
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Affiliation(s)
- William P McCormack
- Department of Educational and Human Sciences, Institute of Exercise Physiology and Wellness, University of Central Florida, Orlando, Florida
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Martinez C, Davis A, Myers H, Butler RJ. Interaction of gender and body composition on rectus femoris morphology as measured with musculoskeletal ultrasound imaging. Sports Health 2014; 6:451-6. [PMID: 25177424 PMCID: PMC4137677 DOI: 10.1177/1941738114539450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Quadriceps function is an important measure in patients recovering postoperatively. Traditionally, strength measures that require high levels of resistance are contraindicated during the early postoperative phase. Thus it may be helpful to evaluate the utilization of other tools, such as ultrasound imaging, that allow for assessment during a position of low resistance. Hypothesis: The rectus femoris cross-sectional area (CSA) is affected by sex and body composition in healthy subjects. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: Thirty-two healthy subjects (16 women, 16 men), selected from a previously larger study, were chosen for analysis. All subjects underwent a maximal volitional isometric contraction protocol from 0° to 90° of knee motion controlled by an isokinetic dynamometer. In the contracted and resting positions, the rectus femoris CSA was measured at each angle using ultrasound imaging. The contractile index (contracted − resting CSA) was calculated at each position. Subjects were separated into 1 of 4 groups based on sex and fat percentage (low or high). These data were analyzed using mixed-factor analysis of variance (group × angle) for each variable, with a critical α level of 0.05. Results: A significant interaction was noted for the CSA of the rectus femoris at rest (P < 0.03) and during contraction (P < 0.02). For both variables, all groups performed similarly, with the exception of women with high body fat percentage. No statistically significant interaction existed for the contractile index; however, a main effect for angle (P < 0.01) was observed. Conclusion: Rectus femoris CSA appears to depend on sex as well as the body composition of individuals. Clinical Relevance: Traditional subjective assessment measures of quadriceps strength and function have low reliability and functional validity. With the improved feasibility of ultrasound imaging in the clinical setting, quadriceps size may be more accurately measured during the early postoperative stages.
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Affiliation(s)
- Corina Martinez
- Department of Physical and Occupational Therapy, Sports Medicine Division, Duke University Health System, Durham, North Carolina
| | - Ashley Davis
- Department of Physical and Occupational Therapy, Sports Medicine Division, Duke University Health System, Durham, North Carolina
| | - Heather Myers
- Department of Physical and Occupational Therapy, Sports Medicine Division, Duke University Health System, Durham, North Carolina
| | - Robert J Butler
- Department of Physical and Occupational Therapy, Sports Medicine Division, Duke University Health System, Durham, North Carolina ; Division of Physical Therapy, Department of Community Health and Family Medicine, Duke University, Durham, North Carolina
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Benavent-Caballer V, Rosado-Calatayud P, Segura-Ortí E, Amer-Cuenca JJ, Lisón JF. Effects of three different low-intensity exercise interventions on physical performance, muscle CSA and activities of daily living: a randomized controlled trial. Exp Gerontol 2014; 58:159-65. [PMID: 25131453 DOI: 10.1016/j.exger.2014.08.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 08/05/2014] [Accepted: 08/08/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the short-term effects of three different resistance training programs, conducted at low intensity, on physical performance, muscle cross-sectional area (CSA) and the capacity to perform daily tasks in older adults living in a geriatric nursing home. DESIGN Randomized controlled trial, with a 4-month intervention period. SETTING A geriatric nursing home in Valencia, Spain. PARTICIPANTS Eighty-nine adults aged 75 to 96 who were independent in their daily activities. INTERVENTION After a baseline assessment, the participants were randomly assigned to the control group or one of the three intervention groups: volitional contraction (VC; n=22), neuromuscular electrical stimulation (NMES; n=22), or neuromuscular electrical stimulation superimposed onto voluntary contractions (NMES+; n=22). The intervention focused on knee extension exercises and its intensity was set at 40% of one-repetition maximum (1RM). MEASUREMENTS The primary outcome measure was mobility. Secondary outcomes were rectus femoris CSA, balance, aerobic endurance, upper-body strength and the capacity to perform daily tasks. All data were collected at baseline and after the 4-month intervention period. RESULTS The two-way ANOVA analysis showed a significant group×time interaction effect for the mobility (P=.022), rectus femoris CSA (P=.001), and the capacity to perform daily tasks (P=.05). The within-group analysis found a more prominent effect in the NMES+ group. Significant improvements were seen in rectus femoris CSA and the capacity to perform daily tasks in all intervention groups. Mobility only improved in the NMES+ group (P=.026). CONCLUSION From a short-term perspective, NMES+ exercise training, performed at low intensity, can improve physical performance, muscle CSA, and the capacity to perform daily activities, and to partially mitigate age-related consequences in older adults.
