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Whang CQY, Debenham MIB, Ogalo E, Ro HJ, Wu H, Berger MJ. The strength of associations between ultrasound measures of upper limb muscle morphology and isometric muscle strength: An exploratory study. Muscle Nerve 2025; 71:73-79. [PMID: 39512180 PMCID: PMC11632562 DOI: 10.1002/mus.28297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 10/28/2024] [Accepted: 10/29/2024] [Indexed: 11/15/2024]
Abstract
INTRODUCTION/AIMS Assessing upper limb muscle strength is important for understanding health outcomes, such as daily function and mortality. Ultrasound (US) is increasingly used to evaluate muscle health, but the relationship between its measures of morphology and isometric strength has not been thoroughly explored in upper limb muscles. The aim of this study was to evaluate the associations between US morphological measures and isometric strength in functionally relevant upper limb muscles in healthy adults. METHODS Twenty-four healthy volunteers (30.0 ± 10.8 years) underwent B-mode, axial US scans of the first dorsal interosseus (FDI), flexor pollicis longus (FPL), biceps brachii (BB), brachialis (BR), and triceps brachii lateral head (TB). Participants performed corresponding maximal voluntary contractions (MVC), including first digit distal phalanx flexion, second digit abduction, and elbow flexion and extension. US images were segmented to obtain maximal muscle thickness (MT) and cross-sectional area (CSA). RESULTS Strong positive correlations were found between muscle strength and BB MT (r = .83; p < .001), BR CSA (r = .84; p < .001), and TB MT (r = .70; p < .001). Moderate positive correlations were found for strength and FDI CSA (r = .67; p < .001), FDI MT (r = .47; p < .05), FPL CSA (r = .54; p < .01), and FPL MT (r = .42; p < .05). No significant correlation was found between strength and BR MT (r = .16; p > .05). DISCUSSION Our data showed moderate-to-strong associations between US muscle morphology and strength, suggesting that US is likely a good biomarker for strength. However, its use is not "one size fits all." Future investigations should continue to assess this relationship in different muscles and expand the generalizability to clinical populations.
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Affiliation(s)
- Christina Q. Y. Whang
- International Collaboration on Repair Discoveries (ICORD), Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Experimental Medicine, Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Mathew I. B. Debenham
- International Collaboration on Repair Discoveries (ICORD), Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Division of Physical Medicine & Rehabilitation, Department of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Emmanuel Ogalo
- International Collaboration on Repair Discoveries (ICORD), Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Hannah J. Ro
- International Collaboration on Repair Discoveries (ICORD), Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Harvey Wu
- International Collaboration on Repair Discoveries (ICORD), Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Michael J. Berger
- International Collaboration on Repair Discoveries (ICORD), Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Experimental Medicine, Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Division of Physical Medicine & Rehabilitation, Department of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
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Hardy EJ, Bass JJ, Inns TB, Piasecki M, Piasecki J, Sale C, Morris RH, Lund JN, Smith K, Wilkinson DJ, Atherton PJ, Phillips BE. Exploring the utility of ultrasound to assess disuse atrophy in different muscles of the lower leg. J Cachexia Sarcopenia Muscle 2024; 15:2487-2496. [PMID: 39183641 PMCID: PMC11634512 DOI: 10.1002/jcsm.13583] [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: 01/14/2024] [Revised: 07/18/2024] [Accepted: 07/23/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Skeletal muscle is a highly plastic tissue crucial for many functions associated with whole-body health across the life course. Magnetic resonance imaging (MRI) is the current gold standard for measuring skeletal muscle size. However, MRI is expensive, and access to facilities is often limited. B-mode ultrasonography (U/S) has been proposed as a potential alternative to MRI for the assessment of muscle size. However, to date, no work has explored the utility of U/S to assess disuse muscle atrophy (DMA) across muscles with different atrophy susceptibility profiles, an omission which may limit the clinical application of previous work. METHODS To address this significant knowledge gap, 10 young men (22 ± years, 24.1 ± 2.3 kg/m2) underwent 15-day unilateral leg immobilization using a knee-brace and air boot. Cross-sectional area (CSA) and muscle thickness (MT) of the tibialis anterior (TA) and medial gastrocnemius (MG) were assessed via U/S before and after immobilization, with CSA and muscle volume assessed via MRI. RESULTS With both muscles combined, there were good correlations between each U/S and MRI measure, both before (e.g., CSAMRI vs. MTU/S and CSAU/S: r = 0.88 and 0.94, respectively, both P < 0.0001) and after (e.g., VOLMRI vs. MTU/S and CSAU/S: r = 0.90 and 0.96, respectively, both P < 0.0001) immobilization. The relationship between the methods was notably stronger for MG than TA at each time-point (e.g., CSAMRI vs. MTU/S: MG, r = 0.70, P = 0.0006; TA, r = 0.37, P = 0.10). There was no relationship between the degree of DMA determined by the two methods in either muscle (e.g., TA pre- vs. post-immobilization, VOLMRI: 136 ± 6 vs. 133 ± 5, P = 0.08; CSAU/S: 6.05 ± 0.3 vs. 5.92 ± 0.4, P = 0.70; relationship between methods: r = 0.12, P = 0.75). CONCLUSIONS Both MTU/S and CSAU/S provide comparable static measures of lower leg muscle size compared with MRI, albeit with weaker agreement in TA compared to MG. Although both MTU/S and CSAU/S can discern differences in DMA susceptibility between muscles, neither can reliably assess degree of DMA. Based on the growing recognition of heterogeneous atrophy profiles between muscles, and the topical importance of less commonly studied muscles (i.e., TA for falls prevention in older adults), future research should aim to optimize accessible methods to determine muscle losses across the body.
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Affiliation(s)
- Edward J. Hardy
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC‐Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), and Nottingham NIHR Biomedical Research CentreUniversity of Nottingham, School of MedicineDerbyUK
- Department of SurgeryRoyal Derby HospitalDerbyUK
| | - Joseph J. Bass
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC‐Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), and Nottingham NIHR Biomedical Research CentreUniversity of Nottingham, School of MedicineDerbyUK
| | - Thomas B. Inns
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC‐Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), and Nottingham NIHR Biomedical Research CentreUniversity of Nottingham, School of MedicineDerbyUK
| | - Mathew Piasecki
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC‐Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), and Nottingham NIHR Biomedical Research CentreUniversity of Nottingham, School of MedicineDerbyUK
| | - Jessica Piasecki
- School of Science and TechnologyNottingham Trent UniversityNottinghamUK
| | - Craig Sale
- School of Science and TechnologyNottingham Trent UniversityNottinghamUK
- Institue of SportManchester Metropolitan UniversityManchesterUK
| | - Robert H. Morris
- School of Science and TechnologyNottingham Trent UniversityNottinghamUK
| | - Jonathan N. Lund
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC‐Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), and Nottingham NIHR Biomedical Research CentreUniversity of Nottingham, School of MedicineDerbyUK
- Department of SurgeryRoyal Derby HospitalDerbyUK
| | - Ken Smith
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC‐Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), and Nottingham NIHR Biomedical Research CentreUniversity of Nottingham, School of MedicineDerbyUK
| | - Daniel J. Wilkinson
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC‐Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), and Nottingham NIHR Biomedical Research CentreUniversity of Nottingham, School of MedicineDerbyUK
| | - Philip J. Atherton
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC‐Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), and Nottingham NIHR Biomedical Research CentreUniversity of Nottingham, School of MedicineDerbyUK
| | - Bethan E. Phillips
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC‐Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), and Nottingham NIHR Biomedical Research CentreUniversity of Nottingham, School of MedicineDerbyUK
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Dias NF, Bergamasco JGA, Scarpelli MC, Silva DG, Chaves TS, Bittencourt D, Medalha RA, Carello Filho PC, De Souza EO, Ugrinowitsch C, Libardi CA. Changes in muscle cross-sectional area during two menstrual cycles may not be exclusively attributed to resistance training. Appl Physiol Nutr Metab 2024; 49:1729-1739. [PMID: 39303293 DOI: 10.1139/apnm-2024-0004] [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] [Indexed: 09/22/2024]
Abstract
This study investigated the impact of menstrual cycle (MC) phases and resistance training (RT) on muscle cross-sectional area (CSA) in two MCs utilizing a within-subject design. Twenty women with regular MCs had their legs randomly allocated to either the control (CON) or RT condition, which included 16 training sessions over two MCs. CSA, estradiol (E2), and progesterone (P4) were assessed during the menstruation (M), ovulation (O), and luteal (L) phases in the first (M1, O1, L1) and second (M2, O2, L2) MCs and at the beginning of the third MC (M3). P4 values were significantly higher during the luteal phase than during menstruation (P < 0.0001) and ovulation (P < 0.0001). No significant differences in E2 concentrations were observed between the MC phases (P = 0.08). For the RT condition, the CSA showed significant increases at O2, L2, and M3 compared to baseline (M1) (all P < 0.0001). No significant changes were observed for the CON condition during the two MCs (P > 0.05). However, RT condition showed a significant change in average CSA across two MCs. Additionally, individual analyses revealed that 19 participants showed variation in CSA above or below the minimum detectable difference during the two MCs. These findings suggest that changes in muscle CSA observed during two MCs may not be exclusively attributed to RT.
