Validity of Quadriceps Muscle Thickness Measurement in Patients with Subacute Stroke during Hospitalization for Assessment of Muscle Wasting and Physical Function

Increasing physical activity (PA) is an important rehabilitation target for patients with sub-acute stroke during hospitalization in order to recover physical function and prevent stroke recurrence. However, the characteristics of low PA in stroke patients during hospitalization who were targets for increased intervention have not been reported. The purpose of this study was to investigate the relationship between the daily number of steps and physical function and quadriceps muscle thickness (QMT) in patients with sub-acute stroke during hospitalization for convalescence rehabilitation. Twenty-nine patients with ischemic or haemorrhagic stroke (mean age, 69 ± 11 years) hospitalized for inpatient convalescent rehabilitation were included. PA was measured using a three-dimensional accelerometer that calculates the daily number of steps taken. Physical function was measured by a short physical performance battery (SPPB; 0–12 points) and the leg motor selectivity score (6 motor stages defined by Brunnstrom), and the QMT of both legs was measured using ultrasonography. PA was significantly correlated with the SPPB score (r = 0.63, p = 0.0002), QMT on the paretic side (r = 0.41, p = 0.02), and QMT on non-paretic side (r = 0.56, p = 0.002). There were no significant effects of the leg motor selectivity score on daily PA (F = 1.37, p = 0.27). In the multiple regression analysis, only the SPPB score showed significant linear regression (β = 0.44, p = 0.02). PA in male patients with sub-acute stroke during hospitalization was related to physical function and QMT and not with the severity of paresis.

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Ultrasound for Non-invasive Assessment and Monitoring of Quadriceps Muscle Thickness in Critically Ill Patients With Acute Kidney Injury

Frontiers in Nutrition ◽

10.3389/fnut.2021.622823 ◽

2021 ◽

Vol 8 ◽

Author(s):

Alice Sabatino ◽

Umberto Maggiore ◽

Giuseppe Regolisti ◽

Giovanni Maria Rossi ◽

Francesca Di Mario ◽

...

Keyword(s):

Acute Kidney Injury ◽

Critically Ill ◽

Critically Ill Patients ◽

Muscle Wasting ◽

Kidney Injury ◽

Muscle Thickness ◽

Quadriceps Muscle ◽

Apache Ii Score ◽

Icu Admission ◽

Icu Stay

Background and aims: Critically ill patients with acute kidney injury (AKI) undergo major muscle wasting in the first few days of ICU stay. An important concern in this clinical setting is the lack of adequate tools for routine bedside evaluation of the skeletal muscle mass, both for the determination of nutritional status at admission, and for monitoring. In this regard, the present study aims to ascertain if ultrasound (US) is able to detect changes in quadriceps muscle thickness of critically ill patients with acute kidney injury (AKI) over short periods of time.Methods: This is a prospective observational study with a follow-up at 5 days. All adult patients with AKI hospitalized at the Renal ICU of the Parma University Hospital over 12 months, with a hospital stay before ICU admission no longer than 72 h, and with a planned ICU stay of at least 5 days, were eligible for the study. An experienced investigator assessed quadriceps rectus femoris and vastus intermedius thickness (QRFT and QVIT) at baseline and after 5 days of ICU stay.Results: We enrolled 30 patients with 74 ± 11 years of age and APACHE II score of 22 ± 5. Muscle thickness decreased by 15 ± 13% within the first 5 days of ICU stay (P < 0.001 for all sites as compared to ICU admission). Patients with more severe muscle loss had lower probability of being discharged home (OR: 0.04, 95%CI: 0.00–0.74; P = 0.031).Conclusions: In critically ill patients with AKI, bedside muscle US identifies patients with accelerated muscle wasting.

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Association of Ultrasound-Derived Metrics of the Quadriceps Muscle with Protein Energy Wasting in Hemodialysis Patients: A Multicenter Cross-Sectional Study

Nutrients ◽

10.3390/nu12113597 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3597

Author(s):

Sharmela Sahathevan ◽

Ban-Hock Khor ◽

Birinder Kaur Sadu Singh ◽

Alice Sabatino ◽

Enrico Fiaccadori ◽

...

