Effect of position and exercise on measurement of muscle quantity and quality: towards a standardised pragmatic protocol for clinical practice

Carly Welch; Zeinab Majid; Isabelle Andrews; Zaki Hassan-Smith; Vicky Kamwa; Hannah Picton; Daisy Wilson; Thomas A Jackson

doi:10.1186/s13102-020-00227-3

Effect of position and exercise on measurement of muscle quantity and quality: towards a standardised pragmatic protocol for clinical practice

Carly Welch^*, Zeinab Majid, Isabelle Andrews, Zaki Hassan-Smith, Vicky Kamwa, Hannah Picton, Daisy Wilson, Thomas A Jackson

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

BACKGROUND: Ultrasonography is an emerging non-invasive bedside tool for muscle quantity/quality assessment; Bioelectrical Impedance Analysis (BIA) is an alternative non-invasive bedside measure of body composition, recommended for evaluation of sarcopenia in clinical practice. We set out to assess impact of position and exercise upon measures towards protocol standardisation.

METHODS: Healthy volunteers aged 18-35 were recruited. Bilateral Anterior Thigh Thickness (BATT; rectus femoris and vastus intermedius), BATT: Subcutaneous Ratio (BATT:SCR), and rectus femoris echogenicity were measured using ultrasound and BIA was performed; 1) lying with upper body at 45° (Reclined), 2) lying fully supine at 180o (Supine), 3) sat in a chair with upper body at 90o (Sitting), and 4) after exercise Reclined. Variability of Skeletal Muscle Mass (SMM) by two different equations from BIA (SMM-Janssen, SMM-Sergi), phase angle, fat percentage, and total body (TBW), extracellular (ECW), and intracellular water (ICW) were assessed.

RESULTS: Forty-four participants (52% female; mean 25.7 years-old (SD 5.0)) were recruited. BATT increased from Reclined to Sitting (+ 1.45 cm, 1.27-1.63), and after exercise (+ 0.51, 0.29-0.73). Echogenicity reduced from Reclined to Sitting (- 2.1, - 3.9 - -0.26). SMM-Sergi declined from Reclined to Supine (- 0.65 kg, - 1.08 - - 0.23) and after exercise (- 0.70 kg, - 1.27 - -0.14). ECW increased from Reclined to Sitting (+ 1.19 L, 0.04-2.35). There were no other statistically significant changes.

CONCLUSION: Standardisation of protocols is especially important for assessment of muscle quantity by ultrasonography; BIA measurements may also vary dependent on the equations used. Where possible, participants should be rested prior to muscle ultrasonography and BIA, and flexion of the knees should be avoided.

Original language	English
Article number	3
Number of pages	8
Journal	BMC Sports Science, Medicine and Rehabilitation
Volume	13
Issue number	1
Early online date	7 Jan 2021
DOIs	https://doi.org/10.1186/s13102-020-00227-3
Publication status	Published - Dec 2021

Bibliographical note

Funding Information:
Dr. Carly Welch is funded by the MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research through a PhD studentship. Dr. Zeinab Majid is funded by the National Institute for Health Research (NIHR) through an Academic Clinical Fellowship. Dr. Daisy Wilson is funded by the NIHR through an Academic Clinical Lectureship. Dr. Thomas Jackson and Dr. Zaki Hassan-Smith are funded by the West Midlands NIHR Clinical Research Network through the Research Scholarship programme. The views expressed in the manuscript are those of the authors and not necessarily those of the NIHR, the NHS, or the Department for Health.

Publisher Copyright:
© 2021, The Author(s).