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Affiliation(s)
- Nathalia F Dias
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - João G A Bergamasco
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Maíra C Scarpelli
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Deivid G Silva
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Talisson S Chaves
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Diego Bittencourt
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Ricardo A Medalha
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Paulo C Carello Filho
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Eduardo O De Souza
- Department of Health Sciences and Human Performance, The University of Tampa, Tampa, FL, USA
| | - Carlos Ugrinowitsch
- Department of Health Sciences and Human Performance, The University of Tampa, Tampa, FL, USA
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Cleiton A Libardi
- MUSCULAB - Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
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Liu Y, Xin C, Wei L, Guo X, Zhang Y, Zhang M, Xing J, Gai Y. Effect of an evidence-based early rehabilitation program on adult patients with venovenous extracorporeal membrane oxygenation: A cohort study. Intensive Crit Care Nurs 2024; 84:103744. [PMID: 39089198 DOI: 10.1016/j.iccn.2024.103744] [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: 12/28/2023] [Revised: 05/07/2024] [Accepted: 06/03/2024] [Indexed: 08/03/2024]
Abstract
OBJECTIVES To assess the efficacy of early rehabilitation program for VV-ECMO patients and observe the influence on the respiratory and skeletal muscles. DESIGN A cohort study. SETTING The study was conducted with VVECMO patients in a comprehensive ICU with 32 beds. MAIN OUTCOME MEASURES Ultrasound measurements were performed on each patients on day 1, 4, 7, 10, and 14, including diaphragmatic excursion (DE), diaphragmatic thickening fraction (DTF), intercostal muscle thickening fraction (ICMTF), thickness of the rectus femoris (RF), thickness of vastus intermedius (VI), and rectus femoris cross-sectional area (RF-CSA). Data on basic characteristics, results of ultrasound measurements, patients outcomes and adverse events were collected. RESULTS 22 patients received usual rehabilitation measures were set as the control group and 23 patients underwent early rehabilitation program were set as the study group. There were no differences in diaphragmatic excursion, diaphragmatic thickening fraction, intercostal muscle thickening fraction, thickness of rectus femoris, thickness of vastus intermedius, rectus femoris cross-sectional area between two groups on day 1 after VV-ECMO treatment (P > 0.05). The variation of diaphragmatic thickening fraction and intercostal muscle thickening fraction decreased on the day 7 and 14 after treatment (P < 0.05). The variation of vastus intermedius thickness and rectus femoris cross-sectional area in the study group was less compared with those in the control group on day 4, 7, 10 and 14. The ECMO duration in the study group was shorter than that in the control group (12.00 [10.00-16.25] days vs. 8.00 [6.00-12.25] days, P = 0.002), but there was no difference in the duration of mechanical ventilation. CONCLUSION Early rehabilitation program can ameliorate muscle atrophy. We recommend implementation of our rehabilitation program in VV-ECMO patients. This program can improve skeletal muscle atrophy and dysfunction in patients with VV-ECMO effectively and perhaps improve quality of life for patients in the future. IMPLICATIONS FOR CLINICAL PRACTICE Early rehabilitation program put higher demands bedside nurses. It requires them to observe conditions of VVECMO patients closely, assess the feasibility of rehabilitation promptly, and monitor for any adverse reactions. Ultrasound measurement is a noninvasive and useful tool to assess muscle atrophy in ICU patients. Early rehabilitation program can improve skeletal muscle atrophy and dysfunction in patients with VV-ECMO effectively.
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Affiliation(s)
- Ying Liu
- Department of Critical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chen Xin
- Department of Critical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lili Wei
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaojing Guo
- Department of Critical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuchen Zhang
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Meng Zhang
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jinyan Xing
- Department of Critical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China.
| | - Yubiao Gai
- Department of Critical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China.
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Halonen EJ, Gabriel I, Kelahaara MM, Ahtiainen JP, Hulmi JJ. Does Taking a Break Matter-Adaptations in Muscle Strength and Size Between Continuous and Periodic Resistance Training. Scand J Med Sci Sports 2024; 34:e14739. [PMID: 39364857 DOI: 10.1111/sms.14739] [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: 05/03/2024] [Revised: 09/19/2024] [Accepted: 09/20/2024] [Indexed: 10/05/2024]
Abstract
We aimed to compare the effects of periodic resistance training (RT) and continuous RT on muscle strength and size. Fifty-five healthy, untrained participants (age 32 ± 5 years) were randomized to periodic (PRT, n = 20 completed the study, 45% females) or continuous (CRT, n = 22 completed the study, 45% females) groups. PRT completed a 10-week RT, a 10-week detraining, and a second identical 10-week RT. CRT began with a 10-week non-RT, followed by a 20-week RT. RT included twice-weekly supervised whole-body RT sessions. Leg press (LP) and biceps curl (BC) one repetition maximum (1RM), countermovement jump (CMJ) height, muscle cross-sectional area (CSA) of vastus lateralis (VL), and biceps brachii (BB) using ultrasound imaging were measured twice at the beginning and every fifth week during the intervention. Both groups increased (p < 0.001) 1RM in LP and BC, CSA in VL and BB, and CMJ height with no differences between the groups. In PRT, 1RM in LP and BC, CSA in VL and BB, and CMJ height decreased during detraining (p < 0.05). During the first 5 weeks of retraining in PRT, increases in LP 1RM, and VL and BB CSA were greater than in CRT during Weeks 10-15 of their CRT (p < 0.01). PRT and CTR ended up in similar postintervention adaptations, as decreased muscle strength and size during detraining in PRT regained rapidly during retraining. Our results therefore suggest that trainees should not be too concerned about occasional short-term training breaks in their daily lives when it comes to lifelong strength training. Trial Registration: ClinicalTrials.gov identifier: NCT05553769.
