Reliability and differences in quadriceps femoris muscle morphology using ultrasonography: The effects of body position and rest time

Tomko, Patrick M.; Muddle, Tyler W.D.; Magrini, Mitchel A.; Colquhoun, Ryan J.; Luera, Micheal J.; Jenkins, Nathaniel D.M.

doi:10.1177/1742271x18780127

Cited by 20 publications

(31 citation statements)

References 46 publications

(73 reference statements)

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“…In this study, for intra-rater comparisons, the ICCs were 0.89 and 0.94 for the RF 50 and RF 70 , respectively, a reliability similar to the highest results found previously in the literature. The SEM values of our study were slightly lower than the ones previously reported by Ruas et al 12 and Santos and Armada-da-Silva 13 and within the range reported by Tomko et al, 16 while the MDs were even lower. 12 These results indicate that RF EI measurements are reliable when obtained in different days by the same rater, meaning that, if results are different between sessions, they are likely because of a real change in the muscle structure.…”

Section: Discussionsupporting

confidence: 80%

“…Specifically, in the RF, ICCs ranged between 0.31 and 0.91. 7,9,[12][13][14]16 Ruas et al 12 reported SEMs of 8.81% (MDs ¼ 24.44%) of the mean EI value, Tomko et al 16 found SEM values ranging from 6.46% to 8.12% of the mean EI, while Santos and Armada-da-Silva 13 reported SEMs ranging from 2.06 to 3.61 (a.u. ).…”

Section: Discussionmentioning

confidence: 99%

“…Customarily, rectus femoris (RF) US measurements are acquired in the midpoint of the thigh length. 7,12,14,16 However, most probes are not wide enough to capture the whole muscle cross-sectional area in a single transverse image. The extremities are usually cut off, and only part of the muscle can be analyzed.…”

Section: Introductionmentioning

confidence: 99%

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Echo intensity reliability between two rectus femoris probe sites

et al. 2019

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Introduction The ultrasound technique has been extensively used to measure echo intensity, with the goal of measuring muscle quality, muscle damage, or to detect neuromuscular disorders. However, it is not clear how reliable the technique is when comparing different days, raters, and analysts, or if the reliability is affected by the muscle site where the image is obtained from. The goal of this study was to compare the intra-rater, inter-rater, and inter-analyst reliability of ultrasound measurements obtained from two different sites at the rectus femoris muscle. Methods Muscle echo intensity was quantified from ultrasound images acquired at 50% [RF50] and at 70% [RF70] of the thigh length in 32 healthy subjects. Results Echo intensity values were higher ( p = 0.0001) at RF50 (61.08 ± 12.04) compared to RF70 (57.32 ± 12.58). Reliability was high in both RF50 and RF70 for all comparisons: intra-rater (ICC = 0.89 and 0.94), inter-rater (ICC = 0.89 and 0.89), and inter-analyst (ICC = 0.98 and 0.99), respectively. However, there were differences ( p < 0.05) between raters and analysts when obtaining/analyzing echo intensity values in both rectus femoris sites. Conclusions The differences in echo intensity values between positions suggest that rectus femoris's structure is not homogeneous, and therefore measurements from different muscle regions should not be used interchangeably. Both sites showed a high reliability, meaning that the measure is accurate if performed by the same experienced rater in different days, if performed by different experienced raters in the same day, and if analyzed by different well-trained analysts, regardless of the evaluated muscle site.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Echo intensity reliability between two rectus femoris probe sites

et al. 2019

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“…It is apparent that changes in position can create a similar musclebulging effect due to the influence of gravity on muscle shape and size [14,25] that may not be due to true muscle gearing. Anecdotally, we noted that the VL appeared flatter and longer in the recumbent positions compared to ST, which may have allowed for only modest changes in CSA as compared to the larger changes in MT [25] (Figure 3). In the present study, we observed a significant decrease in VL CSA after 15 min of rest in the recumbent position (from IP to NDLR), with no significant change in MT, which is consistent with the findings of others [22,24].…”

Section: Discussionmentioning

confidence: 99%

Effects of Rest Position on Morphology of the Vastus Lateralis and Its Relationship with Lower-Body Strength and Power

