Quadriceps Muscle Quality Research Articles

Quadriceps muscle quality and quantity following tibial plateau fracture repair.

To investigate the qualitative and quantitative changes seen in quadriceps muscles [QM] following tibial plateau fracture and surgery. A consecutive series of patients with an isolated tibial plateau fracture presenting to a single academic center were enrolled and prospectively followed. Bilateral knee MRIs were performed preoperatively and 3 and 12 months postoperatively to assess quantity and quality of the quadriceps muscles. All patients underwent tibial plateau operative repair and were made non-weight-bearing for 10 weeks postoperatively then advanced to weight-bearing as tolerated. Functional status assessed via the short musculoskeletal functional assessment (SMFA); knee range of motion [ROM]; vastus medialis oblique [VMO] and vastus lateralis [VL] muscle quantity (axial width, cross sectional area [CSA] and volume) on injured and contralateral limb; VMO, sartorius, semi-membranous and biceps femoris [BF] muscle quality (fat and water content, and proton density fat fraction). All muscle quantitative and qualitative measurements were compared across all time points. Ten patients were included in the final analysis, 6 males and 4 females, with average age of 43.62 ± 16.3years. While the VMO and VL axial width and CSA were significantly decreased at 3months preoperatively, this was not statistically significant. There was no significant difference between any QM quantitative measurements at any time points. There was no difference in fat content, water content or PDFF at any time point for the VMO, sartorius, semi-membranous and BF muscles. Regression analysis also showed no association between 12-month SMFA scores and knee ROM with VMO/VL CSA at 1year. QM quantity and quality do not significantly change at 3months and 1year postoperatively following tibial plateau fracture surgery. Prognostic Level II.

Longitudinal Changes in Quadriceps Morphology over the First 3 Months after Anterior Cruciate Ligament Reconstruction.

Neuromuscular deficits and atrophy after anterior cruciate ligament reconstruction (ACLR) may be accompanied by changes in muscle composition and poor quadriceps muscle quality (QMQ). Quadriceps atrophy occurs after ACLR but improves within the first three postoperative months, yet this hypertrophy could be attributable to increases in noncontractile tissue (i.e., poor QMQ). The purposes of this study were to evaluate changes in QMQ after ACLR and to determine if changes in QMQ and cross-sectional area (CSA) occur in parallel or independently. A longitudinal prospective cohort design was implemented to evaluate QMQ and CSA in 20 individuals with ACLR and 12 healthy controls. Participants completed three testing sessions (baseline/presurgery, 1 month, and 3 months) during which ultrasound images were obtained from the vastus lateralis (VL) and rectus femoris (RF). QMQ was calculated as the echo intensity (EI) of each image, with high EI representing poorer QMQ. Anatomical CSA was also obtained from each image. RF and VL EI were greater at 1 and 3 months in the ACLR limb compared with baseline and the contralateral limb and did not change between 1 and 3 months. VL and RF CSA in the ACLR limb were smaller at 1 and 3 months compared with the contralateral limb and controls (VL only) but increased from 1 to 3 months. Changes in QMQ and CSA were not correlated. QMQ declines within the first month after ACLR and does not improve by 3 months although hypertrophy occurs, suggesting that these morphological characteristics change independently after ACLR. Poorer QMQ represents greater concentration of noncontractile tissues within the muscle and potentially contributes to chronic quadriceps dysfunction observed after ACLR.

Relationship between physical activity levels and changes in skeletal muscle characteristics in patients with stroke

Purpose This study aimed to investigate the relationship between physical activity (PA) levels and short-term changes in skeletal muscle characteristics in patients with subacute hemiparetic stroke. Materials and Methods This prospective observational study included 76 patients with stroke who received inpatient care in a convalescent rehabilitation ward. The PA level was measured as the duration of daily total PA (≥ 1.5 metabolic equivalents) using a triaxial accelerometer for 7 days after admission. The outcomes were changes in the quadriceps muscle quality and quantity on the affected and unaffected sides, as assessed by ultrasonography at admission and 1 month after admission. Results Multiple regression analysis indicated that the duration of total PA was significantly associated with a percentage change in quadriceps muscle quality (p = 0.011) and quantity (p = 0.012) on the affected side. However, no significant relationship was observed between the muscle quality and quantity on the unaffected side. Conclusions The results revealed that PA was associated with changes in the quadriceps muscle quality and quantity on the affected side in patients with subacute hemiparetic stroke. These findings highlight the importance of promoting PA in stroke rehabilitation to improve muscle properties and functional outcomes.

Accelerated age-related decline in quadriceps muscle quality in the setting of knee osteoarthritis: a systematic review with network meta-analysis

Accelerated age-related decline in quadriceps muscle quality in the setting of knee osteoarthritis: a systematic review with network meta-analysis

Quadriceps Muscle Quality Does Not Reflect Self-report Or Muscle Function In Individuals With Acl Reconstruction