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Affiliation(s)
- Eeli J Halonen
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyvaskyla, Finland
| | | | | | - Juha P Ahtiainen
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyvaskyla, Finland
| | - Juha J Hulmi
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyvaskyla, Finland
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Perry JL, Kinter S, Williams JL, Snodgrass TD, Sitzman TJ. Does Notching Along the Nasal Velar Surface During Nasopharyngoscopy Predict Discontinuity of the Underlying Levator Veli Palatini Muscle? Cleft Palate Craniofac J 2024; 61:1096-1103. [PMID: 36890699 PMCID: PMC10485175 DOI: 10.1177/10556656231161991] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
To determine the sensitivity and specificity of velar notching seen on nasopharyngoscopy for levator veli palatini (LVP) muscle discontinuity and anterior positioning. Nasopharyngoscopy and MRI of the velopharynx were performed on patients with VPI as part of their routine clinical care. Two speech-language pathologists independently evaluated nasopharyngoscopy studies for the presence or absence of velar notching. MRI was used to evaluate LVP muscle cohesiveness and position relative to the posterior hard palate. To determine the accuracy of velar notching for detecting LVP muscle discontinuity, sensitivity, specificity, and positive predictive value (PPV) were calculated. A craniofacial clinic at a large metropolitan hospital. PARTICIPANTS Thirty-seven patients who presented with hypernasality and/or audible nasal emission on speech evaluation and completed nasopharyngoscopy and velopharyngeal MRI study as part of their preoperative clinical evaluation. Among patients with partial or total LVP dehiscence on MRI, presence of a notch accurately identified discontinuity in the LVP 43% (95% CI 22-66%) of the time. In contrast, the absence of a notch accurately indicated LVP continuity 81% (95% CI 54-96%) of the time. The PPV for the presence of notching to identify a discontinuous LVP was 78% (95% CI 49-91%). The distance from the posterior edge of the hard palate to the LVP, known as effective velar length, was similar in patients with and without notching (median 9.8 mm vs 10.5 mm, P = 1.00). The observation of a velar notch on nasopharyngoscopy is not an accurate predictor of LVP muscle dehiscence or anterior positioning.
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Affiliation(s)
- Jamie L Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina, USA
| | - Sara Kinter
- Department of Pediatrics, Division of Craniofacial Medicine, University of Washington, Seattle, Washington, USA
- Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
- Center for Child Health, Behavior, & Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Jessica L Williams
- Barrow Cleft and Craniofacial Center, Phoenix, AZ, USA
- Department of Speech and Hearing Science, Arizona State University, Tempe, AZ, USA
| | - Taylor D Snodgrass
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina, USA
| | - Thomas J Sitzman
- Barrow Cleft and Craniofacial Center, Phoenix, AZ, USA
- Division of Plastic Surgery, Phoenix Children's Hospital, Phoenix, Arizona, USA
- Division of Plastic Surgery, Mayo Clinic Arizona, Scottsdale, Arizona, USA
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Rodriguez C, Mota JD, Palmer TB, Heymsfield SB, Tinsley GM. Skeletal muscle estimation: A review of techniques and their applications. Clin Physiol Funct Imaging 2024; 44:261-284. [PMID: 38426639 DOI: 10.1111/cpf.12874] [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: 01/13/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
Quantifying skeletal muscle size is necessary to identify those at risk for conditions that increase frailty, morbidity, and mortality, as well as decrease quality of life. Although muscle strength, muscle quality, and physical performance have been suggested as important assessments in the screening, prevention, and management of sarcopenic and cachexic individuals, skeletal muscle size is still a critical objective marker. Several techniques exist for estimating skeletal muscle size; however, each technique presents with unique characteristics regarding simplicity/complexity, cost, radiation dose, accessibility, and portability that are important factors for assessors to consider before applying these modalities in practice. This narrative review presents a discussion centred on the theory and applications of current non-invasive techniques for estimating skeletal muscle size in diverse populations. Common instruments for skeletal muscle assessment include imaging techniques such as computed tomography, magnetic resonance imaging, peripheral quantitative computed tomography, dual-energy X-ray absorptiometry, and Brightness-mode ultrasound, and non-imaging techniques like bioelectrical impedance analysis and anthropometry. Skeletal muscle size can be acquired from these methods using whole-body and/or regional assessments, as well as prediction equations. Notable concerns when conducting assessments include the absence of standardised image acquisition/processing protocols and the variation in cut-off thresholds used to define low skeletal muscle size by clinicians and researchers, which could affect the accuracy and prevalence of diagnoses. Given the importance of evaluating skeletal muscle size, it is imperative practitioners are informed of each technique and their respective strengths and weaknesses.
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Affiliation(s)
- Christian Rodriguez
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Jacob D Mota
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Ty B Palmer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Steven B Heymsfield
- Metabolism and Body Composition Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
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Voskuil CC, Dudar MD, Carr JC. Exploring the Relationship between Ultrasonographic Measures of the Quadriceps and Knee Extensor Muscle Fitness in Endurance-Trained Individuals. TRANSLATIONAL SPORTS MEDICINE 2024; 2024:3415740. [PMID: 38654724 PMCID: PMC11023727 DOI: 10.1155/2024/3415740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/04/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024]
Abstract
Background B-mode ultrasonography is an accessible and cost-effective method to assess muscle size and quality through muscle thickness (MT) and echo intensity (EI), respectively. Muscle thickness and EI have demonstrated relationships with maximal strength and local muscle endurance, providing a noninvasive and efficient modality to examine muscle fitness. However, these relationships have not been quantified in the individual quadriceps muscles of habitually endurance-trained populations, which may provide information to practitioners regarding rehabilitation and performance. Methods Twenty-three participants (males: N = 10; females: N = 13) underwent B-mode ultrasonography to assess MT, EI, and adipose tissue thickness-corrected echo intensity (cEI) in the vastus intermedius (VI), vastus lateralis (VL), and rectus femoris (RF). Muscle fitness was evaluated through maximal strength (1RM) and local muscle endurance (4 sets to failure at 50% 1RM) during dynamic knee extension. Relationships between ultrasonography outcomes and muscle fitness were examined through stepwise multiple linear regression. Results The results indicate that VI cEI is the strongest predictor of 1RM strength (r = -0.643), while no ultrasonography-derived measures significantly predicted local muscle endurance. Conclusion The study demonstrates that ultrasonography, specifically measures of cEI in the VI, has the greatest association with maximal strength in endurance-trained individuals. These findings suggest monitoring VI muscle size and quality may benefit practitioners who aim to improve knee extension strength for performance or following injury. In addition, the findings support the use of EI examinations in trained populations.
