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July 3, 2023
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Article

A Procedure for Measuring Anterior Scalene Morphology and Quality with Ultrasound Imaging: An Intra- and Inter-rater Reliability Study

Publicated to: ULTRASOUND IN MEDICINE AND BIOLOGY. 49 (8): 1817-1823 - 2023-08-01 49(8), DOI: 10.1016/j.ultrasmedbio.2023.04.005

Authors:

Valera-Calero, JA; Gómez-Sánchez, S; Fernández-de-las-Peñas, C; Plaza-Manzano, G; Sánchez-Jorge, S; Navarro-Santana, MJ
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Affiliations

Cátedra Institucional En Docencia, Clínica E Investigación En Fisioterapia: Terapia Manual, Punción Seca Y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Spain. - Author
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain - Author
Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain - Author
Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain. - Author
Faculty of Health, Universidad Católica de Ávila, Ávila, Spain. - Author
Grupo In Physio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. - Author
Grupo In Physio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. Electronic address: gusplaza@ucm.es. - Author
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Grp Physio, Madrid, Spain - Author
Pl Ramon y Cajal S-N, Madrid 28040, Spain - Author
Univ Catolica Avila, Fac Hlth, Avila, Spain - Author
Univ Complutense Madrid, Dept Radiol Rehabil & Physiotherapy, Madrid, Spain - Author
Univ Francisco Vitoria, Fac Hlth Sci, Pozuelo De Alarcon, Spain - Author
Univ Rey Juan Carlos, Catedra Inst Docencia Clin Invest Fisioterapia Ter, Alcorcon, Spain - Author
Univ Rey Juan Carlos, Dept Phys Therapy Occupat Therapy Rehabil & Phys M, Alcorcon, Spain - Author
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Abstract

Ultrasound (US) imaging is an essential tool for clinicians because of its cost-effectiveness and accessibility for assessing multiple muscle metrics including muscle quality, size and shape. Although previous studies highlighted the importance of the anterior scalene muscle (AS) in patients with neck pain, studies analyzing the reliability of US measurements for this muscle are lacking. This study aimed to develop a protocol for assessing AS muscle shape and quality measured with US and investigating its intra- and inter-examiner reliability.Through use of a linear transducer, B-mode images of the anterolateral neck region at the C7 level were acquired in 28 healthy volunteers by two examiners (one experienced and one novel). Cross-sectional area, perimeter, shape descriptors and mean echo-intensity were measured twice by each examiner in randomized order. Intra-class correlation coefficients (ICCs), standard errors of measurement and minimal detectable changes were calculated.Results indicated no muscle side-to-side asymmetries (p > 0.05). Gender differences were found for muscle size (p < 0.01), but muscle shape and brightness were comparable (p > 0.05). Intra-examiner reliability was good to excellent for all metrics for the experienced and (ICC >0.846) and novel (ICC >780) examiners. Although inter-examiner reliability was good for most of the metrics (ICC >0.709), the estimates for assessing solidity and circularity were unacceptable (ICC <0.70).This study found that the described ultrasound procedure for locating and measuring anterior scalene muscle morphology and quality is highly reliable in asymptomatic individuals.Copyright © 2023 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
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Keywords

anatomical variationscervical musclesdeepdiagnostic accuracy studiesfatigueguidelinesneckpainreliabilitytriangleultrasound imagingvalidityAccuracy studyAdultAnterior scaleneAnterior scalene muscleArticleBiomechanicsBody massControlled studyCorrelation coefficientCost effectivenessCross-sectional studyDiagnosisDiagnostic accuracyDiagnostic accuracy studiesDiagnostic accuracy studyDiagnostic test accuracy studyEchographyFemaleGoniometryHumanHumansImage analysisInterrater reliabilityIntra classIntrarater reliabilityMajor clinical studyMaleMinimum detectable changeMorphologyMuscleMuscle massNeck painNeck painsObservational studyProceduresReliabilityReproducibilityReproducibility of resultsScientific literatureSize and shapeThoracic outlet syndromeUltrasonic imagingUltrasonographyUltrasoundUltrasound imaging

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal ULTRASOUND IN MEDICINE AND BIOLOGY due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2023, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category Acoustics and Ultrasonics.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2026-04-04:

  • WoS: 3
  • Scopus: 3
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-04:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 18.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 18 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

    It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

    • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
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