Non–Weight-Bearing and Weight-Bearing Ultrasonography of Select Foot Muscles in Young, Asymptomatic Participants: A Descriptive and Reliability Study

Battaglia, Patrick J.; Mattox, Ross; Winchester, Brett; Kettner, Norman W.

doi:10.1016/j.jmpt.2016.10.001

Cited by 12 publications

(10 citation statements)

References 19 publications

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“…As far as we know, this is the first study to report a reliable method for measuring the TP CSA using US. Our ICC scores were similar to or higher than those reported for other lower extremity muscles, which ranged from 0.57 to 0.99 15,26,29,30,34–36 . The SEM and LoA were also comparable to or lower than those seen in other studies 26,29,30 .…”

Section: Discussionsupporting

confidence: 86%

“…Our ICC scores were similar to or higher than those reported for other lower extremity muscles, which ranged from 0.57 to 0.99. 15,26,29,30,[34][35][36] The SEM and LoA were also comparable to or lower than those seen in other studies. 26,29,30 For thickness measurements, our LoA ranged from 5.8% to 9.7%, whereas other researchers saw a range of 9% to 18% for foot and leg muscles.…”

Section: Discussionsupporting

confidence: 71%

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Ultrasound Imaging Is Reliable for Tibialis Posterior Size Measurements

Johnson

Bruening

Violette

et al. 2020

J of Ultrasound Medicine

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Objectives-The tibialis posterior (TP) is a vital muscle for controlling the medial longitudinal arch of the foot during weight-bearing activities. Dysfunction of this muscle is associated with a variety of pathologic conditions; thus, it is important to reliably assess its morphologic characteristics. Ultrasound (US) has been used to assess characteristics of TP tendons but not the muscle crosssectional area (CSA). The purpose of this study was to establish a reliable US technique to measure the TP CSA and thickness. Methods-Twenty-three healthy volunteers participated. We evaluated the CSA and thickness at 4 measurement locations (anterior and posterior views at both 30% and 50% of the shank length). Results-The participants included 12 female and 11 male volunteers (mean age AE SD, 31.23 AE 14.93 years). Excellent reliability was seen for the CSA and thickness at all locations (intraclass correlation coefficients, 0.988-0.998). Limits of agreement (LoA) and standard errors of the measurement (SEMs) were slightly lower at the 30% locations

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 71%

Ultrasound Imaging Is Reliable for Tibialis Posterior Size Measurements

Johnson

Bruening

Violette

et al. 2020

J of Ultrasound Medicine

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“…A comparison of our results to previous studies that focused on still images further supports the benefits of cine loops. We showed comparable ICCs as several previous studies but lower LoAs in those studies reporting these additional metrics . Although ICCs have been traditionally used to evaluate reliability, they are highly affected by the subject's measurement range and may inflate the true reliability for this type of application.…”

Section: Discussionsupporting

confidence: 81%

“…Although optimal US settings (eg, transducer and frequency selection, depth, and focus position) are assumed across studies, transducer placement strategies and techniques have not been well standardized. Measurements of the foot muscles, for example, have been performed at the thickest part of the muscle, 50% of the foot length, and various positions on the leg referenced to internal bony landmarks . When measuring the abductor hallucis (ABDH) thickness, Mickle et al 20 found higher intraclass correlation coefficients (ICCs) and lower limits of agreement (LoAs) when using the medial malleolus landmark as opposed to the thickest part of the muscle, suggesting that the use of landmarks is likely more reliable than image‐based subjective locations.…”

mentioning

confidence: 99%

Use of Cine Loops and Structural Landmarks in Ultrasound Image Processing Improves Reliability and Reduces Error in the Assessment of Foot and Leg Muscles

