Radiofrequency Echographic Multi Spectrometry (REMS) for the assessment of muscle strength

Objective: Due to the limitations of available methods for muscle strength evaluation, there is a need to develop more effective ways to quantify muscle function and performance in individuals suffering from musculoskeletal diseases. This study investigated the relationship between handgrip strength and a novel parameter derived from ultrasound scans of the forearm obtained using Radiofrequency Echographic Multi Spectrometry (REMS) technology. Estimations of muscle strength were performed in two study groups: healthy subjects and individuals affected by sarcopenia. Methods: A total of 58 Caucasian volunteers (30 healthy individuals and 28 subjects affected by sarcopenia) were recruited. A handgrip strength test was used to measure the Maximum Voluntary Contraction (MVC) of each subject’s dominant arm. Transversal echographic scans of the forearm were performed using an EchoStation device (Echolight S.p.a., Lecce, Italy) equipped with a 40 mm linear probe. A dedicated segmentation algorithm was designed and optimized for automatic identification of the ulnar and radius muscle profiles. The correlation between MVC values and REMS-based estimations of MVC (MVCREMS) was established using a linear regression approach. Results: MVCREMS showed excellent correlation with the MVC taken as ground truth. A high correlation value (r=0.95) was found in the overall population, and the corresponding values in the healthy and pathological subgroups were r=0.90 and r=0.83, respectively (p<0.0001). Conclusion: This technique allows reliable estimation of muscle strength in both pathological and healthy subjects, and is a valid alternative to conventional handgrip tests for use in primary care. In the future, this technique might help to enhance the assessment, screening and prevention of musculoskeletal diseases.