PTOtherJournal of intellectual disability research : JIDR2026

Measuring Muscle Mass in Adults With Intellectual Disabilities: The Reliability and Construct Validity of Calf Circumference.

Kirsten I de Oude, Rosalie J E Bonnet, Roy G Elbers and 2 others

PMID 41239952

WHAT IT FOUND

Calf circumference was highly reliable when measured by the same therapist.

It correlated moderately with leg and limb muscle mass but not whole-body muscle mass. Use it only as part of a broader assessment, never alone.

Key findings

01Intrarater reliability of calf circumference was excellent (ICC 0.94).

02Calf circumference correlated moderately with segmental leg muscle mass (r = 0.60) and skeletal muscle index (r = 0.69), but weakly and nonsignificantly with whole-body skeletal muscle mass (r = 0.19).

03The authors do not recommend calf circumference as a sole indicator of muscle mass due to risk of overestimation in obesity.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Small sample (n = 36) limits generalisability and increases influence of outliers. BIA was used as reference standard; its equations are unknown and may not be valid for adults with intellectual disability. Participants had cardiovascular risk factors and high obesity prevalence, which may distort both BIA and calf circumference. Room temperature and hydration status were not recorded, potentially affecting BIA. Sample excluded people with profound intellectual disability or significant physical limitations.

Declared interests

The authors declare no conflicts of interest. The study was funded by the HA-ID Consortium, which includes care organisations that provided participants.

The easy way to misread this

Do not use calf circumference alone to estimate whole-body muscle mass. It correlated poorly with total skeletal muscle mass (r = 0.19) and may overestimate muscle in adults with obesity.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →