Effect of hypnotic suggestion on knee extensor neuromuscular properties in resting and fatigued states

PubMed Central

Antonini Philippe, Roberta; Guglielmo, Luiz Guilherme A.

2018-01-01

Purpose The aim of this study was to investigate whether hypnotic suggestions can alter knee extensor neuromuscular function at rest and during exercise. Methods Thirteen healthy volunteers (8 men and 5 women, 27 ± 3 years old) took part in this counterbalanced, crossover study including two experimental (hypnosis and control) sessions. Knee extensor neuromuscular function was tested before and after hypnosis suggestion by using a combination of voluntary contraction, transcutaneous femoral nerve electrical stimulation and transcranial magnetic stimulation (TMS). A fatiguing exercise (sustained submaximal contraction at 20% maximal voluntary contraction (MVC) force) was also performed to evaluate the potential influence of hypnosis on the extent and origin of neuromuscular adjustments. Results Hypnosis did not (p>0.05) alter MVC force or knee extensor neural properties. Corticospinal excitability, assessed with the amplitude of knee extensor motor evoked potentials, was also unchanged (p>0.05), as was the level of intracortical inhibition assessed with paired pulse TMS (short-interval intracortical inhibition, SICI). Time to task failure (~300 s) was not different (p>0.05) between the two sessions; accordingly, hypnosis did not influence neuromuscular adjustments measured during exercise and at task failure (p>0.05). Conclusion Hypnotic suggestions did not alter neuromuscular properties of the knee extensor muscles under resting condition or during/after exercise, suggesting that hypnosis-induced improvement in exercise performance and enhanced corticospinal excitability might be limited to highly susceptible participants. PMID:29684047

Open extensor tendon injuries: an epidemiologic study.

PubMed

Patillo, Dominic; Rayan, Ghazi M

2012-01-01

To report the epidemiology, mechanism, anatomical location, distribution, and severity of open extensor tendon injuries in the digits, hand, and forearm as well as the frequency of associated injuries to surrounding bone and soft tissue. Retrospective chart review was conducted for patients who had operative repair of open digital extensor tendon injuries in all zones within an 11-year period. Data was grouped according to patient characteristics, zone of injury, mechanism of injury, and presence of associated injury. Statistical analysis was used to determine the presence of relevant associations. Eighty-six patients with 125 severed tendons and 105 injured digits were available for chart reviews. Patients were predominantly males (83%) with a mean age of 34.2 years and the dominant extremity was most often injured (60%). The thumb was the most commonly injured (25.7%), followed by middle finger (24.8), whereas small finger was least affected (10.5%). Sharp laceration was the most common mechanism of injury (60%), and most of these occurred at or proximal to the metacarpophalangeal joints. Most saw injuries occurred distal to the metacarpophalangeal joint. Zone V was the most commonly affected in the fingers (27%) while zone VT was the most commonly affected in the thumb (69%). Associated injuries to bone and soft tissue occurred in 46.7% of all injuries with saw and crush/avulsions being predictive of fractures and damage to the underlying joint capsule. The extensor mechanism is anatomically complex, and open injuries to the dorsum of the hand, wrist, and forearm, especially of crushing nature and those inflicted by saws, must be thoroughly evaluated. Associated injuries should be ruled out in order to customize surgical treatment and optimize outcome.

Sonographically guided percutaneous needle tenotomy for treatment of common extensor tendinosis in the elbow.

PubMed

McShane, John M; Nazarian, Levon N; Harwood, Marc I

2006-10-01

Chronic tendinosis of the common extensor tendon of the lateral elbow can be a difficult problem to treat. We report our experience with sonographically guided percutaneous needle tenotomy to relieve pain and improve function in patients with this condition. We performed sonographically guided percutaneous needle tenotomy on 58 consecutive patients who had persistent pain and disability resulting from common extensor tendinosis. Under a local anesthetic and sonographic guidance, a needle was advanced into the common extensor tendon, and the tip of the needle was used to repeatedly fenestrate the tendinotic tissue. Calcifications, if present, were mechanically fragmented, and the adjacent bony surface of the apex and face of the epicondyle were abraded. Finally, the fenestrated tendon was infiltrated with a solution containing corticosteroid mixed with bupivacaine. After the procedure, patients were instructed to perform passive stretches and to undergo physical therapy. During a subsequent telephone interview, patients answered questions about their experience, their functioning level, and their perceptions of procedure outcome. Fifty-five (95%) of 58 patients were contacted by telephone and agreed to participate in the study. Thirty-five (63.6%) of 55 respondents reported excellent outcomes, 16.4% good, 7.3% fair, and 12.7% poor. The average follow-up time from the date of the procedure to the date of the interview was 28 months (range, 17-44 months). No adverse events were reported; 85.5% stated that they would refer a friend or close relative for the procedure. Sonographically guided percutaneous needle tenotomy for lateral elbow tendinosis is a safe, effective, and viable alternative for patients in whom all other nonsurgical treatments failed.

Isometric endurance of the back extensors in school-aged adolescents with and without low back pain.

PubMed

Johnson, Olubusola E; Mbada, Chidozie E; Akosile, Christopher O; Agbeja, Oyinade A

2009-01-01

Studies on back extensor endurance in adolescents are scarce. This study sought to establish reference data and pattern of back extensor endurance in school-aged adolescents with and without low-back pain (LBP) from Nigeria. This study recruited 625 adolescents aged 11 to 19 years from eight randomly selected secondary schools. The modified Biering-Sørensen test of Static Muscular Endurance (BSME) was used to assess isometric endurance of the back extensors. Demographic and anthropometric data were collected. A modified LBP questionnaire was used to assess the presence of LBP. Descriptive and inferential analyses were used to analyze data. Significance was set at 0.05 alpha-level. The mean isometric holding time (IHT) of all the participants was 132.9 $\\pm$ 65.6. Males had significantly higher significant (p=0.026) IHT than females. Adolescents without LBP had a higher significant IHT (p=0.042) than those with reported history of previous LBP and those with present LBP (p=0.000) respectively. Using percentile values, poor endurance was defined as IHT that is < 90.0 s and < 67 s for males and females respectively; medium endurance was defined as IHT that ranged between 90 and 193 s and 67 and 170 s for males and females respectively while good endurance was defined as IHT that is > 193 s and > 170 s for males and females respectively. IHT was significantly related to each of body mass index, hip circumference and waist-to-hip ratio (p < 0.05). Isometric back extensors endurance in Nigerian adolescents was comparable to the original Biering-Sørensen mean value. Majority of the participants had medium endurance performance with the back endurance pattern in the ratio 1:2:1. Male had higher isometric back extensors endurance than females. Decreased isometric back extensors endurance was associated with the presence of LBP in adolescents.

Gouty involvement of the patella and extensor mechanism of the knee mimicking aggressive neoplasm. A case series.

PubMed

Kester, Christopher; Wallace, Matthew T; Jelinek, James; Aboulafia, Albert

2018-06-01

Gout is a common inflammatory crystal deposition disease that occurs in many joints throughout the body. Active gout is most often associated with painful synovitis causing searing joint pains, but gout can also produce large masses of space-occupying deposits called tophi. Tophi are most frequently seen in juxta-articular locations with or without bony erosion and are often misdiagnosed as degenerative joint disease. Soft tissue deposits and tendon involvement are also known manifestations of gout, but can present with indeterminate and alarming findings on imaging. We present three cases of tophaceous gout mimicking aggressive neoplasms in the extensor mechanism of the knee. All cases presented as extensor tendon masses eroding into the patella, with imaging findings initially concerning for primary musculoskeletal malignancy.

Comparative anatomy of the cheek muscles within the Centromochlinae subfamily (Ostariophysi, Siluriformes, Auchenipteridae).

PubMed

Sarmento-Soares, Luisa Maria; Porto, Marcovan

2006-02-01

Glanidium melanopterum Miranda Ribeiro, a typical representative of the subfamily Centromochlinae (Siluriformes: Auchenipteridae), is herein described myologically and compared to other representative species within the group, Glanidium ribeiroi, G. leopardum, Tatia neivai, T. intermedia, T. creutzbergi, Centromochlus heckelii, and C. existimatus. The structure of seven pairs of striated cephalic muscles was compared anatomically: adductor mandibulae, levator arcus palatini, dilatator operculi, adductor arcus palatini, extensor tentaculi, retractor tentaculi, and levator operculi. We observed broad adductor mandibulae muscles in both Glanidium and Tatia, catfishes with depressed heads and smaller eyes. Similarities between muscles were observed: the presence of a large aponeurotic insertion for the levator arcus palatini muscle; an adductor arcus palatini muscle whose origin spread over the orbitosphenoid, pterosphenoid, and parasphenoid; and the extensor tentaculi muscle broadly attached to the autopalatine. There is no retractor tentaculi muscle in either the Glanidium or Tatia species. On the other hand, in Centromochlus, with forms having large eyes and the tallest head, the adductor mandibulae muscles are slim; there is a thin aponeurotic or muscular insertion for the levator arcus palatini muscle; the adductor arcus palatini muscle originates from a single osseous process, forming a keel on the parasphenoid; the extensor tentaculi muscle is loosely attached to the autopalatine, permitting exclusive rotating and sliding movements between this bone and the maxillary. The retractor tentaculi muscle is connected to the maxilla through a single tendon, so that both extensor and retractor tentaculi muscles contribute to a wide array of movements of the maxillary barbels. A discussion on the differences in autopalatine-maxillary movements among the analyzed groups is given. (c) 2005 Wiley-Liss, Inc.

