Transverse plane panoramic ultrasound image of the long head of the biceps femoris (BF), semitendinosus (ST) and semimembranosus (SM) muscles. Muscle cross-sectional area and echo intensity values were determined for the BF, ST and SM by manually tracing the border of each muscle using the polygon selection function in ImageJ software. Muscle thickness values were determined as the distance between the superficial and deep fascia of each muscle at the widest distance. Examples of the corresponding gray-scale histogram values from each muscle are provided.

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Reliability of Panoramic Ultrasound Imaging in Simultaneously Examining Muscle Size and Quality of the Hamstring Muscles in Young, Healthy Males and Females

Article

Full-text available

Mar 2015

The purpose of this study was to examine the reliability of ultrasound (US) measures of cross-sectional area (CSA), muscle thickness (MT) and echo intensity (EI) of the hamstrings, with comparisons between males and females. In 20 healthy participants (10 males, 10 females), CSA, MT and EI were measured from panoramic US scans of the hamstrings on...

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... to examine the reliability of panoramic US to measure the size and quality of the BF, ST and SM such that future studies can determine the minimum sample sizes neces- sary for observing real differences with adequate statistical power. Moreover, it may also be of great value to examine the relationships between CSA, MT and EI of the BF, ST and SM. Although the correlations between EI versus CSA and MT have rarely been examined, the relationships between CSA and MT have garnered recent attention (Larrie-Baghal et al. 2012), especially since some US units are incapable of measuring CSA (Rezasoltani 2003), and therefore, measuring MT may be the only way these devices can estimate muscle size (Larrie-Baghal et al. 2012; Rezasoltani 2003). Thus, given the importance of these relationships to estimates of muscle size and quality and the potential influence of gender and intermuscular differences on the reliability of US measurements of the lower body, further research is warranted examining the reliability and relationships of several US measures and specific hamstring muscles in males and females. Therefore, the purpose of this investigation was to examine the reliability of US measures of CSA, MT and EI of the hamstring muscles in young, healthy males and females. A secondary aim of this study was to compare CSA, MT and EI between genders and to examine the relationships between these parameters in each hamstring muscle. Ten healthy males (mean standard deviation (SD): age 5 24 6 3 y, mass 5 81 6 12 kg, height 5 176 6 7 cm) and 10 healthy females (age 5 21 6 1 y, mass 5 60 6 7 kg, height 5 165 6 9 cm) volunteered for this investigation. This study was approved by the university’s institutional re- view board for human subjects research, and all participants signed and completed an informed consent document and health history questionnaire. All participants were free of any current or ongoing neuromuscular diseases or musculoskeletal injuries specific to the ankle, knee or hip joints. Each participant visited the laboratory on two separate occasions, separated by 2–7 d, at approximately the same time of day ( 6 2 h). For each trial, participants laid on a padded wooden table in the prone position with the lower limbs extended and relaxed, while panoramic US imaging assessments were performed of the hamstring muscle group, which included the long head of the BF, ST and SM. To prevent rotation and movement of the leg during the assessments, an adjustable restraining strap was placed over the distal lower limb of the right leg while the foot was relaxed in a neutral position against the wall (Fig. 1). All assessments were performed after participants had rested for 10 min to allow for any fluid shifts to stabilize (Berg et al. 1993). Participants were instructed to maintain the same lifestyle between trials and to refrain from any vigorous physical activity or exercise within 4 h of testing (O’Sullivan et al. 2009). Panoramic US images of the hamstring muscle group were obtained on the right leg using a portable B-mode US imaging device (GE Logiq S8, Milwaukee, WI, USA) and linear-array probe (Model ML6-15-D, 4–15 MHz, 50-mm field-of-view). US settings were optimized for image quality, including gain (50 dB), depth (8 cm) (Blackburn et al. 2009) and frequency (12 MHz), and were set prior to testing and held constant between participants and across trials (Rosenberg et al. 2014). All US images were scanned in the transverse plane at 50% of the distance between the greater trochanter and the lateral joint line of the knee (Magnusson et al. 1997) and were marked while the participants were standing in an upright position (O’Sullivan et al. 2009). For each scan, the primary investigator moved the probe manually at a slow and continuous rate along the surface of the skin from the lateral to the medial sides of the hamstring musculature using a special function on the US imaging device called LogiqView (GE Logiq S8). An adjustable, custom-made apparatus that was fitted over each participant’s right thigh (at the midpoint of the thigh) was used during each assessment to help keep the probe perpendicular to the skin, and a generous amount of water-soluble transmission gel was applied to both the probe and the skin to provide acoustic coupling without depressing the dermal surface (Wilhelm et al. 2014) (Fig. 1). For each session, two panoramic US images were taken and the mean was calculated for each of the dependent variables, which included muscle CSA, MT and EI. The same experienced sonographer (T.B.P.) performed all assessments and, after the completion of each scan, reviewed the images to ensure they were of sufficient quality (Ahtiainen et al. 2010). All US images were analyzed using ImageJ software (Version 1.47v, National Institutes of Health, Bethesda, MD, USA). Prior to analysis, each image was scaled individually from area in pixels to cm with the straight- line function using a known distance of 1 cm (Fig. 2) (Scanlon et al. 2014). Muscle CSAs of the BF, ST and SM were determined using the polygon selection function by selecting a region of interest (ROI) within each muscle that included as much of the muscle as possible without any surrounding bone or fascia (Fig. 2) (Rosenberg et al. 2014). MT was determined as the distance between the superficial and deep fascia of each muscle at the widest distance (Schmalz et al. 2001; Strasser et al. 2013). Muscle quality was determined from the mean EI values assessed by gray-scale analysis using the standard histogram function of the same pre- selected ROIs used to calculate CSA for each muscle (Fig. 2) (Rosenberg et al. 2014). EI values in the ROIs were calculated in arbitrary units (AU) on a scale of 0–255 (black 5 0, white 5 255). One-way repeated-measures analyses of variance (ANOVAs) were used to examine the means for systematic variability in CSA, MT and EI of each muscle for the males and females across trials 1 and 2. The intra- class correlation coefficient (ICC) representing relative consistency (test–retest reliability), the standard error of measurement (SEM) representing absolute consistency and the minimal difference (MD) needed to be considered real were calculated for the male and female groups across trials for each muscle. Both the SEM and MD were expressed as absolute values and percentages of the mean. Model ‘‘2, k ’’ from Shrout and Fleiss (1979) was used to calculate the ICC. Model 2, k is a two-way random factor model that uses scores representing the average of the k (number of trial) scores (Palmer et al. 2013). Model 2, k uses random and systematic error in the denominator of the ICC equation, and consequently, the ICCs gener- ated with this model can be generalized to other laboratories and testers (Weir 2005). The ICC (2, k ) was calculated with the equation (Shrout and Fleiss ...

