Novel Ultrasonographic Thickness and Strength Assessments of the Flexor Digitorum: A Reliability Analysis

Abstract

OBJECTIVES: Clinical conditions such as focal dystonia often require the assessment of atrophy and weakness of the finger muscles. However, due to a lack of well-established protocols, the current investigation focused on assessing the reliability of thickness and strength assessments of the flexor digitorum (FD) muscle, including both the superficialis and profundus components. As a secondary assessment, the reliability of the strength measurement of the extensor digitorum muscle was examined as well. METHODS: Different thickness measurements of the FD were taken via ultrasonography and averaged to estimate the mean thickness of the FD. Likewise, individual finger strength measurements taken by a custom-made finger pressure device were averaged to compute the mean strength of the flexor and extensor digitorum muscles. Test-retest reliability of the above measurements performed at two different time points (about 6 months apart) were examined on the right and left hands of 10 participants. RESULTS: Findings indicated excellent test-retest reliability (ICC > 0.92) for the mean thickness assessment of the FD and mean strength of the flexor and extensor digitorum for both dominant and non-dominant hands. The standard error of measurement was ≤4.3% for all three mean assessments, indicating high sensitivity. Likewise, the smallest detectable change was also sufficiently small for the mean thickness and mean strength of the flexor digitorum (≤5.1%) and moderately small (≤12%) for the strength of the extensor digitorum. CONCLUSIONS: Results indicated an excellent relative and absolute reliability, for both hands, for the mean thickness and strength assessments of the flexor digitorum muscle and for the mean strength of the extensor digitorum (measured for both hands). These measurements can be used for future investigations and can contribute to the establishment of more precise methods for assessing the muscles in the forearms which serve the hand.