Diaphragm and peripheral muscle thickness on ultrasound: Intra-rater reliability and variability of a methodology using non-standard recumbent positions

Baldwin, Claire E., Paratz, Jennifer D. and Bersten, Andrew D. (2011) Diaphragm and peripheral muscle thickness on ultrasound: Intra-rater reliability and variability of a methodology using non-standard recumbent positions. Respirology, 16 7: 1136-1143. doi:10.1111/j.1440-1843.2011.02005.x


Author Baldwin, Claire E.
Paratz, Jennifer D.
Bersten, Andrew D.
Title Diaphragm and peripheral muscle thickness on ultrasound: Intra-rater reliability and variability of a methodology using non-standard recumbent positions
Journal name Respirology   Check publisher's open access policy
ISSN 1323-7799
1440-1843
Publication date 2011-10-01
Sub-type Article (original research)
DOI 10.1111/j.1440-1843.2011.02005.x
Open Access Status Not yet assessed
Volume 16
Issue 7
Start page 1136
End page 1143
Total pages 8
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Formatted abstract
Background and objective: Reliable measurement of diaphragm and peripheral muscle thickness, using diagnostic ultrasound, has only been validated in the erect posture. However, in many clinical populations, including critically ill patients, the erect posture presents logistic difficulties. This study aimed to validate ultrasound measurement of diaphragm and peripheral muscle thickness in the recumbent position.

Methods: An observational methodology of repeated but blind ultrasound and anthropometric measurements was applied, to assess inta-rater reliability. Thirteen healthy volunteers (aged 20–73 years) participated. A pneumotachograph was used to target lung volume, as diaphragm thickness was measured from ultrasound at end- xpiration, and both 25% and 50% of inspiratory capacity, while semi-recumbent. The thicknesses of the mid-upper arm, mid-forearm and mid-thigh musculature were also measured bilaterally  while supine. 

Results: Diaphragm thickness could be reliably measured at end-expiration (intra- lass correlation coefficient (ICC) = 0.990, 95% confidence interval: 0.918–0.998), 25% of inspiratory capacity (ICC = 0.959 (0.870–0.988)) and 50% of inspiratory capacity (ICC = 0.994 (0.980–0.998)).Peripheral muscle thickness measurements were also reliable (ICC = 0.998–1.0). Supine anthropometric measurements of limb segment lengths and girths were highly reproducible. 

Conclusions: This ultrasound technique has good reliability in recumbent positions, making it useful for application to clinical populations when the erect posture is not practical. 
Keyword Anthropometry
Critical care
Reproducibility of result
Respiratory muscle
Supine position
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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