The use of cln-hropome-ry for clssessing muscle size
M.G. Bemben, Y. ScIb, T. Abe
lnf. ). Kodsu Training Res･ 2005; 1 : 33-36
The gold slondcu･d for ossessing muscle size (cross-secIionc･l ctrec, ond yolume) has been mc･gneIic
resonopce imQging t岬ond computerized tomogrqphy (CT), however, lhese.processes ore very
expenswe qnd generotly require o medicoL fQCiliv′ Cnd in the cose oF CT′ con.nvolye exposure to
high leyets of rQdiQtion. The odyent of a-mode uIIrQSOUnd, in coniunclion with simple onlhrop｡metric
measures, such qs circumference, con perhc'ps o拝er c'quick, yqlid cnd reliclble′ ond cos- effective
method lo estimclte muscle cross-sectionoL cwecl (CSA) Cnd frock chonges in muscle CSA ら"owing
-raining. The purpose of this sh'dy wos -o docurnen一一he reliqbilify ond qccur∝y of a-mode ulfrosound
in combinolion with on-hropomefry for cISSeSSing Kc'C.-su -rclining induced chonges in muscle-bone
CSA. The dqfc'from lhirV-three young men (mecln c･ge, 22.2 ± 5･l yrs日n fbur different I和ining
groups were combined for dle SIdislicol qnolysis. All subiects were ossessed prior lo Iroining ond
-hree doys Qber the lqs- IrQining session･ An-hropome-ric qssessmen- ohhe righ- thigh circumference
wos lqken qHhe mid point oHhe thigh the-∨een -he lqlerQl condyle of the femur ond greqIer
frochclnter), C'nd midline c'nlerior tQAT) C'nd poslerior (HAT) mec-sures of subculc,neous Qdipose tissue
Ihickness′ QI the sc'me leyel CIS -he circumference mecISUreS, WCLS Ob-oiれed w汁h B-mode uL-rc,sound･
The muscle-bone CSA wos estimclfed with the fo一lowing equ｡Iion: 【7r tr - (QAT + HAT) /2)2 ; rヨ
circumference / 2汀】･ EQCh subiec- olso hod -heir right thigh imoged, QI -he some poin- os the
Dr. T. Abe′ Depqrhenl of
Exercise qnd sport science,
Tokyo仙eh･opolitqn Uniyer叫,
1 -1仙nclmトohsQWO′ Hochioii,
lbkyo 1 92-0397, JqpQn
cLrCUmference mecISUre′ by MRl･ The es-imqted muscle-bone CSA wos on oyerc,ge, 21% higher lhon
Ihe仙RI meqsured CSA prior to lrc'ining buHhe two me-hods were significonlly tp･0･Ol ) CorrelQfed
(r=0.81 I. The correlolion between the chqnges in esf;mo†ed clnd MRI meosured CSA due Io muscle
hypertrophy following KQOIsu tmining was OIso high tr-0･86) Cnd significqn=p<0･01 l qnd only
cIbebe@comp. metro-U. CIC ･ i p
differed on QYerC'ge by 1 ･8% between two me-hods･ ln conclusion, if cIPPeqrS -ho† onlhropometry in
see end of clrfkle for
cludlOrS'q純1icLfions
combinQIion with ul-rosound con proyide a reliqble′ C'ccurQte, C.nd cos- efkc-iye ol-ernc.-ire method for
c'ssessing muscle hyperrrophy.