Keyword(s):

Muscle Wasting ◽

Area Under The Curve ◽

Muscle Thickness ◽

Rectus Femoris ◽

Quadriceps Muscle ◽

Imaging Method ◽

Protein Energy Wasting ◽

Cross Sectional ◽

Protein Energy ◽

Gender Specific

This study aimed to assess muscle wasting and risk of protein energy wasting (PEW) in hemodialysis (HD) patients using an ultrasound (US) imaging method. PEW was identified using the ISRNM criteria in 351 HD patients. Quadriceps muscle thickness of rectus femoris (RF) and vastus intermedius (VI) muscles and cross-sectional area (CSA) of the RF muscle (RFCSA) were measured using US and compared with other physical measures. Associations of US indices with PEW were determined by logistic regression. Irrespective of gender, PEW vs. non-PEW patients had smaller RF, VI muscles, and RFCSA (all p < 0.001). US muscle sites (all p < 0.001) discriminated PEW from non-PEW patients, but the RFCSA compared to bio-impedance spectroscopy had a greater area under the curve (AUC, 0.686 vs. 0.581), sensitivity (72.8% vs. 65.8%), and specificity (55.6% vs. 53.9%). AUC of the RFCSA was greatest for PEW risk in men (0.74, 95% CI: 0.66–0.82) and women (0.80, 95% CI: 0.70–0.90) (both p < 0.001). Gender-specific RFCSA values (men < 6.00 cm2; women < 4.47 cm2) indicated HD patients with smaller RFCSA were 8 times more likely to have PEW (AOR = 8.63, 95% CI: 4.80–15.50, p < 0.001). The US approach enabled discrimination of muscle wasting in HD patients with PEW. The RFCSA was identified as the best US site with gender-specific RFCSA values to associate with PEW risk, suggesting potential diagnostic criteria for muscle wasting.

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Validation by CT scan of quadriceps muscle thickness measurement by ultrasound in acute kidney injury

Journal of Nephrology ◽

10.1007/s40620-019-00659-2 ◽

2019 ◽

Vol 33 (1) ◽

pp. 109-117 ◽

Cited By ~ 5

Author(s):

Alice Sabatino ◽

Giuseppe Regolisti ◽

Francesca di Mario ◽

Andrea Ciuni ◽

Anselmo Palumbo ◽

...

Keyword(s):

Acute Kidney Injury ◽

Ct Scan ◽

Kidney Injury ◽

Muscle Thickness ◽

Quadriceps Muscle ◽

Thickness Measurement

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Association between knee extensor and ankle plantarflexor muscle thickness and echo intensity with postural sway, mobility and physical function in older adults

Experimental Gerontology ◽

10.1016/j.exger.2021.111385 ◽

2021 ◽

Vol 150 ◽

pp. 111385

Author(s):

Mathew William Hill ◽

Matthew Roberts ◽

Michael James Price ◽

Anthony David Kay

Keyword(s):

Older Adults ◽

Physical Function ◽

Postural Sway ◽

Knee Extensor ◽

Muscle Thickness ◽

Echo Intensity

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6ADMISSION FOR AN ELECTIVE COLORECTAL SURGERY PROCEDURE IS ASSOCIATED WITH REDUCED QUADRICEPS MUSCLE THICKNESS AT ONE WEEK POST-OPERATIVELY?

Age and Ageing ◽

10.1093/ageing/afy122.04 ◽

2018 ◽

Vol 47 (suppl_3) ◽

pp. iii2-iii2

Author(s):

C Welch ◽

T Pinkney ◽

C A Greig ◽

Z K Hassan-Smith ◽

J M Lord ◽

...

Keyword(s):

Colorectal Surgery ◽

Muscle Thickness ◽

Quadriceps Muscle ◽

Elective Colorectal Surgery

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Ultrasonography to measure quadriceps muscle in critically ill patients: A literature review of reported methodologies

Anaesthesia and Intensive Care ◽

10.1177/0310057x19875152 ◽

2019 ◽

Vol 47 (5) ◽

pp. 423-434 ◽

Cited By ~ 4

Author(s):

Luke M Weinel ◽

Matthew J Summers ◽

Lee-Anne Chapple

Keyword(s):

Layer Thickness ◽

Critically Ill ◽

Critically Ill Patients ◽

Muscle Wasting ◽

Muscle Layer ◽

Quadriceps Muscle ◽

Cross Sectional Area ◽

Muscle Size ◽

Sectional Area ◽

Cross Sectional

Muscle wasting in the intensive care unit (ICU) is common and may impair functional recovery. Ultrasonography (US) presents a modern solution to quantify skeletal muscle size and monitor muscle wasting. However, no standardised methodology for the conduct of ultrasound-derived quadriceps muscle layer thickness or cross-sectional area in this population exists. The aim of this study was to compare methodologies reported for the measurement of quadriceps muscle layer thickness (MLT) and cross-sectional area (CSA) using US in critically ill patients. Databases PubMed, Ovid, Embase, and CINAHL were searched for original research publications that reported US-derived quadriceps MLT and/or CSA conducted in critically ill adult patients. Data were extracted from eligible studies on parameters relating to US measurement including anatomical location, patient positioning, operator technique and image analysis. It was identified that there was a clear lack of reported detail and substantial differences in the reported methodology used for all parameters. A standardised protocol and minimum reporting standards for US-derived measurement of quadriceps muscle size in ICU is required to allow for consistent measurement techniques and hence interpretation of results.