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... may be the only way these devices can estimate muscle size (Larrie-Baghal et al. 2012; Rezasoltani 2003). Thus, given the importance of these relationships to estimates of muscle size and quality and the potential influence of gender and intermuscular differences on the reliability of US measurements of the lower body, further research is warranted examining the reliability and relationships of several US measures and specific hamstring muscles in males and females. Therefore, the purpose of this investigation was to examine the reliability of US measures of CSA, MT and EI of the hamstring muscles in young, healthy males and females. A secondary aim of this study was to compare CSA, MT and EI between genders and to examine the relationships between these parameters in each hamstring muscle. Ten healthy males (mean standard deviation (SD): age 5 24 6 3 y, mass 5 81 6 12 kg, height 5 176 6 7 cm) and 10 healthy females (age 5 21 6 1 y, mass 5 60 6 7 kg, height 5 165 6 9 cm) volunteered for this investigation. This study was approved by the university’s institutional re- view board for human subjects research, and all participants signed and completed an informed consent document and health history questionnaire. All participants were free of any current or ongoing neuromuscular diseases or musculoskeletal injuries specific to the ankle, knee or hip joints. Each participant visited the laboratory on two separate occasions, separated by 2–7 d, at approximately the same time of day ( 6 2 h). For each trial, participants laid on a padded wooden table in the prone position with the lower limbs extended and relaxed, while panoramic US imaging assessments were performed of the hamstring muscle group, which included the long head of the BF, ST and SM. To prevent rotation and movement of the leg during the assessments, an adjustable restraining strap was placed over the distal lower limb of the right leg while the foot was relaxed in a neutral position against the wall (Fig. 1). All assessments were performed after participants had rested for 10 min to allow for any fluid shifts to stabilize (Berg et al. 1993). Participants were instructed to maintain the same lifestyle between trials and to refrain from any vigorous physical activity or exercise within 4 h of testing (O’Sullivan et al. 2009). Panoramic US images of the hamstring muscle group were obtained on the right leg using a portable B-mode US imaging device (GE Logiq S8, Milwaukee, WI, USA) and linear-array probe (Model ML6-15-D, 4–15 MHz, 50-mm field-of-view). US settings were optimized for image quality, including gain (50 dB), depth (8 cm) (Blackburn et al. 2009) and frequency (12 MHz), and were set prior to testing and held constant between participants and across trials (Rosenberg et al. 2014). All US images were scanned in the transverse plane at 50% of the distance between the greater trochanter and the lateral joint line of the knee (Magnusson et al. 1997) and were marked while the participants were standing in an upright position (O’Sullivan et al. 2009). For each scan, the primary investigator moved the probe manually at a slow and continuous rate along the surface of the skin from the lateral to the medial sides of the hamstring musculature using a special function on the US imaging device called LogiqView (GE Logiq S8). An adjustable, custom-made apparatus that was fitted over each participant’s right thigh (at the midpoint of the thigh) was used during each assessment to help keep the probe perpendicular to the skin, and a generous amount of water-soluble transmission gel was applied to both the probe and the skin to provide acoustic coupling without depressing the dermal surface (Wilhelm et al. 2014) (Fig. 1). For each session, two panoramic US images were taken and the mean was calculated for each of the dependent variables, which included muscle CSA, MT and EI. The same experienced sonographer (T.B.P.) performed all assessments and, after the completion of each scan, reviewed the images to ensure they were of sufficient quality (Ahtiainen et al. 2010). All US images were analyzed using ImageJ software (Version 1.47v, National Institutes of Health, Bethesda, MD, USA). Prior to analysis, each image was scaled individually from area in pixels to cm with the straight- line function using a known distance of 1 cm (Fig. 2) (Scanlon et al. 2014). Muscle CSAs of the BF, ST and SM were determined using the polygon selection function by selecting a region of interest (ROI) within each muscle that included as much of the muscle as possible without any surrounding bone or fascia (Fig. 2) (Rosenberg et al. 2014). MT was determined as the distance between the superficial and deep fascia of each muscle at the widest distance (Schmalz et al. 2001; Strasser et al. 2013). Muscle quality was determined from the mean EI values assessed by gray-scale analysis using the standard histogram function of the same pre- selected ROIs used to calculate CSA for each muscle (Fig. 2) (Rosenberg et al. 2014). EI values in the ROIs were calculated in arbitrary units (AU) on a scale of 0–255 (black 5 0, white 5 255). One-way repeated-measures analyses of variance (ANOVAs) were used to examine the means for systematic variability in CSA, MT and EI of each muscle for the males and females across trials 1 and 2. The intra- class correlation coefficient (ICC) representing relative consistency (test–retest reliability), the standard error of measurement (SEM) representing absolute consistency and the minimal difference (MD) needed to be considered real were calculated for the male and female groups across trials for each muscle. Both the SEM and MD were expressed as absolute values and percentages of the mean. Model ‘‘2, k ’’ from Shrout and Fleiss (1979) was used to calculate the ICC. Model 2, k is a two-way random factor model that uses scores representing the average of the k (number of trial) scores (Palmer et al. 2013). Model 2, k uses random and systematic error in the denominator of the ICC equation, and consequently, the ICCs gener- ated with this model can be generalized to other laboratories and testers (Weir 2005). The ICC (2, k ) was calculated with the equation (Shrout and Fleiss ...

