Validity of bioelectrical impedance and ultrasonographic methods for estimating the muscle volume of the upper arm

The present study aimed to investigate the validity of bioelectrical impedance and ultrasonographic methods for predicting the muscle volume of the upper arm. Bioelectrical impedance of the right upper arm and the thickness of elbow flexor and extensor muscles were measured from 26 healthy young adult men using a specially designed bioelectrical impedance data acquisition system and brightness-mode ultrasound apparatus, respectively. As reference data, the muscle volume (MV_MRI) of the right upper arm was determined using a magnetic resonance imaging method. The impedance index was calculated as L ²/Z, where L is the upper arm length and Z is the impedance of the shoulder to the elbow. The muscle volume (MV_ULT) was calculated as π·(d/2)²·L, where d is muscle thickness. L ²/Z and MV_ULT were significantly correlated with MV_MRI with correlation coefficients of 0.971 and 0.962, respectively. In these relationships, the standard errors of estimation were 44.2 cm³ (6.3%) for L ²/Z and 50.7 cm³ (7.2%) for MV_ULT. There was no significant difference between the absolute errors of muscle volumes estimated by L ²/Z and MV_ULT: 36.2 (4.8, SEM) cm³ for L ²/Z versus 40.3 (5.8) cm³ for MV_ULT. The present results suggest that both bioelectrical impedance and ultrasonographic methods may be useful for predicting the muscle volume of the upper arm. Accepted: 7 March 2000     

The effect of specific bioactive collagen peptides on function and muscle remodeling during human resistance training

Aim

Bioactive collagen peptides (CP) have been suggested to augment the functional, structural (size and architecture), and contractile adaptations of skeletal muscle to resistance training (RT), but with limited evidence. This study aimed to determine if CP vs. placebo (PLA) supplementation enhanced the functional and underpinning structural, and contractile adaptations after 15 weeks of lower body RT.

Methods

Young healthy males were randomized to consume either 15 g of CP (n = 19) or PLA (n = 20) once every day during a standardized program of progressive knee extensor, knee flexor, and hip extensor RT 3 times/wk. Measurements pre- and post-RT included: knee extensor and flexor isometric strength; quadriceps, hamstrings, and gluteus maximus volume with MRI; evoked twitch contractions, 1RM lifting strength, and architecture (with ultrasound) of the quadriceps.

Results

Percentage changes in maximum strength (isometric or 1RM) did not differ between-groups (0.684 ≤ p ≤ 0.929). Increases in muscle volume were greater (quadriceps 15.2% vs. 10.3%; vastus medialis (VM) 15.6% vs. 9.7%; total muscle volume 15.7% vs. 11.4%; [all] p ≤ 0.032) or tended to be greater (hamstring 16.5% vs. 12.8%; gluteus maximus 16.6% vs. 12.9%; 0.089 ≤ p ≤ 0.091) for CP vs. PLA. There were also greater increases in twitch peak torque (22.3% vs. 12.3%; p = 0.038) and angle of pennation of the VM (16.8% vs. 5.8%, p = 0.046), but not other muscles, for CP vs. PLA.

Conclusions

CP supplementation produced a cluster of consistent effects indicating greater skeletal muscle remodeling with RT compared to PLA. Notably, CP supplementation amplified the quadriceps and total muscle volume increases induced by RT.     

A comparison of 3D ultrasound to MRI for the measurement and estimation of gastrocnemius muscle volume in adults and young people with and without cerebral palsy

Muscle volume (MV) is an important parameter for understanding muscle morphology and adaptations to training, growth and pathology. In this study, we assessed the validity of freehand 3D ultrasound (3DUS) for measuring medial gastrocnemius MV in adults, typically developing (TD) children and children with cerebral palsy (CP). We also assessed the validity between our direct measures of MV and estimates derived from anatomical cross sectional area (ACSA) and muscle length (ML), using previously outlined methods. The medial gastrocnemius of all groups was scanned with 3DUS and MRI. Images from both methods were digitized to derive MV, ACSA and ML. Measured MV was compared between methods and compared to estimated MV derived from recently published algorithms. MV had a mean difference of ?0.13% (standard error of estimate (SEE) = 2.23%, R² = 0.99) between MRI and 3DUS and 19.82% (SEE = 4.73% and R² = 0.99) and ?3.11% (SEE = 6.55%, R² = 0.99) mean differences between the measured and estimated MV from two methods of estimation. The 3DUS is a valid method for the measurement of MV in adults, TD children and those with CP. Estimation methods of MV may be useful in clinical practice, but require further replication on various populations and careful methodological consideration. Clin. Anat. 32:319–327, 2019. © 2018 Wiley Periodicals, Inc.     

