Exploring the relationship between ultrasound parameters and muscle strength in older adults: a meta-analysis of sarcopenia-related exercise performance
Open accessAbstract
Introduction: Ultrasound (US) imaging has emerged as a promising tool for assessing age-related muscle changes. This meta-analysis aimed to comprehensively evaluate the associations between US parameters and muscle strength, as well as sarcopenia-related functional performance in older adults by integrating data from multiple studies. Methods: A systematic literature search was conducted in PubMed, Web of Science, and Embase until June 2023. Studies reporting Pearson’s correlation coefficients between US parameters [echo intensity (EI), muscle thickness (MT), cross-sectional area (CSA), pinnations angle (PA), fascicle length (FL)] and measures of muscle strength or physical performance in older adults were included. Effect sizes were pooled using a random-effects model and presented in forest plots. Heterogeneity was assessed using I2, and publication bias was evaluated using Egger’s test. Results: Twenty-eight studies met the inclusion criteria. Meta-analysis revealed moderate to strong correlations between EI, MT, and CSA with muscle strength. However, no significant associations were found between US parameters and gait speed. For chair stand tests, the strength of associations varied by test type, with weak correlations observed between echo intensity and muscle thickness with sit-to-stand tests. US parameters did not exhibit significant correlations with the Timed Up and Go test. Conclusion: Ultrasonographic measurements of echo intensity (EI) and muscle thickness (MT) demonstrated moderate to strong correlations with muscle strength and functional assessments related to sarcopenia. To enhance the accuracy of sarcopenia diagnosis and the effectiveness of management strategies, there is a need for larger, longitudinal studies that evaluate a comprehensive range of ultrasonographic parameters. Systematic review registration: https://inplasy.com, identifier INPLASY202410086.
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Yuan and Kim et al. concluded that MT and CSA were moderately related to muscle strength but only weakly to performance-based measures.
“Yuan and Kim et al. extended the evidence by pooling data across multiple variables, concluding that MT and CSA were moderately related to muscle strength but only weakly to performance-based mea sures (Yuan and Kim, 2024).”
From Ultrasound-derived muscle variables and physical function in older adults: A scoping review. (2026) · cites this paper as Yuan and Kim, 2024
The Discussion (§4) reports a moderate association between muscle thickness (MT) and strength and weak associations between MT and sit-to-stand performance. But it describes cross-sectional area (CSA) as strongly correlated with maximal strength, not moderately correlated, and does not report a weak CSA association with performance-based measures. (LLM, conf=0.88)
Experimental — accuracy not yet measuredOther recent reviews assessed multiple ultrasound parameters but were limited to healthy, community-dwelling cohorts.
“others, assessed multiple parameters but were limited to healthy, community-dwelling cohorts (Yuan and Kim, 2024).”
From Ultrasound-derived muscle variables and physical function in older adults: A scoping review. (2026) · cites this paper as Yuan and Kim, 2024
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- Authors
- Yuan, H., & Kim, M.-K.
- Affiliations
- Kyungpook National University (KR)
- Corresponding author
- Kim, Maeng-Kyu
- ORCID
- Kim, Maeng-Kyu
- Venue
- Frontiers in Medicine
- Publisher
- Frontiers Media SA
- Published
- 2024-09-27
- Volume
- 11
- Pages
- 1429530-1429530
- ISSN
- 2296-858X (ISSN-L)
- PMC
- PMC11466788
- OpenAlex
- W4402933868
- Semantic Scholar
- 167850146abb44c1a8c7e00d36b3f146ded8a65c
- Cited by
- 9
- References
- 55
- Citations by year
- 2026: 4 · 2025: 5
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- sarcopenia, muscle strength, muscle ultrasound, echo intensity, muscle thickness, cross-sectional area, fascicle length, older adults, functional performance, walking speed, sit-to-stand test, Timed Up and Go test
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