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      Interrater reliability of quantitative ultrasound using force feedback among examiners with varied levels of experience

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          Background. Quantitative ultrasound measures are influenced by multiple external factors including examiner scanning force. Force feedback may foster the acquisition of reliable morphometry measures under a variety of scanning conditions. The purpose of this study was to determine the reliability of force-feedback image acquisition and morphometry over a range of examiner-generated forces using a muscle tissue-mimicking ultrasound phantom.

          Methods. Sixty material thickness measures were acquired from a muscle tissue mimicking phantom using B-mode ultrasound scanning by six examiners with varied experience levels (i.e., experienced, intermediate, and novice). Estimates of interrater reliability and measurement error with force feedback scanning were determined for the examiners. In addition, criterion-based reliability was determined using material deformation values across a range of examiner scanning forces (1–10 Newtons) via automated and manually acquired image capture methods using force feedback.

          Results. All examiners demonstrated acceptable interrater reliability (intraclass correlation coefficient, ICC = .98, p < .001) for material thickness measures obtained using force feedback. Individual examiners exhibited acceptable reliability with the criterion-based reference measures (ICC > .90, p < .001), independent of their level of experience. The measurement error among all examiners was 1.5%–2.9% across all applied stress conditions.

          Conclusion. Manual image capture with force feedback may aid the reliability of morphometry measures across a range of examiner scanning forces, and allow for consistent performance among examiners with differing levels of experience.

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          Most cited references 20

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          Influence of concentric and eccentric resistance training on architectural adaptation in human quadriceps muscles.

          Studies using animal models have been unable to determine the mechanical stimuli that most influence muscle architectural adaptation. We examined the influence of contraction mode on muscle architectural change in humans, while also describing the time course of its adaptation through training and detraining. Twenty-one men and women performed slow-speed (30 degrees /s) concentric-only (Con) or eccentric-only (Ecc) isokinetic knee extensor training for 10 wk before completing a 3-mo detraining period. Fascicle length of the vastus lateralis (VL), measured by ultrasonography, increased similarly in both groups after 5 wk (Delta(Con) = +6.3 +/- 3.0%, Delta(Ecc) = +3.1 +/- 1.6%, mean = +4.7 +/- 1.7%; P < 0.05). No further increase was found at 10 wk, although a small increase (mean approximately 2.5%; not significant) was evident after detraining. Fascicle angle increased in both groups at 5 wk (Delta(Con) = +11.1 +/- 4.0%, Delta(Ecc) = +11.9 +/- 5.4%, mean = 11.5 +/- 3.2%; P < 0.05) and 10 wk (Delta(Con) = +13.3 +/- 3.0%, Delta(Ecc) = +21.4 +/- 6.9%, mean = 17.9 +/- 3.7%; P < 0.01) in VL only and remained above baseline after detraining (mean = 13.2%); smaller changes in vastus medialis did not reach significance. The similar increase in fascicle length observed between the training groups mitigates against contraction mode being the predominant stimulus. Our data are also strongly indicative of 1) a close association between VL fascicle length and shifts in the torque-angle relationship through training and detraining and 2) changes in fascicle angle being driven by space constraints in the hypertrophying muscle. Thus muscle architectural adaptations occur rapidly in response to resistance training but are strongly influenced by factors other than contraction mode.
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            Use of diagnostic ultrasound for assessing muscle size.