Topographical anatomy of the radial nerve and its muscular branches related to surface landmarks.

PubMed

Cho, Hyejin; Lee, Hye-Yeon; Gil, Young-Chun; Choi, Yun-Rak; Yang, Hee-Jun

2013-10-01

Understanding of the anatomy of the radial nerve and its branches is vital to the treatment of humeral fracture or the restoration of upper extremity function. In this study, we dissected 40 upper extremities from adult cadavers to locate the course of the radial nerve and the origins and insertions of the branches of the radial nerve using surface landmarks. The radial nerve reached and left the radial groove and pierced the lateral intermuscular septum, at the levels of 46.7, 60.5, and 66.8% from the acromion to the transepicondylar line, respectively. Branches to the long head of the triceps brachii originated in the axilla, and branches to the medial and lateral heads originated in the axilla or in the arm. The muscular attachments to the long, medial, and lateral heads were on average 34.0 mm proximal, 16.4 mm distal, and 19.3 mm proximal to the level of inferior end of the deltoid muscle, respectively. The radial nerve innervated 65.0% of the brachialis muscles. Branches to the brachioradialis and those to the extensor carpi radialis longus arose from the radial nerve above the transepicondylar line. Branches to the extensor carpi radialis brevis usually arose from the deep branch of radial nerve (67.5%); however, in some cases, branches to the extensor carpi radialis brevis arose from either the radial nerve (20.0%) or the superficial branch of the radial nerve (12.5%). Using these data, the course of the radial nerve can be estimated by observing the surface of the arm. Copyright © 2012 Wiley Periodicals, Inc.

Extensor tendinopathy of the elbow assessed with sonoelastography: histologic correlation.

PubMed

Klauser, Andrea S; Pamminger, Mathias; Halpern, Ethan J; Abd Ellah, Mohamed M H; Moriggl, Bernhard; Taljanovic, Mihra S; Deml, Christian; Sztankay, Judit; Klima, Guenther; Jaschke, Werner R

2017-08-01

To compare agreement between conventional B-mode ultrasound (US) and compression sonoelastography (SEL) of the common extensor tendons of the elbow with histological evaluation. Twenty-six common extensor tendons were evaluated in 17 cadavers (11 females, median age 85 years and 6 males, median age 80 years). B-mode US was graded into: Grade 1, homogeneous fibrillar pattern; grade 2, hypoechoic areas and/or calcifications <30%; and grade 3 > 30%. SEL was graded into: Grade 1 indicated blue (hardest) to green (hard); grade 2 yellow (soft); and grade 3 red (softest). B-mode US, SEL, and a combined grading score incorporating both were compared to histological findings in 76 biopsies. Histological alterations were detected in 55/76 biopsies. Both modalities showed similar results (sensitivity, specificity, and accuracy 84%, 81%, and 83% for B-mode US versus 85%, 86%, and 86% for SEL, respectively, P > 0.3). However, a combination of both resulted in significant improvement in sensitivity (96%, P < 0.02) without significant change in specificity (81%, P < 0.3), yielding an improved overall accuracy (92%). Combined imaging of the extensor tendons with both modalities is superior to either modality alone for predicting the presence of pathologic findings on histology. • Combination of B-mode US and SEL proved efficiency in diagnosing lateral epicondylitis. • Combination of B-mode US and SEL in lateral epicondylitis correlates to histology. • Combination of both modalities provides improved sensitivity without loss of specificity.

Comparing two methods to record maximal voluntary contractions and different electrode positions in recordings of forearm extensor muscle activity: Refining risk assessments for work-related wrist disorders.

PubMed

Dahlqvist, Camilla; Nordander, Catarina; Granqvist, Lothy; Forsman, Mikael; Hansson, Gert-Åke

2018-01-01

Wrist disorders are common in force demanding industrial repetitive work. Visual assessment of force demands have a low reliability, instead surface electromyography (EMG) may be used as part of a risk assessment for work-related wrist disorders. For normalization of EMG recordings, a power grip (hand grip) is often used as maximal voluntary contraction (MVC) of the forearm extensor muscles. However, the test-retest reproducibility is poor and EMG amplitudes exceeding 100% have occasionally been recorded during work. An alternative MVC is resisted wrist extension, which may be more reliable. To compare hand grip and resisted wrist extension MVCs, in terms of amplitude and reproducibility, and to examine the effect of electrode positioning. Twelve subjects participated. EMG from right forearm extensors, from four electrode pairs, was recorded during MVCs, on three separate occasions. The group mean EMG amplitudes for resisted wrist extension were 1.2-1.7 times greater than those for hand grip. Resisted wrist extension showed better reproducibility than hand grip. The results indicate that the use of resisted wrist extension is a more accurate measurement of maximal effort of wrist extensor contractions than using hand grip and should increase the precision in EMG recordings from forearm extensor muscles, which in turn will increase the quality of risk assessments that are based on these.

Sonographically guided percutaneous needle tenotomy for treatment of common extensor tendinosis in the elbow: is a corticosteroid necessary?

PubMed

McShane, John M; Shah, Vinil N; Nazarian, Levon N

2008-08-01

Chronic refractory common extensor tendinosis of the lateral elbow has been shown to respond to sonographically guided percutaneous needle tenotomy (PNT) followed by corticosteroid injection. In this analysis, we attempted to determine whether the corticosteroid is a necessary component of the procedure. We performed PNT on 57 consecutive patients (age range, 34-61 years) with persistent pain and disability resulting from common extensor tendinosis. Under a local anesthetic and sonographic guidance, a needle was advanced into the tendon, and the tip of the needle was used to fenestrate the tendinotic tissue, break up any calcifications, and abrade the adjacent bone. After the procedure, patients underwent a specified physical therapy protocol. During a subsequent telephone interview, patients answered questions about their symptoms, the level of functioning, and perceptions of the procedure outcome. Of the 52 patients who agreed to participate in the study, 30 (57.7%) reported excellent outcomes, 18 (34.6%) good, 1 (1.9%) fair, and 3 (5.8%) poor. The average follow-up time from the date of the procedure to the telephone interview was 22 months (range, 7-38 months). No adverse events were reported, and 90% stated that they would refer a friend or close relative for the procedure. Sonographically guided PNT for refractory lateral elbow tendinosis is an effective procedure, and subsequent corticosteroid injection is not necessary.

Supplemental Stimulation Improves Swing Phase Kinematics During Exoskeleton Assisted Gait of SCI Subjects With Severe Muscle Spasticity.

PubMed

Ekelem, Andrew; Goldfarb, Michael

2018-01-01

Spasticity is a common comorbidity associated with spinal cord injury (SCI). Robotic exoskeletons have recently emerged to facilitate legged mobility in people with motor complete SCI. Involuntary muscle activity attributed to spasticity, however, can prevent such individuals from using an exoskeleton. Specifically, although most exoskeleton technologies can accommodate low to moderate spasticity, the presence of moderate to severe spasticity can significantly impair gait kinematics when using an exoskeleton. In an effort to potentially enable individuals with moderate to severe spasticity to use exoskeletons more effectively, this study investigates the use of common peroneal stimulation in conjunction with exoskeleton gait assistance. The electrical stimulation is timed with the exoskeleton swing phase, and is intended to acutely suppress extensor spasticity through recruitment of the flexion withdrawal reflex (i.e., while the stimulation is activated) to enable improved exoskeletal walking. In order to examine the potential efficacy of this approach, two SCI subjects with severe extensor spasticity (i.e., modified Ashworth ratings of three to four) walked in an exoskeleton with and without supplemental stimulation while knee and hip motion was measured during swing phase. Stimulation was alternated on and off every ten steps to eliminate transient therapeutic effects, enabling the acute effects of stimulation to be isolated. These experiments indicated that common peroneal stimulation on average increased peak hip flexion during the swing phase of walking by 21.1° (236%) and peak knee flexion by 14.4° (56%). Additionally, use of the stimulation decreased the swing phase RMS motor current by 228 mA (15%) at the hip motors and 734 mA (38%) at the knee motors, indicating improved kinematics were achieved with reduced effort from the exoskeleton. Walking with the exoskeleton did not have a significant effect on modified Ashworth scores, indicating the common peroneal stimulation has only acute effects on suppressing extensor tone and aiding flexion. This preliminary data indicates that such supplemental stimulation may be used to improve the quality of movement provided by exoskeletons for persons with severe extensor spasticity in the lower limb.

