Reliability of skeletal muscle ultrasound in critically ill trauma patients

Vieira, Luciana; Rocha, Lara Patrícia Bastos; Mathur, Sunita; Santana, Larissa; Melo, Priscilla; Maldaner, Vinicius; Durigan, João Luíz Quagliotti; Cipriano, Gerson

doi:10.5935/0103-507x.20190072

Cited by 16 publications

(17 citation statements)

References 38 publications

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“…Although inter- and intrarater reliability obtained by the instructors was consistent with previous reliability studies of muscle architecture, 15 , 16 , 17 , 18 , 39 , 40 , 41 , 42 varied reliability was obtained between participants. Overall, the highest inter- and intrarater reliability was 0.96 and 0.96, respectively, and the lowest inter- and intrarater reliability was 0.00 and 0.19, respectively.…”

Section: Discussionsupporting

confidence: 87%

“…Ultrasound for the assessment of peripheral skeletal muscle architecture in critical illness has revealed excellent reliability levels, including parameters such as thickness, cross-sectional area, and echogenicity. 12 In particular, the reliability of ultrasound measurement of quadriceps thickness in ICU patients has been widely reported to range from 0.76-1.00; 15 , 16 , 17 , 18 , 39 , 40 , 41 , 42 notable, in the eMUSICS program it was consistently 0.70 for participants and 0.90 for instructors. Although reliability of pennation angle has not been reported for ICU patients, studies in non-ICU populations have reported weak to moderate reliability and high variability, ranging from 0.38-0.74.…”

Section: Discussionmentioning

confidence: 99%

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Evaluating a Muscle Ultrasound Education Program: Theoretical Knowledge, Hands-on Skills, Reliability, and Satisfaction of Critical Care Physiotherapists

González-Seguel

Pinto-Concha

Ríos-Castro

et al. 2021

Archives of Rehabilitation Research and Clinical Translation

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Objective To evaluate learning results of critical care physiotherapists participating in a muscle ultrasound (MUS) educational program. Design Cross-sectional study. Setting A custom-made 20-hour MUS course was performed over a 2-week time period, including knobs familiarization, patient positioning, anatomic landmarks, image acquisition, and limb muscle measurements. Participants Nineteen critical care physiotherapists with little to no prior experience in ultrasound (N=19). Interventions Not applicable. Main Outcome Measures Theoretical knowledge, hands-on skills acquisition, and satisfaction were assessed. Inter- and intrarater reliability on landmarks, thickness, and pennation angle of quadriceps between participants was evaluated using intraclass correlation coefficients (ICCs). Reliability among instructors measured prior to the course was also reported as a reference. Results The percentage score (mean±SD) of knowledge questionnaires was 69±11 (pre-course), 89±10 (post-course), and 92±9 (hands-on skills). Course satisfaction scores ranged from 90%-100%. Pooled interrater reliability of participants (median ICC [interquartile range]) was good (0.70 [0.59-0.79]) for thickness, moderate (0.47 [0.46-0.92]) for landmarks, and absent (0.00 [0.00-0.05]) for pennation angle and the intrarater reliability was good (0.76 [0.51-0.91]) for thickness and weak (0.35 [0.29-0.52]) for pennation angle. Interrater ICC values for instructors were excellent (0.90) for thickness, good (0.67) for landmarks, and moderate (0.41) for pennation angle and intrarater ICC values were excellent (0.94) for thickness and good (0.75) for pennation angle. Conclusions Although our sample was quite small and homogeneous, increased theoretical knowledge, high hands-on performance acquisition, and good satisfaction of physiotherapists were observed. Reliability was moderate to excellent for thickness and landmarks and absent to weak for pennation angle. Landmarking and pennation angle remain challenges for physiotherapist training in the application of MUS. Further studies are needed to identify variables that could modify reliability during MUS training.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Evaluating a Muscle Ultrasound Education Program: Theoretical Knowledge, Hands-on Skills, Reliability, and Satisfaction of Critical Care Physiotherapists

González-Seguel

Pinto-Concha

Ríos-Castro

et al. 2021

Archives of Rehabilitation Research and Clinical Translation

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“…Although inter and intra-rater reliability obtained by the instructors was consistent with preceding reliability studies of muscle architecture [15][16][17][18][39][40][41][42], there was varied reliability obtained between participants. Overall, the highest inter and intra-rater reliability was found in the group 3 ranged from 0.69 to 0.96 and 0.90 to 0.96, respectively.…”

Section: Discussionsupporting

confidence: 78%

Evaluating a muscle ultrasound education programme: theoretical knowledge, hands-on skills, reliability and satisfaction of critical care physiotherapists