Validity and reliability of a freehand 3D ultrasound system for the determination of triceps surae muscle volume in children with cerebral palsy

This study assessed the validity, intra‐rater and inter‐rater reliability of segmentation of in vivo medial gastrocnemius (MG), lateral gastrocnemius (LG) and soleus (SOL) muscle volume measurement using a single sweep freehand 3D ultrasound (3DUS) in children with cerebral palsy (CP). The MG, LG and SOL of both limbs of 18 children with CP (age 8 years 4 months ± 1 year 10 months, 11 males, unilateral CP = 9, bilateral CP = 9, Gross Motor Functional Classification System I = 11, II = 7) were scanned using freehand 3DUS and magnetic resonance imaging (MRI). All freehand 3DUS and MRI images were segmented and volumes rendered by two raters. Validity was assessed using limits of agreement method. Intra‐rater and inter‐rater reliability was assessed using intra‐class correlation (ICC), coefficient of variance (CV) and minimal detectable change (MDC). Freehand 3DUS overestimated muscle volume of the MG and LG by < 0.3 mL (1%) and underestimated SOL by < 1.3 mL (1.5%) compared with MRI. ICCs for intra‐rater reliability of the segmentation process for the freehand 3DUS system and MRI for muscle volume were > 0.98 and 0.99, respectively, for all muscles. ICCs for inter‐rater reliability of the segmentation process for freehand 3DUS and MRI volumes were > 0.96 and 0.98, respectively, for all muscles. MDCs for single rater freehand 3DUS and MRI were < 4.0 mL (14%) and 3.2 mL (11%), respectively, in all muscles. Freehand 3DUS is a valid and reliable method for the measurement of lower leg muscle volume that can be measured with a single sweep in children with CP in vivo. It can be used as an alternative to MRI for the detection of clinically relevant changes in calf muscle volume as the result of growth and interventions.     

Non-uniform changes in magnetic resonance measurements of the semitendinosus muscle following intensive eccentric exercise

This study was designed to determine the regional differences of magnetic resonance (MR) measurements in the hamstrings [biceps femoris muscle long head (BFl) and short head (BFs), semimembranosus muscle (SM), and semitendinosus muscle (ST)] following eccentric knee-flexion exercise. Twelve male volunteers performed eccentric knee-flexion exercise. Maximum isometric torque, plasma creatine kinase (CK) activity, muscle soreness, and MR images of the hamstrings were measured before and immediately following exercise, and on the first, second, third and seventh days following the exercise. Cross-sectional areas (CSAs) and transverse relaxation times (T2s) of the hamstrings were measured from the T2-weightened MR imaging sequences of 30% (proximal), 50% (middle), and 70% (distal) areas of the thigh length. The CSA of the ST at proximal and middle regions had significantly increased on the third day, but no significant changes were found for the BFl or SM. Immediately following exercise, T2 values had increased significantly in the BFs, BFl, and ST. On the third day, T2 values of only ST increased significantly at proximal, middle and distal regions. Significant differences of T2 values between proximal and distal regions in the ST were found for the second, third and seventh days following the exercise. These results suggest that because of the anatomical characteristics of the muscles, the degrees of response following the exercise differed among the muscles and the regions of ST muscle.     

Prediction and validation of total and regional skeletal muscle mass by ultrasound in Japanese adults

The present study was performed to develop regression-based prediction equations for skeletal muscle (SM) mass by ultrasound and to investigate the validity of these equations in Japanese adults. Seventy-two Japanese men (n=38) and women (n=34) aged 18–61 years participated in this study and were randomly separated into two groups: the model development group (n=48) and the validation group (n=24). The total and regional SM mass were measured using magnetic resonance imaging (MRI) 1.5 T-scanners with spin-echo sequence. Contiguous transverse images (about 150 slices) with a slice thickness of 1 cm were obtained from the first cervical vertebra to the ankle joints. The volume of SM was calculated from the summation of digitized cross-sectional area. The SM volume was converted into mass units (kg) by an assumed SM density of 1.04 kg l⁻¹. The muscle thickness (MTH) was measured by B-mode ultrasound (5 MHz scanning head) at nine sites on the anatomical SM belly. Strong correlations were observed between the site-matched SM mass (total, arm, trunk body, thigh, and lower leg) by MRI measurement and the MTH × height (in m) in the model development group (r=0.83–0.96 in men, r=0.53–0.91 in women, P<0.05). When the SM mass prediction equations were applied to the validation group, significant correlations were also observed between the MRI-measured and predicted SM mass (P<0.05). The predicted total SM mass for the validation group was 19.6 (6.5) kg and was not significantly different from the MRI-measured SM mass of 20.2 (6.5) kg. Bland–Altman analysis did not indicate a bias in prediction of the total SM mass for the validation group (r=0.00, NS). These results suggested that ultrasound-derived prediction equations are a valid method to predict SM mass and an alternative to MRI measurement in healthy Japanese adults.     

