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Echo intensity as an indicator of skeletal muscle quality: applications, methodology, and future directions.

Authors
  • Stock, Matt S1, 2
  • Thompson, Brennan J3, 4
  • 1 School of Kinesiology and Physical Therapy, University of Central Florida, 12805 Pegasus Drive, HPA 1, Room 258, Orlando, FL, 32816-2205, USA. [email protected]
  • 2 Neuromuscular Plasticity Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, USA. [email protected]
  • 3 Department of Kinesiology and Health Science, Utah State University, Logan, UT, USA.
  • 4 Sorenson Legacy Foundation Center for Clinical Excellence, Movement Research Clinic, Utah State University, Logan, UT, USA.
Type
Published Article
Journal
European Journal of Applied Physiology and Occupational Physiology
Publisher
Springer-Verlag
Publication Date
Feb 01, 2021
Volume
121
Issue
2
Pages
369–380
Identifiers
DOI: 10.1007/s00421-020-04556-6
PMID: 33221942
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

This narrative review provides an overview of the current knowledge of B-mode ultrasound-derived echo intensity (EI) as an indicator of skeletal muscle quality. PubMed and Google Scholar were used to search the literature. Advanced search functions were used to find original studies with the terms 'echo intensity' and/or 'muscle quality' in the title and/or abstract. Publications that conceptually described muscle quality but did not include measurement of EI were not a focus of the review. Importantly, the foundational premise of EI remains unclear. While it is likely that EI reflects intramuscular adiposity, data suggesting that these measurements are influenced by fibrous tissue is limited to diseased muscle and animal models. EI appears to show particular promise in studying muscular aging. Studies have consistently reported an association between EI and muscle function, though not all chronic interventions have demonstrated improvements. Based on the existing literature, it is unclear if EI can be used as a marker of muscle glycogen following exercise and nutritional interventions, or if EI is influenced by hydration status. Inconsistent methodological approaches used across laboratories have made comparing EI studies challenging. Image depth, rest duration, participant positioning, probe tilt, and the decision to correct for subcutaneous adipose tissue thickness are all critical considerations when interpreting the literature and planning studies. While some areas show conflicting evidence, EI shows promise as a novel tool for studying muscle quality. Collaborative efforts focused on methodology are necessary to enhance the consistency and quality of the EI literature.

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