González-Seguel

Pinto-Concha²,

Ríos-Castro

et al. 2021

Preprint

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Background: There is scarce evidence on learning outcomes of physiotherapists receiving formal muscle ultrasound training focused on the intensive care setting. The aim was to evaluate the theoretical knowledge, hands-on skills, satisfaction and reliability of critical care physiotherapists participating in a muscle ultrasound (MUS) educational programme. Methods: A cross-sectional study involving 19 critical care physiotherapists with little to no prior experience in ultrasound who completed standardized 20-hours in MUS was performed over 2-week time period; including knobology, patient positioning, anatomical landmarks, image acquisition and limb muscle measurements. Theoretical knowledge, hands-on skills acquisition and satisfaction were assessed. Inter and intra-rater reliability on landmarks, thickness and pennation angle of quadriceps between participants was evaluated using intraclass correlation coefficient (ICC). Reliability among instructors measured prior to the course was also reported as reference. Results: The percentage score (mean±SD) of knowledge questionnaires was 69±0.11 (pre-course), 89±0.10 (post-course) and 92±0.09 (hands-on skills). Course satisfaction scores were ranged from 90% to 100%. Participants obtained pooled inter-rater reliability (median ICC [IQR]) of 0.70 [0.59 to 0.79] for thickness, 0.47 [0.46 to 0.92] for landmarks, 0.00 [0.00 to 0.05] for pennation angle; and intra-rater reliability of 0.76 [0.51 to 0.91] for thickness, and 0.35 [0.29 to 0.52] for pennation angle. Instructors obtained inter-rater ICC values of 0.90 for thickness, 0.67 for landmarks and 0.41 for pennation angle; and intra-rater ICC values of 0.94 for thickness and 0.75 for pennation angle. Conclusions: Increasing on theoretical knowledge, high hands-on performance acquisition, and good satisfaction of physiotherapists were observed. Reliability was moderate to excellent for thickness and landmarks, and absent to weak for pennation angle. Landmarking and pennation angle remain challenges for physiotherapist training in the application of muscle ultrasound. Further studies are needed to identify variables that could modify the reliability during MUS training.

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“…intra-rater reliability ICC = 0.99; interrater reliability ICC = 0.96-0.97, test-retest reliability ICC = 0.88-0.91). 44,45 . Importantly, our findings pertaining to LM-related echogenicity are in agreement with the aforementioned studies.…”

Section: Discussionmentioning

confidence: 99%

Reliability of lumbar multifidus and iliocostalis lumborum thickness and echogenicity measurements using ultrasound imaging

Farragher

Pranata

El-Ansary

et al. 2021

Australas J Ultrason Med

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Purpose: To establish the test-retest and inter-rater reliability of lumbar multifidus (LM) and iliocostalis lumborum (IL) muscle thickness and echogenicity as derived using ultrasound imaging. Methods: Ultrasound images of the LM and IL were collected from 11 healthy participants on two occasions, 1 week apart, by two independent assessors. Measures of LM and IL thickness and echogenicity were subject to test-retest and inter-rater reliability, which was assessed by calculation of an F statistic, the interclass correlation coefficient (ICC), the standard error of measurement, 95% confidence intervals and Bland-Altman plots. This study was given approval by The University of Melbourne Behavioural and Social Sciences Human Ethics Sub-Committee (ref: 1749845). Results: Assessors A and B showed good to excellent test-retest reliability for LM thickness (ICC 3,3 A: 0.89 and B: 0.98), LM echogenicity (ICC 3,3 A: 0.93 and B: 0.95) and IL echogenicity (ICC 3,3 A: 0.87 and B: 0.83). Test-retest reliability for IL thickness was poor for Assessor A but excellent for Assessor B. Both assessors demonstrated excellent inter-rater reliability for LM thickness and echogenicity (ICC 2,3 : 0.79 and 0.94), but poor reliability for IL thickness and echogenicity (ICC 2,3 : 0.00 and 0.39). Conclusions: Inter-rater and test-retest reliability was excellent for LM but was less reliable for measures of the IL muscle.

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Reliability of skeletal muscle ultrasound in critically ill trauma patients

Cited by 16 publications

References 38 publications

Evaluating a Muscle Ultrasound Education Program: Theoretical Knowledge, Hands-on Skills, Reliability, and Satisfaction of Critical Care Physiotherapists

Evaluating a Muscle Ultrasound Education Program: Theoretical Knowledge, Hands-on Skills, Reliability, and Satisfaction of Critical Care Physiotherapists

Evaluating a muscle ultrasound education programme: theoretical knowledge, hands-on skills, reliability and satisfaction of critical care physiotherapists

Reliability of lumbar multifidus and iliocostalis lumborum thickness and echogenicity measurements using ultrasound imaging

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