Phosphate metabolism of prior eccentrically loaded vastus medialis muscle during exercise in humans

The possible alteration of metabolism of the m. vastus medialis was investigated during exercise after eccentric loading. Twelve male subjects performed stepping exercise for 25–60 min. One week before and 24 h after stepping they performed concentric leg exercise at stepwise increasing intensity, while power output was measured. During this concentric exercise and recovery therefrom, phosphorous metabolites were also measured in the m. vastus medialis with magnetic resonance spectroscopy. Creatine kinase and myoglobin in blood were measured before and 72 h after stepping. T1 and T2 ¹H-relaxation times for water were calculated from magnetic resonance images collected 72 h after stepping, and used as measures for oedema. The subjects perceived substantial soreness from 24 to 72 h after stepping. The ratio of inorganic phosphate over phosphocreatine at rest increased from 0.12± 0.02 (before) to 0.19± 0.04 (24 h after stepping) (P < 0.05). Creatine kinase activity was slightly elevated 72 h after stepping (71 [49–812] U L^-1 [median, range]; P < 0.05) compared with baseline values (58 [26–409] U L^-1), whereas myoglobin concentration was not significantly elevated (15 [8–120] μg L^-1 compared with 8 [8–41] μg L^-1). In the eccentrically exercised muscles, T1 and T2 values were not or only slightly higher than in the concentrically exercised contralateral muscles. The relation between power and the ratio of inorganic phosphate over phosphocreatine during concentric exercise, and the recovery data for inorganic phosphate, phosphocreatine and pH did not alter after stepping. These data suggest that quadriceps metabolism during concentric exercise and recovery therefrom is not affected by prior eccentric overload, but it cannot be excluded that metabolism will alter during exercise after more strenuous prior eccentric overload.     

Validity and reliability of a structured‐light 3D scanner and an ultrasound imaging system for measurements of facial skin thickness

Three‐dimensional (3 D)‐scanning‐based morphological studies of the face are commonly included in various clinical procedures. This study evaluated validity and reliability of a 3 D scanning system by comparing the ultrasound (US) imaging system versus the direct measurement of facial skin. The facial skin thickness at 19 landmarks was measured using the three different methods in 10 embalmed adult Korean cadavers. Skin thickness was first measured using the ultrasound device, then 3 D scanning of the facial skin surface was performed. After the skin on the left half of face was gently dissected, deviating slightly right of the midline, to separate it from the subcutaneous layer, and the harvested facial skin's thickness was measured directly using neck calipers. The dissected specimen was then scanned again, then the scanned images of undissected and dissected faces were superimposed using Morpheus Plastic Solution (version 3.0) software. Finally, the facial skin thickness was calculated from the superimposed images. The ICC value for the correlations between the 3 D scanning system and direct measurement showed excellent reliability (0.849, 95% confidence interval = 0.799–0.887). Bland‐Altman analysis showed a good level of agreement between the 3 D scanning system and direct measurement (bias = 0.49 ± 0.49 mm, mean±SD). These results demonstrate that the 3 D scanning system precisely reflects structural changes before and after skin dissection. Therefore, an in‐depth morphological study using this 3 D scanning system could provide depth data about the main anatomical structures of face, thereby providing crucial anatomical knowledge for utilization in various clinical applications. Clin. Anat. 30:878–886, 2017. © 2017 Wiley Periodicals, Inc.     

Anthropometric measurements of knee joints in Thai population: Correlation to the sizing of current knee prostheses

Anthropometric data on the distal femoral condyle and the proximal tibia of 200 knees in 200 Thai subjects were measured using magnetic resonance imaging (MRI). The data including the resected femoral anterior-posterior (AP) length, the resected femoral medial-lateral (ML) width, the resected tibial AP length and the resected tibial ML width were measured. A characterization of the aspect ratio (the ML to AP dimensions) was made for the distal part of the femur and the aspect ratio (the AP to ML dimensions) was made for the proximal part of the tibia. All parameters were compared to the size of the total knee prosthesis with four prosthetic systems which currently used in Thailand: NexGen (Zimmer), P.F.C. Sigma (Depuy-Johnson & Johnson), Genesis II (Smith & nephew), and Scorpio (Stryker). The results of this study could provide fundamental data for the design of knee prostheses suitable for the Thai population.     

