{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:53:13Z","timestamp":1786978393363,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32GM136615"],"award-info":[{"award-number":["T32GM136615"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01AR06393"],"award-info":[{"award-number":["U01AR06393"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>\n                      Spinal muscular atrophy (SMA) and Duchenne muscular dystrophy (DMD) are progressive neuromuscular disorders characterized by severe muscle weakness and functional decline (Pillen et al.,\n                      <jats:italic>Muscle Nerve<\/jats:italic>\n                      2008; 37(6):679\u2013693). With new therapeutics, objective methods with increased sensitivity are needed to assess muscle function. Ultrasound imaging is a promising approach for assessing muscle fat and fibrosis in neuromuscular disorders. This study builds on prior work by combining ultrasound\u2010based measurements of muscle size, shape, and quality, relating these measures to muscle strength, and proposing a multivariable image\u2010based estimate of muscle function.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Maximum voluntary elbow flexion torque of 36 participants (SMA, DMD, and healthy controls) was measured by hand\u2010held dynamometry and elbow flexor muscles were imaged using ultrasound. Muscle size (cross\u2010sectional area, maximum Feret diameter or width, and thickness), quality (echogenicity, texture anisotropy index), and cross\u2010sectional shape (diameter ratio) were measured. Multivariable regression was used to select ultrasound measurements that predict elbow flexion torque.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant differences were observed in muscle size (decreased), shape (thinned), and quality (decreased) with increased disease severity and compared to healthy participants. CSA (brachioradialis\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.51), maximum Feret diameter (biceps\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.49, brachioradialis\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.58) and echogenicity (brachioradialis\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.61) were most correlated with torque production. Multivariable regression models identified that muscle size (CSA, maximum Feret diameter) and quality (echogenicity) were both essential to predict elbow flexion torque (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.65).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>A multivariable approach combining muscle size and quality improves strength predictions over single variable approaches. These methods present a promising avenue for the development of sensitive and functionally relevant biomarkers of neuromuscular disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.28263","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T09:35:47Z","timestamp":1727688947000},"page":"1205-1214","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Development of an ultrasound\u2010based metric of muscle functional capacity for use in patients with neuromuscular disease"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9381-2152","authenticated-orcid":false,"given":"Allison N.","family":"McCrady","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering University of Virginia School of Engineering &amp; Applied Science  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9726-8059","authenticated-orcid":false,"given":"Chelsea D.","family":"Masterson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Neurology &amp; Public Health University of Virginia School of Medicine  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8224-5164","authenticated-orcid":false,"given":"Laura E.","family":"Barnes","sequence":"additional","affiliation":[{"name":"Department of Systems and Information Engineering University of Virginia School of Engineering &amp; Applied Science  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3381-5594","authenticated-orcid":false,"given":"Rebecca J.","family":"Scharf","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Neurology &amp; Public Health University of Virginia School of Medicine  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2019-1153","authenticated-orcid":false,"given":"Silvia S.","family":"Blemker","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of Virginia School of Engineering &amp; Applied Science  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMANEUROL.2020.1264"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2023.1167762"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073809332702"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00018\u2010013\u20101396\u2010z"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010013\u20103324\u20109"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.07.006"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMA.1963.03700150043007"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/DMCN.12213"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880040304"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3233\/JND\u2010150083"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00415\u2010022\u201011084\u20100\/FIGURES\/4"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21015"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24296"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24904"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2007.03.008"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2011.10.020"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.EJPN.2020.06.001"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2010.06.019"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181eccf8f"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0b013e31815ef675"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00696087"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2011.06.750"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ULTRASMEDBIO.2023.02.021"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.2196\/40856"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000091824"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1590\/1806\u20109282.65.2.165"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.PMRJ.2013.03.010"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2017.12.017"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/162329b0"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.33.5.769"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.2307\/1932409"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1076\u20106332(03)00671\u20108"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469\u20108749.2004.tb00508.x"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021\u20109290(01)00173\u20107"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awab411"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1152\/JAPPLPHYSIOL.00080.2023\/ASSET\/IMAGES\/LARGE\/JAPPLPHYSIOL.00080.2023_F004.JPEG"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ULTRASMEDBIO.2017.04.010"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.NMD.2011.02.014"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2006.11.011"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1080\/10255842.2014.916698"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2017.02.009"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEP.0B013E318227CCFF"}],"container-title":["Muscle &amp; 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