Architectural anatomy of the quadriceps and the relationship with muscle strength: An observational study utilising real‐time ultrasound in healthy adults

Abstract

Quadriceps atrophy and morphological change is a known phenomenon that can impact significantly on strength and functional performance in patients with acute or chronic presentations conditions. Real‐time ultrasound (RTUS) imaging is a noninvasive valid and reliable method of quantifying quadriceps muscle anatomy and architecture. To date, there is a paucity of normative data on the architectural properties of superficial and deep components of the quadriceps muscle group to inform assessment and evaluation of intervention programs. The aims of this study were to (1) quantify the anatomical architectural properties of the quadriceps muscle group (rectus femoris, vastus intermedius, and vastus lateralis) using RTUS in healthy older adults and (2) to determine the relationship between RTUS muscle parameters and measures of quadriceps muscle strength. Thirty middle aged to older males and females (age range 55–79 years; mean age =59.9 ± 7.08 years) were recruited. Quadriceps muscle thickness, cross‐sectional area, pennation angle, and echogenicity were measured using RTUS. Quadriceps strength was measured using hand‐held dynamometry. For the RTUS‐derived quadriceps morphological data, rectus femoris mean results; circumference 9.3 cm; CSA 4.6 cm2; thickness 1.5 cm; echogenicity 100.2 pixels. Vastus intermedius mean results; thickness 1.8 cm; echogenicity 99.1 pixels. Vastus lateralis thickness 1.9 cm; pennation angle 17.3°; fascicle length 7.0 cm. Quadriceps force was significantly correlated only with rectus femoris circumference (r = 0.48, p = 0.007), RF echogenicity (r = 0.38, p = 0.037), VI echogenicity (r = 0.43, p = 0.018), and VL fascicle length (r = 0.43, p = 0.019). Quadriceps force was best predicted by a three‐variable model (adjusted R2 = 0.46, p < 0.001) which included rectus femoris echogenicity (B = 0.43, p = 0.005), vastus lateralis fascicle length (B = 0.33, p = 0.025) and rectus femoris circumference (B = 0.31, p = 0.041). Thus respectively, rectus femoris echogenicity explains 43%, vastus lateralis fascicle length explains 33% and rectus femoris circumference explains 31% of the variance of quadriceps force. The study findings suggest that RTUS measures were reliable and further research is warranted to establish whether these could be used as surrogate measures for quadriceps strength in adults to inform exercise and rehabilitation programs.

Comparison of the asymmetries in muscle mass, biomechanical property and muscle activation asymmetry of quadriceps femoris between patients with unilateral and bilateral knee osteoarthritis

“…The thickness of RF, VI, VM, VL, and thigh subcutaneous fat (SF) were measured. Measurement method: L15-4 linear array probe was selected, the frequency was 4–12 MHz ( Aily et al, 2019 ; Chopp-Hurley et al, 2020 ; El-Ansary et al, 2021 ), and the ultrasonic mode was set as muscle inspection mode. The subject was placed in supine position, legs relaxed and straight, without internal and external rotation of the hip and knee.…”

MyoVision-US: an Artificial Intelligence-Powered Software for Automated Analysis of Skeletal Muscle Ultrasonography

“…35 and educational contexts related to muscle ultrasound imaging. 7,12,13,17,18,28,[30][31][32][33][34] For manual analyses, all muscle ultrasound parameters (muscle thickness, anatomical CSA, and EI) were analyzed in triplicate where the mean of the three values used in the final analyses. All muscle thickness parameters were measured in centimeters.…”

Application of conventional ultrasound coupled with shear wave elastography in the assessment of muscle strength in patients with type 2 diabetes

“…Muscle morphological parameters such as thickness, pennation angle, fiber length, and cross-sectional area (CSA) can be used to evaluate the structural and functional states of skeletal muscles ( 16 ). However, for individuals with diabetes, before any observable changes in muscle morphology can be measured, the imbalance of muscle protein metabolism, accumulation of glycation end products, and the alteration of muscle composition via intermuscular adipose tissue (IMAT) infiltration changing in the tissue’s mechanical properties can ultimately cause changes in muscle stiffness ( 4 , 17 ).…”