Reliability and validity of the ultrasound technique to measure the rectus femoris muscle diameter in older CAD-patients

Abstract

BackgroundThe increasing age of coronary artery disease (CAD) patients and the occurrence of sarcopenia in the elderly population accompanied by 'fear of moving' and hospitalization in these patients often results in a substantial loss of skeletal muscle mass and muscle strength. Cardiac rehabilitation can improve exercise tolerance and muscle strength in CAD patients but less data describe eventual morphological muscular changes possibly by more difficult access to imaging techniques. Therefore the aim of this study is to assess and quantify the reliability and validity of an easy applicable method, the ultrasound (US) technique, to measure the diameter of rectus femoris muscle in comparison to the muscle dimensions measured with CT scans.Methods45 older CAD patients without cardiac event during the last 9 months were included in this study. 25 patients were tested twice with ultrasound with a two day interval to assess test-retest reliability and 20 patients were tested twice (once with US and once with CT) on the same day to assess the validity of the US technique compared to CT as the gold standard. Isometric and isokinetic muscle testing was performed to test potential zero-order correlations between muscle diameter, muscle volume and muscle force.ResultsAn intraclass correlation coefficient (ICC) of 0.97 ((95%CL: 0.92 - 0.99) was found for the test-retest reliability of US and the ICC computed between US and CT was 0.92 (95%CL: 0.81 - 0.97). The absolute difference between both techniques was 0.01 ± 0.12 cm (p = 0.66) resulting in a typical percentage error of 4.4%. Significant zero-order correlations were found between local muscle volume and muscle diameter assessed with CT (r = 0.67, p = 0.001) and assessed with US (r = 0.49, p < 0.05). Muscle strength parameters were also significantly correlated with muscle diameter assessed with both techniques (range r = 0.45-r = 0.61, p < 0.05).ConclusionsUltrasound imaging can be used as a valid and reliable measurement tool to assess the rectus femoris muscle diameter in older CAD patients.

Validity of measuring distal vastus medialis muscle using rehabilitative ultrasound imaging versus magnetic resonance imaging

“…Finally, Thomaes et al (2012) Other studies comparing MRI and RUSI measures of different muscles have shown good results but differing analytical techniques limits the comparison to the present study. The CSA of lumbar multifidus was compared using MRI and RUSI at vertebral levels from L2 to S1 and no significant differences were found, despite differences in position for imaging (Hides, Richardson, 1995).…”

“…Three previous studies have compared measures taken from US and MRI images of the quadriceps muscle group (Walton, Roberts, 1997, Reeves, Maganaris, 2004, Thomaes, Thomis, 2012. Direct comparison to the present study is limited for two of these studies (Walton, Roberts, 1997, Reeves, Maganaris, 2004, as they compared CSA rather than linear measurements using a compound scanning technique (Cavalieri technique).…”

“…Several studies have reported RUSI as a valid method for measuring the size of muscles when compared to MRI, including; the lumbar multifidus (Hides et al , 1995), cervical multifidus (Lee et al , 2007), abdominals (Hides et al , 2006), trapezius (O'Sullivan et al , 2009), quadriceps (Walton et al , 1997, Reeves, Maganaris, 2004, Thomaes et al , 2012 and anterior hip muscles (Mendis et al , 2010). A systematic review of 13 studies on the validity of using RUSI compared with MRI or computed tomography (CT) concluded that RUSI can provide valid measurements of skeletal muscles (Pretorius and Keating, 2008).…”

Evaluation of Factors Influencing Thigh Circumference Measurement in Dogs

“…Therefore, minimal changes in TC are likely clinically relevant. Ideally a CT scan would have been utilised to confirm true changes in limb circumference under this cadaver model (Thomaes et al, 2012), but this was cost prohibitive for the scope of this study. When interpreting our study results, one should also consider that long-haired dogs were used for evaluation of hair clipping; therefore the findings may not be applicable to short-haired dogs.…”

“…Definitive measurement of muscle mass involves advanced imaging, making it impractical and cost prohibitive in most clinical cases. Limb circumference measurement with a tape measure is frequently used in both human and veterinary patients as an indirect measure of changes in muscle mass over time (Doxey, 1987a, Doxey, 1987b, Jarvela et al, 2002, Thomaes et al, 2012).…”