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... be of great value to examine the relationships between CSA, MT and EI of the BF, ST and SM. Although the correlations between EI versus CSA and MT have rarely been examined, the relationships between CSA and MT have garnered recent attention (Larrie-Baghal et al. 2012), especially since some US units are incapable of measuring CSA (Rezasoltani 2003), and therefore, measuring MT may be the only way these devices can estimate muscle size (Larrie-Baghal et al. 2012; Rezasoltani 2003). Thus, given the importance of these relationships to estimates of muscle size and quality and the potential influence of gender and intermuscular differences on the reliability of US measurements of the lower body, further research is warranted examining the reliability and relationships of several US measures and specific hamstring muscles in males and females. Therefore, the purpose of this investigation was to examine the reliability of US measures of CSA, MT and EI of the hamstring muscles in young, healthy males and females. A secondary aim of this study was to compare CSA, MT and EI between genders and to examine the relationships between these parameters in each hamstring muscle. Ten healthy males (mean standard deviation (SD): age 5 24 6 3 y, mass 5 81 6 12 kg, height 5 176 6 7 cm) and 10 healthy females (age 5 21 6 1 y, mass 5 60 6 7 kg, height 5 165 6 9 cm) volunteered for this investigation. This study was approved by the university’s institutional re- view board for human subjects research, and all participants signed and completed an informed consent document and health history questionnaire. All participants were free of any current or ongoing neuromuscular diseases or musculoskeletal injuries specific to the ankle, knee or hip joints. Each participant visited the laboratory on two separate occasions, separated by 2–7 d, at approximately the same time of day ( 6 2 h). For each trial, participants laid on a padded wooden table in the prone position with the lower limbs extended and relaxed, while panoramic US imaging assessments were performed of the hamstring muscle group, which included the long head of the BF, ST and SM. To prevent rotation and movement of the leg during the assessments, an adjustable restraining strap was placed over the distal lower limb of the right leg while the foot was relaxed in a neutral position against the wall (Fig. 1). All assessments were performed after participants had rested for 10 min to allow for any fluid shifts to stabilize (Berg et al. 1993). Participants were instructed to maintain the same lifestyle between trials and to refrain from any vigorous physical activity or exercise within 4 h of testing (O’Sullivan et al. 2009). Panoramic US images of the hamstring muscle group were obtained on the right leg using a portable B-mode US imaging device (GE Logiq S8, Milwaukee, WI, USA) and linear-array probe (Model ML6-15-D, 4–15 MHz, 50-mm field-of-view). US settings were optimized for image quality, including gain (50 dB), depth (8 cm) (Blackburn et al. 2009) and frequency (12 MHz), and were set prior to testing and held constant between participants and across trials (Rosenberg et al. 2014). All US images were scanned in the transverse plane at 50% of the distance between the greater trochanter and the lateral joint line of the knee (Magnusson et al. 1997) and were marked while the participants were standing in an upright position (O’Sullivan et al. 2009). For each scan, the primary investigator moved the probe manually at a slow and continuous rate along the surface of the skin from the lateral to the medial sides of the hamstring musculature using a special function on the US imaging device called LogiqView (GE Logiq S8). An adjustable, custom-made apparatus that was fitted over each participant’s right thigh (at the midpoint of the thigh) was used during each assessment to help keep the probe perpendicular to the skin, and a generous amount of water-soluble transmission gel was applied to both the probe and the skin to provide acoustic coupling without depressing the dermal surface (Wilhelm et al. 2014) (Fig. 1). For each session, two panoramic US images were taken and the mean was calculated for each of the dependent variables, which included muscle CSA, MT and EI. The same experienced sonographer (T.B.P.) performed all assessments and, after the completion of each scan, reviewed the images to ensure they were of sufficient quality (Ahtiainen et al. 2010). All US images were analyzed using ImageJ software (Version 1.47v, National Institutes of Health, Bethesda, MD, USA). Prior to analysis, each image was scaled individually from area in pixels to cm with the straight- line function using a known distance of 1 cm (Fig. 2) (Scanlon et al. 2014). Muscle CSAs of the BF, ST and SM were determined using the polygon selection function by selecting a region of interest (ROI) within each muscle that included as much of the muscle as possible without any surrounding bone or fascia (Fig. 2) (Rosenberg et al. 2014). MT was determined as the distance between the superficial and deep fascia of each muscle at the widest distance (Schmalz et al. 2001; Strasser et al. 2013). Muscle quality was determined from the mean EI values assessed by gray-scale analysis using the standard histogram function of the same pre- selected ROIs used to calculate CSA for each muscle (Fig. 2) (Rosenberg et al. 2014). EI values in the ROIs were calculated in arbitrary units (AU) on a scale of 0–255 (black 5 0, white 5 255). One-way repeated-measures analyses of variance (ANOVAs) were used to examine the means for systematic variability in CSA, MT and EI of each muscle for the males and females across trials 1 and 2. The intra- class correlation coefficient (ICC) representing relative consistency (test–retest reliability), the standard error of measurement (SEM) representing absolute consistency and the minimal difference (MD) needed to be considered real were calculated for the male and female groups across trials for each muscle. Both the SEM and MD were expressed as absolute values and percentages of the mean. Model ‘‘2, k ’’ from Shrout and Fleiss (1979) was used to calculate the ICC. Model 2, k is a two-way random factor model that uses scores representing the average of the k (number of trial) scores (Palmer et al. 2013). Model 2, k uses random and systematic error in the denominator of the ICC equation, and consequently, the ICCs gener- ated with this model can be generalized to other laboratories and testers (Weir 2005). The ICC (2, k ) was calculated with the equation (Shrout and Fleiss ...