Key words: B-mode ulh,C'sound, musc一e hyperfrophy′ muscle･bone cross-secIionol crreo
1 NTRODUCT10N
b recent years, a number of publications have
The ability to assess the effectiveness of different
reportedthat a variety oHow intensity activities′ hke
exercise interventions, like l{aatsu training, and
walking or resistance training (20% of lRM)with
changes in muscle CSA and volume in vivo has
restriction of muscular venous blood flow′ i.e.,
become inαeasingly important. h order to dothis,
Kaatsu一廿aiming, cap resultinsignincantand rapid (∼
methods such as the endogenous excretion of 3counting′ Or isotope dilution with substances like
2 weeks) increases n musde hypertrophy (Abe etal･,
2005; Thkarada etal., 2000). The rapid time course of
these dlangeS need to be assessed on a daily basis and
deuterium oxide, Canindirectly assess totalmusde
therefore would predude the use of devices正ke Ⅳm
mass, however, radiographic techniques offer an
and CT imagmg.
methylhistadine or crea血ine, whole body potassium
unlque Opportunity for the direct visualization of
The use of equations based on bnb drcumferences′
spedfic areas of musdethat can be diredly血ked to
corrected for skinfoldthidkness, were血st developed
musde hypertrophy resul血g from different foms of
to estimate re由onalmusde-bone CSA (Dekoning et
training.
CTand MRI imagmg canacmrately assess dlangeS
alり1986; Jelliffe and Jelliffe′ 1969)′ then the
in muscle CSA and are considered the 〝gold
al., 1982), however, these simple methods generany
standard" for assessing musde size, however, these
resulted in an overestimation of 15 - 25% when
ted血ques are very expensive,involve either x-ray or
compared to more sophisticated tedhniques sudh as
equations were corrected for gender (HeymS丘eld et
radiation exposure, time consuming, and are most
cT scans (HeymS丘eld etal.′ 1979) andthese methods
often located in medicalhd】ities. These factors often
lacked the sensitivity to monitor small changes in
preclude the use of these devices for most
musde mass assodatedwith trab的g programs. To
researdlerS′ eSpedally for large sample size studies
improve the ability and sensitivity of estimated
andthe need for frequentanalyses.
musde-bone CSA assessments′血asound has been
34
Assessing仙uscIe cross secfioncll Arccl
adapted to provide a more accurate measure of
subcutaneous fatthan skinfolds (Black et al.′ 1988;
Borkanet al･, 1982; Weiss, 1984; and Weiss and
Clark, 1987) and new estimation equations have
been developedthat may providethe sensitivity to
track sman changes in musde-bone CSA over short
time periodswith repeated measures.
Therefore′ the purpose of this study was to
document the validity of B-mode ultrasound for
measuring subcutaneous fatand providingthe ability
to mathematicany estimate musde-bone CSA before
and after short ten training when compared to the
a∝q)ted standard of MRI measures.
midline of the thigh′ both anteriorly (QAT) and
posteriorly (HAT) for subcutaneous adipose tissue
thidmess (AT), at the same level asthe drcumference
measures,withB-modeultrasound (SSD-500,Aloka,
Japan)･ A 5-MHz scanning head was coatedwith
water-soluble仕ansmission gel to provide acoustic
contactwithOut depressingthe demalsurface. The
fomulathat was used to estimatethe musde-bone
CSA was as follows: 【Muscle-Bone CSA =花(r -
(QAT 'HAT) / 2)2],'wherでr wasthe radius of the
rightthigh calculated as clrCumference / 2 7E ′ and
QAT and HAT wereultrasound measured (Abe et a1.,
1994) anterior and posterior thigh adipose tissue
thidkness′ respectively (Figure 1 ). This measu托ment
Lu ETHODS
was camied out prior to training (baselhe) andthree
Suhiecls
The data from thhy-three young men (mean age,
22･2 ± 5･l yrs; meanheight, 173.3 ± 6.0 cm; and
mean weight′ 65･1 ± 9.4 kg) in four different
training groups were combined for the statistical
analysisI There were two treatment groups, walktrajning combinedwithKaatsu (Wdk-Kaatsu′ n=9)
and lowintensity (20% OHRM) resistance exerdse
combinedwith Kaatsu (LIT-ltaatsu, n-9) and two
control groups, walking control (n=8) and light
resistance traiI血g con加1 (uT n=7). Bebre tes血g′
days afterthe last trah血g session.
