Reliability of Ultrasound Muscle Assessment in People With Critical Illness Performed by Occupational Therapy Students and Occupational Therapists.
Felipe Douglas Silva Barbosa, Raquel Pereira de Santana, Maria Isabel Souza Matos and 1 others
After 8 hours of training, occupational therapy students and therapists measured ICU patients' muscle thickness by ultrasound with excellent agreement both between and within examiners, across five muscle groups.
One student's biceps measurement was only 'satisfactory'.
Key findings
1Interexaminer reliability was excellent for all five muscle groups (ICC 0.785–0.986), and intraexaminer reliability was excellent for most measurements (ICC 0.779–0.997).
2Two intraexaminer measurements fell below 'excellent': one student's biceps brachii (ICC 0.583, rated 'satisfactory') and one examiner's forearm flexor group (ICC 0.748, rated 'good').
3Novice examiners who completed 8 hours of structured training covering positioning, equipment use, image acquisition, and muscle thickness analysis achieved excellent reliability in the majority of measurements.
Still to come
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Seven patients at a single hospital — the reliability estimates are imprecise and may not generalise to other ICU populations. The study only tested consistency (reliability). It did not test whether the measurements are accurate, change with recovery, or predict functional outcomes. The observational design with no control over confounding factors limits causal inference. No knowledge test or training-satisfaction questionnaire was used to confirm the training was adequate. All four examiners were from the same institution and trained by the same person, so the results may not reflect what happens in a different training context.
Declared interests
No funding was received. The authors declare no conflicts of interest.
The easy way to misread this
Do not read 'excellent reliability' as evidence that ultrasound muscle thickness is a valid or clinically useful measure for ICU patients. This study only tested whether examiners get consistent readings; it did not test whether those readings predict outcomes, track recovery, or match a gold standard. The sample was seven patients at one hospital, and the two below-excellent results (biceps 0.583, forearm flexors 0.748) remind you that consistency is not guaranteed for every muscle or every examiner.
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 →