            The typical "gold standard" for assessing muscle size has been magnetic resonance imaging (MRI) and computerized tomography; however, these processes are very expensive and generally require a medical facility. The advent of B-mode diagnostic ultrasound (US) can perhaps offer a quick, cost-effective method to measure muscle size. The purpose of this study was to document the reliability of B-mode US for assessing muscle size in a variety of populations. Thirty-eight postmenopausal women (avg. age = 58.9 +/- 0.7 years) had both their right rectus femoris and biceps brachii imaged, 85 older men and women (avg. age = 65.0 +/- 0.4 yrs) had their right rectus femoris imaged, and 10 young men and women (avg. age = 26.1 +/- 2.4 yrs) had their right rectus femoris imaged by both US and MRI. The location used for imaging on the right rectus femoris was a point 15 cm above to the superior border of the patella following the midline of the anterior surface of the thigh, whereas the biceps brachii was measured at maximal girth following the midline of the anterior surface of the upper arm. All trials utilizing US (Fukuda Denshi, model 4500) and a 5 Mz transducer (FUT-L104) were obtained in duplicate on 2 separate days. The young subjects that also had their rectus femoris measured by MRI were imaged with a Picker 1.5 Tesla (The Edge), which used a fast spin sequence and 192 x 256 resolution to obtain 2 5-mm-thick slices separated by a 1-mm-thick space. All intraclass correlation coefficients for the various groups and muscles measured by US ranged from r = 0.72-0.99, whereas coefficients of variation (CVs) ranged between 3.5% and 6.7%. The intraclass correlation for the MRI images was r = 0.90 and the CV was 5.2%. In conclusion, it appears that diagnostic US can provide a reliable and cost-effective alternative method for assessing muscle.
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              Is Open Access

              Ultrasound as a Tool to Assess Body Fat

               Dale Wagner (2013)
              Ultrasound has been used effectively to assess body fat for nearly 5 decades, yet this method is not known as well as many other body composition techniques. The purpose of this review is to explain the technical principles of the ultrasound method, explain the procedures for taking a measurement and interpreting the results, evaluate the reliability and validity of this method for measuring subcutaneous and visceral adipose tissue, highlight the advantages and limitations of ultrasound relative to other body composition methods, consider its utility to clinical populations, and introduce new body composition-specific ultrasound technology. The focus of this review is adipose, although various tissue thicknesses (e.g., muscle and bone) can be measured with ultrasound. Being a portable imaging device that is capable of making fast regional estimates of body composition, ultrasound is an attractive assessment tool in instances when other methods are limited. Furthermore, much of the research suggests that it is reliable, reproducible, and accurate. The biggest limitations appear to be a lack of standardization for the measurement technique and results that are highly dependent on operator proficiency. New ultrasound devices and accompanying software designed specifically for the purpose of body composition assessment might help to minimize these limitations.

                Author and article information

                PeerJ Inc. (San Francisco, USA )
                21 June 2016
                : 4
                [1 ]Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center, Veterans Affairs Medical Center , Washington, D.C., United States
                [2 ]Geriatrics and Extended Care Service, Veterans Affairs Medical Center , Washington, D.C., United States
                [3 ]Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University , Washington, D.C., United States
                [4 ]Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Hospital , Washington, D.C., United States
                [5 ]Health Sciences Division, Howard Community College , Columbia, MD, United States
                [6 ]Research Service, Veterans Affairs Medical Center , Washington, D.C., United States
                [7 ]Departments of Medicine, Biochemistry & Molecular Medicine, School of Medicine and Health Sciences, George Washington University , Washington, D.C., United States
                [8 ]Departments of Medicine and Rehabilitation Medicine, School of Medicine, Georgetown University , Washington, D.C., United States

                This is an open access article, free of all copyright, made available under the Creative Commons Public Domain Dedication. This work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.

                Funded by: NIH National Center for Advancing Translational Sciences (NCATS)
                Award ID: UL1TR000075
                Award ID: UL1TR000101
                Funded by: National Institutes of Health (NIH)
                This publication was partially supported by Award Number UL1TR000075 and UL1TR000101 from the NIH National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), through the Clinical and Translational Science Awards Program (CTSA), and a VISN 5 Pilot Research Grant (VISN 5; VA Station: 688)—VHA/VA Capitol Health Care Network. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Evidence Based Medicine
                Radiology and Medical Imaging
                Science and Medical Education
                Human–Computer Interaction


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