Linear relationship between electromyography and shear wave elastography measurements persists in deep muscles of the upper extremity.

Recent works have demonstrated a linear relationship between muscle activation and shear modulus in various superficial muscles. As such, it may be possible to overcome limitations of traditional electromyography (EMG) methods by assessing activation using shear wave elastography. However, the relationship has not been wholly validated in deep muscles. This study measured the association between squared shear wave velocity, which is related to shear modulus, and activation within superficial and deep muscles. This relationship was also compared between surface and intramuscular EMG electrodes. We simultaneously recorded EMG and shear wave velocity in one deep (brachialis) and one superficial (brachioradialis) muscle in ten healthy individuals during isometric elbow flexion across a wide range of contraction intensities. Muscle activation and squared shear wave velocity demonstrated good reliability (ICC > 0.75) and showed a linear relationship (P < 0.05) for all muscle/EMG electrode type combinations (study conditions) after down-sampling. Study condition was not a significant within-subject factor to the slope or intercept of the relationship (P > 0.05). This work demonstrates that activation of both superficial and deep muscles can be assessed noninvasively using ultrasound shear wave elastography and is a critical step toward demonstrating elastography's utility as an alternative to EMG.