Validity and Reliability of A-Mode Ultrasound for Body Composition Assessment of NCAA Division I Athletes

This study evaluated the validity and reliability of the BodyMetrix™ BX2000 A-mode ultrasound for estimating percent body fat (%BF) in athletes by comparing it to skinfolds and the BOD POD. Forty-five (22 males, 23 females) National Collegiate Athletic Association (NCAA) Division-I athletes volunteered for this study. Subjects were measured once in the BOD POD then twice by two technicians for skinfolds and ultrasound. A one-way repeated-measures ANOVA revealed significant differences between body composition methods (F = 13.24, p < 0.01, η² = 0.24). This difference was further explained by a sex-specific effect such that the mean difference between ultrasound and BOD POD was large for females (~ 5% BF) but small for males (~ 1.5% BF). Linear regression using the %BF estimate from ultrasound to predict %BF from BOD POD resulted in an R(2) = 0.849, SEE = 2.6% BF and a TE = 4.4% BF. The inter-rater intraclass correlation (ICC) for skinfold was 0.966 with a large 95% confidence interval (CI) of 0.328 to 0.991. The inter-rater ICC for ultrasound was 0.987 with a much smaller 95% CI of 0.976 to 0.993. Both skinfolds and ultrasound had test-retest ICCs ≥ 0.996. The BX2000 ultrasound device had excellent test-retest reliability, and its inter-rater reliability was superior to the skinfold method. The validity of this method is questionable, particularly for female athletes. However, due to its excellent reliability, coaches and trainers should consider this portable and easy to use A-mode ultrasound to assess body composition changes in athletes.