Johnson

Stoneman

McClung

et al. 2019

J of Ultrasound Medicine

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Objectives-Foot and leg muscle strength and size are crucial to proper function. It is important to assess these characteristics reliably. Our primary objective was to compare the measurement of still images to cine loops. The secondary purpose was to determine interoperator and intraoperator reliability between operators of different experience levels using video clips and internal and external landmarks.Methods-Twelve healthy volunteers participated in our study. Internal (navicular tuberosity) and external (lateral leg length at 30% and 50% from the knee joint line) landmarks were used. Two operators each captured and later measured still and cine loop images of selected foot and leg muscles.Results-The 12 participants included 8 male and 4 female volunteers (mean age AE SD, 23.5 AE 1.9 years). Good to excellent intraoperator and interoperator reliability was seen (intraclass correlation coefficient range of 0.946-0.998). The use of cine loops improved the intraclass correlation coefficients for both intraoperator and interoperator reliability (0.5%-4% increases). The use of cine loops decreased the intraoperator standard error of the measurement and limits of agreement of the novice operator (decreases of 45%-73% and 24%-51%, respectively), and these became comparable to those of experienced operators using still images. The interoperator standard errors of the measurement dropped by 42% to 53%, whereas the limits of agreement dropped by 27% to 40%. No substantial changes were noted in the tibialis anterior across reliability metrics.Conclusions-Improved protocols that take advantage of using internal bony landmarks and cine loops during both the image-gathering and measurement processes improve the reliability of research examining muscle size changes in the lower leg or foot associated with muscle changes due to exercise, injury, disuse, or disease.

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“…Intertester reliability of these measurements have been found to be good to excellent. 30 The average measurement of the 3 images were utilized for analysis in each condition. Measures of active and resisted contraction were normalized to resting measures and reported as an activation ratio, 10,14,31 calculated using the formula: Activation ratio = Contracted measurement Resting measurement :…”

Section: Methodsmentioning

confidence: 99%

Ultrasound Measures of Intrinsic Foot Muscle Size and Activation Following Lateral Ankle Sprain and Chronic Ankle Instability

Fraser¹,

Koldenhoven²,

Hertel³

2021

Journal of Sport Rehabilitation

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Context: Tibial nerve impairment and reduced plantarflexion, hallux flexion, and lesser toe flexion strength have been observed in individuals with recent lateral ankle sprain (LAS) and chronic ankle instability (CAI). Diminished plantar intrinsic foot muscles (IFMs) size and contraction are a likely consequence. Objectives: To assess the effects of ankle injury on IFM size at rest and during contraction in young adults with and without LAS and CAI. Setting: Laboratory. Design: Cross-sectional. Patients: A total of 22 healthy (13 females; age = 19.6 [0.9], body mass index [BMI] = 22.5 [3.2]), 17 LAS (9 females; age =21.8 [4.1], BMI = 24.1 [3.7]), 21 Copers (13 females; age = 20.8 [2.9], BMI = 23.7 [2.9]), and 20 CAI (15 females; age = 20.9 [4.7], BMI = 25.1 [4.5]). Main Outcome Measures: Foot Posture Index (FPI), Foot Mobility Magnitude (FMM), and ultrasonographic cross-sectional area of the abductor hallucis, flexor digitorum brevis, quadratus plantae, and flexor hallucis brevis were assessed at rest, and during nonresisted and resisted contraction. Results: Multiple linear regression analyses assessing group, sex, BMI, FPI, and FMM on resting and contracted IFM size found sex (B = 0.45; P < .001), BMI (B = 0.05; P = .01), FPI (B = 0.07; P = .05), and FMM × FPI interaction (B = −0.04; P = .008) accounted for 19% of the variance (P = .002) in resting abductor hallucis measures. Sex (B = 0.42, P < .001) and BMI (B = 0.03, P = .02) explained 24% of resting flexor digitorum brevis measures (P < .001). Having a recent LAS (B = 0.06, P = .03) and FMM (B = 0.04, P = .02) predicted 11% of nonresisted quadratus plantae contraction measures (P = .04), with sex (P < .001) explaining 13% of resting quadratus plantae measures (B = 0.24, P = .02). Both sex (B = 0.35, P = .01) and FMM (B = 0.15, P = .03) predicted 16% of resting flexor hallucis brevis measures (P = .01). There were no other statistically significant findings. Conclusions: IFM resting ultrasound measures were primarily determined by sex, BMI, and foot phenotype and not injury status. Routine ultrasound imaging of the IFM following LAS and CAI cannot be recommended at this time but may be considered if neuromotor impairment is suspected.

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Non–Weight-Bearing and Weight-Bearing Ultrasonography of Select Foot Muscles in Young, Asymptomatic Participants: A Descriptive and Reliability Study

Cited by 12 publications

References 19 publications

Ultrasound Imaging Is Reliable for Tibialis Posterior Size Measurements

Ultrasound Imaging Is Reliable for Tibialis Posterior Size Measurements

Use of Cine Loops and Structural Landmarks in Ultrasound Image Processing Improves Reliability and Reduces Error in the Assessment of Foot and Leg Muscles

Ultrasound Measures of Intrinsic Foot Muscle Size and Activation Following Lateral Ankle Sprain and Chronic Ankle Instability

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