Supplemental Stimulation Improves Swing Phase Kinematics During Exoskeleton Assisted Gait of SCI Subjects With Severe Muscle Spasticity

PubMed Central

Ekelem, Andrew; Goldfarb, Michael

2018-01-01

Spasticity is a common comorbidity associated with spinal cord injury (SCI). Robotic exoskeletons have recently emerged to facilitate legged mobility in people with motor complete SCI. Involuntary muscle activity attributed to spasticity, however, can prevent such individuals from using an exoskeleton. Specifically, although most exoskeleton technologies can accommodate low to moderate spasticity, the presence of moderate to severe spasticity can significantly impair gait kinematics when using an exoskeleton. In an effort to potentially enable individuals with moderate to severe spasticity to use exoskeletons more effectively, this study investigates the use of common peroneal stimulation in conjunction with exoskeleton gait assistance. The electrical stimulation is timed with the exoskeleton swing phase, and is intended to acutely suppress extensor spasticity through recruitment of the flexion withdrawal reflex (i.e., while the stimulation is activated) to enable improved exoskeletal walking. In order to examine the potential efficacy of this approach, two SCI subjects with severe extensor spasticity (i.e., modified Ashworth ratings of three to four) walked in an exoskeleton with and without supplemental stimulation while knee and hip motion was measured during swing phase. Stimulation was alternated on and off every ten steps to eliminate transient therapeutic effects, enabling the acute effects of stimulation to be isolated. These experiments indicated that common peroneal stimulation on average increased peak hip flexion during the swing phase of walking by 21.1° (236%) and peak knee flexion by 14.4° (56%). Additionally, use of the stimulation decreased the swing phase RMS motor current by 228 mA (15%) at the hip motors and 734 mA (38%) at the knee motors, indicating improved kinematics were achieved with reduced effort from the exoskeleton. Walking with the exoskeleton did not have a significant effect on modified Ashworth scores, indicating the common peroneal stimulation has only acute effects on suppressing extensor tone and aiding flexion. This preliminary data indicates that such supplemental stimulation may be used to improve the quality of movement provided by exoskeletons for persons with severe extensor spasticity in the lower limb. PMID:29910710

Central and peripheral fatigue in knee and elbow extensor muscles after a long-distance cross-country ski race.

PubMed

Boccia, G; Dardanello, D; Zoppirolli, C; Bortolan, L; Cescon, C; Schneebeli, A; Vernillo, G; Schena, F; Rainoldi, A; Pellegrini, B

2017-09-01

Although elbow extensors (EE) have a great role in cross-country skiing (XC) propulsion, previous studies on neuromuscular fatigue in long-distance XC have investigated only knee extensor (KE) muscles. In order to investigate the origin and effects of fatigue induced by long-distance XC race, 16 well-trained XC skiers were tested before and after a 56-km classical technique race. Maximal voluntary isometric contraction (MVC) and rate of force development (RFD) were measured for both KE and EE. Furthermore, electrically evoked double twitch during MVC and at rest were measured. MVC decreased more in KE (-13%) than in EE (-6%, P = 0.016), whereas the peak RFD decreased only in EE (-26%, P = 0.02) but not in KE. The two muscles showed similar decrease in voluntary activation (KE -5.0%, EE -4.8%, P = 0.61) and of double twitch amplitude (KE -5%, EE -6%, P = 0.44). A long-distance XC race differently affected the neuromuscular function of lower and upper limbs muscles. Specifically, although the strength loss was greater for lower limbs, the capacity to produce force in short time was more affected in the upper limbs. Nevertheless, both KE and EE showed central and peripheral fatigue, suggesting that the origins of the strength impairments were multifactorial for the two muscles. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The diagnostic validity of musculoskeletal ultrasound in lateral epicondylalgia: a systematic review.

PubMed

Dones, Valentin C; Grimmer, Karen; Thoirs, Kerry; Suarez, Consuelo G; Luker, Julie

2014-03-03

Ultrasound is considered a reliable, widely available, non-invasive and inexpensive imaging technique for assessing soft tissue involvement in Lateral epicondylalgia. Despite the number of diagnostic studies for Lateral Epicondylalgia, there is no consensus in the current literature on the best abnormal ultrasound findings that confirm lateral epicondylalgia. Eligible studies identified by searching electronic databases, scanning reference lists of articles and chapters on ultrasound in reference books, and consultation of experts in sonography. Three reviewers (VCDIII, KP, KW) independently searched the databases using the agreed search strategy, and independently conducted all stages of article selection. Two reviewers (VCDIII, KP) then screened titles and abstracts to remove obvious irrelevance. Potentially relevant full text publications which met the inclusion criteria were reviewed by the primary investigator (VCDIII) and another reviewer (CGS). Among the 15 included diagnostic studies in this review, seven were Level II diagnostic accuracy studies for chronic lateral epicondylalgia based on the National Health and Medical Research Council Hierarchy of Evidence. Based from the pooled sensitivity of abnormal ultrasound findings with homogenous results (p > 0.05), the hypoechogenicity of the common extensor origin has the best combination of diagnostic sensitivity and specificity. It is moderately sensitive [Sensitivity: 0.64 (0.56-0.72)] and highly specific [Specificity: 0.82 (0.72-0.90)] in determining elbows with lateral epicondylalgia. Additionally, bone changes on the lateral epicondyle [Sensitivity: 0.56 (0.50-0.62)] were moderately sensitive to chronic LE. Conversely, neovascularity [Specificity: 1.00 (0.97-1.00)], calcifications [Specificity: 0.97 (0.94-0.99)] and cortical irregularities [Specificity: 0.96 (0.88-0.99)] have strong specificity for chronic lateral epicondylalgia. There is insufficient evidence supporting the use of Power Doppler Ultrasonogrophy, Real-time Sonoelastography and sonographic probe-induced tenderness in diagnosing LE. The use of Gray-scale Ultrasonography is recommended in objectively diagnosing lateral epicondylalgia. The presence of hypoechogenicity and bone changes indicates presence of a stressed common extensor origin-lateral epicondyle complex in elbows with lateral epicondylalgia. In addition to diagnosis, detection of these abnormal ultrasound findings allows localization of pathologies to tendon or bone that would assist in designing an appropriate treatment suited to patient's condition.

Adaptive response of slow and fast skeletal muscle in the monkey to spaceflight

NASA Technical Reports Server (NTRS)

Bodine-Fowler, Sue

1996-01-01

Experiments were designed to determine the effects of the absence of weight support on hindlimb muscles of the monkey: an ankle flexor (tibialis anterior, TA), two ankle extensors (medical gastrocnemius, MG and soleus, SOL), and a knee extensor (vastus lateralis, VL). These experiments will be performed as part of the BION mission. The original project proposed to assess the effects of weightlessness in adult Rhesus monkeys which were to be flown on the Space Shuttle as part of SLS-3. Feasibility studies were carried out and a series of experiments were performed at NASA/Ames Research Center to assess the effects of a 21-day restraint period in the ESOP on muscle properties. The results of these studies are summarized.

Risk factors and clinical features of text message injuries.

PubMed

Sharan, Deepak; Ajeesh, P S

2012-01-01

Use of mobile phone and sending text message is a very common in today's life. While sending a text message the users need to use their thumb and other palm muscles extensively. The thumb most of the time adducted on the key pad of the mobile and use high force to type the letters. Studies in literature showed that text messaging has an adverse effect on musculoskeletal system of hand. But the extensive study on the type of disorders set in among the users who extensively use mobile phone for texting. This study aims at to evaluate risk factor and clinical feature of the MSD due to hand held devices. Twenty seven subjects participated in this study. Predefined protocols were used to evaluate type of MSD occurred among the subjects. The study revealed that development of tendinitis in extensor pollicis longus, myofascial pain syndrome (70.37%) of adductor pollicis, 1st interossei and extensor digitorum communis . Other associated problems diagnosed were thoracic outlet syndrome (51.85%), fibromyalgia syndrome (25.93%), hypothyroidism (7.41%), wrist tendinitis (14.81%) and De Quervain's syndrome (7.41%). It has been observed that the pathology were tendinitis of extensor pollicis longus, myofascial pain syndrome of thenar muscles and 1st interossei, extensor digitorum communis.

Functional anatomy of the lateral collateral ligament of the elbow.

PubMed

Hackl, M; Bercher, M; Wegmann, K; Müller, L P; Dargel, J

2016-07-01

The aim of this study was to analyze the functional anatomy of the lateral collateral ligament complex (LCLC) and the surrounding forearm extensors. Using 81 human cadaveric upper extremities, the anatomy of the forearm extensors-especially the anconeus, supinator and extensor carpi ulnaris (ECU)-was analyzed. After removal of aforementioned extensors the functional anatomy of the LCLC was analyzed. The origin of the LCLC was evaluated for isometry. The insertion types of the lateral ulnar collateral ligament (LUCL) were analyzed and classified. The ECU runs parallel to the RCL to dynamically preserve varus stability. The supinator and anconeus muscle fibers coalesce with the LCLC and lengthen during pronation. The anconeus fibers run parallel to the LUCL in full flexion. The LCLC consists of the annular ligament (AL) and the isometric radial collateral ligament (RCL). During elbow flexion, its posterior branches (LUCL) tighten while the anterior branches loosen. When performing a pivot shift test, the loosened LUCL fibers do not fully tighten in full extension. The LUCL inserts along with the AL at the supinator crest. Three different insertion types could be observed. The LUCL represents the posterior branch of the RCL rather than a distinct ligament. It is non-isometric and lengthens during elbow flexion. The RCL was found to be of vital importance for neutralization of posterolateral rotatory forces. Pronation of the forearm actively stabilizes the elbow joint as the supinator, anconeus and biceps muscle work in unison to increase posterolateral rotatory stability.

[The Omega "Omega" pulley plasty: a new technique for the surgical management of the De Quervain's disease].