Chronic quadriceps dysfunction following anterior cruciate ligament reconstruction (ACLR) leads to disability and has been implicated as a risk factor for knee osteoarthritis (OA). However, the most appropriate quadriceps function assessment for identifying individuals at heightened risk of OA and disability is unclear. Quadriceps muscle quality (QMQ) assessed via ultrasound imaging is associated with quadriceps strength and functional ability in the elderly, but has yet to be evaluated following ACLR. PURPOSE: To compare QMQ between limbs and evaluate relationships between QMQ, quadriceps function, and self-report function in individuals with ACLR. METHODS: Twenty-six individuals with unilateral ACLR (73% females; age = 23 ± 3 yr; time since ACLR = 56 ± 45 months; International Knee Documentation Committee Index [IKDC] = 87 ± 9) volunteered for this study. QMQ was calculated as the echo intensity of cross-sectional ultrasound images of the rectus femoris (RF) and vastus lateralis (VL), and averaged as a composite quadriceps value. Isometric (peak torque and rate of torque development) and isokinetic (peak torque and power at 180°/s) quadriceps function was assessed in the ACLR limb and normalized to body mass. QMQ was compared between limbs via paired t-tests, and relationships between QMQ, quadriceps function, and self-report function (IKDC) were evaluated via Pearson correlations. RESULTS: QMQ did not differ between limbs for the RF (arbitrary grayscale units: 110 ± 8 vs. 110 ± 7, p = 0.472), VL (112 ± 9 vs. 113 ± 9, p = 0.203), or quadriceps composite (111 ± 8 vs. 112 ± 7, p = 0.326), and was not correlated with any quadriceps function index (r = -0.283 - 0.122, p > 0.05). IKDC was not correlated with QMQ of the VL (r = -0.093, p = 0.332) or quadriceps composite (r = -0.242, p = 0.127), but poorer RF QMQ was associated with poorer self-report function (r = -0.376, p = 0.035). CONCLUSIONS: Poor QMQ of the RF is indicative of poor self-report function, but QMQ does not differ between limbs and is not associated with quadriceps function in individuals with ACLR. These data suggest that QMQ has limited clinical application for identifying individuals at heightened risk of OA and disability following ACLR. Previous reports of associations between QMQ and muscle function in elderly subjects likely reflect age-related sarcopenia.

Ultrasonic Assessment of Quadriceps Muscle Quality Does Not Reflect Muscle Function in Healthy Individuals

Muscle quality assessed by ultrasound imaging represents the composition of the muscle. Poor muscle quality (i.e. greater echo intensity) indicates greater intramuscular fat and connective tissue, and is associated with lesser functional ability and strength in older adults. If validated as a robust indicator of muscle function, this measure could be used to evaluate patient populations who experience muscle dysfunction and are unable to produce maximal muscle contraction due to pain and inhibition (e.g. knee osteoarthritis, anterior cruciate ligament injury). However, the relationships between muscle quality and muscle function are unknown. PURPOSE: To evaluate relationships between quadriceps muscle quality and isometric peak torque, isokinetic peak torque, and voluntary activation. METHODS: Quadriceps (vastus lateralis) muscle quality was assessed from the gray-scale echo intensity obtained from transverse plane ultrasound images. Quadriceps function was assessed via maximal isometric peak torque, isokinetic peak torque at 60 and 240 °/s, and central activation ratio (CAR) in 23 healthy individuals (20 females, 3 males; Age = 21±1 yr; Height = 1.70±0.01m; Mass = 65.6±9.8kg). CAR refers to the ratio of peak voluntary torque to the torque resulting from an electrical stimulus superimposed on the quadriceps during maximal isometric contraction. Relationships between muscle quality and each index of muscle function were calculated via Pearson correlations. RESULTS: Quadriceps muscle quality was not significantly correlated with isometric peak torque (r = 0.324, p = 0.152), isokinetic peak torque at 60°/s (r = 0.013, p = 0.955) or 240°/s (r = −0.071, p = 0.749), or CAR (r = 0.366, p = 0.103). CONCLUSION: Muscle quality does not appear to be an indicator of muscle function in healthy individuals. These findings suggest that muscle quality is not likely a surrogate for muscle function in individuals with joint pathologies who experience muscle dysfunction. The disagreement between our results in healthy, young individuals and those from previous investigations involving older adults may suggest that muscle quality reflects undefined factors associated with sarcopenia. Future research is necessary to evaluate relationships between muscle quality and function in pathological populations.

Obesity and Knee Osteoarthritis Are Not Associated With Impaired Quadriceps Specific Strength in Adults

To assess whether adults, aged 50-59 years, who are obese or moderately to severely obese have impaired quadriceps strength and muscle quality in comparison with adults who are not obese, both groups with and without knee osteoarthritis (OA). Cross-sectional observational study. Rural community acquired sample. Seventy-seven men and 84 women, aged 50-59 years. Comparisons by using mixed models for clustered data (2 lower limbs per participant) between groups defined by body mass index (BMI) (<30 kg/m(2), 30-35 kg/m(2), and ≥35 kg/m(2)), with and without knee OA MAIN OUTCOME MEASUREMENT: The slope of the relationship between quadriceps muscle cross-sectional area (CSA) and isokinetic knee extensor strength (dynamometer) in each BMI and OA group. There were 113 limbs (48.7% women), 101 limbs (38.6% women), and 89 limbs (73.0% women) in the <30 kg/m(2), 30-35 kg/m(2), and ≥35 kg/m(2) BMI groups, respectively; knee OA was present in 10.6%, 28.7%, and 58.4% of the limbs in each of these respective groups. Quadriceps CSA did not significantly differ among BMI groups in either gender or between subjects with and without knee OA. Peak quadriceps strength also did not significantly differ by BMI group or by the presence of knee OA. Multivariable analyses also demonstrated that peak quadriceps strength did not differ by BMI group, even after adjusting for (a) gender, (b) OA status, (c) intramuscular fat, or (d) quadriceps attenuation. The slopes for the relationships between quadriceps strength and CSA did not differ by BMI group, OA status, or their interaction. Individuals who were obese and at risk for knee OA did not appear to have altered muscle strength or muscle quality compared with adults who were not obese and were aged 50-59 years. The absence of a difference in the relationship between peak quadriceps strength and CSA provided further evidence that there was not an impairment in quadriceps muscle quality in this cohort, which suggests that factors other than strength might mediate the association between obesity and knee OA.