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Affiliation(s)
- V Benavent-Caballer
- University Cardenal Herrera-CEU, Department of Physiotherapy, Avda. Seminari s/n., 46113 Moncada, Valencia, Spain.
| | - P Rosado-Calatayud
- University Cardenal Herrera-CEU, Department of Physiotherapy, Avda. Seminari s/n., 46113 Moncada, Valencia, Spain
| | - E Segura-Ortí
- University Cardenal Herrera-CEU, Department of Physiotherapy, Avda. Seminari s/n., 46113 Moncada, Valencia, Spain
| | - J J Amer-Cuenca
- University Cardenal Herrera-CEU, Department of Physiotherapy, Avda. Seminari s/n., 46113 Moncada, Valencia, Spain
| | - J F Lisón
- University Cardenal Herrera-CEU, Department of Physiotherapy, Avda. Seminari s/n., 46113 Moncada, Valencia, Spain
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Park ES, Sim E, Rha DW, Jung S. Estimation of gastrocnemius muscle volume using ultrasonography in children with spastic cerebral palsy. Yonsei Med J 2014; 55:1115-22. [PMID: 24954345 PMCID: PMC4075375 DOI: 10.3349/ymj.2014.55.4.1115] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to investigate useful parameters for estimating gastrocnemius (GCM) muscle volume (MV) using ultrasonography (US) and anthropometry in children with spastic cerebral palsy (CP). MATERIALS AND METHODS Eighteen legs from nine children with spastic CP aged 2 to 6 years were investigated in this study. Tibial length (TL) of each leg was measured and muscle thickness (MT) and anatomical cross-sectional area (aCSA) of GCM muscles were assessed using US. The volume of the GCM was measured by magnetic resonance imaging (MRI) scans. The relationship of TL, MT, and aCSA with MV measured by MRI was investigated. Simple and multiple regression analyses were performed to establish muscle volume prediction equations. RESULTS Resting MT, aCSA, and TL were highly related to MV of both medial and lateral head of GCM determined by MRI. The MV prediction equation based on simple regression analysis resulted in r² values ranging from 0.591 to 0.832 (p<0.05). The r² values were higher using aCSA as independent variable than using MT. The MV prediction equation based on multiple regression analysis resulted in r² values ranging from 0.779 to 0.903 (p<0.05). However, the relatively high standard error of the estimate values ranged from 18.0-33.6% on simple regression and 15.5-25.6% on multiple regression. The contribution of aCSA was higher than that of MT for predicting MV of GCM. CONCLUSION Our study demonstrated the suitability of US assessment of aCSA and MT combined with TL for estimating MV of GCM in children with spastic CP and showed that aCSA is more useful parameter than MT.
