Validity and reliability of rectus femoris ultrasound measurements: Comparison of curved-array and linear-array transducers

• Published in: Journal of rehabilitation research and development Vol. 51; no. 7; pp. 1155 - 1164
• Main Authors: Hammond, Kendra, Mampilly, Jobby, Laghi, Franco A., Goyal, Amit, Collins, Eileen G., McBurney, Conor, Jubran, Amal, Tobin, Martin J.
• Format: Journal Article
• Language: English
• Published: United States Department of Veterans Affairs 01.01.2014; Superintendent of Documents
• Subjects: Adult; Age; Aged; Aged, 80 and over; Agreements; Atrophy, Muscular; Body mass index; Causes of; Chronic obstructive pulmonary disease; Clinical Competence; Comparative analysis; Complications and side effects; Diagnosis; Female; Healthy Volunteers; Humans; Lung diseases, Obstructive; Male; Medical imaging; Methods; Middle Aged; Mortality; Muscle Strength; Muscles; Observer Variation; Organ Size; Physiological aspects; Pulmonary Disease, Chronic Obstructive - pathology; Pulmonary Disease, Chronic Obstructive - physiopathology; Quadriceps Muscle - anatomy & histology; Quadriceps Muscle - diagnostic imaging; Quadriceps Muscle - physiopathology; Reproducibility of Results; Studies; Thigh; Transducers; Ultrasonography - instrumentation; Ultrasound imaging; Validity; Young Adult; ultrasound imaging; quadriceps femoris; critical illness neuropathy; reproducibility; human muscle; intensive care unit; probe configuration; COPD; critical illness myopathy; sarcopenia
• ISSN: 0748-7711; 1938-1352; 1938-1352
• DOI: 10.1682/JRRD.2013.08.0187

Muscle-mass loss augers increased morbidity and mortality in critically ill patients. Muscle-mass loss can be assessed by wide linear-array ultrasound transducers connected to cumbersome, expensive console units. Whether cheaper, hand-carried units equipped with curved-array transducers can be used as alternatives is unknown. Accordingly, our primary aim was to investigate in 15 nondisabled subjects the validity of measurements of rectus femoris cross-sectional area by using a curved-array transducer against a linear-array transducer-the reference-standard technique. In these subjects, we also determined the reliability of measurements obtained by a novice operator versus measurements obtained by an experienced operator. Lastly, the relationship between quadriceps strength and rectus area recorded by two experienced operators with a curved-array transducer was assessed in 17 patients with chronic obstructive pulmonary disease (COPD). In nondisabled subjects, the rectus cross-sectional area measured with the curved-array transducer by the novice and experienced operators was valid (intraclass correlation coefficient [ICC]: 0.98, typical percentage error [%TE]: 3.7%) and reliable (ICC: 0.79, %TE: 9.7%). In the subjects with COPD, both reliability (ICC: 0.99) and repeatability (%TE: 7.6% and 9.8%) were high. Rectus area was related to quadriceps strength in COPD for both experienced operators (coefficient of determination: 0.67 and 0.70). In conclusion, measurements of rectus femoris cross-sectional area recorded with a curved-array transducer connected to a hand-carried unit are valid, reliable, and reproducible, leading us to contend that this technique is suitable for cross-sectional and longitudinal studies.