Keywords

Diagnostic imaging
Electric impedance
Muscles
Sarcopenia

ASJC Scopus subject areas

Orthopedics and Sports Medicine
Physical Therapy, Sports Therapy and Rehabilitation
Rehabilitation

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WelchC2021EffectFinal published version, 920 KBLicence: Creative Commons: Attribution (CC BY)

Cite this

Welch, C., Majid, Z., Andrews, I., Hassan-Smith, Z., Kamwa, V., Picton, H., Wilson, D., & Jackson, T. A. (2021). Effect of position and exercise on measurement of muscle quantity and quality: towards a standardised pragmatic protocol for clinical practice. BMC Sports Science, Medicine and Rehabilitation, 13(1), Article 3. Advance online publication. https://doi.org/10.1186/s13102-020-00227-3

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abstract = "BACKGROUND: Ultrasonography is an emerging non-invasive bedside tool for muscle quantity/quality assessment; Bioelectrical Impedance Analysis (BIA) is an alternative non-invasive bedside measure of body composition, recommended for evaluation of sarcopenia in clinical practice. We set out to assess impact of position and exercise upon measures towards protocol standardisation.METHODS: Healthy volunteers aged 18-35 were recruited. Bilateral Anterior Thigh Thickness (BATT; rectus femoris and vastus intermedius), BATT: Subcutaneous Ratio (BATT:SCR), and rectus femoris echogenicity were measured using ultrasound and BIA was performed; 1) lying with upper body at 45° (Reclined), 2) lying fully supine at 180o (Supine), 3) sat in a chair with upper body at 90o (Sitting), and 4) after exercise Reclined. Variability of Skeletal Muscle Mass (SMM) by two different equations from BIA (SMM-Janssen, SMM-Sergi), phase angle, fat percentage, and total body (TBW), extracellular (ECW), and intracellular water (ICW) were assessed.RESULTS: Forty-four participants (52% female; mean 25.7 years-old (SD 5.0)) were recruited. BATT increased from Reclined to Sitting (+ 1.45 cm, 1.27-1.63), and after exercise (+ 0.51, 0.29-0.73). Echogenicity reduced from Reclined to Sitting (- 2.1, - 3.9 - -0.26). SMM-Sergi declined from Reclined to Supine (- 0.65 kg, - 1.08 - - 0.23) and after exercise (- 0.70 kg, - 1.27 - -0.14). ECW increased from Reclined to Sitting (+ 1.19 L, 0.04-2.35). There were no other statistically significant changes.CONCLUSION: Standardisation of protocols is especially important for assessment of muscle quantity by ultrasonography; BIA measurements may also vary dependent on the equations used. Where possible, participants should be rested prior to muscle ultrasonography and BIA, and flexion of the knees should be avoided.",

keywords = "Diagnostic imaging, Electric impedance, Muscles, Sarcopenia",

author = "Carly Welch and Zeinab Majid and Isabelle Andrews and Zaki Hassan-Smith and Vicky Kamwa and Hannah Picton and Daisy Wilson and Jackson, {Thomas A}",

note = "Funding Information: Dr. Carly Welch is funded by the MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research through a PhD studentship. Dr. Zeinab Majid is funded by the National Institute for Health Research (NIHR) through an Academic Clinical Fellowship. Dr. Daisy Wilson is funded by the NIHR through an Academic Clinical Lectureship. Dr. Thomas Jackson and Dr. Zaki Hassan-Smith are funded by the West Midlands NIHR Clinical Research Network through the Research Scholarship programme. The views expressed in the manuscript are those of the authors and not necessarily those of the NIHR, the NHS, or the Department for Health. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = dec,

doi = "10.1186/s13102-020-00227-3",

language = "English",

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T1 - Effect of position and exercise on measurement of muscle quantity and quality

T2 - towards a standardised pragmatic protocol for clinical practice

AU - Welch, Carly

AU - Majid, Zeinab

AU - Andrews, Isabelle

AU - Hassan-Smith, Zaki

AU - Kamwa, Vicky

AU - Picton, Hannah

AU - Wilson, Daisy

AU - Jackson, Thomas A

N1 - Funding Information: Dr. Carly Welch is funded by the MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research through a PhD studentship. Dr. Zeinab Majid is funded by the National Institute for Health Research (NIHR) through an Academic Clinical Fellowship. Dr. Daisy Wilson is funded by the NIHR through an Academic Clinical Lectureship. Dr. Thomas Jackson and Dr. Zaki Hassan-Smith are funded by the West Midlands NIHR Clinical Research Network through the Research Scholarship programme. The views expressed in the manuscript are those of the authors and not necessarily those of the NIHR, the NHS, or the Department for Health. Publisher Copyright: © 2021, The Author(s).

