Muscle measurements in daily clinical practice: correlations between ultrasound, bioelectrical impedance analysis and hand grip strength

Abstract

Objectives: Muscle ultrasound is gaining importance as a measurement tool to evaluate sarcopenia in daily clinical practice. This study sought to collect reference values of the biceps brachii (BB) in healthy subjects, and to correlate them to bioelectrical impedance analysis (BIA) and hand grip strength (HGS). Methods: Ultrasound was used to measure muscle thickness (MT), cross-sectional area (CSA) and muscle stiffness (EG). Lean mass (LM), fat mass (FM) and phase angle (PhA) were measured by BIA. HGS was measured using a Jamar dynamometer. Intra-rater reliability was calculated using intraclass correlation (ICC). Correlations were investigated using Pearson correlation (PCC). Results: One-hundred-twenty-three Caucasian individuals (51 male and 72 female subjects) between 18 and 69 years old were included. ICC for ultrasound was 0.99 (CI 0.98-0.99). LM, PhA and HGS showed significant correlations with MT and CSA in the entire population (PCC>0.684). These correlations were more significant and stronger in male than in female subjects (PCC>0.419 and >0.279 resp.). Significant correlations with respect to FM and EG were seen exclusively in female subjects. Conclusion: Significant correlations were observed between parameters of muscle quantity measured by ultrasound, BIA and HGS. Intra-rater reliability was excellent. Future studies in larger populations are needed to clarify the observed gender differences.

Relation Between Ultrasonographic Measurements of the Biceps Brachii and Total Muscle Mass in Older Hospitalized Persons: A Pilot Study

“…In our results, no significant correlation was obtained between these parameters in women, perhaps due to the smaller sample size of the female cohort. Furthermore, as has been obtained in a younger population, the correlation between MT and muscle mass is stronger in men than in women 24 .…”

“…As shown in Table 3 , the skeletal muscle mass of the patients studied correlates directly and strongly with both BB muscle thickness and cross-sectional area. This is also seen in younger community-dwelling persons[ 24 ]. The results are maintained when studying men and women separately, except for muscle thickness, which ceases to correlate with muscle mass in the hospitalized women studied.…”

“…Some authors have become interested in this muscle in recent years and have carried out studies trying to provide data and values about BB. Reference values have recently been published in healthy subjects in the same way as had previously been done with lower extremities muscles[ 24 ]. They used the same location as used in this study for muscle measurement and obtained an excellent ICC of 0.99, which demonstrates high reliability of the results.…”

“…A control group was not included in the present pilot study. However, researchers from the same research group previously carried out a study with younger healthy subjects in which the relationship between BB ultrasound measurements and muscle mass was studied[ 24 ].…”

“…Rectus femoris and vastus lateralis are the most studied muscles in research and a relationship between ultrasonographic measurements of these muscles with low muscle mass, low muscle strength and even sarcopenia in older persons has been shown [18][19][20][21] . However, for screening purposes of large groups of persons, either patients or healthy subjects, measuring the rectus femoris of vastus lateralis can pose some practical issues and some studies have been done in order to look into measurements of the upper limb [22][23][24] . Another viable candidate for a muscle that require less patient collaboration and in which the anatomical point determination is easier is the biceps brachii (BB).…”