州RJ州eosLJred納uscfe CSA
Each subjectalso hadtheirright thighimaged, at
the same point as the drcumference measure′ by
MRI (GE Signa l･5-T sea-er, TI spinecho sequence,
256 X 256 resolution, 1 cm s五ce). The es血lated CV
for this technique has been determined to be
approximately 2% (Abe etal･, 2003). Subjects were
assessed prior to training and then againfollowing
the various trainjnginterventions.
hs血donalapprovalwas obtained and eadh subject
signedinformed consent･ subjects did not parddpate
inanyvigorous leg or armexerdses onthe days of
assessment.
ShfisliccII Ancllysis
All data are reported as means and standard
deviations (SD) ･ Reladonships between the estimated
musde-bone CSA and MRI measured CSA of themid
Esfimcffed州uscJe･Bone CSA
Each subject had their right mid thigh
anthropometrically assessedwitha drcumference
taken atthemid poht oftheright upper leg between
the lateral condyle of the femur and greater
trochanter･ subjects were then measured at the
thighat baseline and betweenthe percent dhanges for
the two methods (post-training minus baseline /
baseline) Were examined using Pearson product
correladonsI A paired t-test wasused to evaluatethe
mean differences between estimated musde_bone
CSA and M刑measured CSAand percent dhanges
Muscle-Bone CSA ≡ T(r - AT)2
r=Circumference/2lT AT= (QAT+ HAT)/2
FigUre l･ S血ematic representation ofthethighCSA andthe dedvati｡n ｡f variables
used to CalCulatethe estimated musde-bone csA･ AT･ adipose dssue thi血ess,･ QAT,
anterior AT･･ HAT, posterior AT.
35
Benben仙G, SQb Y, Abe T
betweenthe two methods. StatisticalsigniBcance was
set at a probabnity level of p < 0.05･
determinethighmuscle CSA as well as changes in
thighCSA following training, however,the tedmique
lS prOhibidve for most researdhers. From a theore也Cal
RESULTS
perspective, B -mode ultrasoundand a drcumference
Reliqbilify of EsIimofed州LJSCle-Bone CSA
measure may offer a mudl more cost effedve, yet
The mean differences between test land 2 formidthighdrcumference′ ultrasound latthickness and
still accurate method to assess thigh musde CSA
dlangeSinmore practicalsettings.
musde-bone CSA were calculated as 0.6%, 0.8%and
The results fromthis study indicatethat B-mode
1.2%′ respectively. Therefore, these results were
ultrasound in combination with a circumference
considered reliable and acceptable for use in this
measure can provide accurate and re払able measures
of musde hypertrophy following Kaatsu traiming,
study.
however, the estimated muscle-bone CSA was
hseline Mecsuremenls of Thigh州LISCle Size
On average, esdmated musde-bone CSA and MRI
overestimated by about 21 % when comparedwith
theかm method at baseline. In other words′the
measured CSA were 171.3 ± 26.8ロ112 and 141.4 ±
ability to assess dlange is good withthe estimated
17.30012, respecdvely. The estimated musde-bone
method (ultrasound + drcumference) but actual
CSA was 21% higher (p<0.01)thanthat ofthe加m
values of muscle-bone CSA are overestimated.
measured CSA, however, there was a slgnificant
Severalpossib山tiesfor the overestimadon may exist･
relationship (r=0.81, p<0･01 ) between estimated
First, the midlline aLnterior and posterior thigh
musde-bone CSAand MRI measured CSA (Figure 2).