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This study evaluated muscle composition, quality, and strength of non-weight bearing and weight bearing muscles between males and females. Twenty-eight, healthy males (n = 14; mean ± SD; age = 25.1 ± 4.2 years; height = 181.9 ± 10.6 cm; weight = 91.6 ± 17.2 kg) and females (n = 14; age = 25.0 ± 3.4 years; height = 165.9 ± 6.9 cm; weight = 66.0 ± 10.2 kg) underwent body composition assessment to estimate body fat (%BF) and total-body, arm, and leg fat-free mass (TFFM, ArmFFM, and LegFFM, respectively) and muscle composition via B-mode ultrasound to measure muscle cross-sectional area (mCSA), echo intensity (EI), and thickness (mT) of four muscles [rectus femoris (RF), vastus lateralis (VL), flexor digitorum superficialis (FDS), and flexor carpi radialis (FCR)]. Additionally, upper- [handgrip strength (HG)] and lower-body [leg extension (LE)] maximal strength were measured, recorded, and expressed relative to FFM to determine muscle quality (MQ) for the dominant arm and leg, respectively. Males had greater TFFM, ArmFFM, and LegFFM (p < 0.001), mCSA for RF, VL, FCR, and FDS (p < 0.001), and mT for RF, VL (p < 0.001–0.006). Females had greater EI for RF, VL, and FDS (p = 0.003–0.01). Negative correlations were identified between EI and MQ for all muscles in males and females, however, no significance was determined. Despite the sex differences in absolute strength and size, muscle quality (relative strength) was not different for the upper nor lower body.

