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Reliability of B-mode ultrasound and shear wave elastography in evaluating sacral bone and soft tissue characteristics in young adults with clinical feasibility in elderly

Article dans une revue avec comité de lecture
Author
ABOU KARAM, Maher
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
MUKHINA, Ekaterina
DARAS, Nils
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
RIVALS, ISabelle
45449 Equipe de Statistique Appliquée (UMRS 1158) [ESA]
PILLET, Helene
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
SKALLI, Wafa
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
CONNESSON, Nathanael
PAYAN, Yohan
ROHAN, PIerre-Yves
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]

URI
http://hdl.handle.net/10985/21559
DOI
10.1016/j.jtv.2022.02.003
Date
2022
Journal
Journal of Tissue Viability

Abstract

Background: Physiologic aging is associated with loss of mobility, sarcopenia, skin atrophy and loss of elasticity. These factors contribute, in the elderly, to the occurrence of a pressure ulcer (PU). Brightness mode ultrasound (US) and shear wave elastography (SWE) have been proposed as a patient-specific, bedside, and predictive tool for PU. However, reliability and clinical feasibility in application to the sacral region have not been clearly established. Method: The current study aimed to propose a simple bedside protocol combining US and SWE. The protocol was first tested on a group of 19 healthy young subjects by two operators. The measurements were repeated three times. Eight parameters were evaluated at the medial sacral crest. Intraclass Correlation Coefficient (ICC) was used for reliability assessment and the modified Bland Altman plot analysis for agreement assessment. The protocol was then evaluated for clinical feasibility on a healthy older group of 11 subjects with a mean age of 65 ± 2.4 yrs. Findings: ICC showed poor to good reliability except for skin SWE and hypodermis thickness with an ICC (reported as: mean(95%CI)) of 0.78(0.50-0.91) and 0.98(0.95-0.99) respectively. No significant differences were observed between the young and older group except for the muscle Shear Wave Speed (SWS) (respectively 2.11 ± 0.27 m/s vs 1.70 ± 0.17 m/s). Interpretation: This is the first protocol combining US and SWE that can be proposed on a large scale in nursing homes. Reliability, however, was unsatisfactory for most parameters despite efforts to standardize the protocol and measurement definitions. Further studies are needed to improve reliability.

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