subcutaneous fat thi血ess sites usedinthis study are
usuany lessthanother possible sites located at lateral
EyqlucIIion of州uscle Hyperfrophy
Percent changes in muscle size were similar
(p>0.05) between estimated musde-bone CSA and
and medial locations of the thigh′ which when
incorporated into the equation that is used to
estimate musde-bone CSA 【7r (r - (QAT + HAT) / 2)2]
for musde-bone CSAand 5.3% forかm measured
resultsinanoverestimation. Second,theinabnity to
account for intramuscdar fatand connective tissue
Mm measured CSA inthe Ⅵ触-Kaatsu group (4.9%
CSA)′ IJT-Kaatsu group (8.0% and 8･5%′
wi血the estimated method compared to the clear
respectively)′ m (1･4% and l･1%, respectively)′and
blageS ObtainedwithMRI whidl takesinto account
wan-control (-0.3% and -0.9%, respectively). There
these factors. Third, the es血nated musde-bone CSA
was also a strong relationship (r=0.86′ p<0.01)
will always include bone whereas the actual
between changes in muscle size (Figure 3) as
measured musde CSA bythe加m method is able to
evaluated by both the estimated (ultrasound +
exclude the bone from the muscle CSA value.
circumierence) and measured (Ⅳ旺旺) procedures.
Finally, the possibility may exist thatwith a large
subcutaneous fat layer around thethigh,･ a higher
DISCUSS10N
It is well established that MRI can accurately
r=0.86(pd).01)
(%)vsua oq･aTOSntJ PaIT!LuPSau!亀ut!占U
5 0 5 0
n
2つlつ】--Il 4 つ一 0 8 ′0 4 0 2 0 0 0 人U 0
(仰uo)VSU3uOqムPSnEPa)]2tJ !)SE
● _A
/●
1
00 1
20 1
40 1
60 1
80 200 220 240 260
MRI一measured muscle CSA (cm2)
FigtJre 2. Relationship between estimated musde-bone CSA
ﾂ
ﾂ
ー10 -5 0 5 10 15 20
Change in MRI-measured muscle CSA (%)
Figure 3. Relationship between changes in muscle size as
and MRI measured CSA procedures prior to training
evaluated bythe es血mted (drcumference +ultrasound)and
仲aseline ).
measured (MRI) procedures fo】lowing tr血Ig.
36
ultrasound probe pressure may compress the fatand
Assessing仙uscle Cross SecIioncJ Arecl
br body compos汁ion of Jc.ponese ctduIIs by B･mode ukrcISOUnd. Am J
result in an underestimation of the adipose tissue
Hum Biold: 161･170.
layer whidh would resultinanoverestimation of total
Abe T, KedrnS CF′ FukunQgd T (2003) Sex difkrences in whole body
muscle-bone CSA. Therefore care must be taken
skelefol muscle mcISS meqSUred by mc9ne-ic resonqnce imqging qnd its
when obtaining measures of subcutaneous adipose
distribu-ion in young Jc.PdneSe CldulTs･ Br J Sports Nted 37: 436-440.
dssuethidknesseswithultrasound to ensure proper
tedmique is usedand rehable data obtained (Abe et
Abe T, YcISUdcl T,仙dorikQWq T, Kecms CF, Sc'b Y, lnoue K, Koizumi
K, Jshii N (2005J Skerefc.I muscle size c'nd circulofing lGF･l clre
increcISeCF ober lwo weeks ohwice dc,ily nKAATSU〝 resisfqnce trc'ining･
al･, 1994,'Amelhni etal･, 1990; Benisarietal., 1993).
lnIJ Kclqfsu Trclining Res 1 : 6･12･
Even wi也the numerous potential reasons for the
Armellini F, Zc.mbon=叫Rigo L, Todesco T, BergdmO･Andreis IA,
overestimation of the muscle-bone CSA method, it
ProccICCi C, BoseJIo O H 990I The contribution of sonogrcIPhy to the
should be pointed out that the overestimation
reported in this study compares favorably with
mecISUremenl of inh･cl-Obdominclr fQt. J Clin Ulh-cISOUnd 1 8:563-567.
Bellkqri A, Roche AF, Sieryogel RM t19931 Reliclbirity of a-mode
uhrcISOnk mecISUremen-s of subcu-｡neous c'dipose tissue ond htrcl-
previously published resdts (Heyms丑eld etal., 1 979).
