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Di Ludovico A, La Bella S, Ciarelli F, Chiarelli F, Breda L, Mohn A. Skeletal muscle as a pro- and anti-inflammatory tissue: insights from children to adults and ultrasound findings. J Ultrasound 2024:10.1007/s40477-024-00917-5. [PMID: 38907089 DOI: 10.1007/s40477-024-00917-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/11/2024] [Indexed: 06/23/2024] Open
Abstract
Previously regarded as a movement and posture control agent, the skeletal muscle is now recognized as an endocrine organ that may affect systemic inflammation and metabolic health. The discovery of myokines such as IL-6, released from skeletal muscle in response to physical exercise, is now one of the most recent insights. Myokines are the mediators of the balance between the pro-inflammatory and anti-inflammatory responses. This underscores the muscle function as a determinant of good health and prevention of diseases. Advances in ultrasound technology improved evaluation of muscle thickness, composition, and determining fat distribution. Combining imaging with molecular biology, researchers discovered the complicated interplay between muscle function, cytokine production and general health effects.The production of myokines with exercise showcasing the adaptability of muscles to high-stress conditions and contributing to metabolism and inflammation regulation. These findings have significant implications in order to provide improvement in metabolic and inflammatory diseases.
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Affiliation(s)
| | | | | | | | - Luciana Breda
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Angelika Mohn
- Department of Pediatrics, University of Chieti, Chieti, Italy
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Oranchuk DJ, Bodkin SG, Boncella KL, Harris-Love MO. Exploring the associations between skeletal muscle echogenicity and physical function in aging adults: A systematic review with meta-analyses. JOURNAL OF SPORT AND HEALTH SCIENCE 2024:S2095-2546(24)00076-0. [PMID: 38754733 DOI: 10.1016/j.jshs.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/18/2024] [Accepted: 04/01/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Assessment and quantification of skeletal muscle within the aging population is vital for diagnosis, treatment, and injury/disease prevention. The clinical availability of assessing muscle quality through diagnostic ultrasound presents an opportunity to be utilized as a screening tool for function-limiting diseases. However, relationships between muscle echogenicity and clinical functional assessments require authoritative analysis. Thus, we aimed to (a) synthesize the literature to assess the relationships between skeletal muscle echogenicity and physical function in older adults (≥60 years), (b) perform pooled analyses of relationships between skeletal muscle echogenicity and physical function, and (c) perform sub-analyses to determine between-muscle relationships. METHODS CINAHL, Embase, MEDLINE, PubMed, and Web of Science databases were systematically searched to identify articles relating skeletal muscle echogenicity to physical function in older adults. Risk-of-bias assessments were conducted along with funnel plot examination. Meta-analyses with and without sub-analyses for individual muscles were performed utilizing Fisher's Z transformation for the most common measures of physical function. Fisher's Z was back-transformed to Pearson's r for interpretation. RESULTS Fifty-one articles (n = 5095, female = ∼2759, male = ∼2301, 72.5 ± 5.8 years, mean ± SD (1 study did not provide sex descriptors)) were extracted for review, with previously unpublished data obtained from the authors of 13 studies. The rectus femoris (n = 34) and isometric knee extension strength (n = 22) were the most accessed muscle and physical qualities, respectively. The relationship between quadriceps echogenicity and knee extensor strength was moderate (n = 2924, r = -0.36 (95% confidence interval: -0.38 to -0.32), p < 0.001), with all other meta-analyses (grip strength, walking speed, sit-to-stand, timed up-and-go) resulting in slightly weaker correlations (r: -0.34 to -0.23, all p < 0.001). Sub-analyses determined minimal differences in predictive ability between muscle groups, although combining muscles (e.g., rectus femoris + vastus lateralis) often resulted in stronger correlations with maximal strength. CONCLUSION While correlations were modest, the affordable, portable, and noninvasive ultrasonic assessment of muscle quality was a consistent predictor of physical function in older adults. Minimal between-muscle differences suggest that echogenicity estimates of muscle quality are systemic. Therefore, practitioners may be able to scan a single muscle to estimate full-body skeletal muscle quality/composition, while researchers should consider combining multiple muscles to strengthen the model.
