Construct and criterion validity of muscle ultrasonography for assessment of skeletal muscle in patients recovering from COVID-19

Background: The purpose was to investigate the content, construct, and criterion validity of muscle ultrasound in a mixed cohort of participants recovering from mild and critical COVID-19.Methods: A secondary analysis of a prospective cross-sectional study was conducted on data obtained from a batte...

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Main Authors: Kirby P. Mayer, Kate Kosmac, Yuan Wen, Selina M. Parry, Sanjay Dhar, Sarah Foster, Jonathan Starck, Ashley A. Montgomery-Yates, Esther E. Dupont-Versteegden, Anna G. Kalema
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-10-01
Series:Frontiers in Physiology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphys.2023.1231538/full
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author Kirby P. Mayer
Kirby P. Mayer
Kate Kosmac
Kate Kosmac
Yuan Wen
Selina M. Parry
Sanjay Dhar
Sarah Foster
Jonathan Starck
Ashley A. Montgomery-Yates
Esther E. Dupont-Versteegden
Esther E. Dupont-Versteegden
Anna G. Kalema
author_facet Kirby P. Mayer
Kirby P. Mayer
Kate Kosmac
Kate Kosmac
Yuan Wen
Selina M. Parry
Sanjay Dhar
Sarah Foster
Jonathan Starck
Ashley A. Montgomery-Yates
Esther E. Dupont-Versteegden
Esther E. Dupont-Versteegden
Anna G. Kalema
author_sort Kirby P. Mayer
collection DOAJ
description Background: The purpose was to investigate the content, construct, and criterion validity of muscle ultrasound in a mixed cohort of participants recovering from mild and critical COVID-19.Methods: A secondary analysis of a prospective cross-sectional study was conducted on data obtained from a battery of muscle and physical function assessments including a muscle biopsy and muscle ultrasonography (US). Rectus femoris (RF) muscle thickness (mT), quadricep complex (QC) mT, RF muscle cross-sectional area (CSA) using 2D freeform trace and estimated from Feret’s diameter, and RF echo intensity (EI) were assessed with US. Muscle fiber CSA, fiber type, protein content in muscle fibers, extracellular matrix content (ECM; wheat-germ agglutin), and percent area of collagen in ECM (picrosirius red) were examined from vastus lateralis muscle biopsies. Spearman rho correlations (r) were performed to assess validity of ultrasound parameters.Results: Thirty-three individuals participated including 11 patients surviving critical COVID-19, 15 individuals recovering from mild-COVID, and 7 controls. There were several significant correlations between RF mT, QC mT, RF CSA, and RF EI with age, comorbid burden, body-mass index, and measures of muscle strength, muscle power, and physical function (range r = 0.35–0.83). RF Feret’s CSA correlated to CSA of type II muscle fibers (r = 0.41, p = 0.022) and the average size of all muscle fibers (r = 0.39, p = 0.031). RF EI was correlated with collagen in muscle ECM (r = 0.53, p = 0.003) and protein content in muscle tissue (r = −0.52, p = 0.012).Conclusion: Muscle size and quality measured using US has moderate content and construct validity, and to lesser extent, fair to moderate criterion validity in a mixed cohort of individuals recovering from COVID. Muscle ultrasound quality (EI) appears to be sensitive at detecting muscle dysfunction as it is associated with strength, power, physical function, and collagen distribution in a mixed group of individuals recovering from COVID-19.
