Clinical Utility of Ultrasound Measurements of Plantar Fascia Width and Cross-Sectional Area

2017 ◽  
Vol 107 (5) ◽  
pp. 375-381 ◽  
Author(s):  
Adebisi Bisi-Balogun ◽  
Michael Rector
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Plantar Fascia ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Plantar Surface ◽  
Plantar Fasciopathy ◽  
Ultrasound Measurements ◽  
The Mean

Background:We sought to develop a standardized protocol for ultrasound (US) measurements of plantar fascia (PF) width and cross-sectional area (CSA), which may serve as additional outcome variables during US examinations of both healthy asymptomatic PF and in plantar fasciopathy and determine its interrater and intrarater reliability.Methods:Ten healthy individuals (20 feet) were enrolled. Participants were assessed twice by two raters each to determine intrarater and interrater reliability. For each foot, three transverse scans of the central bundle of the PF were taken at its insertion at the medial calcaneal tubercle, identified in real time on the plantar surface of the foot, using a fine wire technique. Reliability was determined using intraclass correlation coefficients (ICC), standard errors of measurement (SEM), and limits of agreement (LOA) expressed as percentages of the mean. Reliability of PF width and CSA measurements was determined using PF width and CSA measurements from one sonogram measured once and the mean of three measurements from three sonograms each measured once.Results:Ultrasound measurements of PF width and CSA showed a mean of 18.6 ± 2.0 mm and 69.20 ± 13.6 mm2 respectively. Intra-reliability within both raters showed an ICC > 0.84 for width and ICC > 0.92 for CSA as well as a SEM% and LOA% < 10% for both width and CSA. Inter-rater reliability showed an ICC of 0.82 for width and 0.87 for CSA as well as a SEM% and LOA% < 10% for width and a SEM% < 10% and LOA% < 20% for CSA. Relative and absolute reliability within and between raters were higher when using the mean of three sonographs compared to one sonograph.Conclusions:Using this novel technique, PF CSA and width may be determined reliably using measurements from one sonogram or the mean of three sonograms. Measurement of PF CSA and width in addition to already established thickness and echogenicity measurements provides additional information on structural properties of the PF for clinicians and researchers in healthy and pathologic PF.

The Effect of Nasal Decongestion on Nasal Patency and Nasalance Scores in Subjects with Normal Speech

2008 ◽  
Vol 45 (6) ◽  
pp. 620-627 ◽  
Author(s):  
Thomas Watterson ◽  
Kerry E. Lewis ◽  
Jennifer C. Ludlow ◽  
Paul C. Ludlow
Keyword(s):  
Outcome Measures ◽  
Correlation Coefficients ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Nasal Patency ◽  
Cross Sectional ◽  
Nasal Decongestant ◽  
The Mean ◽  
Separation Plate ◽  
Normal Speech

Objective: The objective of this study was to evaluate the effects of pharmacological decongestion on nasalance scores. Participants: The participants were 20 adults with normal speech and resonance. Methods: Nasal patency was first determined by measuring the mean minimal cross-sectional area of the nasal passages by acoustic rhinometry. Each participant then read two passages as two predecongestion nasalance scores were obtained. A nasal decongestant was then administered to each nostril without removing the separation plate. Ten minutes later, nasalance scores were repeated. Finally, the separation plate was removed and the mean minimal cross-sectional area was obtained again. Main Outcome Measures: The outcome measures were the pre- and postdecongestion measurements of nasal patency and nasalance scores. Results: Minimal cross-sectional area increased significantly from 0.53 cm2 before decongestion to 0.66 cm2 after decongestion. For the Turtle Passage, the group mean nasalance for the two predecongestion measures (10.70% versus 11.55%) were significantly different and the pre- versus postdecongestion measures (10.70% versus 12.15%) were also significantly different. For the Mouse Passage, the group mean nasalance scores for the two predecongestion measures (32.10% versus 32.00%) were not significantly different but the pre- versus postdecongestion means (32.10 versus 34.40) were significantly different. Correlation coefficients showed a negligible relationship between measures of nasal patency and nasalance scores for both stimulus passages. Conclusions: Nasalance score variability was small and not meaningful for standard clinical purposes. The correlation between nasalance scores and nasal patency was weak.

