Concordance of Freehand 3D Ultrasound Muscle Measurements With Sarcopenia Parameters in a Geriatric Rehabilitation Ward.

Abstract

Background: Sarcopenia is a devastating disease for older adults, but it lacks accessible and reliable tools for measuring total appendicular skeletal muscle mass (ASMM). Two-dimensional muscle ultrasound (US) has been developed for its bedside clinical advantages and feasibility but lacks standardization and prediction performance. We previously validated a new 3D-US technique to measure muscle volume (MV) at bedside and applied it in a geriatric rehabilitation setting. Objectives were to analyse the concordance between 3D-US MV and ASMM and compare concordance between 3D-US MV and 2D-US parameters with ASMM.

Methods: Participants were recruited in a Geriatric rehabilitation ward in Nantes, France, from May to October 2022. Exclusion criteria were as follows: oedema in the lower limbs or recent history of unilateral lower limb damage or stroke. ASMM was measured with bioelectrical impedance analysis; 3D-US and 2D-US acquisitions were performed on three muscles of the right lower limb. Measures of strength (hand grip, knee extension and ankle dorsiflexion) were also recorded. Reliability of 3D-US MV measurements on 10 participants was high (ICC = 0.99). We used Lin's concordance correlation coefficients (CCC) and bias correction factor for agreement between variables and linear regression models for prediction equations.

Results: Fifty-eight participants had an interpretable ASMM of whom 17 (29%) had a diagnosis of sarcopenia. Volumes of TA, RF and VL were all significantly concordant with ASMM measured by BIA (all p values < 0.001), with CCCs respectively of 0.72, 0.61 and 0.60. MV were all significantly concordant with isometric strength (p values < 0.001). Concordance and correlation with ASMM were higher with 3D-US than 2D-US measurements regardless of the muscle. Prediction of ASMM reached an adjusted R² of 0.8 with tibialis anterior volume, biometrics and 2D measurements.

Conclusions: This study was the first to use 3D-US in a geriatric setting and develop a model to predict ASMM in very old hospitalized patients. MV measurements with 3D-US proved to be reliable and more concordant with appendicular muscle mass and strength than 2D parameters.