Establishing Ultrasound Reliability for Assessing Foot Muscle Hypertrophy During Load Carriage With and Without Blood Flow Restriction
Description
Background: Strengthening foot muscles is important for improving balance and reducing fall risk in the elderly population. However, adherence to traditional strengthening exercises is often low, and heavier loads are not welltolerated in older adults. Load carriage, such as walking with a weighted vest, may be a more practical approach to improving foot strength. Additionally, blood flow restriction (BFR) training can promote hypertrophy with lighter loads. Assessment of foot strength via traditional muscle testing is challenging and ultrasound is a good solution, but examiner reliability of foot muscle assessment is imperative prior to outcome investigation.
Purpose: To establish reliability of ultrasound measurements of foot muscles so that ultrasound can be used to evaluate muscle hypertrophy in response to load carriage training with and without BFR.
Methods: Cross-sectional measurements were obtained of foot muscles using ultrasound within a single session. Reliability was assessed using the coefficient of variation (CoV) with a goal of a CoV < 10%. Once this was consistently achieved, measurements were repeated across several days and participants. With examiner reliability established, the next phase will involve pilot investigation using ultrasound to measure foot muscle size change following treadmill walking and BFR.
Results: Repeated measurements across multiple days and participants demonstrated examiner reliability, with CoV consistently < 10%.
Discussion: A CoV < 10% indicates good reliability and is consistent with prior investigation using other examiners. This provides confidence for the next phase of investigation to determine whether foot muscle hypertrophy is greater following load carriage with or without BFR.
Citation Information
Howard, Ella; Eshenaur, Jadah; and McClinton, Shane, "Establishing Ultrasound Reliability for Assessing Foot Muscle Hypertrophy During Load Carriage With and Without Blood Flow Restriction" (2026). Office of Research DMU Research Symposium. 21.
https://digitalcommons.dmu.edu/researchsymposium/2025rs/2025abstracts/21
Establishing Ultrasound Reliability for Assessing Foot Muscle Hypertrophy During Load Carriage With and Without Blood Flow Restriction
Background: Strengthening foot muscles is important for improving balance and reducing fall risk in the elderly population. However, adherence to traditional strengthening exercises is often low, and heavier loads are not welltolerated in older adults. Load carriage, such as walking with a weighted vest, may be a more practical approach to improving foot strength. Additionally, blood flow restriction (BFR) training can promote hypertrophy with lighter loads. Assessment of foot strength via traditional muscle testing is challenging and ultrasound is a good solution, but examiner reliability of foot muscle assessment is imperative prior to outcome investigation.
Purpose: To establish reliability of ultrasound measurements of foot muscles so that ultrasound can be used to evaluate muscle hypertrophy in response to load carriage training with and without BFR.
Methods: Cross-sectional measurements were obtained of foot muscles using ultrasound within a single session. Reliability was assessed using the coefficient of variation (CoV) with a goal of a CoV < 10%. Once this was consistently achieved, measurements were repeated across several days and participants. With examiner reliability established, the next phase will involve pilot investigation using ultrasound to measure foot muscle size change following treadmill walking and BFR.
Results: Repeated measurements across multiple days and participants demonstrated examiner reliability, with CoV consistently < 10%.
Discussion: A CoV < 10% indicates good reliability and is consistent with prior investigation using other examiners. This provides confidence for the next phase of investigation to determine whether foot muscle hypertrophy is greater following load carriage with or without BFR.