Ultrasound-Based Mechanical Adaptation of Achilles Tendon After 12-Week Running with Minimalist Shoes

2020 ◽  
Vol 10 (5) ◽  
pp. 1205-1209
Author(s):  
Xini Zhang ◽  
Zhen Luo ◽  
Junqing Wang ◽  
Yang Yang ◽  
Weijie Fu
Keyword(s):  
Achilles Tendon ◽  
Isometric Contraction ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Mechanical Adaptation ◽  
Intraclass Correlation Coefficients ◽  
The Cross

This study aimed to investigate the effect of a 12-week running program using minimalist shoes on ultrasoundbased mechanical adaptation of Achilles tendon (AT). Fifteen male recreational runners accustomed to run in standard cushioned shoes with rearfoot strike pattern were recruited. They were required to wear minimalist shoes without a compulsory transition in foot strike pattern, and be involved in a 12-week running program. Before and after the intervention, the cross-sectional area of AT was collected in the prone position via an ultrasound device. The ankle plantarflexion moment, recorded on an isokinetic dynamometer, was synchronized to the image changes in vivo AT length. Intraclass correlation coefficient was determined to evaluate the intraand interobserver variabilities. Paired t-test was used to quantify the effects of training program (pre- and posttraining) on each variable of the cross-sectional area, AT force, AT stress, and AT strain during an isometric contraction. Seven participants dropped out after the intervention. The results showed that the intraclass correlation coefficients for the intra- and interobserver reliabilities were good to excellent (intraclass correlation coefficients = 0.895–0.996) for the cross-sectional area and elongation. After 12-week running with minimalist shoes, plantarflexion moment, AT force, AT stress, and AT strain significantly increased during an isometric contraction (P < 0.05). The mechanical adaptation of AT improved after 12-week running with minimalist shoes by more efficient energy storage and release, which could prevent or reduce the risk of injury potentially.

scholarly journals Rectus Femoris Mimicking Ultrasound Phantom for Muscle Mass Assessment: Design, Research, and Training Application

2021 ◽  
Vol 10 (12) ◽  
pp. 2721
Author(s):  
Nobuto Nakanishi ◽  
Shigeaki Inoue ◽  
Rie Tsutsumi ◽  
Yusuke Akimoto ◽  
Yuko Ono ◽  
...  
Keyword(s):  
Measurement Accuracy ◽  
Rectus Femoris ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Phantom Model ◽  
Ultrasound Measurements ◽  
Ultrasound Phantom

Ultrasound has become widely used as a means to measure the rectus femoris muscle in the acute and chronic phases of critical illness. Despite its noninvasiveness and accessibility, its accuracy highly depends on the skills of the technician. However, few ultrasound phantoms for the confirmation of its accuracy or to improve technical skills exist. In this study, the authors created a novel phantom model and used it for investigating the accuracy of measurements and for training. Study 1 investigated how various conditions affect ultrasound measurements such as thickness, cross-sectional area, and echogenicity. Study 2 investigated if the phantom can be used for the training of various health care providers in vitro and in vivo. Study 1 showed that thickness, cross-sectional area, and echogenicity were affected by probe compression strength, probe angle, phantom compression, and varying equipment. Study 2 in vitro showed that using the phantom for training improved the accuracy of the measurements taken within the phantom, and Study 2 in vivo showed the phantom training had a short-term effect on improving the measurement accuracy in a human volunteer. The new ultrasound phantom model revealed that various conditions affected ultrasound measurements, and phantom training improved the measurement accuracy.

scholarly journals Atrophy patterns in isolated subscapularis lesions

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gernot Seppel ◽  
Andreas Voss ◽  
Daniel J. H. Henderson ◽  
Simone Waldt ◽  
Bernhard Haller ◽  
...  
Keyword(s):  
Muscle Atrophy ◽  
Area Ratio ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
Subscapularis Muscle ◽  
Mri Scans ◽  
The Mean ◽  
The Cross