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The purpose of this study was to investigate the relationship between muscular parameters of quadriceps/hamstrings and knee joint kinetics in gait. Muscle architecture (thickness, pennation angle, and fascicle length), and quality (echo intensity) of individual quadriceps and hamstrings of 30 healthy participants (16 males and 14 females) was measured using ultrasound. Peak knee flexion moment (KFM), KFM impulse, peak knee adduction moment (KAM), and KAM impulse during walking were obtained at preferred speed. Pearson’s correlation coefficient and multiple regression analyses were performed at significance level of 0.05, and Cohen’s f² values were calculated to examine the effect sizes of multiple regression. The hamstring-to-quadriceps muscle thickness ratio (r = 0.373) and semitendinosus echo intensity (r = − 0.371) were predictors of first peak KFM (R² = 0.294, P = 0.009, f² = 0.42), whereas only vastus medialis (VM) echo intensity was a significant predictor of second peak KFM (r = 0.517, R² = 0.267, P = 0.003, f² = 0.36). Only the VM thickness was the predictor of first (r = 0.504, R² = 0.254, P = 0.005, f² = 0.34) and second peak KAM (r = 0.581, R² = 0.337, P = 0.001, f² = 0.51), and KAM impulse (r = 0.693, R² = 0.480, P < 0.001, f² = 0.92). In conclusion, the greater hamstring-to-quadriceps muscle thickness ratio and the muscle architecture and quality of medial quadriceps/hamstring play an important role in KFM and KAM, and may have implications in knee osteoarthritis.