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Affiliation(s)
- Caleb C. Voskuil
- Texas Christian University, Department of Kinesiology, Fort Worth, TX, USA
| | - Monique D. Dudar
- Texas Christian University, Department of Kinesiology, Fort Worth, TX, USA
| | - Joshua C. Carr
- Texas Christian University, Department of Kinesiology, Fort Worth, TX, USA
- Department of Medical Education, Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, TX, USA
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Biały M, Szewczyk W, Kłaptocz P, Gnat R. Assessment of Lateral Abdominal Muscle Activation Asymmetry via M-mode Ultrasonography. Cureus 2024; 16:e57563. [PMID: 38707132 PMCID: PMC11068978 DOI: 10.7759/cureus.57563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
INTRODUCTION This study aimed to evaluate the asymmetry in the lateral abdominal muscles (LAMs) expressed as tissue deformation index asymmetry (aTDI) with the use of M-mode ultrasonography. The muscles of interest were the transversus abdominis, internal oblique, and external oblique. METHODS This is a cohort of 126 healthy subjects who participated in the study. Measurements were taken by two raters, blinded to the aim of the study. M-mode ultrasounds with a measurement frequency of 5 MHz were utilized to record the postural response of LAMs to external perturbation in the form of rapid arm abduction with load, and individual aTDI values for each muscle were calculated. RESULTS The aTDI values from deep to superficial LAMs were 78.28% for transversus abdominis, 55.68% for internal oblique, and 44.80% for external oblique. Only the aTDI for transversus abdominis results differed significantly from those of the other LAMs (P<0.05). CONCLUSION LAM asymmetry values exhibit the following gradient: transversus abdominis >internal oblique >external oblique. Specifically, only transversus abdominis demonstrates noteworthy asymmetry in postural activity. This observation contributes to the literature by indicating that transversus abdominis asymmetry may serve as a marker for assessing the variability in motor control of the deep abdominal musculature. The dominance of transversus abdominis (TrA) asymmetric activity underlines the importance of personalized approaches for patients with lumbopelvic disorders or for athletes seeking to enhance performance.
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Affiliation(s)
- Maciej Biały
- Physiotherapy, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, POL
- Physiotherapy, Functional Diagnostics Laboratory, Sport-Klinika, Scanmed Sport, Żory, POL
- Physiotherapy, Shoulder and Knee Clinic, Katowice, POL
| | | | | | - Rafał Gnat
- Physiotherapy, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, POL
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Sørensen B, Aagaard P, Hjortshøj MH, Hansen SK, Suetta C, Couppé C, Magnusson SP, Johannsen FE. Physiological and clinical effects of low-intensity blood-flow restricted resistance exercise compared to standard rehabilitation in adults with knee osteoarthritis-Protocol for a randomized controlled trial. PLoS One 2023; 18:e0295666. [PMID: 38096198 PMCID: PMC10721028 DOI: 10.1371/journal.pone.0295666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Osteoarthritis (OA) is a common disease with high socioeconomical costs. In Denmark, standard rehabilitation (SR) consists of a combination of patient education and supervised physical exercise involving a standardized neuromuscular training program. As an evidence-based alternative, high-load (>70% 1RM) resistance training (HIRT) has shown positive rehabilitation effects in knee-OA but may not be tolerated in all patients (~25%) due to knee joint pain. However, low-load resistance training (20-40% 1RM) with concurrent partial blood-flow restriction (BFR) appears to produce effects similar to HIRT yet involving reduced joint pain during and after exercise. The aim is to examine the effect of low-load BFR training compared to SR on pain, thigh muscle mass and muscle function in adults with knee-OA. We hypothesize that 12 weeks of BFR will lead to superior improvements in pain, muscle mass and mechanical muscle function compared to SR. METHODS AND ANALYSIS 90 participants diagnosed with radiographic knee-OA will be randomized to either BFR or SR twice a week for 12 weeks. BFR will consist of two selected lower limb strength exercises performed with an inflated pneumatic occlusion cuff. Intervention procedures in SR consist of a full 8 weeks GLA:D course followed by 4 weeks of team group training. Primary outcome variable is the change in KOOS-Pain subscale from baseline to 12 weeks. Secondary outcome variables are changes in pain sensitivity, functional performance, muscle mass and mechanical muscle function. Intention-to-treat and per-protocol analyses will be conducted. One-way analysis of variance will be performed to evaluate between-group changes. Pre-to-post intervention comparisons will be analyzed using a mixed linear model. Regression analysis will be performed to evaluate potential associations between selected outcome variables.
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Affiliation(s)
- Brian Sørensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
- Institute of Sports Medicine Copenhagen (ISMC), Bispebjerg Hospital, Copenhagen NV, Denmark
- Department of Physical & Occupational Therapy, Bispebjerg Hospital, Copenhagen NV, Denmark
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Mikkel H. Hjortshøj
- Institute of Sports Medicine Copenhagen (ISMC), Bispebjerg Hospital, Copenhagen NV, Denmark
- Department of Physical & Occupational Therapy, Bispebjerg Hospital, Copenhagen NV, Denmark
- Centre for Health and Rehabilitation, University College Absalon, Slagelse, Denmark
| | - Sofie K. Hansen
- Department of Geriatric and Palliative Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen NV, Denmark
| | - Charlotte Suetta
- Department of Geriatric and Palliative Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen NV, Denmark
- Faculty of Health, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Couppé
- Institute of Sports Medicine Copenhagen (ISMC), Bispebjerg Hospital, Copenhagen NV, Denmark
- Department of Physical & Occupational Therapy, Bispebjerg Hospital, Copenhagen NV, Denmark
| | - S. Peter Magnusson
- Institute of Sports Medicine Copenhagen (ISMC), Bispebjerg Hospital, Copenhagen NV, Denmark
- Department of Physical & Occupational Therapy, Bispebjerg Hospital, Copenhagen NV, Denmark
| | - Finn E. Johannsen
- Institute of Sports Medicine Copenhagen (ISMC), Bispebjerg Hospital, Copenhagen NV, Denmark
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11
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Darden N, Sharma S, Wu X, Mancini B, Karamchandani K, Bonavia AS. Long-term clinical outcomes in critically ill patients with sepsis and pre-existing low muscle mass: a retrospective cohort study. BMC Anesthesiol 2023; 23:313. [PMID: 37715183 PMCID: PMC10503077 DOI: 10.1186/s12871-023-02274-y] [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: 04/20/2023] [Accepted: 09/10/2023] [Indexed: 09/17/2023] Open
Abstract
PURPOSE Critically ill patients with sepsis account for significant disease morbidity and healthcare costs. Low muscle mass has been proposed as an independent risk factor for poor short-term outcomes, although its effect on long-term outcomes remains unclear. METHODS Retrospective cohort analysis of patients treated at a quaternary care medical center over 6 years (09/2014 - 12/2020). Critically ill patients meeting Sepsis-3 criteria were included, with low muscle mass defined by [Formula: see text] 5th percentile skeletal muscle index, measured at the L3 lumbar level (L3SMI) on Computed-Tomography (CT) scan ([Formula: see text] 41.6 cm2/m2 for males and [Formula: see text] 32.0 cm2/m2 for females). L3SMI was calculated by normalizing the CT-measured skeletal muscle area to the square of the patient's height (in meters). Measurements were taken from abdominal/pelvic CT scan obtained within 7 days of sepsis onset. The prevalence of low muscle mass and its association with clinical outcomes, including in-hospital and one-year mortality, and post-hospitalization discharge disposition in survivors, was analyzed. Unfavorable post-hospitalization disposition was defined as discharge to a location other than the patient's home. RESULTS Low muscle mass was present in 34 (23%) of 150 patients, with mean skeletal muscle indices of 28.0 ± 2.9 cm2/m2 and 36.8 ± 3.3 cm2/m2 in females and males, respectively. While low muscle mass was not a significant risk factor for in-hospital mortality (hazard ratio 1.33; 95% CI 0.64 - 2.76; p = 0.437), it significantly increased one-year mortality after adjusting for age and illness severity using Cox multivariate regression (hazard ratio 1.9; 95% CI 1.1 - 3.2; p = 0.014). Unfavorable post-hospitalization discharge disposition was not associated with low muscle mass, after adjusting for age and illness severity in a single, multivariate model. CONCLUSION Low muscle mass independently predicts one-year mortality but is not associated with in-hospital mortality or unfavorable hospital discharge disposition in critically ill patients with sepsis.