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Affiliation(s)
- Dustin J Oranchuk
- Muscle Morphology, Mechanics, and Performance Laboratory, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - Stephan G Bodkin
- Muscle Morphology, Mechanics, and Performance Laboratory, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT 84108, USA
| | - Katie L Boncella
- Muscle Morphology, Mechanics, and Performance Laboratory, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Michael O Harris-Love
- Muscle Morphology, Mechanics, and Performance Laboratory, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
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Ciuffreda G, Bueno-Gracia E, Albarova-Corral I, Montaner-Cuello A, Pérez-Rey J, Pardos-Aguilella P, Malo-Urriés M, Estébanez-de-Miguel E. In Vivo Effects of Joint Movement on Nerve Mechanical Properties Assessed with Shear-Wave Elastography: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2024; 14:343. [PMID: 38337859 PMCID: PMC10855485 DOI: 10.3390/diagnostics14030343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
Peripheral nerves are subjected to mechanical tension during limb movements and body postures. Nerve response to tensile stress can be assessed in vivo with shear-wave elastography (SWE). Greater tensile loads can lead to greater stiffness, which can be quantified using SWE. Therefore, this study aimed to conduct a systematic review and meta-analysis to perform an overview of the effect of joint movements on nerve mechanical properties in healthy nerves. The initial search (July 2023) yielded 501 records from six databases (PubMed, Embase, Scopus, Web of Science, Cochrane, and Science Direct). A total of 16 studies were included and assessed with a modified version of the Downs and Black checklist. Our results suggest an overall tendency for stiffness increase according to a pattern of neural tensioning. The main findings from the meta-analysis showed a significant increase in nerve stiffness for the median nerve with wrist extension (SMD [95%CI]: 3.16 [1.20, 5.12]), the ulnar nerve with elbow flexion (SMD [95%CI]: 2.91 [1.88, 3.95]), the sciatic nerve with ankle dorsiflexion (SMD [95%CI]: 1.13 [0.79, 1.47]), and the tibial nerve with both hip flexion (SMD [95%CI]: 2.14 [1.76, 2.51]) and ankle dorsiflexion (SMD [95%CI]: 1.52 [1.02, 2.02]). The effect of joint movement on nerve stiffness also depends on the nerve segment, the amount of movement of the joint mobilized, and the position of other joints comprised in the entirety of the nerve length. However, due to the limited number of studies, many aspects of nerve behavior together with the effect of using different ultrasound equipment or transducers for nerve stiffness evaluation still need to be fully investigated.
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Affiliation(s)
- Gianluca Ciuffreda
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
| | - Elena Bueno-Gracia
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
| | - Isabel Albarova-Corral
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
| | - Alberto Montaner-Cuello
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
| | - Jorge Pérez-Rey
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
| | - Pilar Pardos-Aguilella
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
| | - Miguel Malo-Urriés
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
| | - Elena Estébanez-de-Miguel
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (E.B.-G.); (I.A.-C.); (A.M.-C.); (J.P.-R.); (P.P.-A.); (M.M.-U.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain
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Kim M, Yoon K, Lee S, Shin MS, Kim KG. Development of an Artificial Soft Solid Gel Using Gelatin Material for High-Quality Ultrasound Diagnosis. Diagnostics (Basel) 2024; 14:335. [PMID: 38337851 PMCID: PMC10855452 DOI: 10.3390/diagnostics14030335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/12/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024] Open
Abstract
For ultrasound diagnosis, a gel is applied to the skin. Ultrasound gel serves to block air exposure and match impedance between the skin and the probe, enhancing imaging efficiency. However, if use of the ultrasound gel exceeds a certain period of time, it may dry out and be exposed to air, causing impedance mismatch and reducing imaging resolution. In such cases, the use of a soft, solid gel proves advantageous, as it can be employed for an extended period without succumbing to the drying phenomenon and can be reused after disinfection. Its soft consistency ensures excellent skin adhesion. Our soft solid gel demonstrated approximately 1.2 times better performance than water, silicone, and traditional ultrasound gels. When comparing the dimensions of grayscale, dead zone, vertical, and horizontal regions, the measurements for the traditional ultrasound gel were 93.79 mm, 45.32 mm, 103.13 mm, 83.86 mm, and 83.86 mm, respectively. In contrast, the proposed soft solid gel exhibited dimensions of 105.64 mm, 34.48 mm, 141.1 mm, and 102.8 mm.
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Affiliation(s)
- Minchan Kim
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 Beon-gil, Namdong-daero, Namdong-gu, Incheon 21565, Republic of Korea; (M.K.); (K.Y.); (S.L.)
| | - Kicheol Yoon
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 Beon-gil, Namdong-daero, Namdong-gu, Incheon 21565, Republic of Korea; (M.K.); (K.Y.); (S.L.)
- Premedicine Course, College of Medicine, Gachon University, 38-13, 3 Beon-gil, Dokjom-ro 3, Namdong-gu, Incheon 21565, Republic of Korea
| | - Sangyun Lee
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 Beon-gil, Namdong-daero, Namdong-gu, Incheon 21565, Republic of Korea; (M.K.); (K.Y.); (S.L.)
- Department of Health and Safety Convergence Sciences & Health and Environmental Convergence Sciences, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Mi-Seung Shin
- Division of Cardiology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, 21 Namdong-daero 774 Beon-gil, Namdong-gu, Incheon 21565, Republic of Korea
| | - Kwang Gi Kim
- Medical Devices R&D Center, Gachon University Gil Medical Center, 21, 774 Beon-gil, Namdong-daero, Namdong-gu, Incheon 21565, Republic of Korea; (M.K.); (K.Y.); (S.L.)
