Ultrasound imaging in women's arm flexor muscles: intra-rater reliability of muscle thickness and echo intensity

Background: Different ultrasound parameters have been frequently used to assess changes associated with training, aging, immobilization, and neuromuscular diseases. However, an exploratory reliability analysis of the echo intensity (EI) and muscle thickness (MT) of the forearm flexors is scarce, especially in women. Objective: The purpose of the present study was to determine the intra-rater reliability of MT and EI assessed by ultrasound in young women. Method: Ultrasonographic MT and EI were acquired in the forearm flexors of 41 young women (22 +/- 2 yrs). Reliability was calculated using intraclass correlation coefficient (ICC2,1), standard error of measurement (SEM), coefficient of variation (CV), smallest detectable change (SDC), and Bland and Altman plot analysis. Results: ICC values for MT and EI were 0.88 (95% CI: 0.78-0.93). The SEM and CV values were lower than 10%. Bland and Altman analysis revealed that ultrasound mean differences were 0.27 mm (Limits of Agreement -LOA 95%: -2.6 to 3.2 mm) and -0.09 a.u. (LOA 95%: - 10.9 to 10.7 a.u.). Conclusion: MT and EI assessed by ultrasonography in young women appear to be reliable and may be used to monitor changes in muscle mass induced by strength training when these changes exceed the precision of ultrasound.