Enhanced echo intensity (EI) on an ultrasound image of skeletal muscle indicates changes in muscle quality, including increases in intramuscular fibrous and adipose tissues. However, it is not known whether muscle quality assessed from the EI of computer-aided gray-scale analysis of an ultrasound image is associated with the muscle strength or body composition of a subject. The objectives of this study were to investigate whether muscle quality assessed from EI measured using gray-scale analysis is associated with muscle strength independently of age or muscle thickness (MT), and to examine the relationship between muscle EI and body composition. Ninety-two healthy women with a mean age of 70.4 ± 5.5 years (range, 51-87 years) dwelling in Kyoto, Japan, participated in the study. The MT, subcutaneous fat thickness (FT), and EI of the quadriceps femoris on the right extremity were assessed from transverse ultrasound images. Knee extensor isometric strength was used as a measure of the quadriceps femoris muscle strength. EI was significantly correlated with quadriceps strength independently of age or MT, and stepwise regression analysis revealed that MT and EI were independently associated with quadriceps strength. Importantly, EI showed no significant correlations with FT, percentage of body fat (%BF), or body mass index (BMI), while FT, BMI, and %BF did not significantly influence muscle strength. These data suggest that muscle quantity (i.e., MT) and muscle quality assessed from EI measured using computer-aided gray-scale analysis independently contribute to muscle strength in middle-aged and elderly persons.

This study investigated the effects of age and inactivity due to being chronically bedridden on atrophy of trunk muscles. The subjects comprised 33 young women (young group) and 41 elderly women who resided in nursing homes or chronic care institutions. The elderly subjects were divided into two groups: independent elderly group who were able to perform activities of daily living involving walking independently (n = 28) and dependent elderly group who were chronically bedridden (n = 13). The thickness of the following six trunk muscles was measured by B-mode ultrasound: the rectus abdominis, external oblique, internal oblique, transversus abdominis, thoracic erector spinae (longissimus) and lumbar multifidus muscles. All muscles except for the transversus abdominis and lumbar multifidus muscles were significantly thinner in the independent elderly group compared with those in the young group. The thicknesses of all muscles in the dependent elderly group was significantly smaller than that in the young group, whereas there were no differences between the dependent elderly and independent elderly groups in the muscle thicknesses of the rectus abdominis and internal oblique muscles. In conclusion, our results suggest that: (1) age-related atrophy compared with young women was less in the deep antigravity trunk muscles than the superficial muscles in the independent elderly women; (2) atrophy associated with chronic bed rest was more marked in the antigravity muscles, such as the back and transversus abdominis.

This study investigated the relationship between age-related declines in muscle thickness of the lower extremities and daily physical activity in elderly women. The subjects comprised 20 young women and 17 elderly women residing in a nursing home. Lower limb muscle thickness was measured by B-mode ultrasound with the following 10 muscles; gluteus maximus, gluteus medius, gluteus minimus, psoas major, rectus femoris, vastus lateralis, vastus intermedius, biceps femoris, gastrocnemius and soleus. Daily physical activity was evaluated using life-space assessment (LSA) which assessed the life-space level, degree of independence, and frequency of attainment. Muscle thickness in the gluteus maximus, gluteus medius, gluteus minimus, psoas major, rectus femoris, vastus lateralis, vastus intermedius, biceps femoris and gastrocnemius, but not soleus, was significantly greater in the young group than the elderly group. The greatest rates of age-related loss of skeletal muscle mass in the lower limbs showed in the psoas major, while the smallest loss showed in soleus muscle. Only the gluteus medius was significantly associated with the LSA score (r = 0.528, p < 0.05) in elderly women. These results suggest that the reduction in skeletal mass with age is smaller in soleus muscle, and that the age-related decline in gluteus medius muscle is influenced by daily physical activity.

This study investigated the relationship between walking ability and age-related muscle atrophy of the lower limbs in elderly women. The subjects comprised 20 young women and 37 elderly women who resided in nursing homes or chronic care institutions. The elderly subjects were divided into three groups according to their walking ability. The muscle thickness of the following ten lower limb muscles were measured by B-mode ultrasound: the gluteus maximus, gluteus medius, gluteus minimus, psoas major, rectus femoris, vastus lateralis, vastus intermedius, biceps femoris, gastrocnemius and soleus. Compared to the young group, muscle thicknesses of all muscles except the soleus muscle were significantly smaller in all the elderly groups. There were no significant differences between the fast- and slow-walking groups in the thickness of any muscle. In the dependent elderly group, noticeable muscle atrophy was observed in the quadriceps femoris muscle. The results of this study suggest that the elderly who are capable of locomotion, regardless of their walking speed, show a moderate degree of age-related atrophy, while those who do not walk exhibit more severe atrophy, especially in the quadriceps femoris muscle.

Prone hip extension has been used as a self-perturbation task to test the stability of the lumbopelvic region. However, the relationship between recruitment patterns in the hip and trunk muscles and lumbopelvic kinematics remains unknown. The present study aimed to examine if the balance of hip and trunk muscle activities are related to pelvic motion and low back muscle activity during prone hip extension. Sixteen healthy participants performed prone hip extension from 30° of hip flexion to 10° of hip extension. Surface electromyography (of the gluteus maximus, semitendinosus, rectus femoris, tensor fasciae latae, multifidus, and erector spinae) and pelvic kinematic measurements were collected. Results showed that increased activity of the hip flexor (tensor fasciae latae) relative to that of hip extensors (gluteus maximus and semitendinosus) was significantly associated with increased anterior pelvic tilt during hip extension (r=0.52). Increased anterior pelvic tilt was also significantly related to the delayed onset timing of the contralateral and ipsilateral multifidus (r=0.57, r=0.53) and contralateral erector spinae (r=0.63). Additionally, the decrease of the gluteus maximus activity relative to the semitendinosus was significantly related to increased muscle activity of the ipsilateral erector spinae (r=-0.57). These results indicate that imbalance between the agonist and antagonist hip muscles and delayed trunk muscle onset would increase motion in the lumbopelvic region.