PubMed

Bakhach, J; Sentucq-Rigal, J; Mouton, P; Boileau, R; Panconi, B; Guimberteau, J-C

2006-02-01

The Omega "Omega" pulley plasty: a new technique for the surgical management of the De Quervain's disease. The De Quervain tenosynovitis is an inadequacy into the first extensor compartment between the osteo-fibrous tunnel and the tendons. This mechanical conflict generates a tenosynovitis of the extensor pollicis brevis and the abductor pollicis longus tendons. This is generally expressed by a tenderness on the radial side of the wrist over the radial styloid process. The medical management consists on corticoids infiltrations of the first extensor compartment, the avoidance of repetitive and stress movements of the first ray with the use of a rest splint. The surgical approach is considered with the recurrence of the painful symptoms. This well-known pathology is reputated to require a simple section of the pulley. Our post-operative complications have been reported in the literature of this classical surgical solution. These complications concern an incomplete release of the extensor pollicis brevis and the abductor pollicis longus tendons particularly when an extensor sub-compartment exists and was overlooked, an irritation of the collateral branches of the sensitive radial nerve or the occurrence of a nevroma after a nerve injury and the most serious complication is a palmar subluxation of the extensor tendons which can occur with the thumb extended and the wrist flexed. In rare cases, this subluxation can be really painful and requires a surgical management with secondary reconstruction of the pulley. This reconstruction necessitates distal pedicle flaps from the dorsal retinaculum or the brachioradialis tendon. To prevent these complications, Codega and Kapandji described techniques of reconstruction of the pulley after its release. More recently, Le Viet reported a procedure using the anterior flap of the pulley; fixed to the dermis it will work as a barrier and maintain the tendons sliding on the radial styloid groove. These techniques require to divide the pulley and to reconstruct it suturing the different flaps. It can generate adherences between the extensor tendons, the overlying skin and the collateral branches of the radial nerve. The authors present a new and original plasty procedure of the first extensor compartment pulley, the "Omega" Omega plasty. It consists to liberate the anterior attachment of the pulley over the anterior lip of the styloïd process respecting its continuity with the periosteum flap. This conservative procedure is very interesting; it permits enough expansion of the tunnel volume decompressing the extensor tendons as a treatment of the De Quervain disease and respecting the anatomy and the continuity of the osteo-fibrous tunnel. This technique is simple, reliable and respects the first ray extensor tendons gliding physiology and biodynamic. In spite of our short clinical experience with only ten cases, all the patients retrieve a normal function of the thumb with complete disappearance of the first ray tenderness and pain without any complications. These preliminary results are encouraging and push us to consider the "Omega" plasty as a first choice for the surgical treatment of the De Quervain tenosynovitis.

Hip-Extensor Strength, Trunk Posture, and Use of the Knee-Extensor Muscles During Running.

PubMed

Teng, Hsiang-Ling; Powers, Christopher M

2016-07-01

Diminished hip-muscle performance has been proposed to contribute to various knee injuries. To determine the association between hip-extensor muscle strength and sagittal-plane trunk posture and the relationships among hip-extensor muscle strength and hip- and knee-extensor work during running. Descriptive laboratory study. Musculoskeletal biomechanical laboratory. A total of 40 asymptomatic recreational runners, 20 men (age = 27.1 ± 7.0 years, height = 1.74 ± 0.69 m, mass = 71.1 ± 8.2 kg) and 20 women (age = 26.2 ± 5.8 years, height = 1.65 ± 0.74 m, mass = 60.6 ± 6.6 kg), participated. Maximum isometric strength of the hip extensors was assessed using a dynamometer. Sagittal-plane trunk posture (calculated relative to the global vertical axis) and hip- and knee-extensor work (sum of energy absorption and generation) during the stance phase of running were quantified while participants ran over ground at a controlled speed of 3.4 m/s. We used Pearson product moment correlations to examine the relationships among hip-extensor strength, mean sagittal-plane trunk-flexion angle, hip-extensor work, and knee-extensor work. Hip-extensor strength was correlated positively with trunk-flexion angle (r = 0.55, P < .001) and hip-extensor work (r = 0.46, P = .003). It was correlated inversely with knee-extensor work (r = -0.39, P = .01). All the correlations remained after adjusting for sex. Our findings suggest that runners with hip-extensor weakness used a more upright trunk posture. This strategy led to an overreliance on the knee extensors and may contribute to overuse running injuries at the knee.

Hip-Extensor Strength, Trunk Posture, and Use of the Knee-Extensor Muscles During Running

PubMed Central

Teng, Hsiang-Ling; Powers, Christopher M.

2016-01-01

Context:  Diminished hip-muscle performance has been proposed to contribute to various knee injuries. Objective:  To determine the association between hip-extensor muscle strength and sagittal-plane trunk posture and the relationships among hip-extensor muscle strength and hip- and knee-extensor work during running. Design:  Descriptive laboratory study. Setting:  Musculoskeletal biomechanical laboratory. Patients or Other Participants:  A total of 40 asymptomatic recreational runners, 20 men (age = 27.1 ± 7.0 years, height = 1.74 ± 0.69 m, mass = 71.1 ± 8.2 kg) and 20 women (age = 26.2 ± 5.8 years, height = 1.65 ± 0.74 m, mass = 60.6 ± 6.6 kg), participated. Main Outcome Measure(s):  Maximum isometric strength of the hip extensors was assessed using a dynamometer. Sagittal-plane trunk posture (calculated relative to the global vertical axis) and hip- and knee-extensor work (sum of energy absorption and generation) during the stance phase of running were quantified while participants ran over ground at a controlled speed of 3.4 m/s. We used Pearson product moment correlations to examine the relationships among hip-extensor strength, mean sagittal-plane trunk-flexion angle, hip-extensor work, and knee-extensor work. Results:  Hip-extensor strength was correlated positively with trunk-flexion angle (r = 0.55, P < .001) and hip-extensor work (r = 0.46, P = .003). It was correlated inversely with knee-extensor work (r = −0.39, P = .01). All the correlations remained after adjusting for sex. Conclusions:  Our findings suggest that runners with hip-extensor weakness used a more upright trunk posture. This strategy led to an overreliance on the knee extensors and may contribute to overuse running injuries at the knee. PMID:27513169

Musculoskeletal injuries in the ultramarathon: the 1990 Westfield Sydney to Melbourne run.

PubMed Central

Fallon, K E

1996-01-01

OBJECTIVE: To document the injuries sustained by participants in a 1005 km ultramarathon. METHODS: Clinical notes were reviewed on entrants in the 1005 km Sydney to Melbourne ultramarathon. An injury was recorded following self referral by a participant or if the history obtained from the runner or his support crew indicated the likelihood of a significant injury which could have an impact upon performance. RESULTS: 64 injuries were found in 32 runners. The knee (31.3%) and ankle (28.1%) regions were most commonly injured. The most common single diagnosis was retropatellar pain syndrome, and Achilles tendinitis and medial tibial stress syndrome were the next most common injuries. Peritendinitis/tendinitis of the tendons passing under the extensor retinaculum at the ankle, an injury infrequently reported in other sports, was common (19% of all injuries). CONCLUSIONS: The injuries were typically associated with running but 12 (19% of the total) involved the tendons of the muscles of the anterior compartment of the lower leg, and in almost every case the major site of inflammation was at the extensor retinaculum at the anterior aspect of the ankle. This injury appears to be relatively specific to the ultramarathon-"ultramarathoner's ankle". Images p321-a PMID:9015594

Work-Related Pain in Extrinsic Finger Extensor Musculature of Instrumentalists Is Associated with Intracellular pH Compartmentation during Exercise

PubMed Central

Moreno-Torres, Angel; Rosset-Llobet, Jaume; Pujol, Jesus; Fàbregas, Sílvia; Gonzalez-de-Suso, Jose-Manuel

2010-01-01

Background Although non-specific pain in the upper limb muscles of workers engaged in mild repetitive tasks is a common occupational health problem, much is unknown about the associated structural and biochemical changes. In this study, we compared the muscle energy metabolism of the extrinsic finger extensor musculature in instrumentalists suffering from work-related pain with that of healthy control instrumentalists using non-invasive phosphorus magnetic resonance spectroscopy (31P-MRS). We hypothesize that the affected muscles will show alterations related with an impaired energy metabolism. Methodology/Principal Findings We studied 19 volunteer instrumentalists (11 subjects with work-related pain affecting the extrinsic finger extensor musculature and 8 healthy controls). We used 31P-MRS to find deviations from the expected metabolic response to exercise in phosphocreatine (PCr), inorganic phosphate (Pi), Pi/PCr ratio and intracellular pH kinetics. We observed a reduced finger extensor exercise tolerance in instrumentalists with myalgia, an intracellular pH compartmentation in the form of neutral and acid compartments, as detected by Pi peak splitting in 31P-MRS spectra, predominantly in myalgic muscles, and a strong association of this pattern with the condition. Conclusions/Significance Work-related pain in the finger extrinsic extensor muscles is associated with intracellular pH compartmentation during exercise, non-invasively detectable by 31P-MRS and consistent with the simultaneous energy production by oxidative metabolism and glycolysis. We speculate that a deficit in energy production by oxidative pathways may exist in the affected muscles. Two possible explanations for this would be the partial and/or local reduction of blood supply and the reduction of the muscle oxidative capacity itself. PMID:20161738