The effects of hip- vs. knee-dominant hamstring exercise on biceps femoris morphology, strength, and sprint performance: a randomized intervention trial protocol

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Background The hamstrings are an important muscle group that contribute to horizontal force during sprint acceleration and are also the most injured muscle group in running-based sports. Given the significant time loss associated with hamstrings injury and impaired sprinting performance following return to sport, identifying exercises that drive adaptations that are both protective of strain injury and beneficial to sprint performance is important for the strength and conditioning professional. This paper describes the study protocol investigating the effects of a 6-week training program using either the hip-dominant Romanian deadlift (RDL) or the knee-dominant Nordic hamstring exercise (NHE) on hamstring strain injury risk factors and sprint performance. Methods A permuted block randomized (1:1 allocation) intervention trial will be conducted involving young, physically-active men and women. A target sample size of 32 will be recruited and enrolled participants will undergo baseline testing involving extended-field-of-view ultrasound imaging and shear wave elastography of the biceps femoris long head muscle, maximal hamstrings strength testing in both the RDL and NHE, and on-field sprint performance and biomechanics. Participants will complete the 6-week training intervention using either the RDL or NHE, according to group allocation. Baseline testing will be repeated at the end of the 6-week intervention followed by 2 weeks of detraining and a final testing session. The primary outcome will be regional changes in fascicle length with secondary outcomes including pennation angle, muscle cross sectional area, hamstring strength, and maximal sprint performance and biomechanics. An exploratory aim will determine changes in shear wave velocity. Discussion Despite extensive research showing the benefits of the NHE on reducing hamstring strain injury risk, alternative exercises, such as the RDL, may offer similar or potentially even greater benefits. The findings of this study will aim to inform future researchers and practitioners investigating alternatives to the NHE, such as the RDL, in terms of their effectiveness in reducing rates of hamstring strain injury in larger scale prospective intervention studies. Trial Registration The trial is prospectively registered on ClinicalTrials.gov (NCT05455346; July 15, 2022).

Regional Hypertrophy: The Effect of Exercises at Long and Short Muscle Lengths in Recreationally Trained Women

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The aim of the present study was to analyse the role of exercises' resistance profile in regional hypertrophy. Thirty-eight healthy women completed a 9-week resistance training program consisting of either 4 sets of 12 repetitions to volitional failure of inclined bicep curls (INC group) or preacher curls (PREA group), three times per week. Pre- and post-intervention muscle thickness was measured using B-mode ultrasound imaging with a linear-array transducer. Scan acquisition sites were determined by measuring 50%, 60% and 70% of the distance between the posterior crest of the acromion and the olecranon. Statistical significance was set at p < 0.05. No region of the INC group grew when comparing pre- to post-intervention. The 70% region of the PREA group grew significantly (muscle thickness increased from 2.7  0.43 cm to 2.94  0.44 cm). We found no growth differences between regions when analysing per group (p = 0.274), region (p = 0.571) or group*region (p = 0.367). Our results show that the distal region of the arm grows in response to the preacher curl that places the highest amount of strain in the range of motion in which the arm muscles are more elongated.

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The reliability of isokinetic peak torque (PT) has been reported mostly using a short-term (<~10 day) inter-trial testing time frame. However, many studies and programs utilize a long-term (several weeks to months) inter-trial testing period. Additionally, the methods by which the PT value is selected and reported from a multiple rep testing scheme have not been well investigated for both reliability and PT absolute performance comparisons. The purpose of this study was to investigate the long-term reliability of isokinetic and isometric PT of the leg extensors with an emphasis on the differences among several PT score selection methods. Thirteen men and women (age = 19.5 years) underwent two testing trials separated by 28.8 (±1.8) days. Testing included maximal voluntary contractions of three sets of three reps for two isokinetic contraction conditions of 60 (Isok60) and 240 (Isok240) deg/s velocities, and three sets of one rep of isometric contractions for the leg extensors. The PT score was derived from seven different methods (see text for descriptions). Reliability as assessed from intraclass correlation coefficients (ICCs) varied widely across contraction conditions and PT score selection parameters. The Isok60 velocity overall had lower reliability (ICCs = 0.48–0.81) than Isok240 (0.77–0.87) across the conditions whereas the isometric PT variables showed moderate reliability (0.71–0.73). Overall the set 1 PT score selection parameters were generally lower (p ≤ 0.05) than those that involved sets two and three. Systematic error (p ≤ 0.05) was shown for 6 out of the 17 PT selection variables. On a subjective interpretation basis, when taking everything into account the best overall combination of time/trial efficiency, reliability, best/highest PT score parameter, and reduced risk of systematic bias appears to be the PT variable that uses the average of the highest two reps of the first two sets of three reps—i.e., averaging the highest two values of the six total reps from the first two sets.

