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Cited by 22Body Composition Measurement TechniquesNutrition and Health in AgingReliability and Agreement in Measurement

Reliability and Validity of Quadriceps Muscle Thickness Measurements in Ultrasonography: A Comparison with Muscle Mass and Strength

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Ogawa, Masato, Matsumoto, Tsuyoshi, Harada, Risa, Yoshikawa, Ryo, Ueda, Yuya, Takamiya, Daiki, Sakai, Yoshitada·2023·Progress in Rehabilitation Medicine
DOI 10.2490/prm.20230008PMC PMC9998244
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Abstract

Objectives: Measurement of skeletal muscle using ultrasonography (US) has received considerable attention as an alternative method of muscle assessment. However, intra- and inter-rater reliability remains controversial. Furthermore, there is no consensus regarding the relationship between muscle assessment using US and muscle mass or physical assessment. We aimed to verify the validity and reliability of muscle measurements using US and its relationships with muscle strength and physical assessment. Methods: The 22 participants were all healthy men. Quadriceps muscle thickness was measured by US by three different raters. Intraclass correlation coefficient (ICC) was used to assess inter- and intra-rater reliability. The maximum isokinetic strength of the quadriceps and handgrip strength were used as measures of lower and upper muscle strength, respectively. Leg muscle mass was assessed using the leg skeletal muscle index (SMI), measured by body impedance analysis, and calf circumference. Results: The intra-rater reliability was excellent which the ICC(1,1) ranges 0.957-0.993, and ICC(1,3) ranges 0.985-0.998. For inter-rater reliability, the values of 0.904 for ICC(2,1) and 0.966 for ICC(2,3) indicated excellent reliability. Leg SMI was significantly correlated with quadriceps thickness (r=0.36). Maximum isokinetic strength and handgrip strength showed weak but statistically significant correlations with quadriceps thickness (r=0.20, r=0.30, respectively). The correlation between quadriceps thickness and calf circumference was not statistically significant. Conclusions: Quadriceps muscle assessment using US is a valid and reliable technique for healthy individuals. Quadriceps muscle thickness was significantly positively correlated with upper and lower muscle strength and leg SMI. Muscle thickness assessment could replace full body muscle assessment in clinical settings.

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  • Measurements of rectus femoris muscle thickness show strong correlations with functional indicators such as handgrip strength (HGS) and the fat-free mass index, supporting its value as a surrogate marker of muscular function and overall physical performance.

    “For example, measurements of rectus femoris muscle thickness show strong correlations with functional indicators such as handgrip strength (HGS) and the fat-free mass index, supporting its value as a surrogate marker of muscular function and overall physical performance [16].”

    From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [16]

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  • The multimodal approach of BIA and MU improves diagnostic accuracy for conditions such as sarcopenia and cachexia and enhances the capacity to track intervention-related changes over time.

    “This multimodal approach improves diagnostic accuracy for conditions such as sarcopenia and cachexia and enhances the capacity to track interventionrelated changes over time [16].”

    From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [16]

    The Discussion (page unavailable) says ultrasound muscle-thickness measurements can track a patient’s condition over time and assess the efficacy of nutritional and rehabilitation therapies. The Methods and Results (pages unavailable) use BIA to compare muscle mass with ultrasound thickness, but the paper does not show that combining them improves diagnostic accuracy for sarcopenia or cachexia, or that the combination improves tracking of intervention-related changes. (LLM, conf=0.86)

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Cited by

Sorted by citations

Authors
Ogawa, M., Matsumoto, T., Harada, R., Yoshikawa, R., Ueda, Y., Takamiya, D., & Sakai, Y.
Affiliations
  • Kobe University Hospital (JP)
  • Kobe University (JP)
ORCID
Venue
Progress in Rehabilitation Medicine
Publisher
Japanese Association of Rehabilitation Medicine
Published
2023
Volume
8
Issue
0
Pages
n/a
ISSN
2432-1354 (ISSN-L)
DOI
10.2490/prm.20230008
PMC
PMC9998244
OpenAlex
W4323913992
Cited by
22
References
3
Citations by year
2026: 4 · 2025: 9 · 2024: 8 · 2023: 1
FWCI
3.91
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Progress in Rehabilitation Medicine (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Institutional Repositories DataBase (IRDB) (submittedVersion)
  • Kobe University Repository Kernel (Kobe University) (submittedVersion, cc-by-nc-nd)
Funders
Japan Society for the Promotion of Science (20K19447)
Topics
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
Keywords
quadriceps muscle thickness, measurement reliability, inter-rater reliability, intraclass correlation coefficient, muscle strength, isokinetic strength, grip strength, skeletal muscle index, leg muscle mass, calf circumference, body impedance analysis, muscle assessment

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