Interactions between Dorsal and Ventral Root Stimulation on the Generation of Locomotor-Like Activity in the Neonatal Mouse Spinal Cord

PubMed Central

2016-01-01

Abstract We investigated whether dorsal (DR) and ventral root (VR) stimulus trains engage common postsynaptic components to activate the central pattern generator (CPG) for locomotion in the neonatal mouse spinal cord. VR stimulation did not activate the first order interneurons mediating the activation of the locomotor CPG by sacrocaudal afferent stimulation. Simultaneous stimulation of adjacent dorsal or ventral root pairs, subthreshold for evoking locomotor-like activity, did not summate to activate the CPG. This suggests that locomotor-like activity is triggered when a critical class of efferent or afferent axons is stimulated and does not depend on the number of stimulated axons or activated postsynaptic neurons. DR- and VR-evoked episodes exhibited differences in the coupling between VR pairs. In DR-evoked episodes, the coupling between the ipsilateral and contralateral flexor/extensor roots was similar and stronger than the bilateral extensor roots. In VR-evoked episodes, ipsilateral flexor/extensor coupling was stronger than both the contralateral flexor/extensor and the bilateral extensor coupling. For both types of stimulation, the coupling was greatest between the bilateral L1/L2 flexor-dominated roots. This indicates that the recruitment and/or the firing pattern of motoneurons differed in DR and VR-evoked episodes. However, the DR and VR trains do not appear to activate distinct CPGs because trains of DR and VR stimuli at frequencies too low to evoke locomotor-like activity did so when they were interleaved. These results indicate that the excitatory actions of VR stimulation converge onto the CPG through an unknown pathway that is not captured by current models of the locomotor CPG. PMID:27419215

Bilateral movements increase sustained extensor force in the paretic arm.

PubMed

Kang, Nyeonju; Cauraugh, James H

2018-04-01

Muscle weakness in the extensors poststroke is a common motor impairment. Unfortunately, research is unclear on whether bilateral movements increase extensor force production in the paretic arm. This study investigated sustained force production while stroke individuals maximally extended their wrist and fingers on their paretic arm. Specifically, we determined isometric force production in three conditions: (a) unilateral paretic arm, (b) unilateral nonparetic arm, and (c) bilateral (both arms executing the same movement simultaneously). Seventeen chronic stroke patients produced isometric sustained force by executing wrist and fingers extension in unilateral and bilateral contraction conditions. Mean force, force variability (coefficient of variation), and signal-to-noise ratio were calculated for each contraction condition. Analysis of two-way (Arm × Type of Condition: 2 × 2; Paretic or Nonparetic Arm × Unilateral or Bilateral Conditions) within-subjects ANOVAs revealed that the bilateral condition increased sustained force in the paretic arm, but reduced sustained force in the nonparetic arm. Further, although the paretic arm exhibited more force variability and less signal-to-noise ratio than the nonparetic arm during a unilateral condition, there were no differences when participants simultaneously executed isometric contractions with both arms. Our unique findings indicate that bilateral contractions transiently increased extensor force in the paretic arm. Implications for Rehabilitation Bilateral movements increased isometric wrsit extensor force in paretic arms and redcued force in nonparetic arms versus unilateral movements. Both paretic and nonparetic arms produced similar force variability and signal-to-noise ratio during bilateral movements. Increased sustained force in the paretic arm during the bilateral condition indicates that rehabilitation protocols based on bilateral movements may be beneficial for functional recovery.

Muscle power is an important measure to detect deficits in muscle function in hip osteoarthritis: a cross-sectional study.

PubMed

Bieler, Theresa; Magnusson, Stig Peter; Christensen, Helle Elisabeth; Kjaer, Michael; Beyer, Nina

2017-07-01

To investigate between-leg differences in hip and thigh muscle strength and leg extensor power in patients with unilateral hip osteoarthritis. Further, to compare between-leg differences in knee extensor strength and leg extensor power between patients and healthy peers. Seventy-two patients (60-87 years) with radiographic and symptomatic hip osteoarthritis not awaiting hip replacement and 35 healthy peers (63-82 years) were included. Hip and thigh muscle strength and leg extensor power were measured in patients and knee extensor strength and leg extensor power in healthy. The symptomatic extremity in patients was significantly (p < 0.05, paired t-test) weaker compared with the non-symptomatic extremity for five hip muscles (8-17%), knee extensors (11%) and leg extensor power (19%). Healthy older adults had asymmetry in knee extensor strength (6%, p < 0.05) comparable to that found in patients, but had no asymmetry in leg extensor power. Patients had generalized weakening of the affected lower extremity and numerically the largest asymmetry was evident for leg extensor power. In contrast, healthy peers had no asymmetry in leg extensor power. These results indicate that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with hip osteoarthritis. Implications for Rehabilitation Even in patients with mild symptoms not awaiting hip replacement a generalized muscle weakening of the symptomatic lower extremity seems to be present. Between-leg differences in leg extensor power (force × velocity) appears to be relatively large (19%) in patients with unilateral hip osteoarthritis in contrast to healthy peers who show no asymmetry. Compared to muscle strength the relationship between functional performance and leg extensor power seems to be stronger, and more strongly related to power of the symptomatic lower extremity. Our results indicate that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with mild symptoms not awaiting hip replacement.

A modified surgical technique for neglected fracture of lateral humeral condyle in children.

PubMed

Sulaiman, Abdul Razak; Munajat, Ismail; Mohd, Emil Fazliq

2011-11-01

Operative treatment for neglected fracture of lateral humeral condyle (LHC) is difficult because of contracted muscle, fibrous tissue formation, and indistinct bony edges. Its success depends on the ability to preserve blood supply during the surgery. We retrospectively reviewed eight cases of neglected fracture of LHC in children treated with open reduction with selected multiple 'V' lengthening of common extensor muscle and internal fixation. The patients were between 3 and 8 years of age. The period of neglect was between 3 and 20 weeks. Four patients with displacement of more than 10 mm and neglect for 5 weeks or more required lengthening of common extensor muscle aponeurosis. The follow-up assessments were between 1 and 6.3 years with a mean of 4.4 years. All patients had union by 2 months. They gained improvement of flexion range of motion between 60° and 120° with a mean of 86.3°. Loss of final range of motion compared with the normal side was between 5° and 35° with a mean of 10°. No patient had limitation of activities or pain. Six cases had excellent and two cases had good Dillon functional score. All patients had lateral condyle prominent with different severities. There was one mild avascular necrosis and one fishtail deformity. Both of them had almost full range of motion. All patients had early physeal closure, except one, who had only 1 year follow-up. There was no case of progressive valgus deformity. Children with neglected fracture of LHC would benefit from anatomical reduction and internal fixation through a proper exposure and if indicated combined with multiple 'V' lengthening of common extensor muscle aponeurosis. This is a level IV study.

Walking and Running Require Greater Effort from the Ankle than the Knee Extensor Muscles.

PubMed

Kulmala, Juha-Pekka; Korhonen, Marko T; Ruggiero, Luca; Kuitunen, Sami; Suominen, Harri; Heinonen, Ari; Mikkola, Aki; Avela, Janne

2016-11-01

The knee and ankle extensors as human primary antigravity muscle groups are of utmost importance in a wide range of locomotor activities. Yet, we know surprisingly little about how these muscle groups work, and specifically, how close to their maximal capacities they function across different modes and intensity of locomotion. Therefore, to advance our understanding of locomotor constraints, we determined and compared relative operating efforts of the knee and ankle extensors during walking, running, and sprinting. Using an inverse dynamics biomechanical analysis, the muscle forces of the knee and ankle extensors during walking (1.6 m·s), running (4.1 m·s), and sprinting (9.3 m·s) were quantified and then related to maximum forces of the same muscle groups obtained from a reference hopping test that permitted natural elastic limb behavior. During walking, the relative effort of the ankle extensors was almost two times greater compared with the knee extensors (35% ± 6% vs 19% ± 5%, P < 0.001). Changing walking to running decreased the difference in the relative effort between the extensor muscle groups, but still, the ankle extensors operated at a 25% greater level than the knee extensors (84% ± 12% vs 63% ± 17%, P < 0.05). At top speed sprinting, the ankle extensors reached their maximum operating level, whereas the knee extensors still worked well below their limits, showing a 25% lower relative effort compared with the ankle extensors (96% ± 11% vs 72% ± 19%, P < 0.01). Regardless of the mode of locomotion, humans operate at a much greater relative effort at the ankle than knee extensor muscles. As a consequence, the great demand on ankle extensors may be a key biomechanical factor limiting our locomotor ability and influencing the way we locomote and adapt to accommodate compromised neuromuscular system function.

Transfer of extensor carpi radialis brevis as an extensor to extensor motor transfer (EEMT) in ulnar nerve palsy.

