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Application of ultrasound for muscle assessment in sarcopenia: towards standardized measurements

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Abstract

Purpose

Measurement of muscle mass is paramount in the screening and diagnosis of sarcopenia. Besides muscle quantity however, also quality assessment is important. Ultrasonography (US) has the advantage over dual-energy X-ray absorptiometry (DEXA) and bio-impedance analysis (BIA) to give both quantitative and qualitative information on muscle. However, before its use in clinical practice, several methodological aspects still need to be addressed. Both standardization in measurement techniques and the availability of reference values are currently lacking. This review aims to provide an evidence-based standardization of assessing appendicular muscle with the use of US.

Methods

A systematic review was performed for ultrasonography to assess muscle in older people. Pubmed, SCOPUS and Web of Sciences were searched. All articles regarding the use of US in assessing appendicular muscle were used. Description of US-specific parameters and localization of the measurement were retrieved.

Results

Through this process, five items of muscle assessment were identified in the evaluated articles: thickness, cross-sectional area, echogenicity, fascicle length and pennation angle. Different techniques for measurement and location of measurement used were noted, as also the different muscles in which this was evaluated. Then, a translation for a clinical setting in a standardized way was proposed.

Conclusions

The results of this review provide thus an evidence base for an ultrasound protocol in the assessment of skeletal muscle. This standardization of measurements is the first step in creating conditions to further test the applicability of US for use on a large scale as a routine assessment and follow-up tool for appendicular muscle.

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Authors and Affiliations

  1. University of Antwerp—University Geriatric Center, Leopoldstraat 26, 2000, Antwerp, Belgium

    Stany Perkisas, Anne-Marie De Cock & Maurits Vandewoude

  2. Laboratory of Applied Biology and Neurophysiologie, Université libre de Bruxelles, Brussels, Belgium

    Stéphane Baudry

  3. Department of Geriatric Medicine, Klinikum, Carl von Ossietzky University, Oldenburg, Germany

    Jürgen Bauer

  4. Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Brussels, Belgium

    David Beckwée

  5. Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

    David Beckwée

  6. Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands

    Hans Hobbelen & Harriët Jager-Wittenaar

  7. Department of Geriatrics, Medical University in Bialystok, Białystok, Poland

    Agnieszka Kasiukiewicz

  8. Department of Geriatrics, Neuroscience and Orthopedics, Teaching Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart School of Medicine, Rome, Italy

    Francesco Landi

  9. Physical and Rehabilitation Medicine, Parc de Salut Mar, Barcelona, Spain

    Ester Marco

  10. Rehabilitation Research Group, Hospital del Mar Research Institute, Barcelona, Spain

    Ester Marco

  11. Universitat Autònoma de Barcelona, Barcelona, Spain

    Ester Marco & Dolores Sanchez-Rodriguez

  12. University Hospital Ramón y Cajal, Madrid, Spain

    Ana Merello, Elisabet Sanchez & Alfonso Cruz-Jentoft

  13. Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland

    Karolina Piotrowicz

  14. Geriatrics Department, Parc Salut Mar, Barcelona, Spain

    Dolores Sanchez-Rodriguez

  15. Institut Hospital Del Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain

    Dolores Sanchez-Rodriguez

  16. Universitat Pompeu Fabra, Barcelona, Spain

    Dolores Sanchez-Rodriguez

  17. Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium

    Aldo Scafoglieri

  18. Belgian Ageing Muscle Society, Liege, Belgium

    Stany Perkisas, Stéphane Baudry, Aldo Scafoglieri & Maurits Vandewoude

  19. Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Hans Hobbelen

  20. Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Harriët Jager-Wittenaar

Authors
  1. Stany Perkisas
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  2. Stéphane Baudry
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  3. Jürgen Bauer
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  4. David Beckwée
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  5. Anne-Marie De Cock
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  6. Hans Hobbelen
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  7. Harriët Jager-Wittenaar
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  8. Agnieszka Kasiukiewicz
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  9. Francesco Landi
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  10. Ester Marco
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  11. Ana Merello
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  13. Elisabet Sanchez
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  14. Dolores Sanchez-Rodriguez
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  15. Aldo Scafoglieri
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  16. Alfonso Cruz-Jentoft
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  17. Maurits Vandewoude
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Corresponding author

Correspondence to Stany Perkisas.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants performed by any of the authors.

Additional information

The authors are part of the SARCUS working group on behalf of the Sarcopenia Special Interest Group of the European Geriatric Medicine Society.

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Perkisas, S., Baudry, S., Bauer, J. et al. Application of ultrasound for muscle assessment in sarcopenia: towards standardized measurements. Eur Geriatr Med 9, 739–757 (2018). https://doi.org/10.1007/s41999-018-0104-9

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  • DOI: https://doi.org/10.1007/s41999-018-0104-9

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