However, the estimated musde-bone CSAthat is
C･bdomincll depth:compclrisons with skinford山icknesses. lnt J Obes
I 7:475･480.
obtained with the ultrasound and circumference
BfclCk E), VorcI J′ HclyWOrd Jd, L^clrks 良 t1988I MecrsuremenI.f
measure can stin provide a valid measure of musde
subcuIc,neous fc.I thickness with high Frequency pulsed uhrcISOUnd.A
hypertrophy, espedally following Kaatsu training
Compqrisons with c. cc.liper ond Mc.diogrc,phic -echnique･ Clin Phys
because the short duration of the intervention
Physio仙ecIS 9: 57･64.
ensuresthatthe shape of the musdeandthe musdes
relationship to血e layer of subcutaneous adipose
Borkcn GA, HuIIs DE, cc,rdc･relli J, Burrows BE f1 982) Compclrison of
ultrcISOUnd cfnd skinfold mecISUremenIs in ossessmenI ｡f subcuk】ne.us
qnd folq帖hess･ Am･ JI Phys･ Anfhropol･ 58:307･31 3.
tissue forany glVenindividualWould not bealtered.
Therefore, in condusion, B-mode ultrasoundthat can
Accurctcy of on cnlhropomeh･ic estimcIIe of lhe muscle cnd bone c.,ec. in
accurately measure subcutaneous adipose tissue
c. frc.nsversc,I cross･sec-ion of the c'rm･ fnH Sports ned 7:246･249.
DeKoning FL′ BinkhorsI RA, KcIUer JJdG, Thissen HOM日986)
thickness from reflected ultrasound waves′ in
Heymsfield SB, Mc仙】nnus C′ Sleyens V, Srnith J t1 982川uscle
combinationwitha drcumference measure appears
moss:Rehdbfe indicqI｡r of protein energy molnurrifion seye叫qnd
to be able to provide an sale, easy, accurate′ more cost
oukome. Am J Clin NuIr 35:1 192-1 199.
effective, and reliable alternative method for
measuring dlangeS h musde-bone CSA′ aLt least for
thethighwhen compared to MRI measurements.
Heymsfield SB, Okfson RP, Kutner MH′ Dixon DW t1979) A
rQdiogrc･phk method of quqn叫ing protein-cc'loric undernutriぬn. Am J
Clin Nulr 52:214-21 8.
JellifFe EP, JclIiFfe DB (1 969) The c･rm circumference c's ct public hecddl
index of pro-ein-cdoric mqlnu州on of edrly childhood･ J Tropkc'l pediQt
AC KNOWLE DGE州E NTS
The authorsthankthe students who partidpated in
this study･ Wealso thankthe Sato l{aatsu Ttainjng
Researdh Foundadon and the Mnistry oH∃ducation,
Science′ Sports and Culture of Japan (Grant
#15300221) fortheir geヮerous suPPOrt･ This paper
15: 225-230.
Weiss L H984I The use of a-mode ulfrqsound for mecISUring †ho
thickness of skeletQl musde a- two upper leg sife･ J Orfhop sporb Phys
Ther a:1 6311 67.
Weiss L, CJork F (1 987) UIIrc'sonic mectsuremenl of upper-orm skeletd
muscle thickness. J Sporh Jued 27:1 28-1 33.
was written while the pnndple author was working
as a visiting professor aLtthe Department of王王xerdse
and Sport Sdence, Tokyo MetropolitanUhiversity･
Aulhors'clffificlfions
M･G･ Bemben, DepQrhen- of Heqld-nd Exercise Science, University
of okfQhomcl, Normcn, OkrQhomcl, USA
Y･ SQfo･ Depc.rhenl oHschemic Circulc.bry Physiology. The university
of Tol叩, Tokyo, Jclpcln
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Universiサ′ Tokyo, JcIPCln