Varanoske

Coker

Johnson

et al. 2019

JFMK

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Ultrasonography of the lower body typically encompasses supine rest due to fluid shifts affecting tissue size and composition. However, vastus lateralis (VL) examination is completed in the lateral recumbent position, and this positional change may influence morphology and its ability to predict function. This study aimed to examine the effect of position on VL morphology and its relationship with lower-body performance. Cross-sectional area (CSA), muscle thickness (MT), pennation angle (PA), echo intensity (UnCorEI), subcutaneous adipose tissue thickness (SFT), and echo intensity corrected for SFT (CorEI) were assessed in 31 resistance-trained males (23.0 ± 2.1 yrs; 1.79 ± 0.08 m; 87.4 ± 11.7 kg) immediately after transitioning from standing to supine (IP), after 15 min of standing (ST), and after 15 min of rest in three recumbent positions: supine (SUP), dominant lateral recumbent (DLR), non-dominant lateral recumbent (NDLR). Participants also completed unilateral vertical jumps, isometric/isokinetic tests, and a one-repetition maximum leg press. CSA, MT, PA, and SFT were greater in ST compared to NDLR, DLR, and SUP (p < 0.05). CSA, UnCorEI, and CorEI were different between recumbent positions; however no differences were observed for MT, PA, and SFT. Different magnitudes of relationships were observed between muscle morphological characteristics measured after rest in different positions and performance variables. Muscle morphology in IP generally appears to be the best predictor of performance for most variables, although utilizing the NDLR and DLR positions may provide comparable results, whereas morphology measured in ST and SUP provide weaker relationships with physical performance. IP also requires less time and fewer requirements on the technician and subject, thus researchers should consider this positioning for VL examination.

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“…Although ultrasound is an attractive method for measuring muscle size, it is important to consider a number of limitations. Methodological issues such as site of scan, identification of landmarks, patient position, and probe placement including angle and force applied can all impact the accuracy of the results and may contribute to the heterogeneity in the parameters measured and reported in the skeletal muscle ultrasound literature. As such, although ultrasound is a relatively straightforward technique, appropriate training with validation and reliability work should be performed to ensure consistency with measurements …”

Section: Discussionmentioning

confidence: 99%

Ultrasound assessment of muscle mass in response to exercise training in chronic kidney disease: a comparison with MRI

Gould

Watson

Wilkinson

et al. 2019

J cachexia sarcopenia muscle

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Background Chronic kidney disease (CKD) is a catabolic condition associated with muscle wasting and dysfunction, which associates with morbidity and mortality. There is a need for simple techniques capable of monitoring changes in muscle size with disease progression and in response to interventions aiming to increase muscle mass and function. Ultrasound is one such technique; however, it is unknown how well changes in muscle cross‐sectional area (CSA) measured using ultrasound relate to changes in whole muscle volume measured using magnetic resonance imaging. We tested whether rectus femoris CSA (RF‐CSA) could be used as a valid indication of changes in quadriceps muscle volume as a single measure of muscle size and following a 12 week exercise intervention that resulted in muscle hypertrophy. Methods Secondary analysis of data was collected from the ExTra CKD study (ISRCTN 36489137). Quadriceps muscle size was assessed from 36 patients with non‐dialysis CKD before and after 12 weeks of supervised exercise that resulted in muscle hypertrophy. Results Strong positive correlations were observed between RF‐CSA and quadriceps volume at baseline ( r 2 = 0.815, CI 0.661 to 0.903; P < 0.001) and following 12 week exercise ( r 2 = 0.845, CI 0.700 to 0.923; P < 0.001). A moderate positive association was also observed between changes in RF‐CSA and quadriceps following exercise training (rho = 0.441, CI 0.085 to 0.697; P = 0.015). Bland–Altman analysis revealed a small bias (bias 0.6% ± 12.5) between the mean percentage changes in RF‐CSA and quadriceps volume but wide limits of agreement from −24 to 25. Conclusions Rectus femoris CSA appears to be a reliable index of total quadriceps volume as a simple measure of muscle size, both as a single observation and in response to exercise training in non‐dialysis CKD patients.

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Reliability and differences in quadriceps femoris muscle morphology using ultrasonography: The effects of body position and rest time

Cited by 20 publications

References 46 publications

Echo intensity reliability between two rectus femoris probe sites

Echo intensity reliability between two rectus femoris probe sites

Effects of Rest Position on Morphology of the Vastus Lateralis and Its Relationship with Lower-Body Strength and Power

Ultrasound assessment of muscle mass in response to exercise training in chronic kidney disease: a comparison with MRI

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