Feasibility and Reliability of Quantifying Passive Muscle Stiffness in Young Children by Using Shear Wave Ultrasound Elastography

Abstract

Objective To investigate the feasibility and reliability of passive muscle stiffness measurements in children through use of shear wave ultrasound elastography. Methods This is a prospective cross -sectional study quantifying the passive stiffness of bilateral lateral gastrocnemii muscles during passive stretch in twenty typically developing children (age range, 2.0–12.6 years). Data collected included passive stiffness of the lateral gastrocnemius muscle (shear modulus in kilopascal [kPa]) at four positions of progressive passive foot dorsiflexion; demographic characteristics of the child participants; and comparison of demographic characteristics with the shear modulus. Results Passive stiffness increased with increasing stretch (mean [SD] range of stretch, 7.1 [2.0]–36.2 [22.0] kPa). For all four foot positions, no significant difference was found between right and left legs (range P=0.42 to P=0.98) or between the sexes (range P=0.28 to P> 0.99). No correlation of passive muscle stiffness to age, body mass index, or ankle range of motion was found. Reliability of measurements was good to excellent (mean [95% CI] range of reliability 0.67 [0.44–0.83] to 0.80 [0.63–0.90]). Conclusions Measurements of passive stiffness of the lateral gastrocnemius muscle are feasible and reliable in children as young as 2 years. Because the present study found no significant difference between sex and the side tested in this age-group, future studies involving children of this age range may not need to be stratified on the basis of these parameters. Defining normal passive muscle stiffness in children is critical for identifying and understanding the implications of abnormal passive muscle stiffness in children with neuromuscular disorders.

Quantitative assessment of rotator cuff muscle elasticity: Reliability and feasibility of shear wave elastography

“…Regarding the muscular tissues, in particular, the crural and the brachial muscles have been shown to have good measurement reliably with satisfactory ICCs (Brandenburg et al, 2015, Koo et al, 2013, Koo et al, 2014, Taniguchi et al, 2015). These muscles are known to have relatively consistent muscle fiber orientation.…”

“…Magnetic resonance elastography (MRE) has shown the capability to measure passive stiffness of thigh muscles (Debernard et al, 2011). However, the cost and accessibility of MRE may not only interfere with its clinical application (Brandenburg et al, 2015), but the time required for a single measurement might prevent its implementation for therapies or evaluations in which multiple measurements at different joint positions are necessary. Similarly, ultrasound elastographic techniques have also been investigated to quantify the material properties of muscles.…”

Shear-Wave Elastography: Basic Physics and Musculoskeletal Applications

“…During the past few years, several studies have been published on SWE of human tendons (5-17) and muscles (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), with promising results. The majority of these studies are experimental (5,6,(9)(10)(11)(12)(13)(14)(16)(17)(18)(19)(20)(21)(22)(23)(24)27,29,(31)(32)(33) with a smaller number of clinical studies (7,8,15,26,28,30,34,35).…”

“…The majority of these studies are experimental (5,6,(9)(10)(11)(12)(13)(14)(16)(17)(18)(19)(20)(21)(22)(23)(24)27,29,(31)(32)(33) with a smaller number of clinical studies (7,8,15,26,28,30,34,35). Additionally, several studies evaluated viscoelastic properties of the Achilles tendon (5)(6)(7)(8)(9)(10)(11)(12)(13)(14).…”

“…Promising results have been published in the recent literature on the utility of SWE in the evaluation of several traumatic and pathologic conditions of various musculoskeletal soft tissues, including tendons (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), muscles (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), nerves (30)(31)(32), and ligaments (33)(34)(35).…”