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spelling doaj.art-62346b9e2a574a0b889780b30be04e552023-10-23T07:18:12ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2023-10-011410.3389/fphys.2023.12315381231538Construct and criterion validity of muscle ultrasonography for assessment of skeletal muscle in patients recovering from COVID-19Kirby P. Mayer0Kirby P. Mayer1Kate Kosmac2Kate Kosmac3Yuan Wen4Selina M. Parry5Sanjay Dhar6Sarah Foster7Jonathan Starck8Ashley A. Montgomery-Yates9Esther E. Dupont-Versteegden10Esther E. Dupont-Versteegden11Anna G. Kalema12Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, KY, United StatesCenter for Muscle Biology, University of Kentucky, Lexington, KY, United StatesDepartment of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, KY, United StatesCenter for Muscle Biology, University of Kentucky, Lexington, KY, United StatesDepartment of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, KY, United StatesDepartment of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, AustraliaDivision of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine, University of Kentucky, Lexington, KY, United StatesDepartment of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, KY, United StatesDepartment of Biology, College of Arts and Sciences, University of Kentucky, Lexington, KY, United StatesDivision of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine, University of Kentucky, Lexington, KY, United StatesDepartment of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, KY, United StatesCenter for Muscle Biology, University of Kentucky, Lexington, KY, United StatesDivision of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine, University of Kentucky, Lexington, KY, United StatesBackground: The purpose was to investigate the content, construct, and criterion validity of muscle ultrasound in a mixed cohort of participants recovering from mild and critical COVID-19.Methods: A secondary analysis of a prospective cross-sectional study was conducted on data obtained from a battery of muscle and physical function assessments including a muscle biopsy and muscle ultrasonography (US). Rectus femoris (RF) muscle thickness (mT), quadricep complex (QC) mT, RF muscle cross-sectional area (CSA) using 2D freeform trace and estimated from Feret’s diameter, and RF echo intensity (EI) were assessed with US. Muscle fiber CSA, fiber type, protein content in muscle fibers, extracellular matrix content (ECM; wheat-germ agglutin), and percent area of collagen in ECM (picrosirius red) were examined from vastus lateralis muscle biopsies. Spearman rho correlations (r) were performed to assess validity of ultrasound parameters.Results: Thirty-three individuals participated including 11 patients surviving critical COVID-19, 15 individuals recovering from mild-COVID, and 7 controls. There were several significant correlations between RF mT, QC mT, RF CSA, and RF EI with age, comorbid burden, body-mass index, and measures of muscle strength, muscle power, and physical function (range r = 0.35–0.83). RF Feret’s CSA correlated to CSA of type II muscle fibers (r = 0.41, p = 0.022) and the average size of all muscle fibers (r = 0.39, p = 0.031). RF EI was correlated with collagen in muscle ECM (r = 0.53, p = 0.003) and protein content in muscle tissue (r = −0.52, p = 0.012).Conclusion: Muscle size and quality measured using US has moderate content and construct validity, and to lesser extent, fair to moderate criterion validity in a mixed cohort of individuals recovering from COVID. Muscle ultrasound quality (EI) appears to be sensitive at detecting muscle dysfunction as it is associated with strength, power, physical function, and collagen distribution in a mixed group of individuals recovering from COVID-19.https://www.frontiersin.org/articles/10.3389/fphys.2023.1231538/fullmuscle dysfunctioncritical illnesspost-intensive care syndromemuscle ultrasoundskeletal musclemuscle wasting
spellingShingle Kirby P. Mayer
Kirby P. Mayer
Kate Kosmac
Kate Kosmac
Yuan Wen
Selina M. Parry
Sanjay Dhar
Sarah Foster
Jonathan Starck
Ashley A. Montgomery-Yates
Esther E. Dupont-Versteegden
Esther E. Dupont-Versteegden
Anna G. Kalema
Construct and criterion validity of muscle ultrasonography for assessment of skeletal muscle in patients recovering from COVID-19
Frontiers in Physiology
muscle dysfunction
critical illness
post-intensive care syndrome
muscle ultrasound
skeletal muscle
muscle wasting
title Construct and criterion validity of muscle ultrasonography for assessment of skeletal muscle in patients recovering from COVID-19
title_full Construct and criterion validity of muscle ultrasonography for assessment of skeletal muscle in patients recovering from COVID-19
title_fullStr Construct and criterion validity of muscle ultrasonography for assessment of skeletal muscle in patients recovering from COVID-19
title_full_unstemmed Construct and criterion validity of muscle ultrasonography for assessment of skeletal muscle in patients recovering from COVID-19
title_short Construct and criterion validity of muscle ultrasonography for assessment of skeletal muscle in patients recovering from COVID-19
title_sort construct and criterion validity of muscle ultrasonography for assessment of skeletal muscle in patients recovering from covid 19
topic muscle dysfunction
critical illness
post-intensive care syndrome
muscle ultrasound
skeletal muscle
muscle wasting
url https://www.frontiersin.org/articles/10.3389/fphys.2023.1231538/full
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