Quantitative ultrasonography of skeletal muscles in children: Normal values

Scholten, Ralph R.; Pillen, Sigrid; Verrips, Aad; Zwarts, Machiel J.

doi:10.1002/mus.10384

Cited by 190 publications

(210 citation statements)

References 15 publications

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“…In addition, anisotropy or angular dependence can also affect the echogenicity of an imaged structure [10]. In this study, we tried to minimise the effects of anisotropy by aligning the transducer at right angles to the forearm bones so that it produced maximum echogenicity of the bones and the median nerve, a method that has previously been described [4,5,7,11], and used the average of three EI measurements of the MN and FMs.…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of the echo intensity of the median nerve and flexor muscles of the forearm in the young and the elderly

Karmakar²,

Lee³

et al. 2012

BJR

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Objectives: Musculoskeletal structures often appear brighter on imaging in the elderly, which makes it difficult to accurately delineate a peripheral nerve during ultrasound-guided regional anaesthetic procedures. The echo intensity of skeletal muscles is significantly increased in the elderly. However, there are no data comparing the echo intensity of peripheral nerves in the young and the elderly, which this study was designed to evaluate. Methods: 13 healthy, young volunteers (aged ,30 years) and 11 elderly patients (aged .60 years) who were scheduled to undergo orthopaedic lower limb surgery were recruited. The settings of the ultrasound system were standardised and a high-frequency linear array transducer was used for the scan. A transverse scan of the median nerve (MN) and the flexor muscles (FMs) at the left mid-forearm was performed and three video loops of the ultrasound scan were recorded for each subject. Still images were captured from the video loops and normalised. Computer-assisted greyscale analysis was then performed on these images to determine the echo intensity of the MN and the FMs of the forearm. Results: The echo intensity of the MN and FMs of the mid-forearm was significantly increased in the elderly (p,0.005). There was also a reduction in contrast between the MN and the adjoining FM in the elderly (p50.04). Conclusion: Under the conditions of this study, the MN and the FMs in the forearm appeared significantly brighter than those in the young, and there was a loss of contrast between these structures in sonograms of the elderly.

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Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of the echo intensity of the median nerve and flexor muscles of the forearm in the young and the elderly

Karmakar²,

Lee³

et al. 2012

BJR

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“…Considering this fact, the above result brings up the question of the validity of using ultrasonic muscle thickness determined at rest to evaluate individual differences in muscle size. In previous studies, muscle thickness measurements with ultrasonography have been performed in standing (Abe et al, 1994;Akagi et al, 2010;Kubo et al, 2003aKubo et al, , 2003bMiyatani et al, 2003Miyatani et al, , 2004Pinkoski et al, 2006;Toji and Kaneko, 2007;Wakahara et al, 2010), supine (Ainscough-Potts et al, 2006;Arts et al, 2010;Campbell et al, 1995;Pillen et al, 2003Pillen et al, , 2007Reimers et al, 1998;Scholten et al, 2003), or prone (Candow and Chilibeck, 2005;Candow et al, 2006;Mohagheghi et al, 2007;Reimers et al, 1998) positions. In the standing position, the gravitational force acted on the muscles of interest in the proximal-distal direction.…”

Section: Discussionmentioning

confidence: 99%

Methodological Issues Related to Thickness-Based Muscle Size Evaluation

Akagi

Iwanuma

Fukuoka

et al. 2011

J Physiol Anthropol

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The purpose of this study was to highlight the issues related to thickness-based muscle size evaluation that is commonly done in field studies. The cross-sectional area, thickness (the vertical distance from the upper end of the elbow flexors to that of the humerus) and width (the horizontal distance from the left to the right end of the elbow flexors) of the elbow flexors at levels from the reference site (60% of the upper arm length from the acromial process of the scapula to the lateral epicondyle of the humerus) to 5 cm distal to it were determined in 11 young men using magnetic resonance imaging, both at rest and during isometric elbow flexion at 30% of maximal voluntary contraction. During 30% of maximal voluntary contraction, the thickness increased but the width decreased at each measurement site compared with those at rest. This was possibly due to difference in muscle slackness between both conditions. The correlation coefficients between the thickness and cross-sectional area for the elbow flexors were significantly lower at rest (rϭ0.551-0.856) than during 30% of maximal voluntary contraction (rϭ0.711-0.922). The present findings indicate that the thickness-based muscle size measurement at rest includes errors owing to the slackness of the resting muscles.