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Affiliation(s)
- Nola Darden
- Department of Anesthesiology and Perioperative Medicine, Penn State Milton S Hershey Medical Center, 500 University Dr, Mailbox H-187, Hershey, PA, 17033, USA
| | | | - Xue Wu
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | | | - Kunal Karamchandani
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Anthony S Bonavia
- Department of Anesthesiology and Perioperative Medicine, Penn State Milton S Hershey Medical Center, 500 University Dr, Mailbox H-187, Hershey, PA, 17033, USA.
- Division of Critical Care Medicine, Department of Anesthesiology and Perioperative Medicine, Penn State Milton S Hershey Medical Center, 500 University Dr, Mailbox H-187, Hershey, PA, 17033, USA.
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Lim C, McKendry J, Giacomin T, Mcleod JC, Ng SY, Currier BS, Coletta G, Phillips SM. Fortetropin supplementation prevents the rise in circulating myostatin but not disuse-induced muscle atrophy in young men with limb immobilization: A randomized controlled trial. PLoS One 2023; 18:e0286222. [PMID: 37220119 DOI: 10.1371/journal.pone.0286222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/11/2023] [Indexed: 05/25/2023] Open
Abstract
Supplementation with Fortetropin® (FOR), a naturally occurring component from fertilized egg yolks, reduces circulating myostatin concentration. We hypothesized that FOR would mitigate muscle atrophy during immobilization. We examined the effect of FOR supplementation on muscle size and strength during 2-wk of single-leg immobilization and recovery. Twenty-four healthy young men (22 ± 2 yrs; BMI = 24.3 ± 2.9 kg/m2) were randomly allocated to either a Fortetropin® supplement (FOR-SUPP, n = 12) group consuming 19.8 g/d of FOR or placebo (PLA-SUPP, n = 12) group consuming energy- and macronutrient-matched cheese powder for 6-wk. The 6-wk period consisted of 2-wk run-in, 2-wk single-leg immobilization, and 2-wk recovery phase returning to habitual physical activities. Ultrasonography, dual-energy X-ray absorptiometry, muscle biopsies and isometric peak torque assessments were performed prior to and following each phase (days 1, 14, 28, and 42) to measure vastus lateralis and muscle fiber cross-section area (CSA), leg lean mass (LM), and muscular strength. Blood samples were taken on days 1 and 42 for measurement of plasma myostatin concentration, which increased in PLA-SUPP (4221 ± 541 pg/mL to 6721 ± 864 pg/mL, P = 0.013) but not in FOR-SUPP (5487 ± 489 pg/mL to 5383 ± 781 pg/mL, P = 0.900). After the immobilization phase, vastus lateralis CSA, LM, and isometric peak torque were decreased by 7.9 ± 1.7% (P < 0.001), -1.6 ± 0.6% (P = 0.037), and -18.7 ± 2.7% (P < 0.001) respectively, with no difference between groups. The decreased peak torque was recovered after 2-wk of normal activity (vs. day 1, P = 0.129); however, CSA and LM were not recovered (vs. day 1, P < 0.001 and P = 0.003, respectively), with no differences between groups. Supplementation with FOR prevented the rise in circulating myostatin but not disuse-induced muscle atrophy in young men after 2-wk of single-leg immobilization.
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Affiliation(s)
- Changhyun Lim
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - James McKendry
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Taylor Giacomin
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Jonathan C Mcleod
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Sean Y Ng
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Brad S Currier
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Giulia Coletta
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Stuart M Phillips
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
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Pedrosa GF, Simões MG, Figueiredo MOC, Lacerda LT, Schoenfeld BJ, Lima FV, Chagas MH, Diniz RCR. Training in the Initial Range of Motion Promotes Greater Muscle Adaptations Than at Final in the Arm Curl. Sports (Basel) 2023; 11:39. [PMID: 36828324 PMCID: PMC9960616 DOI: 10.3390/sports11020039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
OBJECTIVE The effects of ROM manipulation on muscle strength and hypertrophy response remain understudied in long-term interventions. Thus, we compared the changes in strength and regional muscle hypertrophy after training in protocols with different ranges of motion (ROM) in the seated dumbbell preacher curl exercise using a within-participant experimental design. DESIGN AND METHODS Nineteen young women had one arm randomly assigned to train in the initial ROM (INITIALROM: 0°-68°; 0° = extended elbow) while the contralateral arm trained in the final ROM (FINALROM: 68°-135°), three times per week over an eight-week study period. Pre- and post-training assessments included one repetition maximum (1RM) testing in the full ROM (0°-135°), and measurement of biceps brachii cross-sectional area (CSA) at 50% and 70% of humerus length. Paired t-tests were used to compare regional CSA changes between groups, the sum of CSA changes at 50% and 70% (CSAsummed), and the strength response between the training protocols. RESULTS The INITIALROM protocol displayed a greater CSA increase than FINALROM protocol at 70% of biceps length (p = 0.001). Alternatively, we observed similar increases between the protocols for CSA at 50% (p = 0.311) and for CSAsummed (p = 0.111). Moreover, the INITIALROM protocol displayed a greater 1RM increase than FINALROM (p < 0.001). CONCLUSIONS We conclude that training in the initial angles of elbow flexion exercise promotes greater distal hypertrophy of the biceps brachii muscle in untrained young women. Moreover, the INITIALROM condition promotes a greater dynamic strength increase when tested at a full ROM compared to the FINALROM.
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Affiliation(s)
- Gustavo F. Pedrosa
- Weight Training Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Lagoa Santa 31270-901, Brazil
- Brazilian Air Force, Aeronautical Instruction and Adaptation Center, Lagoa Santa 33400-000, Brazil
| | - Marina G. Simões
- Weight Training Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Lagoa Santa 31270-901, Brazil
| | - Marina O. C. Figueiredo
- Weight Training Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Lagoa Santa 31270-901, Brazil
| | - Lucas T. Lacerda
- Weight Training Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Lagoa Santa 31270-901, Brazil
- Department of Physical Education, State University of Minas Gerais, Divinópolis 35501-170, Brazil
| | - Brad J. Schoenfeld
- Department of Health Sciences, CUNY Lehman College, Bronx, New York, NY 10468, USA
| | - Fernando V. Lima
- Weight Training Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Lagoa Santa 31270-901, Brazil
| | - Mauro H. Chagas
- Weight Training Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Lagoa Santa 31270-901, Brazil
| | - Rodrigo C. R. Diniz
- Weight Training Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Lagoa Santa 31270-901, Brazil
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The 2-Point Method: A Quick, Accurate, and Repeatable Approach to Estimate Ultrasound-Derived Quadriceps Femoris Cross-Sectional Area. Int J Sports Physiol Perform 2022; 17:1480-1488. [PMID: 35894906 DOI: 10.1123/ijspp.2021-0381] [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: 08/04/2021] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE To analyze the feasibility of the 2-point method for estimating ultrasound-derived quadriceps femoris cross-sectional area (QUADACSA). First, (1) the agreement between QUADACSA measured by panoramic ultrasound and magnetic resonance imaging (MRI) was studied, and thereafter, we examined 2 approaches of the 2-point method in terms of (2) estimation errors and (3) test-retest repeatability. METHODS Both thighs of 16 young men were analyzed. Ultrasound-QUADACSA versus MRI-QUADACSA comparison was conducted at 6 thigh lengths (20%-70% of the thigh length). Thereafter, ultrasound-QUADACSA corresponding to 30% and 60% (2-point30%-60%) or 20% and 70% (2-point20%-70%) were used to estimate QUADACSA of the remaining regions. Estimated QUADACSA resulting from both 2-point approaches was compared with the measured one. Finally, the test-retest repeatability was examined by comparing the errors generated on 2 separate estimations. Statistics included the standard error of measurement (SEM) expressed in absolute (in square centimeters) and relative terms (in percentage) as a coefficient of variation (CV), as well as the intraclass correlation cofficient (ICC) and bias. RESULTS An excellent agreement (ICC ≥ 0.980) and reduced errors (SEM ≤ 2.43 cm2) resulted from the ultrasound-QUADACSA versus MRI-QUADACSA comparison. Although estimation errors found were reduced (CV ≤ 7.50%), they proved to be lower and less biased for the 2-point30%-60%, especially at the central regions (SEM ≤ 2.01 cm2; bias ≤ 0.89 cm2). Similarly, repeatability analysis revealed lower test-retest errors for the 2-point30%-60% (CV ≤ 1.9%) than for the 2-point20%-70% (CV ≤ 4.6%). CONCLUSION The 2-point method, especially that implemented using the 30% and 60% regions, represents an accurate and repeatable strategy to evaluate QUADACSA.