MRI evaluation of topical heat and static stretching as therapeutic modalities for the treatment of eccentric exercise-induced muscle damage

The aim of this study was to monitor the effects of topical heat and/or static stretch treatments on the recovery of muscle damage by eccentric exercise. For this purpose, 32 untrained male subjects performed intense eccentric knee extension exercise, followed by 2 weeks of treatment (heat, stretch, heat plus stretch) or no treatment (control, n=8/group). Isometric strength testing, pain ratings, and multi-echo magnetic resonance imaging of the thigh were performed before and at 2, 3, 4, 8, and 15 days following the exercise. Increased T2 relaxation time, muscle swelling, pain ratings, and strength loss confirmed significant muscle damage during the post-exercise period. Pain ratings and muscle volume recovered to baseline by 15 days, although muscle strength remained lower [77 (4) vs. 95 (3) kg pre-exercise, mean (SE)] and T2 values higher [32.2 (0.8) vs. 28.6 (0.2) ms pre-exercise]. Our results indicate that heat and/or static stretching does not consistently reduce soreness, swelling or muscle damage. The practical implication of our findings is that clinicians should be aware that prescribing heat and/or static stretching following intense eccentric or unaccustomed exercise will not enhance the recovery of damaged muscles.     

MR扩散张量成像和纤维束示踪技术评价经阴道分娩初产妇肛提肌损伤

目的 探讨MR扩散张量成像(DTI)和纤维束示踪技术在经阴道分娩初产妇肛提肌损伤评价中的应用价值,为产后盆底康复治疗及盆腔器官脱垂的预防提供客观依据。方法 纳入2014年6月—2015年1月在天津市第一中心医院经阴道自然分娩后6个月初产妇50名(观察组),无症状未孕未产志愿者33名(对照组)进行前瞻性研究。受试者行盆底横断面、冠状面FSE T₂WI MR及DTI检查。对DTI图像进行后处理获得肛提肌各分支(耻骨内脏肌、髂尾肌)的3D肌肉纤维束图像,并评价其纤维示踪的精确性,对能够得到较为精确纤维束示踪图像者测量其各向异性分数(FA)、表观扩散系数(ADC)值。应用FSE T₂WI MRI影像评价产妇肛提肌损伤情况,并将其分为耻骨内脏肌无损伤组、耻骨内脏肌损伤组,采用方差分析比较对照组、无损伤组及损伤组间FA、ADC值的差异。结果 2组受试者均获得较为精确的耻骨内脏肌3D肌肉纤维束图像及对应的FA及ADC值,而髂尾肌3D肌肉纤维束图像均不精确。12例(24.0%,12/50)产妇存在耻骨内脏肌损伤,其中9例表现为单侧部分缺损,3例表现为双侧萎缩;4例(8.0%,4/50)产妇存在髂尾肌损伤,均表现为单侧部分缺损。对照组未发现肛提肌损伤。对照组、耻骨内脏肌无损伤组和损伤组耻骨内脏肌的FA值分别为0.49±0.08、0.52±0.11、0.53±0.13,ADC值分别为(1.79±0.29)×10^-3 mm²/s、(1.75±0.34)×10^-3 mm²/s、(1.93±0.35)×10^-3 mm²/s,差异均无统计学意义(F=1.217、1.747, P值均>0.05)。结论 DTI纤维束成像能够3D显示耻骨内脏肌纤维束结构,但髂尾肌的显示较为困难。目前DTI尚不能准确定量诊断肛提肌损伤情况。     

Comparison of point counting and planimetry methods for the assessment of cerebellar volume in human using magnetic resonance imaging: a stereological study

The cerebellum is involved in motor learning and cognitive function in human. Many studies have been conducted to assess the cerebellar volume. To the best of our knowledge, there is no cerebellar volume study evaluating the efficiency and the accuracy of point-counting and planimetry methods of the Cavalieri principle in the literature. In this study, the volume of cerebellum was estimated in 53 Turkish young volunteers (26 males and 27 females), aged between 20 and 25 who are free of any neurological symptoms and signs, using serial magnetic resonance (MR) images. The cerebellar volumes of subjects were determined on MR images using the point-counting and planimetry methods. The mean results of planimetry method were 116.69 +/- 10.1 and 114.41 +/- 9.3 cm(3 )in males and females, respectively. The mean results of point-counting method were 116.34 +/- 10.6 and 113.48 +/- 8.8 cm(3 )in males and females, respectively. Our results revealed that female subjects had less cerebellar volumes compared with males, although there was no statistical significant difference between genders (P > 0.05). Total cerebellar volumes obtained by two different methods were not statistically different (P = 0.189) and they were correlated well to each other (r = 0.935). We found that the point-counting method takes less time than the planimetric method (mean 8 +/- 3.6 vs. 15 +/- 5.5 min). Thus, while planimetric and stereological approaches yield very similar results, the stereological method has the advantage of greater speed and, therefore, efficiency.