Abstract Background While supraspinatus atrophy can be described according to the system of Zanetti or Thomazeau there is still a lack of characterization of isolated subscapularis muscle atrophy. The aim of this study was to describe patterns of muscle atrophy following repair of isolated subscapularis (SSC) tendon. Methods Forty-nine control shoulder MRI scans, without rotator cuff pathology, atrophy or fatty infiltration, were prospectively evaluated and subscapularis diameters as well as cross sectional areas (complete and upper half) were assessed in a standardized oblique sagittal plane. Calculation of the ratio between the upper half of the cross sectional area (CSA) and the total CSA was performed. Eleven MRI scans of patients with subscapularis atrophy following isolated subscapularis tendon tears were analysed and cross sectional area ratio (upper half /total) determined. To guarantee reliable measurement of the CSA and its ratio, bony landmarks were also defined. All parameters were statistically compared for inter-rater reliability, reproducibility and capacity to quantify subscapularis atrophy. Results The mean age in the control group was 49.7 years (± 15.0). The mean cross sectional area (CSA) was 2367.0 mm2 (± 741.4) for the complete subscapularis muscle and 1048.2 mm2 (± 313.3) for the upper half, giving a mean ratio of 0.446 (± 0.046). In the subscapularis repair group the mean age was 56.7 years (± 9.3). With a mean cross sectional area of 1554.7 mm2 (± 419.9) for the complete and of 422.9 mm2 (± 173.6) for the upper half of the subscapularis muscle, giving a mean CSA ratio of 0.269 (± 0.065) which was seen to be significantly lower than that of the control group (p < 0.05). Conclusion Analysis of typical atrophy patterns of the subscapularis muscle demonstrates that the CSA ratio represents a reliable and reproducible assessment tool in quantifying subscapularis atrophy. We propose the classification of subscapularis atrophy as Stage I (mild atrophy) in case of reduction of the cross sectional area ratio < 0.4, Stage II (moderate atrophy) in case of < 0.35 and Stage III (severe atrophy) if < 0.3.

scholarly journals The influence of muscle pennation angle and cross-sectional area on contact forces in the ankle joint

2016 ◽  
Vol 52 (1) ◽  
pp. 12-23 ◽  
Author(s):  
Ran S Sopher ◽  
Andrew A Amis ◽  
D Ceri Davies ◽  
Jonathan RT Jeffers
Keyword(s):  
Pennation Angle ◽  
Muscle Architecture ◽  
Cross Sectional Area ◽  
Contact Forces ◽  
Sectional Area ◽  
Muscle Forces ◽  
Cross Sectional ◽  
Contact Loads ◽  
The Mean ◽  
And Function

Data about a muscle’s fibre pennation angle and physiological cross-sectional area are used in musculoskeletal modelling to estimate muscle forces, which are used to calculate joint contact forces. For the leg, muscle architecture data are derived from studies that measured pennation angle at the muscle surface, but not deep within it. Musculoskeletal models developed to estimate joint contact loads have usually been based on the mean values of pennation angle and physiological cross-sectional area. Therefore, the first aim of this study was to investigate differences between superficial and deep pennation angles within each muscle acting over the ankle and predict how differences may influence muscle forces calculated in musculoskeletal modelling. The second aim was to investigate how inter-subject variability in physiological cross-sectional area and pennation angle affects calculated ankle contact forces. Eight cadaveric legs were dissected to excise the muscles acting over the ankle. The mean surface and deep pennation angles, fibre length and physiological cross-sectional area were measured. Cluster analysis was applied to group the muscles according to their architectural characteristics. A previously validated OpenSim model was used to estimate ankle muscle forces and contact loads using architecture data from all eight limbs. The mean surface pennation angle for soleus was significantly greater (54%) than the mean deep pennation angle. Cluster analysis revealed three groups of muscles with similar architecture and function: deep plantarflexors and peroneals, superficial plantarflexors and dorsiflexors. Peak ankle contact force was predicted to occur before toe-off, with magnitude greater than five times bodyweight. Inter-specimen variability in contact force was smallest at peak force. These findings will help improve the development of experimental and computational musculoskeletal models by providing data to estimate force based on both surface and deep pennation angles. Inter-subject variability in muscle architecture affected ankle muscle and contact loads only slightly. The link between muscle architecture and function contributes to the understanding of the relationship between muscle structure and function.

A computed method for noninvasive MRI assessment of pulmonary arterial hypertension

2004 ◽  
Vol 96 (2) ◽  
pp. 463-468 ◽  
Author(s):  
Eric Laffon ◽  
Christophe Vallet ◽  
Virginie Bernard ◽  
Michel Montaudon ◽  
Dominique Ducassou ◽  
...  
Keyword(s):  
Arterial Pressure ◽  
Pulmonary Arterial Pressure ◽  
Cross Sectional Area ◽  
Physical Parameters ◽  
Sectional Area ◽  
Biophysical Parameters ◽  
Cross Sectional ◽  
Mean Pulmonary Arterial Pressure ◽  
Pulmonary Arterial ◽  
The Mean