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“…22 Muscle thickness measurement using B-mode ultrasound has been used in several studies in normal children. 15,16 It is a reliable method in normal children for the quadriceps femoris 15 and in young adults for muscles of the upper arm, forearm, abdomen, back, thigh, and calf. 23 The present study showed a significant correlation between MTQ and GMFM-66 scores.…”

Section: Discussionmentioning

confidence: 99%

“…This positioning was easy to maintain even for children with severe knee flexion contracture. As previously described, 15,16 transverse ultrasound images of the quadriceps femoris were used to measure the MTQ. The transducer was positioned at the midpoint between the anterior superior iliac spine and the proximal end of the patella.…”

Section: Measurementsmentioning

confidence: 99%

Relation between muscle thickness, spasticity, and activity limitations in children and adolescents with cerebral palsy

Ohata

Tsuboyama

Haruta

et al. 2008

Develop Med Child Neuro

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The aim of this study was to investigate the relation between muscle thickness of the quadriceps femoris muscle, knee joint function (spasticity and range of motion), and activity and participation measures in children and adolescents with cerebral palsy (CP). Thirty-eight children and adolescents with mild to severe CP (20 males, 18 females; mean age 12y 8mo [SD 3y 7mo], range 6-18y) participated. The severity and type of CP of participants covered all five levels of the Gross Motor Function Classification System and three types: spastic (quadriplegia, hemiplegia, and diplegia), athetotic, and hypotonic. The thickness of the quadriceps femoris muscle (MTQ) was measured from B-mode ultrasound images. Activity limitations were evaluated by the Gross Motor Function Measurement-66 (GMFM-66) and the Pediatric Evaluation of Disability Inventory (PEDI). Spasticity was assessed with the modified Ashworth scale (MAS). After adjustment for age and body mass index, the MTQ showed significant positive correlations with GMFM-66 and PEDI scores; however, there was no significant correlation with MAS ratings. The degree of knee flexion contracture correlated positively with the MAS rating of the knee flexor muscles and negatively with the MTQ. These results established the clinical relevance of assessment of muscle thickness across a broad spectrum of individuals with CP.Children with cerebral palsy (CP) have various impairments that interfere with their activity and participation, according to the International Classification of Functioning, Disability and Health (ICF). These impairments include neuromuscular and musculoskeletal problems 1 such as spasticity, muscle contracture, dyscoordination, loss of selective motor control, and weakness. Muscle weakness is one of the common problems of body function in children and adults with CP. Even children with mild CP demonstrate substantial weakness compared with age-related peers. 2 Many researchers have reported the relation between muscle strength and motor function in children with mild to moderate CP; 3,4 however, little is known about the influence of muscle weakness on motor function in children with severe CP. Their motor control problems, behavioural issues, and insufficient comprehension can make the measurement of muscle strength difficult. In children with CP, especially with severe CP, immobility affects not only their daily activities, but their cardiorespiratory conditioning, use of medication, demand for health care resources, and cognitive status. 5 Thus, assessment of the influence of immobility, such as reduction in muscle strength, is important for children with severe CP.Spasticity is another motor impairment in children with CP. Damiano et al. 6 demonstrated a relation between higher resistance torque and lower strength, particularly in the antagonist muscles, across a wide range of functional levels; however, their inclusion criteria required the ability to produce maximum effort. Thus, it is still unclear whether spasticity is related to muscle strength and...

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Quantitative ultrasonography of skeletal muscles in children: Normal values

Cited by 190 publications

References 15 publications

Quantitative evaluation of the echo intensity of the median nerve and flexor muscles of the forearm in the young and the elderly

Quantitative evaluation of the echo intensity of the median nerve and flexor muscles of the forearm in the young and the elderly

Methodological Issues Related to Thickness-Based Muscle Size Evaluation

Relation between muscle thickness, spasticity, and activity limitations in children and adolescents with cerebral palsy

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