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15
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Ruple BA, Smith MA, Osburn SC, Sexton CL, Godwin JS, Edison JL, Poole CN, Stock MS, Fruge AD, Young KC, Roberts MD. Comparisons between skeletal muscle imaging techniques and histology in tracking midthigh hypertrophic adaptations following 10 weeks of resistance training. J Appl Physiol (1985) 2022; 133:416-425. [PMID: 35771220 DOI: 10.1152/japplphysiol.00219.2022] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
This study had two aims. AIM1 was to determine the agreement between mid-thigh vastus lateralis (VL) cross-sectional area measured by ultrasound (mCSAUS) versus magnetic resonance imaging (mCSAMRI) at a single time point, and the ability of each to detect hypertrophic changes. AIM2 was to assess the relationships between pre-to-post training changes in thigh lean mass determined by DXA, VL mCSAUS, ultrasound-determined VL thickness (VLThick), and VL mean myofiber cross-sectional area (fCSA) with changes in VL mCSAMRI. Twelve untrained males (Age: 20±1 y, BMI: 26.9±5.4 kg/m2; n=12) engaged in a 10-week resistance training program (2x/week) where right mid-thigh images and VL biopsies were obtained prior to and 72-hours following the last training bout. Participants' VL mCSAMRI (p=0.005), DXA thigh lean mass (p=0.015), and VLThick (p=0.001) increased following training, whereas VL mCSAUS and fCSA did not. For AIM1, mCSAUS demonstrated excellent concordance (CCC = 0.830) with mCSAMRI, albeit mCSAUS values were systematically lower compared to mCSAMRI (mean bias: -2.29 cm2). Additionally, PRE-to-POST VL mCSA changes between techniques exhibited good agreement (CCC = 0.700; mean bias: -1.08 cm2). For AIM2, moderate, positive correlations existed for PRE-to-POST changes in VL mCSAMRI and DXA thigh lean mass (r=0.580, p=0.048), mCSAUS (r=0.622, p=0.031), and VLThick (r=0.520, p=0.080). A moderate, negative correlation existed between mCSAMRI and fCSA (r=-0.569, p=0.054). Our findings have multiple implications: i) resistance training-induced hypertrophy was dependent on the quantification method, ii) ultrasound-determined mCSA shows good agreement with MRI, and iii) tissue-level changes poorly agreed with mean fCSA changes and this requires further research.
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Affiliation(s)
- Bradley A Ruple
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Morgan A Smith
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Shelby C Osburn
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Casey L Sexton
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Joshua S Godwin
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Joseph L Edison
- Edward Via College of Osteopathic Medicine, Auburn, AL, United States
| | - Christopher N Poole
- Department of Educational Leadership and Human Development, Texas A&M University-Central Texas, Killeen, Texas, United States
| | - Matt S Stock
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL, United States
| | - Andrew D Fruge
- Dietetics and Hospitality, Auburn University, Auburn, AL, United States
| | - Kaelin C Young
- School of Kinesiology, Auburn University, Auburn, AL, United States.,Edward Via College of Osteopathic Medicine, Auburn, AL, United States
| | - Michael D Roberts
- School of Kinesiology, Auburn University, Auburn, AL, United States.,Edward Via College of Osteopathic Medicine, Auburn, AL, United States
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Naruse M, Trappe SW, Trappe TA. Human skeletal muscle size with ultrasound imaging: a comprehensive review. J Appl Physiol (1985) 2022; 132:1267-1279. [PMID: 35358402 PMCID: PMC9126220 DOI: 10.1152/japplphysiol.00041.2022] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Skeletal muscle size is an important factor in assessing adaptation to exercise training and detraining, athletic performance, age-associated atrophy and mobility decline, clinical conditions associated with cachexia, and overall skeletal muscle health. Magnetic resonance (MR) imaging and computed tomography (CT) are widely accepted as the gold standard methods for skeletal muscle size quantification. However, it is not always feasible to use these methods (e.g., field studies, bedside studies, large cohort studies). Ultrasound has been available for skeletal muscle examination for more than 50 years and the development, utility, and validity of ultrasound imaging are underappreciated. It is now possible to use ultrasound in situations where MR and CT imaging are not suitable. This review provides a comprehensive summary of ultrasound imaging and human skeletal muscle size assessment. Since the first study in 1968, more than 600 articles have used ultrasound to examine the cross-sectional area and/or volume of 107 different skeletal muscles in more than 27,500 subjects of various ages, health status, and fitness conditions. Data from these studies, supported by decades of technological developments, collectively show that ultrasonography is a valid tool for skeletal muscle size quantification. Considering the wide-ranging connections between human health and function and skeletal muscle mass, the utility of ultrasound imaging will allow it to be employed in research investigations and clinical practice in ways not previously appreciated or considered.
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Affiliation(s)
- Masatoshi Naruse
- Human Performance Laboratory, Ball State University, Muncie, IN, United States
| | - Scott W Trappe
- Human Performance Laboratory, Ball State University, Muncie, IN, United States
| | - Todd A Trappe
- Human Performance Laboratory, Ball State University, Muncie, IN, United States
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Hernández-Belmonte A, Martínez-Cava A, Pallarés JG. Pectoralis Cross-Sectional Area can be Accurately Measured using Panoramic Ultrasound: A Validity and Repeatability Study. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:460-468. [PMID: 34857426 DOI: 10.1016/j.ultrasmedbio.2021.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/13/2021] [Accepted: 10/20/2021] [Indexed: 06/13/2023]
Abstract
The objective of the current study was to examine the validity and repeatability of panoramic ultrasound in evaluating the anatomical cross-sectional area (ACSA) of the pectoralis major. Specifically, we aimed to quantify the measurement errors generated during the image acquisition and analysis (repeatability), as well as when comparing with magnetic resonance imaging (MRI) (validity). Moreover, we aimed to analyze the influence of the operator's experience on these measurement errors. Both sides of the chest of 16 participants (n = 32) were included. Errors made by two operators (trained and novice) when measuring pectoralis major ACSA (50% of sternum-areola mammae distance) were examined. Acquisition errors included the comparison of two images acquired 5 min apart. Acquisition 1 was analyzed twice to quantify analysis errors. Thereafter, acquisition 1 was compared with MRI. Statistics include the standard error of measurement (SEM), expressed in absolute (cm2) and relative (%) terms as a coefficient of variation (CV), and the calculation of systematic bias. Errors made by the trained operator were lower than those made by the novice, especially during the image acquisition (SEM = 0.25 vs. 0.66 cm2, CV = 1.06 vs. 2.98%) and when compared with MRI (SEM = 0.27 vs. 1.90 cm2, CV = 1.13 vs. 8.16%). Furthermore, although both operators underestimated the ACSA, magnitude and variability [SD] of these errors were lower for the trained operator (bias = -0.19 [0.34] cm2) than for the novice (bias = -1.97 [2.59] cm2). Panoramic ultrasound is a valid and repeatable technique for measuring pectoralis major ACSA, especially when implemented by a trained operator.