The present method enables the noninvasive assessment of mean pulmonary arterial pressure from magnetic resonance phase mapping by computing both physical and biophysical parameters. The physical parameters include the mean blood flow velocity over the cross-sectional area of the main pulmonary artery (MPA) at the systolic peak and the maximal systolic MPA cross-sectional area value, whereas the biophysical parameters are related to each patient, such as height, weight, and heart rate. These parameters have been measured in a series of 31 patients undergoing right-side heart catheterization, and the computed mean pulmonary arterial pressure value (PpaComp) has been compared with the mean pressure value obtained from catheterization (PpaCat) in each patient. A significant correlation was found that did not differ from the identity line PpaComp = PpaCat ( r = 0.92). The mean and maximal absolute differences between PpaComp and PpaCat were 5.4 and 11.9 mmHg, respectively. The method was also applied to compute the MPA systolic and diastolic pressures in the same patient series. We conclude that this computed method, which combines physical (whoever the patient) and biophysical parameters (related to each patient), improves the accuracy of MRI to noninvasively estimate pulmonary arterial pressures.

scholarly journals Patients with Achilles Tendon Rupture Have a Degenerated Contralateral Achilles Tendon: An Elastography Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Qianru Li ◽  
Qi Zhang ◽  
Yehua Cai ◽  
Yinghui Hua
Keyword(s):  
Achilles Tendon ◽  
Axial Strain ◽  
Achilles Tendon Rupture ◽  
Cross Sectional Area ◽  
Control Group ◽  
Computer Assisted ◽  
Study Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean

Purpose. To evaluate differences of Achilles tendon (AT) hardness and morphology between asymptomatic tendons in patients with acute AT ruptures on the contralateral side and asymptomatic tendons in healthy people by using computer-assisted quantification on axial-strain sonoelastography (ASE). Methods. The study consisted of 33 asymptomatic tendons in 33 patients (study group) and 34 tendons in 19 healthy volunteers (control group). All the tendons were examined by both ASE and conventional ultrasound. Computer-assisted quantification on ASE was applied to extract hardness variables, including the mean (Hmean), 20th percentile (H20), median (H50) and skewness (Hsk) of the hardness within tendon, and the ratio of the mean hardness within tendon to that outside tendon (Hratio) and three morphological variables: the thickness (THK), cross-sectional area, and eccentricity (ECC) of tendons. Results. The Hmean, Hsk, H20, H50, and Hratio in the proximal third of the tendon body in study group were significantly smaller than those in control group (Hmean: 0.43±0.09 vs 0.50±0.07, p=0.001; Hsk: -0.53±0.51 vs -1.09±0.51, p<0.001; H20: 0.31±0.10 vs 0.40±0.10, p=0.001; H50: 0.45±0.10 vs 0.53±0.08, p<0.001; Hratio: 1.01±0.25 vs 1.20±0.23, p=0.003). The THK and cross-sectional area of tendons in the study group were larger than those in the control group (p<0.05). Conclusions. As a quantitative objective method, the computer-assisted ASE reveals that the asymptomatic ATs contralateral to acute rupture are softer than those of healthy control group at the proximal third and the asymptomatic tendons in people with rupture history are thicker, larger, and rounder than those of normal volunteers especially at the middle and distal thirds of AT body.

scholarly journals INDIRECT DECOMPRESSION BY LATERAL FUSION: ANALYSIS OF SAGITAL ALIGNMENT

2021 ◽  
Vol 20 (1) ◽  
pp. 50-54
Author(s):  
Thyago Guirelle Silva ◽  
Rodrigo Augusto do Amaral ◽  
Raphael Rezende Pratali ◽  
Luiz Pimenta
Keyword(s):  
Magnetic Resonance ◽  
Pelvic Incidence ◽  
Magnetic Resonance Images ◽  
Cross Sectional Area ◽  
Disc Height ◽  
Lower Limbs ◽  
Sectional Area ◽  
Cross Sectional ◽  
Indirect Decompression ◽  
The Mean

ABSTRACT Objective: To verify the effectiveness of indirect decompression after lateral access fusion in patients with high pelvic incidence. Methods: A retrospective, non-comparative, non-randomized analysis of 22 patients with high pelvic incidence who underwent lateral access fusion, 11 of whom were male and 11 female, with a mean age of 63 years (52-74), was conducted. Magnetic resonance exams were performed within one year after surgery. The cross-sectional area of the thecal sac, anterior and posterior disc heights, and bilateral foramen heights, measured pre- and postoperatively in axial and sagittal magnetic resonance images, were analyzed. The sagittal alignment parameters were measured using simple radiographs. The clinical results were evaluated using the ODI and VAS (back and lower limbs) questionnaires. Results: In all cases, the technique was performed successfully without neural complications. The mean cross-sectional area increased from 126.5 mm preoperatively to 174.3 mm postoperatively. The mean anterior disc height increased from 9.4 mm preoperatively to 12.8 mm postoperatively, while the posterior disc height increased from 6.3 mm preoperatively to 8.1 mm postoperatively. The mean height of the right foramen increased from 157.3 mm in the preoperative period to 171.2 mm in the postoperative period and that of the left foramen increased from 139.3 mm in the preoperative to 158.9 mm in the postoperative. Conclusions: This technique is capable of correcting misalignment in spinal deformity, achieving fusion and promoting the decompression of neural elements. Level of evidence III; Retrospective study.

