Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 7, 2014
   Pages 1155 — 1164

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

Kendra Hammond, MD;1–2 Jobby Mampilly, MD;1–2 Franco A. Laghi, BS;1 Amit Goyal, MD;1–2 Eileen G. Collins, RN, PhD;1–3 Conor McBurney, BS;1 Amal Jubran, MD;1–2* Martin J. Tobin, MD1–2

1Edward Hines, Jr. Department of Veterans Affairs Hospital, Hines, IL; 2Division of Pulmonary and Critical Care Medicine, Loyola University Stritch School of Medicine, Maywood, IL; 3Department of Biobehavioral Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL

Abstract — 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.

Key words: COPD, critical illness myopathy, critical illness neuropathy, human muscle, intensive care unit, probe configuration, quadriceps femoris, reproducibility, sarcopenia, ultrasound imaging.


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This article and any supplementary material should be cited as follows:
Hammond K, Mampilly J, Laghi FA, Goyal A, Collins EG, McBurney C, Jubran A, Tobin MJ. Validity and reliability of rectus femoris ultrasound measurements: Comparison of curved-array and linear-array transducers. J Rehabil Res Dev. 2014;51(7):1155–64.
http://dx.doi.org/10.1682/JRRD.2013.08.0187
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