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ULTRASOUND MED BIOL

Objective: Measuring muscle quantity and quality is very important because the loss of muscle quantity and quality is associated with several adverse effects specifically in older people. Ultrasound is a method widely used to measure muscle quantity and quality. One problem with ultrasound is its limited field of view, which makes it impossible to measure the muscle quantity and quality of certain muscles. In this study, we aimed to evaluate the intra- and inter-rater reliability of extended-field-of-view (EFOV) ultrasound for the measurement of muscle quantity and quality in nine muscles of the limbs and trunk. Methods: Two examiners took two ultrasound EFOV images with a linear probe from each of the muscle sites. The intraclass correlation coefficient (ICC) was used, and the standard error of measurement and coefficient of variation were calculated. Results: Intra-rater reliability was good to excellent (ICC = 0.2-1.00) for all muscle measurements. The inter-rater reliability for most of the muscle measurements was good to excellent (ICC = 0.82-0.98). Inter-rater reliability was moderate (0.58-0.72) for some muscle quantity measurements of the tibialis anterior, gastrocnemius, rectus femoris, biceps femoris and triceps brachii muscles. Conclusion: Muscle quantity and quality can be measured reliably using EFOV US.

Association Between the Medial-Lateral Quadriceps and Hamstring Muscle Thickness and the Knee Kinematics and Kinetics During Single-Leg Landing

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Mar 2023

Background Muscle thickness can influence the joint kinematics and/or kinetics during dynamic activities. The relationship between the muscle thickness of individual quadriceps and hamstrings or medial-to-lateral thigh muscle thickness ratio and the knee kinematics/kinetics with respect to anterior cruciate ligament (ACL) injury risk remains unclear. Hypothesis Higher medial-to-lateral thigh muscle thickness ratio would be associated with lower knee valgus angle/moment and lower tibial internal rotation angle/moment during single-leg landing. Study Design Cross-sectional. Level of Evidence Level 4. Methods Muscle thickness of the vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), and semitendinosus (ST) of 30 healthy participants (16 males and 14 females) were measured using ultrasound. Knee joint kinematics and kinetics during single-leg landing were obtained. Stepwise multiple regression analysis, a follow-up Fisher’s r to z test to examine the sex as a moderator, and independent t tests to evaluate sex difference were performed. Results Both knee valgus moment ( R ² = 0.466, P < 0.001) and tibial external rotation moment ( R ² = 0.330, P < 0.001) at peak anterior tibial shear force during single-leg landing were negatively correlated with medial-to-lateral (ie, (VM+ST):(VL+BF)) thickness ratio regardless of sex, whereas medial-to-lateral thigh muscle thickness ratio was not correlated with knee valgus and tibial external rotation angles. Male participants exhibited higher (VM+ST):(VL+BF) thickness ratio than female participants ( P = 0.005), and lower knee valgus moment ( P = 0.04) and tibial external rotation moment ( P = 0.05), as well. Conclusion The knee joint moments in frontal and transverse planes during single-leg landing were associated with the medial-to-lateral thigh muscle thickness ratio; thus, the medial-lateral thigh muscle thickness could be a potential contributor to frontal and transverse plane knee joint loading during dynamic movement. Clinical Relevance Strength training that aims to selectively strengthen the medial/lateral thigh muscles might be considered in a new ACL injury prevention training program to alter the biomechanical parameters associated with ACL injuries.