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Can Hip Joint Position affect Quadriceps Muscle Responses during Knee Extension Exercise?

International Journal of Sports Medicine ◽

10.1055/a-1179-8374 ◽

2020 ◽

Vol 41 (13) ◽

pp. 929-935

Author(s):

Denis César Leite Vieira ◽

Marco Aurélio Araujo Dourado ◽

Lucas Ugliara ◽

Joao Luiz Quagliotti Durigan ◽

Brad J. Schoenfeld ◽

...

Keyword(s):

Vastus Lateralis ◽

Muscle Thickness ◽

Rectus Femoris ◽

Peak Torque ◽

Quadriceps Muscle ◽

Knee Extension ◽

Knee Extensors ◽

Work Output ◽

Before And After ◽

Knee Extension Exercise

AbstractThis study investigated the acute effects of seated and supine knee extension exercise on muscle swelling, torque, and work output. Twelve resistance-trained men performed two isokinetic concentric-only knee-extension training protocols at different hip positions in a counter-balanced order. They completed the knee extension exercise in the seated (hip angle at 85°) and supine (hip angle at 180°) positions. The torque and work output were assessed during each set. Moreover, muscle thickness of the middle and proximal vastus lateralis and rectus femoris were evaluated before and after each protocol and used as an indicator of muscle swelling. Middle rectus femoris and proximal vastus lateralis thickness increased significantly (p=0.01) with no difference between exercise variations. However, the middle vastus lateralis thickness increased (p=0.01) only after the seated knee extension exercise (~7%). Knee extensors’ peak torque and work output were approximately 8% higher (p=0.04) in the seated when compared to the supine hip position. There was a similar decrease in torque and work output throughout both protocols (p=0.98). In conclusion, seated knee extension exercises produced greater torque, work output, and muscle swelling in the vastus lateralis when compared to the supine knee extension exercise.

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The Effects of Anterior Cruciate Ligament Reconstruction on Individual Quadriceps Muscle Thickness and Circulating Biomarkers

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16244895 ◽

2019 ◽

Vol 16 (24) ◽

pp. 4895 ◽

Cited By ~ 2

Author(s):

Jae-Ho Yang ◽

Seung-Pyo Eun ◽

Dong-Ho Park ◽

Hyo-Bum Kwak ◽

Eunwook Chang

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Muscle Atrophy ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Muscle Thickness ◽

Quadriceps Muscle ◽

Circulating Biomarkers ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate

Anterior cruciate ligament reconstruction (ACLR) frequently results in quadriceps atrophy. The present study investigated the effect of ACLR on the muscle thickness of the different constituent muscles of the quadriceps and circulating biomarkers related to muscle atrophy and hypertrophy. Fourteen subjects underwent anterior cruciate ligament reconstruction following injury. Quadriceps muscle thicknesses were measured using ultrasound, and circulating biomarkers in the blood were measured using enzyme-linked immunosorbent assays (ELISAs) at the preoperative visit (PRE) and at two postoperative visits (PO1, PO2) in the early stages post-surgery. Differences between time points were analyzed using one-way repeated measures analysis of variance (ANOVA) tests. The most important finding was that severe muscle atrophy occurred in the vastus intermedius (VI) after ACLR (PRE: 20.45 ± 6.82 mm, PO1: 16.05 ± 6.13 mm, PO2: 13.18 ± 4.7 mm, F = 59.0, p < 0.001). Furthermore, the myostatin level was slightly increased, and IGF-1 was significantly reduced throughout the entire period. Therefore, we suggest that inducing selective hypertrophy in the vastus intermedius during the process of rehabilitation would be important for athletes and individuals who engage in explosive sports. Moreover, inhibiting myostatin level increases and maintaining IGF-1 levels in the early phase of recovery after ACLR to prevent muscle atrophy may provide a pharmaceutical option for rehabilitation after anterior cruciate ligament injury.

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