scholarly journals A Quantitative Comparison of Multispectral Refraction Topography and Autorefractometer in Young Adults

2021 ◽  
Vol 8 ◽  
Author(s):  
Yunru Liao ◽  
Zhenlan Yang ◽  
Zijing Li ◽  
Rui Zeng ◽  
Jing Wang ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
High Agreement ◽  
Intraclass Correlation Coefficients ◽  
Repeatability And Reproducibility ◽  
The Mean

Purpose: Purpose of this study is to evaluate the measuring consistency of central refraction between multispectral refraction topography (MRT) and autorefractometry.Methods: This was a descriptive cross-sectional study including subjects in Sun Yat-sen Memorial Hospital from September 1, 2020, to December 31, 2020, ages 20 to 35 years with a best corrected visual acuity of 20/20 or better. All patients underwent cycloplegia, and the refractive status was estimated with autorefractometer, experienced optometrist and MRT. We analyzed the central refraction of the autorefractometer and MRT. The repeatability and reproducibility of values measured using both devices were evaluated using intraclass correlation coefficients (ICCs).Results: A total of 145 subjects ages 20 to 35 (290 eyes) were enrolled. The mean central refraction of the autorefractometer was −4.69 ± 2.64 diopters (D) (range −9.50 to +4.75 D), while the mean central refraction of MRT was −4.49 ± 2.61 diopters (D) (range −8.79 to +5.02 D). Pearson correlation analysis revealed a high correlation between the two devices. The intraclass correlation coefficient (ICC) also showed high agreement. The intrarater and interrater ICC values of central refraction were more than 0.90 in both devices and conditions. At the same time, the mean central refraction of experienced optometrist was −4.74 ± 2.66 diopters (D) (range −9.50 to +4.75D). The intra-class correlation coefficient of central refraction measured by MRT and subjective refraction was 0.939.Conclusions: Results revealed that autorefractometry, experienced optometrist and MRT show high agreement in measuring central refraction. MRT could provide a potential objective method to assess peripheral refraction.

scholarly journals Intra- and inter-muscular differences in the cross-sectional area of the quadriceps muscles assessed by extended field-of-view ultrasonography

2020 ◽  
Vol 22 (2) ◽  
pp. 152 ◽  
Author(s):  
Chrysostomos Sahinis ◽  
Eleftherios Kellis ◽  
Nikiforos Galanis ◽  
Konstantinos Dafkou ◽  
Athanasios Ellinoudis
Keyword(s):  
Vastus Lateralis ◽  
Intraclass Correlation ◽  
Cross Sectional Area ◽  
Field Of View ◽  
Cost Evaluation ◽  
Sectional Area ◽  
Cross Sectional ◽  
Vastus Intermedius ◽  
Extended Field ◽  
Extended Field Of View

Aim: Τo examine the inter- and intra-muscular differences in the anatomical cross-sectional area (CSA) of the quadricep muscles, using extended - field of view (EFOV) ultrasonography (US).Material and methods: Panoramic transverse US images of the thigh were acquired from 10 young participants at five different locations across the thigh, in two sessions, spaced a week apart. The CSA of the vastus medialis (VM), rectus femoris (RF), vastus intermedius (VI), vastus lateralis (VL) and tensor vastus intermedius (TVI) was quantified.Results: The intraclass correlation coefficients ranged from 0.75 to 0.97 and the standard error of measurement ranged from 0.78% to 6.61%, indicating high test-retest reliability. Analysis of the variance indicated that among the 5 quadriceps muscles the VL and the RF displayed the greater CSA proximally, the VI medially and the VM distally across the thigh (p <0.05). No differences in the quadriceps CSA measured with and without including the TVI were found (p >0.05).Conclusions: The EFOV US technique provides transverse scans of the quadriceps muscle in vivo and allowed a reliable and non-invasive determination of CSA at a low cost. Evaluation of CSA along the thigh largely depends on the measurement site. Future studies that examine the quadriceps CSA using EFOV after any form of intervention should consider changes of at least 6.5% as meaningful.

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