PubMed

Jamali, Allah Rakha; Bhatti, Anisuddin; Mehboob, Ghulam

2006-07-01

To evaluate functional outcome and correction of deformity with extensor carpiradialis brevis motor transfer to replace the intrinsic muscles as an extensor to extensor motor transfer (EEMT). This was a prospective observational study with one group pretest posttest design conducted from 1996 to 2004. Convenience sampling technique was used and the sample size was twenty one. The independent variable was transfer of extensor carpiradialis brevis to replace the intrinsic muscles. The dependent variable was functional outcome and the correction of deformity. The extraneous variables were age, sex interval between injury and transfer as well as local factors related to wound and grafts used. The average follow up was 22.5 months. The mean preoperative unassisted extensor lag was 56.79 +/- 10.39 which improved to 9.6% +/- 5.4 (correction of 83%) at six months after surgery. With open hand assessment 76.19% reported good to excellent results, while 79.89% achieved good to excellent results with closed hand assessment. The mechanism of closing was good to excellent in 89.42% cases, however only 71.42% patients considered their hands good to excellent. Significant problems were seen with use of tendoachilles as a graft. Extensor carpiradialis brevis transfer to replace the intrinsic muscles as an extensor to extensor motor transfer can achieve good functional outcome as well as correction of deformity despite shortcomings in physical rehabilitation.

A Systematic Review of Tennis Elbow Surgery: Open Versus Arthroscopic Versus Percutaneous Release of the Common Extensor Origin.

PubMed

Pierce, Todd P; Issa, Kimona; Gilbert, Benjamin T; Hanly, Brian; Festa, Anthony; McInerney, Vincent K; Scillia, Anthony J

2017-06-01

To compare complications, function, pain, and patient satisfaction after conventional open, percutaneous, or arthroscopic release of the extensor origin for the treatment of lateral epicondylitis. A thorough review of 4 databases-PubMed, EBSCOhost, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus, and Scopus-was performed to identify all studies that addressed surgical management of lateral epicondylitis. We included (1) studies published between 2000 and 2015 and (2) studies with clearly defined surgical techniques. We excluded (1) non-English-language manuscripts, (2) isolated case reports, (3) studies with fewer than 10 subjects, (4) animal studies, (5) studies with additional adjunctive procedures aside from release of the extensor origin, (6) clinical or systematic review manuscripts, (7) studies with a follow-up period of 6 months or less, and (8) studies in which less than 80% of patients completed follow-up. Each study was analyzed for complication rates, functional outcomes, pain, and patient satisfaction. Thirty reports were identified that included 848 open, 578 arthroscopic, and 178 percutaneous releases. Patients within each release group had a similar age (46 years vs 46 years vs 48 years; P = .9 and P = .4, respectively), whereas there was a longer follow-up time in patients who underwent surgery by an open technique (49.4 months vs 42.6 months vs 23 months, P < .001). There were no differences in complication rates among these techniques (3.8% vs 2.9% vs 3.9%; P = .5 and P = .9, respectively). However, open techniques were correlated with higher surgical-site infection rates than arthroscopic techniques (0.7% vs 0%, P = .04). Mean Disabilities of the Arm, Shoulder and Hand scores were substantially better with both open and arthroscopic techniques than with percutaneous release (19.9 points vs 21.3 points vs 29 points, P < .001). In addition, there was less pain reported in the arthroscopic and percutaneous release groups as opposed to their open counterparts (1.9 points vs 1.4 points vs 1.3 points, P < .0001). There were no differences among the techniques in patient satisfaction rate (93.7% vs 89% vs 88%; P = .08 and P = .07, respectively). Functional outcomes of open and arthroscopic releases may be superior to those of percutaneous release. In addition, patients may report less pain with arthroscopic and percutaneous techniques. Although the risk of complications is similar regardless of technique, patients may be counseled that their risk of infectious complications may be slightly higher with open releases. However, it is important to note that this statistical difference may not necessarily portend noticeable clinical differences. Level IV, systematic review of Level III and IV evidence. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Knee strength, power and stair performance of the elderly 5 years after unicompartmental knee arthroplasty.

PubMed

Li, Yumeng; Kakar, Rumit S; Fu, Yang-Chieh; Mahoney, Ormonde M; Kinsey, Tracy L; Simpson, Kathy J

2018-04-13

Unicompartmental knee arthroplasty (UKA) has been shown to demonstrate some satisfactory short-term outcomes. However, to our knowledge, there have been no reports on midterm or long-term knee extensor strength and leg extensor power post-UKA. Therefore, the purposes of this study were: (1) to assess the isokinetic knee extensor strength, leg extensor power and stair performance of elderly participants at 5 years UKA post-operation; (2) to compare the differences in knee extensor strength and leg extensor power between the UKA and contralateral healthy limbs. Nineteen elderly participants (75 ± 5 years) who had a medial or a lateral compartment UKA at 5 years post-operation were recruited. The isokinetic knee extensor strength and leg extensor power were measured. The stair performance was tested on a 4-step stair, and ascent and descent velocities were calculated. The pain level was assessed. The UKA limbs' knee extensor strength and leg extensor power were 1.01 ± 0.39 Nm/kg and 0.98 ± 0.27 W/kg, respectively. The stair ascent and descent velocities were 0.37 ± 0.07 and 0.38 ± 0.11 m/s, respectively. In addition, the UKA limbs exhibited comparable knee strength and leg power relative to the contralateral limbs. In general, the knee extensor strength and leg extensor power exhibited by the UKA limbs at 5 years post-operation may be typical in comparison with the normative data. We suggest that UKA is a satisfactory treatment in regard to the recovery of knee strength, leg power and ability to climb up and down stairs.

Traumatic Extensor Tendon Injuries to the Hand: Clinical Anatomy, Biomechanics, and Surgical Procedure Review.

PubMed

Colzani, Giulia; Tos, Pierluigi; Battiston, Bruno; Merolla, Giovanni; Porcellini, Giuseppe; Artiaco, Stefano

2016-04-01

The extensor apparatus is a complex muscle-tendon system that requires integrity or optimal reconstruction to preserve hand function. Anatomical knowledge and the understanding of physiopathology of extensor tendons are essential for an accurate diagnosis of extensor tendon injuries (ETIs) of the hand and wrist, because these lesions are complex and commonly observed in clinical practice. A careful clinical history and assessment still remain the first step for the diagnosis, followed by US and MR to confirm the suspect of ETI or to investigate some doubtful conditions and rule out associate lesions. During last decades the evolution of surgical techniques and rehabilitative treatment protocol led to gradual improvement in clinical results of ETI treatment and surgical repair. Injury classification into anatomical zones and the evaluation of the characteristics of the lesions are considered key points to select the appropriate treatment for ETI. Both conservative and surgical management can be indicated in ETI, depending on the anatomical zone and on the characteristics of the injuries. As a general rule, an attempt of conservative treatment should be performed when the lesion is expected to have favorable result with nonoperative procedure. Many surgical techniques have been proposed over the time and with favorable results if the tendon injury is not underestimated and adequately treated. Despite recent research findings, a lack of evidence-based knowledge is still observed in surgical treatment and postoperative management of ETI. Further clinical and biomechanical investigations would be advisable to clarify this complex issue.

Traumatic Extensor Tendon Injuries to the Hand: Clinical Anatomy, Biomechanics, and Surgical Procedure Review

PubMed Central

Colzani, Giulia; Tos, Pierluigi; Battiston, Bruno; Merolla, Giovanni; Porcellini, Giuseppe; Artiaco, Stefano

2016-01-01

The extensor apparatus is a complex muscle-tendon system that requires integrity or optimal reconstruction to preserve hand function. Anatomical knowledge and the understanding of physiopathology of extensor tendons are essential for an accurate diagnosis of extensor tendon injuries (ETIs) of the hand and wrist, because these lesions are complex and commonly observed in clinical practice. A careful clinical history and assessment still remain the first step for the diagnosis, followed by US and MR to confirm the suspect of ETI or to investigate some doubtful conditions and rule out associate lesions. During last decades the evolution of surgical techniques and rehabilitative treatment protocol led to gradual improvement in clinical results of ETI treatment and surgical repair. Injury classification into anatomical zones and the evaluation of the characteristics of the lesions are considered key points to select the appropriate treatment for ETI. Both conservative and surgical management can be indicated in ETI, depending on the anatomical zone and on the characteristics of the injuries. As a general rule, an attempt of conservative treatment should be performed when the lesion is expected to have favorable result with nonoperative procedure. Many surgical techniques have been proposed over the time and with favorable results if the tendon injury is not underestimated and adequately treated. Despite recent research findings, a lack of evidence-based knowledge is still observed in surgical treatment and postoperative management of ETI. Further clinical and biomechanical investigations would be advisable to clarify this complex issue. PMID:27616821

Surgical Treatment of Traumatic Myositis Ossificans of the Extensor Carpi Radialis Muscle in a Dog.

PubMed

Morton, Bridget A; Hettlich, Bianca F; Pool, Roy R

2015-07-01

To report clinical signs, diagnostic imaging findings, and outcome in a dog with traumatic myositis ossificans of the origin of the extensor carpi radialis muscle. Clinical report. An 8-month-old intact female Irish Setter Dog. After radiographic and computed tomographic evaluation of an osseous proliferation arising from the cranial cortex of the right distal humeral diaphysis, the protruding bone was surgically removed and evaluated by histopathology. Traumatic myositis ossificans was successfully treated with surgical removal of the osseous proliferation resulting in improved postoperative range of motion of the right elbow joint. There was no evidence of lameness or abnormal bone regrowth associated with the surgical site radiographically at follow up. Surgical removal of a traumatic myositis ossificans lesion resulted in full return to function in a young, competitive show dog. © Copyright 2014 by The American College of Veterinary Surgeons.