- Department of Biomedical Engineering, College of Health Science, Gachon University, 191 Hambak-moero, Yeonsu-gu, Incheon 21936, Republic of Korea
- Department of Health Sciences and Technology, Gachon Advanced Institute for Health Sciences and Technology (GAIHST), Gachon University, 38-13, 3 Beon-gil, Dokjom-ro, Namdong-gu, Incheon 21565, Republic of Korea
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López Jiménez E, Neira Álvarez M, Menéndez Colino R, Checa López M, Grau Jiménez C, Pérez Rodríguez P, Vasquez Brolen B, Arias Muñana E, Ramírez Martín R, Alonso Bouzón C, Amor Andrés MS, Bermejo Boixareu C, Brañas F, Alcantud Ibáñez M, Alcantud Córcoles R, Cortés Zamora EB, Gómez Jiménez E, Romero Rizos L, Avendaño Céspedes A, Hernández Socorro CR, Abizanda P. Muscle mass loss measured with portable ultrasound in hospitalized older adults: The ECOSARC study. J Nutr Health Aging 2024; 28:100010. [PMID: 38267149 DOI: 10.1016/j.jnha.2023.100010] [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: 10/28/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES The main objective was to analyze the evolution of muscle of the Quadriceps Rectus Femoris (QRF) between admission and discharge, in older adults hospitalized with an acute medical disease in Acute Geriatric Units (AGUs). DESIGN Prospective multicentric observational cohort study. SETTING Seven AGUs from University Hospitals in Spain. PARTICIPANTS Hospitalized adults ≥ 70 years old, able to ambulate and without severe dementia. MEASUREMENTS Ultrasound measurements of QRF were acquired at 2/3 distal between anterior-superior iliac spine and patella in both legs by trained Geriatricians. Ultrasound Chison model ECO2 was used. QRF area, thickness, edema, echogenicity, and fasciculations were measured. RESULTS From the complete sample (n = 143), in 45 (31.5%) participants, ultrasound images were classified as non-valid by an expert radiologist. Mean age was 87.8 (SD 5.4). Mean hospital stay 7.6 days (SD 4.3). From those with valid images, 36 (49.3%), 2 (2.7%), and 35 (47.9%) presented a decrease, equal values, or an increase in QRF area from baseline to discharge, respectively, and 37 (50.0%), 2 (2.7%), and 35 (47.3%) presented a decrease, equal values, or an increase in QRF thickness, respectively. 26 (35.6%) presented a decrease in more than 0.2 cm2 of QRF area, and 23 (31.1%) a decrease in more than 0.1 cm of QRF thickness. Only 4 (5.4%) patients presented new edema, while 13 (17.6%) worsened echogenicity. CONCLUSION One third of older adults develop significant muscle loss during a hospitalization for acute medical diseases. TRIAL REGISTRATION NUMBER NCT05113758.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Fátima Brañas
- Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Rubén Alcantud Córcoles
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Elisa Belén Cortés Zamora
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Gómez Jiménez
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Fundación Hospital Nacional de Parapléjicos, Toledo, Spain
| | - Luis Romero Rizos
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Spain
| | - Almudena Avendaño Céspedes
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | | | - Pedro Abizanda
- Complejo Hospitalario Universitario de Albacete, Albacete, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Spain.
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Umbrello M, Brogi E, Formenti P, Corradi F, Forfori F. Ultrasonographic Features of Muscular Weakness and Muscle Wasting in Critically Ill Patients. J Clin Med 2023; 13:26. [PMID: 38202033 PMCID: PMC10780243 DOI: 10.3390/jcm13010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Muscle wasting begins as soon as in the first week of one's ICU stay and patients with multi-organ failure lose more muscle mass and suffer worse functional impairment as a consequence. Muscle wasting and weakness are mainly characterized by a generalized, bilateral lower limb weakness. However, the impairment of the respiratory and/or oropharyngeal muscles can also be observed with important consequences for one's ability to swallow and cough. Muscle wasting represents the result of the disequilibrium between breakdown and synthesis, with increased protein degradation relative to protein synthesis. It is worth noting that the resulting functional disability can last up to 5 years after discharge, and it has been estimated that up to 50% of patients are not able to return to work during the first year after ICU discharge. In recent years, ultrasound has played an increasing role in the evaluation of muscle. Indeed, ultrasound allows an objective evaluation of the cross-sectional area, the thickness of the muscle, and the echogenicity of the muscle. Furthermore, ultrasound can also estimate the thickening fraction of muscle. The objective of this review is to analyze the current understanding of the pathophysiology of acute skeletal muscle wasting and to describe the ultrasonographic features of normal muscle and muscle weakness.
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Affiliation(s)
- Michele Umbrello
- Department Intensive Care and Anesthesia, ASST Ovest Milanese, Ospedale Nuovo di Legnano, 20025 Legnano, Italy
| | - Etrusca Brogi
- Department Anaesthesia and Intensive Care, University of Pisa, 56126 Pisa, Italy
| | - Paolo Formenti
- Departement of Anesthesia and Intensive Care, ASST Nord Milano, Ospedale E Bassini, 20092 Cinisello Balsamo, Italy
| | - Francesco Corradi
- Department Anaesthesia and Intensive Care, University of Pisa, 56126 Pisa, Italy
| | - Francesco Forfori
- Department Anaesthesia and Intensive Care, University of Pisa, 56126 Pisa, Italy
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