Prediction of maximum isometric muscle strength of knee extensors using ultrasonography

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  • 大腿四頭筋の超音波画像を用いた等尺性膝関節伸展筋力の推定

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Muscle echo intensity (EI) determined by ultrasonography has recently been reported asan index of intramuscular fat. The muscle thickness (MT) and EI of the quadriceps femorismuscle were reported to be influenced by the muscle strength (MS) of the knee extensors.This study was performed to investigate whether the MT and EI of the quadriceps femorisare associated with the MS of knee extensors, and to establish a predictive formula for themaximal isometric MS of knee extensors.Forty healthy volunteers 20-59 years old were included in this study. The maximalisometric MS of knee extensors on the dominant extremity was measured at kneeflexion of 60°, and was defined as the maximal value over three repeated measurements.Transverse ultrasound images of the quadriceps on the dominant extremity were obtainedwith a B-mode ultrasound imaging device and multi-frequency linear transducer. Duringmeasurements, the participants were completely relaxed and sat comfortably withthe knee flexed at 90°. A 10-MHz transducer with gain of 58 dB was used during allmeasurements. The transducer was positioned perpendicular to the longitudinal axis ofthe quadriceps femoris, at the midpoint between the anterior superior iliac spine andthe proximal end of the patella. The same investigator then obtained three consecutiveimages. The subcutaneous fat thickness, MT of each muscle, and EI of each muscle wereanalyzed from three images acquired for the rectus femoris (RF) and vastus intermedius(VI), and the mean values of the three measurements were recorded. Pearson’s andSpearman’s correlation coefficients were calculated to investigate the relationships betweensubcutaneous fat thickness, MT, EI, physical characteristics, and MS. Stepwise multipleregression analysis was then performed with MS value as the dependent variable, and thecharacteristics of the participants and values from the ultrasound images as independentvariables. In addition, multiple regression analysis was performed in two groups dividedaccording to age, i.e., the young adult group and the middle-aged group.There were no significant differences in height, weight, BMI, or muscle circumferencebetween the young adult group and middle-aged group. MS showed significant negativecorrelations with subcutaneous fat thickness, RFEI, and VIEI, and significant positivecorrelations with height, weight, circumference, RFMT, and VIMT. Stepwise regressionanalysis identified height and VIMT as factors significantly associated with MS (adjustedR2 = 0.65). Height and VIMT contributed to MS in young and middle-aged individuals.

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