Feasibility and reliability of quantifying passive muscle stiffness in young children by using shear wave ultrasound elastography

Joline E. Brandenburg, Sarah F. Eby, Pengfei Song, Heng Zhao, Bradford W. Landry, Shirley Kingsley-Berg, William R. Bamlet, Shigao Chen, Gary C. Sieck, Kai Nan An

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Objectives - The purpose of this study was to investigate the feasibility and reliability of passive muscle stiffness measurements in children by shear wave ultrasound elastography. Methods - We conducted a prospective cross-sectional study quantifying the passive stiffness of bilateral lateral gastrocnemius muscles during passive stretching in 20 typically developing children (age range, 2.0-12.6 years). Data collected included passive stiffness of the lateral gastrocnemius muscle (shear modulus in kilopascals) at 4 positions of progressive passive foot dorsiflexion, demographic characteristics of the participants, and comparison of demographic characteristics with the shear modulus. Results - Passive stiffness increased with increasing stretching (mean [SD] range of stiffness, 7.1 [2.0] to 36.2 [22.0] kPa). For all 4 foot positions, no significant difference was found between right and left legs (range, P = .42 to P = .98) or between the sexes (range, P = .28 to P >99). No correlation of passive muscle stiffness with age, body mass index, or ankle range of motion was found. The reliability of measurements was good to excellent (mean [95% confidence interval] range of reliability, 0.67 [0.44-0.83] to 0.80 [0.63-0.90]). Conclusions - Measurements of passive stiffness of the lateral gastrocnemius muscle are feasible and reliable in children as young as 2 years. Because this study found no significant difference between sex and the side tested in this age group, future studies involving children of this age range may not need to be stratified on the basis of these parameters. Defining normal passive muscle stiffness in children is critical for identifying and understanding the implications of abnormal passive muscle stiffness in children with neuromuscular disorders.

Original languageEnglish (US)
Pages (from-to)663-670
Number of pages8
JournalJournal of Ultrasound in Medicine
Issue number4
StatePublished - Apr 1 2015


  • Elastography
  • Feasibility
  • Gastrocnemius muscle
  • Pediatric ultrasound
  • Pediatrics
  • Skeletal muscle
  • Ultrasound elastography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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