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Affiliation(s)
| | - Alejandro Martínez-Cava
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain
| | - Jesús G Pallarés
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain.
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Hernández-Belmonte A, Martínez-Cava A, Pallarés JG. Panoramic ultrasound requires a trained operator and specific evaluation sites to maximize its sensitivity: A comprehensive analysis of the measurement errors. Physiol Behav 2022; 248:113737. [PMID: 35150708 DOI: 10.1016/j.physbeh.2022.113737] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/08/2022] [Indexed: 01/07/2023]
Abstract
This study aimed to examine the validity and repeatability of panoramic ultrasound to evaluate the anatomical cross-sectional area (ACSA) of quadriceps femoris muscles. Specifically, we aimed to quantify the errors generated during the image acquisition and analysis (repeatability), as well as when comparing with magnetic resonance imaging (MRI) (validity). Moreover, we analyzed the influence of the operator's experience, and the region of the thigh, on these errors. Both thighs of 16 subjects were included. The validity and repeatability study quantified the errors made by two operators (trained and novice) when measuring ACSA of vastus lateralis (VL), vastus medialis-intermedius (VMVI), and rectus femoris (RF), in six thigh regions (from 20% to 70%). Two ACSA images were acquired 5 min apart to examine acquisition errors, whereas acquisition #1 was analyzed twice to quantify analysis errors. Thereafter, ACSA of acquisition #1 was compared with that measured by MRI. Statistics included the standard error of measurement (SEM) expressed in absolute (cm2) and relative terms (%) as a coefficient of variation (CV). Measurement errors were lower for the trained operator than for the novice: Acquisition (SEM = 0.05-0.78 vs. 0.25-1.42 cm2), analysis (SEM = 0.13-1.93 vs. 0.30-3.05 cm2) and compared-with-MRI (SEM = 0.13-1.93 vs. 0.30-3.05 cm2). Regions with the lowest errors were those located at the middle of the thigh (40-50%), although slight between-muscle differences were found: VMVI (30-40%), VL (40-50%), RF (50-60%). The accurate implementation of panoramic ultrasound to measure ACSA of quadriceps femoris muscles requires a trained operator and specific evaluation sites.
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Affiliation(s)
| | - Alejandro Martínez-Cava
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain
| | - Jesús G Pallarés
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain.
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Willemse L, Wouters EJM, Pisters MF, Vanwanseele B. Intra-assessor reliability and measurement error of ultrasound measures for foot muscle morphology in older adults using a tablet-based ultrasound machine. J Foot Ankle Res 2022; 15:6. [PMID: 35078499 PMCID: PMC8788121 DOI: 10.1186/s13047-022-00510-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/07/2022] [Indexed: 12/25/2022] Open
Abstract
Background To gain insight into the role of plantar intrinsic foot muscles in fall-related gait parameters in older adults, it is fundamental to assess foot muscles separately. Ultrasonography is considered a promising instrument to quantify the strength capacity of individual muscles by assessing their morphology. The main goal of this study was to investigate the intra-assessor reliability and measurement error for ultrasound measures for the morphology of selected foot muscles and the plantar fascia in older adults using a tablet-based device. The secondary aim was to compare the measurement error between older and younger adults and between two different ultrasound machines. Methods Ultrasound images of selected foot muscles and the plantar fascia were collected in younger and older adults by a single operator, intensively trained in scanning the foot muscles, on two occasions, 1–8 days apart, using a tablet-based and a mainframe system. The intra-assessor reliability and standard error of measurement for the cross-sectional area and/or thickness were assessed by analysis of variance. The error variance was statistically compared across age groups and machines. Results Eighteen physically active older adults (mean age 73.8 (SD: 4.9) years) and ten younger adults (mean age 21.9 (SD: 1.8) years) participated in the study. In older adults, the standard error of measurement ranged from 2.8 to 11.9%. The ICC ranged from 0.57 to 0.97, but was excellent in most cases. The error variance for six morphology measures was statistically smaller in younger adults, but was small in older adults as well. When different error variances were observed across machines, overall, the tablet-based device showed superior repeatability. Conclusions This intra-assessor reliability study showed that a tablet-based ultrasound machine can be reliably used to assess the morphology of selected foot muscles in older adults, with the exception of plantar fascia thickness. Although the measurement errors were sometimes smaller in younger adults, they seem adequate in older adults to detect group mean hypertrophy as a response to training. A tablet-based ultrasound device seems to be a reliable alternative to a mainframe system. This advocates its use when foot muscle morphology in older adults is of interest. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-022-00510-1.
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Logeson ZS, MacLennan RJ, Abad GKB, Methven JM, Gradl MR, Pinto MD, Pinto RS, Stock MS. The impact of skeletal muscle disuse on distinct echo intensity bands: A retrospective analysis. PLoS One 2022; 17:e0262553. [PMID: 35015790 PMCID: PMC8752001 DOI: 10.1371/journal.pone.0262553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/28/2021] [Indexed: 11/18/2022] Open
Abstract
Echo intensity (EI) is a novel tool for assessing muscle quality. EI has traditionally been reported as the mean of the pixel histogram, with 0 and 255 arbitrary units (A.U.) representing excellent and poor muscle quality, respectively. Recent work conducted in youth and younger and older adults suggested that analyzing specific EI bands, rather than the mean, may provide unique insights into the effectiveness of exercise and rehabilitation interventions. As our previous work showed deterioration of muscle quality after knee joint immobilization, we sought to investigate whether the increase in EI following disuse was limited to specific EI bands. Thirteen females (age = 21 yrs) underwent two weeks of left knee immobilization and ambulated via crutches. B-mode ultrasonography was utilized to obtain images of the immobilized vastus lateralis. The percentage of the total number of pixels within bands of 0–50, 51–100, 101–150, 151–200, and 201–255 A.U. was examined before and after immobilization. We also sought to determine if further subdividing the histogram into 25 A.U. bands (i.e., 0–25, 26–50, etc.) would be a more sensitive methodological approach. Immobilization resulted in a decrease in the percentage of pixels within the 0–50 A.U. band (-3.11 ± 3.98%), but an increase in the 101–150 A.U. (2.94 ± 2.64%) and 151–200 A.U. (0.93 ± 1.42%) bands. Analyses of variance on the change scores indicated that these differences were large and significant (%EI0-50 vs. %EI101-150: p < .001, d = 1.243); %EI0-50 vs. %EI151-200: p = .043, d = 0.831). The effect size for the %EI51-100 versus %EI101-150 comparison was medium/large (d = 0.762), but not statistically significant (p = .085). Further analysis of the 25 A.U. bands indicated that the percentage of pixels within the 25–50 A.U. band decreased (-2.97 ± 3.64%), whereas the 101–125 (1.62 ± 1.47%) and 126–150 A.U. (1.18 ± 1.07%) bands increased. Comparison of the 50 A.U. and 25 A.U. band methods found that 25 A.U. bands offer little additional insight. Though studies are needed to ascertain the factors that may influence specific bands, changes in EI during muscle disuse are not homogeneous across the pixel histogram. We encourage investigators to think critically about the robustness of data obtained from EI histograms, rather than simply reporting the EImean value, in muscle quality research.