PY - 2021/12

Y1 - 2021/12

N2 - BACKGROUND: Ultrasonography is an emerging non-invasive bedside tool for muscle quantity/quality assessment; Bioelectrical Impedance Analysis (BIA) is an alternative non-invasive bedside measure of body composition, recommended for evaluation of sarcopenia in clinical practice. We set out to assess impact of position and exercise upon measures towards protocol standardisation.METHODS: Healthy volunteers aged 18-35 were recruited. Bilateral Anterior Thigh Thickness (BATT; rectus femoris and vastus intermedius), BATT: Subcutaneous Ratio (BATT:SCR), and rectus femoris echogenicity were measured using ultrasound and BIA was performed; 1) lying with upper body at 45° (Reclined), 2) lying fully supine at 180o (Supine), 3) sat in a chair with upper body at 90o (Sitting), and 4) after exercise Reclined. Variability of Skeletal Muscle Mass (SMM) by two different equations from BIA (SMM-Janssen, SMM-Sergi), phase angle, fat percentage, and total body (TBW), extracellular (ECW), and intracellular water (ICW) were assessed.RESULTS: Forty-four participants (52% female; mean 25.7 years-old (SD 5.0)) were recruited. BATT increased from Reclined to Sitting (+ 1.45 cm, 1.27-1.63), and after exercise (+ 0.51, 0.29-0.73). Echogenicity reduced from Reclined to Sitting (- 2.1, - 3.9 - -0.26). SMM-Sergi declined from Reclined to Supine (- 0.65 kg, - 1.08 - - 0.23) and after exercise (- 0.70 kg, - 1.27 - -0.14). ECW increased from Reclined to Sitting (+ 1.19 L, 0.04-2.35). There were no other statistically significant changes.CONCLUSION: Standardisation of protocols is especially important for assessment of muscle quantity by ultrasonography; BIA measurements may also vary dependent on the equations used. Where possible, participants should be rested prior to muscle ultrasonography and BIA, and flexion of the knees should be avoided.

AB - BACKGROUND: Ultrasonography is an emerging non-invasive bedside tool for muscle quantity/quality assessment; Bioelectrical Impedance Analysis (BIA) is an alternative non-invasive bedside measure of body composition, recommended for evaluation of sarcopenia in clinical practice. We set out to assess impact of position and exercise upon measures towards protocol standardisation.METHODS: Healthy volunteers aged 18-35 were recruited. Bilateral Anterior Thigh Thickness (BATT; rectus femoris and vastus intermedius), BATT: Subcutaneous Ratio (BATT:SCR), and rectus femoris echogenicity were measured using ultrasound and BIA was performed; 1) lying with upper body at 45° (Reclined), 2) lying fully supine at 180o (Supine), 3) sat in a chair with upper body at 90o (Sitting), and 4) after exercise Reclined. Variability of Skeletal Muscle Mass (SMM) by two different equations from BIA (SMM-Janssen, SMM-Sergi), phase angle, fat percentage, and total body (TBW), extracellular (ECW), and intracellular water (ICW) were assessed.RESULTS: Forty-four participants (52% female; mean 25.7 years-old (SD 5.0)) were recruited. BATT increased from Reclined to Sitting (+ 1.45 cm, 1.27-1.63), and after exercise (+ 0.51, 0.29-0.73). Echogenicity reduced from Reclined to Sitting (- 2.1, - 3.9 - -0.26). SMM-Sergi declined from Reclined to Supine (- 0.65 kg, - 1.08 - - 0.23) and after exercise (- 0.70 kg, - 1.27 - -0.14). ECW increased from Reclined to Sitting (+ 1.19 L, 0.04-2.35). There were no other statistically significant changes.CONCLUSION: Standardisation of protocols is especially important for assessment of muscle quantity by ultrasonography; BIA measurements may also vary dependent on the equations used. Where possible, participants should be rested prior to muscle ultrasonography and BIA, and flexion of the knees should be avoided.

KW - Diagnostic imaging

KW - Electric impedance

KW - Muscles

KW - Sarcopenia

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DO - 10.1186/s13102-020-00227-3

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Effect of position and exercise on measurement of muscle quantity and quality: towards a standardised pragmatic protocol for clinical practice

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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