Reliability of B-mode ultrasound and shear wave elastography in evaluating sacral bone and soft tissue characteristics in young adults with clinical feasibility in elderly |
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| Affiliation: | 1. Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Institute of Technology, 151 bd de l’Hôpital, 75013, Paris, France;2. Univ. Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France;3. Sorbonne Université, INSERM, UMRS1158, Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France;4. Equipe de Statistique Appliquée, ESPCI Paris, PSL Research University, Paris, France;1. Universidad de Cádiz (España), Departamento de Enfermería y Fisioterapia, Servicio Andaluz de Salud, Avenida de Europa Nº1, 2º H, 29003, Málaga, Spain;2. Universidad de Cádiz (España), Departamento de Enfermería y Fisioterapia, 11500, Cádiz, Spain;3. Servicio Andaluz de Salud, Argentina Nº 2, 11630 Arcos de La Frontera, Cádiz, Spain;1. Department of Plastic and Reconstructive Surgery, Ramón y Cajal University Hospital, Madrid, Spain;2. Department of Plastic and Reconstructive Surgery, Ospedale Policlinico San Martino, Genoa University, Genova, Italy;1. Koç University School of Nursing, Turkey;2. T.C. ?stanbul Kültür University, Faculty of Health Sciences, Nursing Department, Turkey;3. Koç University Hospital, Turkey;1. Department of General Surgery, Jilin University Second Hospital, Changchun, China;2. Department of Pediatrics, Jilin University First Hospital, Changchun, China;1. Siirt University, Faculty of Health Sciences, Department of Nursing Fundamentals, Siirt, Turkey;2. Siirt University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Siirt, Turkey |
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| Abstract: | BackgroundPhysiologic aging is associated with loss of mobility, sarcopenia, skin atrophy and loss of elasticity. These factors contribute, in the elderly, to the occurrence of a pressure ulcer (PU). Brightness mode ultrasound (US) and shear wave elastography (SWE) have been proposed as a patient-specific, bedside, and predictive tool for PU. However, reliability and clinical feasibility in application to the sacral region have not been clearly established.MethodThe current study aimed to propose a simple bedside protocol combining US and SWE. The protocol was first tested on a group of 19 healthy young subjects by two operators. The measurements were repeated three times. Eight parameters were evaluated at the medial sacral crest. Intraclass Correlation Coefficient (ICC) was used for reliability assessment and the modified Bland Altman plot analysis for agreement assessment. The protocol was then evaluated for clinical feasibility on a healthy older group of 11 subjects with a mean age of 65 ± 2.4 yrs.FindingsICC showed poor to good reliability except for skin SWE and hypodermis thickness with an ICC (reported as: mean (95%CI)) of 0.78 (0.50–0.91) and 0.98 (0.95–0.99) respectively. No significant differences were observed between the young and older group except for the muscle Shear Wave Speed (SWS) (respectively 2.11 ± 0.27 m/s vs 1.70 ± 0.17 m/s).InterpretationThis is the first protocol combining US and SWE that can be proposed on a large scale in nursing homes. Reliability, however, was unsatisfactory for most parameters despite efforts to standardize the protocol and measurement definitions. Further studies are needed to improve reliability. |
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| Keywords: | Pressure ulcer Sacrum Medial sacral crest Elderly Ultrasound Shear wave elastography Elasticity Reliability |
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