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Affiliation(s)
- Zachary S. Logeson
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, Florida, United States of America
| | - Rob J. MacLennan
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, Stillwater, Oklahoma, United States of America
| | - Gerard-Kyle B. Abad
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, Florida, United States of America
| | - Johnathon M. Methven
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, Florida, United States of America
| | - Molly R. Gradl
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, Florida, United States of America
| | - Matheus D. Pinto
- Centre for Exercise and Sport Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Ronei S. Pinto
- Exercise Research Laboratory, Physical Education, Physiotherapy and Dance School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Matt S. Stock
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, Florida, United States of America
- * E-mail:
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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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Carr JC, Gerstner GR, Voskuil CC, Harden JE, Dunnick D, Badillo KM, Pagan JI, Harmon KK, Girts RM, Beausejour JP, Stock MS. The Influence of Sonographer Experience on Skeletal Muscle Image Acquisition and Analysis. J Funct Morphol Kinesiol 2021; 6:91. [PMID: 34842750 PMCID: PMC8628927 DOI: 10.3390/jfmk6040091] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 01/05/2023] Open
Abstract
The amount of experience with ultrasonography may influence measurement outcomes while images are acquired or analyzed. The purpose of this study was to identify the interrater reliability of ultrasound image acquisition and image analysis between experienced and novice sonographers and image analysts, respectively. Following a brief hands-on training session (2 h), the experienced and novice sonographers and analysts independently performed image acquisition and analyses on the biceps brachii, vastus lateralis, and medial gastrocnemius in a sample of healthy participants (n = 17). Test-retest reliability statistics were computed for muscle thickness (transverse and sagittal planes), muscle cross-sectional area, echo intensity and subcutaneous adipose tissue thickness. The results show that image analysis experience generally has a greater impact on measurement outcomes than image acquisition experience. Interrater reliability for measurements of muscle size during image acquisition was generally good-excellent (ICC2,1: 0.82-0.98), but poor-moderate for echo intensity (ICC2,1: 0.43-0.77). For image analyses, interrater reliability for measurements of muscle size for the vastus lateralis and biceps brachii was poor-moderate (ICC2,1: 0.48-0.70), but excellent for echo intensity (ICC2,1: 0.90-0.98). Our findings have important implications for laboratories and clinics where members possess varying levels of ultrasound experience.
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Affiliation(s)
- Joshua C. Carr
- Neuromuscular Physiology Laboratory, Texas Christian University, Fort Worth, TX 76129, USA; (J.C.C.); (C.C.V.)
- Department of Medical Education, TCU & UNTHSC School of Medicine, Fort Worth, TX 76129, USA
| | - Gena R. Gerstner
- Neuromechanics Laboratory, Department of Human Movement Sciences, Old Dominion University, Norfolk, VA 23529, USA; (G.R.G.); (J.E.H.)
| | - Caleb C. Voskuil
- Neuromuscular Physiology Laboratory, Texas Christian University, Fort Worth, TX 76129, USA; (J.C.C.); (C.C.V.)
| | - Joel E. Harden
- Neuromechanics Laboratory, Department of Human Movement Sciences, Old Dominion University, Norfolk, VA 23529, USA; (G.R.G.); (J.E.H.)
| | - Dustin Dunnick
- Department of Health and Physical Education, Arkansas Tech University, Russellville, AR 72801, USA;
| | - Kristin M. Badillo
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (K.M.B.); (J.I.P.); (K.K.H.); (R.M.G.); (J.P.B.)
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
| | - Jason I. Pagan
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (K.M.B.); (J.I.P.); (K.K.H.); (R.M.G.); (J.P.B.)
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
| | - Kylie K. Harmon
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (K.M.B.); (J.I.P.); (K.K.H.); (R.M.G.); (J.P.B.)
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
| | - Ryan M. Girts
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (K.M.B.); (J.I.P.); (K.K.H.); (R.M.G.); (J.P.B.)
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
| | - Jonathan P. Beausejour
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (K.M.B.); (J.I.P.); (K.K.H.); (R.M.G.); (J.P.B.)
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
| | - Matt S. Stock
- Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA; (K.M.B.); (J.I.P.); (K.K.H.); (R.M.G.); (J.P.B.)
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL 32816, USA
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Johnson NR, Kotarsky CJ, Hackney KJ, Trautman KA, Dicks ND, Byun W, Keith JF, David SL, Stastny SN. Measures Derived from Panoramic Ultrasonography and Animal-Based Protein Intake Are Related to Muscular Performance in Middle-Aged Adults. J Clin Med 2021; 10:988. [PMID: 33801196 PMCID: PMC7957891 DOI: 10.3390/jcm10050988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 01/18/2023] Open
Abstract
Ultrasonography advantageously measures skeletal muscle size and quality, but some muscles may be too large to capture with standardized brightness mode (B-mode) imaging. Panoramic ultrasonography can capture more complete images and may more accurately measure muscle size. We investigated measurements made using panoramic compared to B-mode ultrasonography images of the rectus femoris with muscular performance. Concurrently, protein intake plays an important role in preventing sarcopenia; therefore, we also sought to investigate the association between animal-based protein intake (ABPI) and muscular performance. Ninety-one middle-aged adults were recruited. Muscle cross-sectional area (CSA) and thickness were obtained using B-mode and panoramic ultrasound and analyzed with Image J software. Muscular performance was assessed using isokinetic dynamometry, a 30-s chair test, and handgrip strength. Three-day food diaries estimated dietary intakes. Linear regression models determined relationships between measures from ultrasonography and muscular performance. Mixed linear models were used to evaluate the association between ABPI and muscular performance. Muscle CSA from panoramic ultrasonography and ABPI were positively associated with lower-body strength (β ± S.E.; CSA, 42.622 ± 20.024, p = 0.005; ABPI, 65.874 ± 19.855, p = 0.001), lower-body endurance (β ± S.E.; CSA, 595 ± 200.221, p = 0.001; ABPI, 549.944 ± 232.478, p = 0.020), and handgrip strength (β ± S.E.; CSA, 6.966 ± 3.328, p = 0.004; ABPI, 0.349 ± 0.171, p = 0.045). Panoramic ultrasound shows promise as a method for assessing sarcopenia. ABPI is related to better muscular performance.
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Affiliation(s)
- Nathaniel R. Johnson
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58105, USA; (N.R.J.); (K.J.H.); (S.L.D.)
| | - Christopher J. Kotarsky
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY 12866, USA;
| | - Kyle J. Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58105, USA; (N.R.J.); (K.J.H.); (S.L.D.)
| | - Kara A. Trautman
- Department of Health and Exercise Science, Gustavus Adolphus College, St. Peter, MN 56082, USA;
| | - Nathan D. Dicks
- Department of Nutrition, Dietetics and Exercise Science, Concordia College, Moorhead, MN 56562, USA;
| | - Wonwoo Byun
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT 84112, USA;
| | - Jill F. Keith
- Department of Family and Consumer Sciences, University of Wyoming, Laramie, WY 82071, USA;
| | - Shannon L. David
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58105, USA; (N.R.J.); (K.J.H.); (S.L.D.)
| | - Sherri N. Stastny
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58105, USA; (N.R.J.); (K.J.H.); (S.L.D.)
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