Effect of age on shear modulus, muscle thickness, echo intensity of the upper limb, lower limb, and trunk muscles in healthy women

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Dec 2022
EUR J APPL PHYSIOL

Purpose This study aimed to examine the effect of age on the mechanical properties, muscle size, and muscle quality in the upper and lower limb and trunk muscles. Methods We evaluated the shear modulus (G), muscle thickness (MT), and echo intensity (EI) of the upper and lower limb and trunk muscles of 83 healthy women (21–83-year-old). The G values of some limb muscles were measured in relaxed and stretched positions. Results Regarding the effect of age on G at the distinct positions, the G of the upper limb muscles were not significantly correlated with age in the relaxed and stretched positions. In contrast, the G of the iliacus showed a significant negative correlation in both positions. Additionally, the G of the rectus femoris had a significant negative correlation only in the relaxed position. Regarding differences among body parts, the G of the lower limb and oblique abdominal muscles showed a significant negative correlation, but no correlation in the upper limb, rectus abdominis, and back muscles. Moreover, MT showed a significant negative correlation with age in the lower limb, abdominal, and erector spinae muscles, but no correlation was detected in the upper limb and lumbar multifidus muscles. EI had a significant positive correlation in all the muscles. Conclusion The effect of age on G depended on body parts, and the G of the lower limb and oblique abdominal muscles negatively associated with age. Additionally, G in the relaxed position may be more susceptible to aging than G in the stretched position.

Critical Evaluation of Commonly used Methods to Determine the Concordance between Sonography and Magnetic Resonance Imaging: A Comparative Study

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Full-text available

Nov 2022

Introduction An increasing number of studies investigate the influence of training interventions on muscle thickness (MT) by using ultrasonography. Ultrasonography is stated as a reliable and valid tool to examine muscle morphology. Researches investigating the effects of a training intervention lasting a few weeks need a very precise measurement since increases in MT can be assumed as small. Therefore, the aim of the present work was to investigate the concordance between MT via sonography and muscle cross-sectional area (MCSA) determined via MRI imaging (gold standard) in the calf muscle. Methods Reliability of sonography measurement and the concordance correlation coefficient, the mean error (ME), mean absolute error (MAE) and the mean absolute percentage error (MAPE) between sonography and MRI were determined. Results Results show intraclass correlation coefficients (ICC) of 0.88–0.95 and MAPE of 4.63–8.57% . Concordance between MT and MCSA was examined showing ρ = 0.69–0.75 for the medial head and 0.39–0.51 c for the lateral head of the gastrocnemius. A MAPE of 15.88–19.94% between measurements were determined. Based on this, assuming small increases in MT due to training interventions, even with an ICC of 0.95 , MAPE shows a high error between two investigators and therefore limited objectivity. Discussion The high MAPE of 15.88–19.94% as well as CCC of ρ c = 0.39–0.75 exhibit that there are significant differences between MRI and sonography. Therefore, data from short term interventions using sonography to detect changes in the MT should be handled with caution.

Effect of intramuscular fat in the thigh muscles on muscle architecture and physical performance in the middle-aged women with knee osteoarthritis

Article

Nov 2022
J ORTHOP SCI

Background We investigated intramuscular fat (IMF) in quadriceps femoris (QF) and hamstring muscles in the middle-aged women with knee osteoarthritis (KOA). We also examined the relationship between muscular infiltration of QF and hamstring muscles and muscle architecture and physical performance of the women with KOA. Methods In this cross-sectional study, 72 women were included. Body muscle and fat mass were measured by BIA, isometric muscle strength was evaluated by hand-held dynamometer. IMF and muscle architecture were calculated from rectus femoris (RF), vastus intermedius (VIM), vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), semitendinosus (ST) and semimembranosus (SM) using B-mode ultrasonography. KOA-related symptoms and functions were assessed with KOOS. The functional performance assessments were evaluated with Stair Climbing Test, 20-Meter Walking Test. Results Women with KOA had more IMF in RF, VIM, VL, VM and BF, ST, SM muscles compared to the healthy women. Pennation angles decreased as the IMF in the RF, VM, BF and ST decreased. As the IMF of the RF and VM increased isometric knee extensor strength decreased and KOOS symptom score, pain score and ADL score increased in women with KOA. Walking and stair climbing speed deteriorated as the IMF in RF, VIM, VM, BF increased in the middle-aged women. As the IMF in BF increased isometric knee flexor strength decreased and KOOS scores increased. Physical performance scores deteriorated as the IMF in BF increased in middle-aged women with KOA. Conclusion IMF in QF and hamstring muscles were higher in the middle-aged women with KOA group compared with that in the healthy group. Weakness of the QF and hamstring muscles may due to the changes in architectural properties of muscle depending on muscular infiltration. IMF in knee muscles is an important determining factor in performance and physical function of middle-aged women with KOA.

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