Comparison of shock transmission and forearm electromyography between experienced and recreational tennis players during backhand strokes.

PubMed

Wei, Shun-Hwa; Chiang, Jinn-Yen; Shiang, Tzyy-Yuang; Chang, Hsiao-Yun

2006-03-01

To test the hypothesis that recreational tennis players transmit more shock impact from the racket to the elbow joint than experienced tennis players during the backhand stroke. Also, to test whether recreational tennis players used higher electromyographic (EMG) activities in common wrist extensor and flexor around epicondylar region at follow-through phase. A repeated-measure, cross-sectional study. National College of Physical Education and Sports at Taipei, Taiwan. Twenty-four male tennis players with no abnormal forearm musculoskeletal injury participated in the study. According to performance level, subjects were categorized into 2 groups: experienced and recreational. Impact transmission and wrist extensor-flexor EMG for backhand acceleration, impact, and follow-through phases were recorded for each player. An independent t test with a significance level of 0.05 was used to examine mean differences of shock impact and EMG between the 2 test groups. One-way ANOVA associated with Tukey multiple comparisons was used to identify differences among different impact locations and EMG phases. Experienced athletes reduced the racket impact to the elbow joint by 89.2%, but recreational players reduced it by only 61.8%. The largest EMG differences were found in the follow-through phase (P<0.05). Experienced athletes showed that their extensor and flexor EMGs were at submaximal level for follow-through phase, whereas recreational players maintained their flexor and extensor EMGs at either supramaximal or maximal level. Our results support the hypothesis that recreational players transmit more shock impact from the racket to the elbow joint and use larger wrist flexor and extensor EMG activities at follow-through phase of the backhand stroke. Follow-through control is proposed as a critical factor for reduction of shock transmission. Clinicians or trainers should instruct beginners to quickly release their grip tightness after ball-to-racket impact to reduce shock impact transmission to the wrist and elbow.

Changes in Gait over a 30-min Walking Session in Obese Females.

PubMed

Singh, Bhupinder; Vo, Huy; Francis, Shelby L; Janz, Kathleen F; Yack, H John

2017-03-01

This study assessed the biomechanical gait changes in obese and normal-weight female adult subjects after a commonly recommended 30-min walking session. Hip and knee adduction and extensor moments, which are the primary modulators of frontal and sagittal plane load distribution, were hypothesized to increase in obese females after a 30-min walking period, resulting in more stress across the hip and knee joint. Ten obese (37.7 ± 4.8 yr of age, body mass index [BMI] = 36.1 ± 4.2 kg·m) and 10 normal-weight control female subjects (38.1 ± 4.5 yr of age, BMI = 22.6 ± 2.3 kg·m) walked 30 min continuously on the treadmill at their self-selected speed. V˙O2max was estimated using Ebbeling protocol. A three-dimensional pre- and posttreadmill gait analysis was conducted using infrared markers and force plates to calculate hip and knee moments. Knee extensor moments increased in both obese, pretreadmill (0.54 ± 0.28 N·m·kg) to posttreadmill (0.78 ± 0.43 N·m·kg) (P = 0.01), and control subjects, pretreadmill (0.57 ± 0.34 N·m·kg) to posttreadmill (0.80 ± 0.49 N·m·kg) (P = 0.02). Hip extensor moments decreased for both obese and control subjects. Knee adduction moments did not change in either obese or control subjects. Knee extensor and adductor moments showed good to moderate relationships with V˙O2max, but not BMI or waist circumference. Obese and normal-weight subjects experienced an increase in knee extensor moments after 30 min of walking similarly; therefore, clinicians do not need special consideration for obese individuals when recommending 30-min walking sessions. Fitness may be the important factor in judging the implications of exercise on joint mechanics and parameters of a walking program.

Ankle and knee kinetics between strike patterns at common training speeds in competitive male runners.

PubMed

Kuhman, Daniel; Melcher, Daniel; Paquette, Max R

2016-01-01

The purpose of this study was to investigate the interaction of foot strike and common speeds on sagittal plane ankle and knee joint kinetics in competitive rear foot strike (RFS) runners when running with a RFS pattern and an imposed forefoot strike (FFS) pattern. Sixteen competitive habitual male RFS runners ran at two different speeds (i.e. 8 and 6 min mile(-1)) using their habitual RFS and an imposed FFS pattern. A repeated measures analysis of variance was used to assess a potential interaction between strike pattern and speed for selected ground reaction force (GRF) variables and, sagittal plane ankle and knee kinematic and kinetic variables. No foot strike and speed interaction was observed for any of the kinetic variables. Habitual RFS yielded a greater loading rate of the vertical GRF, peak ankle dorsiflexor moment, peak knee extensor moment, peak knee eccentric extensor power, peak dorsiflexion and sagittal plane knee range of motion compared to imposed FFS. Imposed FFS yielded greater maximum vertical GRF, peak ankle plantarflexor moment, peak ankle eccentric plantarflexor power and sagittal plane ankle ROM compared to habitual RFS. Consistent with previous literature, imposed FFS in habitual RFS reduces eccentric knee extensor and ankle dorsiflexor involvement but produce greater eccentric ankle plantarflexor action compared to RFS. These acute differences between strike patterns were independent of running speeds equivalent to typical easy and hard training runs in competitive male runners. Current findings along with previous literature suggest differences in lower extremity kinetics between habitual RFS and imposed FFS running are consistent among a variety of runner populations.

Differences in muscle activity during hand-dexterity tasks between women with arthritis and a healthy reference group.

PubMed

Brorsson, Sofia; Nilsdotter, Anna; Thorstensson, Carina; Bremander, Ann

2014-05-15

Impaired hand function is common in patients with arthritis and it affects performance of daily activities; thus, hand exercises are recommended. There is little information on the extent to which the disease affects activation of the flexor and extensor muscles during these hand-dexterity tasks. The purpose of this study was to compare muscle activation during such tasks in subjects with arthritis and in a healthy reference group. Muscle activation was measured in m. extensor digitorium communis (EDC) and in m. flexor carpi radialis (FCR) with surface electromyography (EMG) in women with rheumatoid arthritis (RA, n = 20), hand osteoarthritis (HOA, n = 16) and in a healthy reference group (n = 20) during the performance of four daily activity tasks and four hand exercises. Maximal voluntary isometric contraction (MVIC) was measured to enable intermuscular comparisons, and muscle activation is presented as %MVIC. The arthritis group used a higher %MVIC than the reference group in both FCR and EDC when cutting with a pair of scissors, pulling up a zipper and-for the EDC-also when writing with a pen and using a key (p < 0.02). The exercise "rolling dough with flat hands" required the lowest %MVIC and may be less effective in improving muscle strength. Women with arthritis tend to use higher levels of muscle activation in daily tasks than healthy women, and wrist extensors and flexors appear to be equally affected. It is important that hand training programs reflect real-life situations and focus also on extensor strength.

Gait adaptations in patients with chronic posterior instability of the knee.

PubMed

Hooper, D M; Morrissey, M C; Crookenden, R; Ireland, J; Beacon, J P

2002-03-01

A retrospective analysis was performed to assess gait in individuals with a long history of posterior knee instability. Descriptive study. There are few studies in the literature concerning evaluation of the biomechanics of the knee in patients with knee posterior instability. Nine individuals with posterior knee instability and a matched control group of uninjured subjects were tested in regards to knee kinematics and kinetics while walking and ascending and descending stairs. The mean follow up time for the individuals with posterior instability was 11.1 years. Individual satisfaction with the knee was measured by having participants complete the Flandry (also known as Hughston Clinic) self-assessment questionnaire. It was found that patients with knee posterior instability who indicated a higher level of satisfaction on the Flandry score walked in a manner that demonstrated greater peak knee extensor torque during stance phase, while less satisfied patients with knee posterior instability demonstrated lower peak knee extensor torque. There was a significant correlation between the self-assessment score and the peak knee extensor torque during level walking (P=0.003). During stair ascent and descent, patients with posterior instability averaged lower knee extensor torque and power than the control subjects, but those differences were only statistically significant in power while descending stairs (P=0.048). Individuals with chronic knee posterior instability modify their gait, and the adaptation can be predicted based upon the individuals self-assessment of their knee using the Flandry questionnaire. These data suggest that gait retraining may be a valuable addition to the traditional muscle strengthening programs, which are commonly used during conservative management of knee posterior instability.

Customizing Extensor Reconstruction in Vascularized Toe Joint Transfers to Finger Proximal Interphalangeal Joints: A Strategic Approach for Correcting Extensor Lag.