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Affiliation(s)
- Eun Sook Park
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Eungeol Sim
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong-Wook Rha
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Soojin Jung
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Matta TT, Nascimento FXMB, Fernandes IA, Oliveira LF. Heterogeneity of rectus femoris muscle architectural adaptations after two different 14-week resistance training programmes. Clin Physiol Funct Imaging 2014; 35:210-5. [PMID: 24750784 DOI: 10.1111/cpf.12151] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 03/20/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Thiago T. Matta
- Biomedical Engineering Program; COPPE; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
- School of Physical Education and Sports; Laboratory of Biomechanics; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Francisco X. M. B. Nascimento
- School of Physical Education and Sports; Laboratory of Biomechanics; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Igor A. Fernandes
- Laboratory Crossbridges; Postgraduate Program in Sport and Exercise Science; Gama Filho University; Rio de Janeiro Brazil
| | - Liliam F. Oliveira
- Biomedical Engineering Program; COPPE; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
- School of Physical Education and Sports; Laboratory of Biomechanics; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
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Rosenberg JG, Ryan ED, Sobolewski EJ, Scharville MJ, Thompson BJ, King GE. Reliability of panoramic ultrasound imaging to simultaneously examine muscle size and quality of the medial gastrocnemius. Muscle Nerve 2014; 49:736-40. [DOI: 10.1002/mus.24061] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 08/13/2013] [Accepted: 08/16/2013] [Indexed: 01/25/2023]
Affiliation(s)
- Joseph G. Rosenberg
- Neuromuscular Research Laboratory, Department of Exercise and Sport Science; 209 Fetzer Hall, CB 8700, University of North Carolina at Chapel Hill Chapel Hill North Carolina 27599-8700 USA
| | - Eric D. Ryan
- Neuromuscular Research Laboratory, Department of Exercise and Sport Science; 209 Fetzer Hall, CB 8700, University of North Carolina at Chapel Hill Chapel Hill North Carolina 27599-8700 USA
| | - Eric J. Sobolewski
- Neuromuscular Research Laboratory, Department of Exercise and Sport Science; 209 Fetzer Hall, CB 8700, University of North Carolina at Chapel Hill Chapel Hill North Carolina 27599-8700 USA
| | - Michael J. Scharville
- Neuromuscular Research Laboratory, Department of Exercise and Sport Science; 209 Fetzer Hall, CB 8700, University of North Carolina at Chapel Hill Chapel Hill North Carolina 27599-8700 USA
| | - Brennan J. Thompson
- Human Performance Laboratory, Department of Health, Exercise, and Sport Sciences; Texas Tech University; Lubbock Texas USA
| | - Gilbert E. King
- Neuromuscular Research Laboratory, Department of Exercise and Sport Science; 209 Fetzer Hall, CB 8700, University of North Carolina at Chapel Hill Chapel Hill North Carolina 27599-8700 USA
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Dieterich AV, Deshon L, Pickard CM, Strauss GR, McKay J. Separate assessment of gluteus medius and minimus: B-mode or M-mode ultrasound? Physiother Theory Pract 2014; 30:438-43. [PMID: 24571572 DOI: 10.3109/09593985.2014.890261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The hip abductors gluteus medius (Gmed) and minimus (Gmin) differ slightly in function and how they are affected by hip joint pathology. A separate assessment of Gmed and Gmin is feasible by ultrasound (US) imaging. B-mode and M-mode US can be used to measure muscle thickness. Two B- and two M-mode scans of Gmed and Gmin thickness were taken in relaxation on 16 asymptomatic volunteers, repeated within 4 days on 11 subjects. Three types of intra-rater reliability of muscle thickness measurements were examined: (1) within-session reliability comparing two scans from the same session, (2) between-days reliability comparing thickness from two scanning occasion within 4 days and (3) reliability of taking thickness measurements by re-measuring the same US scans after 1 week. Thickness measurements on B- and M-mode images provided ICC3,1 >0.96 for within-session reliability. ICC3,k >0.89 for between-days reliability and ICC3,1 >0.85 for re-reading the same scans were estimated. Minimal detectable changes >1.0 mm within-session, >2.4 mm between-days and >1.7 mm for re-reading scans indicated that small thickness changes are not detectable. The investigation suggests a slight advantage for fascia recognition in B-mode and the advantage of visual control of muscle relaxation in M-mode.
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Affiliation(s)
- Angela V Dieterich
- School of Physiotherapy and Exercise Science, Curtin Health Innovation Research Institute (CHIRI), Curtin University , Perth , Australia and
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