de Jesus Ferreira Leandro Gomes, de Almeida Ventura Álvaro, da Silva Almeida Isabella, Mansur Henrique, Babault Nicolas, Durigan João Luiz Quagliotti, de Cássia Marqueti Rita
Laboratory of Muscle and Tendon Plasticity, Graduate Program in Rehabilitation Science, Faculdade de Ceilândia, Universidade de Brasília, Distrito Federal, Brasília 70910-900, Brazil.
Laboratory of Molecular Analysis, Graduate Program in Rehabilitation Science, Faculdade de Ceilândia, Universidade de Brasília, Distrito Federal, Brasília 70910-900, Brazil.
J Clin Med. 2022 Nov 24;11(23):6934. doi: 10.3390/jcm11236934.
COVID-19 is associated with musculoskeletal disorders. Ultrasound is a tool to assess muscle architecture and tendon measurements, offering an idea of the proportion of the consequences of the disease, since significant changes directly reflect the reduction in the ability to produce force and, consequently, in the functionality of the patient; however, its application in post-COVID-19 infection needs to be determined. We aimed to assess the intra- and inter-rater reliability of ultrasound measures of the architecture of the vastus lateralis (VL), rectus femoris (RF), vastus medialis (VM), gastrocnemius lateralis (GL), gastrocnemius medialis (GM), soleus (SO), and tibialis anterior (TA) muscles, as well as the patellar tendon (PT) cross-sectional area (CSA) in post-COVID-19 patients. An observational, prospective study with repeated measures was designed to evaluate 20 post-COVID-19 patients, who were measured for the pennation angle (θp), fascicular length (Lf), thickness, echogenicity of muscles, CSA and echogenicity of the PT. The intra-class correlation coefficient (ICC) and 95% limits of agreement were used. The intra-rater reliability presented high or very high correlations (ICC = 0.71-1.0) for most measures, except the θp of the TA, which was classified as moderate (ICC = 0.69). Observing the inter-rater reliability, all the evaluations of the PT, thickness and echogenicity of the muscles presented high or very high correlations. For the Lf, only the RF showed as low (ICC = 0.43), for the θp, RF (ICC = 0.68), GL (ICC = 0.70) and TA (ICC = 0.71) moderate and the SO (ICC = 0.40) low. The ultrasound reliability was acceptable for the muscle architecture, muscle and tendon echogenicity, and PT CSA, despite the low reliability for the Lf and θp of the RF and SO, respectively.
新型冠状病毒肺炎（COVID-19）与肌肉骨骼疾病有关。超声是一种评估肌肉结构和肌腱测量的工具，能让人了解该疾病后果的比例情况，因为显著变化直接反映出产生力量的能力下降，进而反映出患者的功能情况；然而，其在COVID-19感染后的应用尚需确定。我们旨在评估COVID-19康复患者股外侧肌（VL）、股直肌（RF）、股内侧肌（VM）、腓骨外侧肌（GL）、腓骨内侧肌（GM）、比目鱼肌（SO）和胫骨前肌（TA）的肌肉结构超声测量的评分者内和评分者间可靠性，以及髌腱（PT）的横截面积（CSA）。设计了一项采用重复测量的观察性前瞻性研究，以评估20例COVID-19康复患者，测量其羽状角（θp）、肌束长度（Lf）、厚度、肌肉回声、CSA以及PT的回声。使用组内相关系数（ICC）和95%一致性界限。除TA的θp被归类为中等（ICC = 0.69）外，大多数测量的评分者内可靠性呈现高或非常高的相关性（ICC = 0.71 - 1.0）。观察评分者间可靠性时，PT、肌肉厚度和回声的所有评估均呈现高或非常高的相关性。对于Lf，只有RF显示为低（ICC = 0.43），对于θp，RF（ICC = 0.68）、GL（ICC = 0.70）和TA（ICC = 0.71）为中等，SO（ICC = 0.40）为低。尽管RF和SO的Lf和θp可靠性较低，但肌肉结构、肌肉和肌腱回声以及PT CSA的超声可靠性是可接受的。