PubMed

Loh, Charles Yuen Yung; Hsu, Chung-Chen; Lin, Cheng-Hung; Chen, Shih-Heng; Lien, Shwu-Huei; Lin, Chih-Hung; Wei, Fu-Chan; Lin, Yu-Te

2017-04-01

Vascularized toe proximal interphalangeal joint transfer allows the restoration of damaged joints. However, extensor lag and poor arc of motion have been reported. The authors present their outcomes of treatment according to a novel reconstructive algorithm that addresses extensor lag and allows for consistent results postoperatively. Vascularized toe joint transfers were performed in a consecutive series of 26 digits in 25 patients. The average age was 30.5 years, with 14 right and 12 left hands. Reconstructed digits included eight index, 10 middle, and eight ring fingers. Simultaneous extensor reconstructions were performed and eight were centralization of lateral bands, five were direct extensor digitorum longus-to-extensor digitorum communis repairs, and 13 were central slip reconstructions. The average length of follow-up was 16.7 months. The average extension lag was 17.9 degrees. The arc of motion was 57.7 degrees (81.7 percent functional use of pretransfer toe proximal interphalangeal joint arc of motion). There was no significant difference in the reconstructed proximal interphalangeal joint arc of motion for the handedness (p = 0.23), recipient digits (p = 0.37), or surgical experience in vascularized toe joint transfer (p = 0.25). The outcomes of different techniques of extensor mechanism reconstruction were similar in terms of extensor lag, arc of motion, and reconstructed finger arc of motion compared with the pretransfer toe proximal interphalangeal joint arc of motion. With this treatment algorithm, consistent outcomes can be produced with minimal extensor lag and maximum use of potential toe proximal interphalangeal joint arc of motion. Therapeutic, IV.

The influence of fat infiltration of back extensor muscles on osteoporotic vertebral fractures.

PubMed

So, Kwang-Young; Kim, Dae-Hee; Choi, Dong-Hyuk; Kim, Choong-Young; Kim, Jeong-Seok; Choi, Yong-Soo

2013-12-01

Retrospective study. To investigate the influence of fat infiltration at low back extensor muscles on osteoporotic vertebral fracture. In persons with stronger back muscles, the risk of osteoporotic vertebral fractures will likely be lower than in those persons with weaker back muscles. However, the degree of influence of fat infiltration of the back extensor muscle on osteoporotic vertebral fracture remains controversial. Two hundred and thirty-seven patients who had undergone lumbar spine magnetic resonance imaging and bone mineral density (BMD) were enrolled in this study. The amount of low back extensor muscle was determined using the pseudocoloring technique on an axial view of the L3 level. The patients were divided into two groups: osteoporotic vertebral fracture group (group A) and non-fracture group (group B). The amount of low back extensor muscle is compared with BMD, degenerative change of disc, osteophyte grade of facet joint and promontory angle to reveal the association between these factors. A negative correlation is found between age and the amount of low back extensor muscle (p=0.001). The amount of low back extensor muscle in group A and group B was 60.3%±14.5% and 64.2%±9.3% respectively, thus showing a significantly smaller amount of low back extensor muscle in the osteoporotic vertebral fracture group (p=0.015). Fat infiltration of low back extensor muscle was increased in osteoporotic vertebral fracture patients. Therefore, fat infiltration of low back extensor muscle in an elderly person may be a risk factor of osteoporotic vertebral fracture.

Physical and functional measures related to low back pain in individuals with lower-limb amputation: an exploratory pilot study.

PubMed

Friel, Karen; Domholdt, Elizabeth; Smith, Douglas G

2005-01-01

For this study, we compared the physical impairments and functional deficits of individuals with lower-limb amputation (LLA) for those with and without low back pain (LBP). Nineteen participants with LLA were placed into two groups based on visual analog scores of LBP. We assessed functional limitations, iliopsoas length, hamstring length, abdominal strength, back extensor strength, and back extensor endurance. Data analysis included correlations and t-tests. We found significant correlations between pain score and functional limitations, iliopsoas length, and back extensor endurance. We also detected significant differences in functional limitations, iliopsoas length, back extensor strength, and back extensor endurance between those with and without LBP. We saw significant differences in back extensor strength and back extensor endurance between those with transtibial and transfemoral amputations. Differences exist in physical measures of individuals with LLA with and without LBP. Clinicians should consider these impairments in individuals with amputation who experience LBP. Because of the participants' characteristics, these findings may be applicable to veterans with LLA.

Spinal mobility and trunk muscle strength in elite hockey players.

PubMed

Lindgren, S; Twomey, L

1988-01-01

Elite hockey players of both sexes from the Australian Institute of Sport were assessed for lumbar spine mobility, trunk flexion and back extensor muscle strength, hamstring flexibility and postural characteristics over a two year period. All the athletes were more mobile in rotation than the 'normal' West Australian population, and demonstrated flexible hamstrings and powerful back extensor muscles; trunk flexion was less strong initially, but improved after intervention in the form of a specific exercise programme, over the measurement period. A questionnaire disclosed that low back pain is a common complaint of hockey players, but rarely required intensive physical and medical treatment. The term 'hockey player's back' has been coined in recognition of the long flat thoracolumbar spine frequently noted in these subjects. Copyright © 1988 Australian Physiotherapy Association. Published by . All rights reserved.

Extensor Tendon Injuries and Repairs in the Hand

PubMed Central

Kontor, J. A.

1982-01-01

Due to their superficial course, the extensor tendons are frequently lacerated over the dorsum of the hand and fingers. Excellent functional results are obtained in repairs of simple tendon lacerations. ‘Open’ mallet lacerations over the distal IP joint or involving the central extensor slip over the proximal IP joint require more precise suturing methods. More proximal extensor tendon divisions near the wrist involve dissection of the retracted finger extensors or long thumb extensor in the distal forearm and more formal tendon repairs, including a possible tendon transfer to the thumb. ‘Closed injuries’, with varying degrees of extensor tendon disruption, occur at three main sites. The mallet injury at the DIP joint and the boutonnière deformity over the PIP joint are sometimes recognized late, but respond to conservative splinting for a minimum of four weeks with guarded motion avoiding secondary stiffening of the remaining small joints of the hand. Surgery of closed injuries most frequently involves the intra-articular traction fracture type of mallet deformities in which the DIP joint has taken the brunt of the injury. PMID:21286174

Extensor Mechanism Disruption after Total Knee Arthroplasty: A Case Series and Review of Literature.

PubMed

Vaishya, Raju; Agarwal, Amit Kumar; Vijay, Vipul

2016-02-04

Extensor mechanism disruption following total knee arthroplasty (TKA) is a rare but devastating complication. These patients may require revision of the implants, but even then, it may not be possible to restore the normal function of the knee after the disruption. The patterns of extensor mechanism disruption can broadly be classified into three types: suprapatellar (quadriceps tendon rupture), transpatellar (patellar fracture), or infrapatellar (patellar tendon rupture). Infrapatellar tendon ruptures are the worst injuries, as they carry maximum morbidity and are challenging to manage. The disruption of the extensor mechanism may occur either intra-operatively or in the immediate postoperative period due to an injury. The treatment of extensor mechanism complications after TKA may include either nonsurgical management or surgical intervention in the form of primary repair or reconstruction with autogenous, allogeneic, or synthetic substitutes. We have provided an algorithm for the management of extensor mechanism disruption after TKA.

Effect of Lumbar Progressive Resistance Exercise on Lumbar Muscular Strength and Core Muscular Endurance in Soldiers.

PubMed

Mayer, John M; Childs, John D; Neilson, Brett D; Chen, Henian; Koppenhaver, Shane L; Quillen, William S

2016-11-01

Low back pain is common, costly, and disabling for active duty military personnel and veterans. The evidence is unclear on which management approaches are most effective. The purpose of this study was to assess the effectiveness of lumbar extensor high-intensity progressive resistance exercise (HIPRE) training versus control on improving lumbar extension muscular strength and core muscular endurance in soldiers. A randomized controlled trial was conducted with active duty U.S. Army Soldiers (n = 582) in combat medic training at Fort Sam Houston, Texas. Soldiers were randomized by platoon to receive the experimental intervention (lumbar extensor HIPRE training, n = 298) or control intervention (core stabilization exercise training, n = 284) at one set, one time per week, for 11 weeks. Lumbar extension muscular strength and core muscular endurance were assessed before and after the intervention period. At 11-week follow-up, lumbar extension muscular strength was 9.7% greater (p = 0.001) for HIPRE compared with control. No improvements in core muscular endurance were observed for HIPRE or control. Lumbar extensor HIPRE training is effective to improve isometric lumbar extension muscular strength in U.S. Army Soldiers. Research is needed to explore the clinical relevance of these gains. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Relationships between explosive and maximal triple extensor muscle performance and vertical jump height.

PubMed

Chang, Eunwook; Norcross, Marc F; Johnson, Sam T; Kitagawa, Taichi; Hoffman, Mark

2015-02-01

The purpose of this study was to examine the relationships between maximum vertical jump height and (a) rate of torque development (RTD) calculated during 2 time intervals, 0-50 milliseconds (RTD50) and 0-200 milliseconds (RTD200) after torque onset and (b) peak torque (PT) for each of the triple extensor muscle groups. Thirty recreationally active individuals performed maximal isometric voluntary contractions (MVIC) of the hip, knee and ankle extensors, and a countermovement vertical jump. Rate of torque development was calculated from 0 to 50 (RTD50) and 0 to 200 (RTD200) milliseconds after the onset of joint torque. Peak torque was identified and defined as the maximum torque value during each MVIC trial. Greater vertical jump height was associated with greater knee and ankle extension RTD50, RTD200, and PT (p ≤ 0.05). However, hip extension RTD50, RTD200, and PT were not significantly related to maximal vertical jump height (p > 0.05). The results indicate that 47.6 and 32.5% of the variability in vertical jump height was explained by knee and ankle extensor RTD50, respectively. Knee and ankle extensor RTD50 also seemed to be more closely related to vertical jump performance than RTD200 (knee extensor: 28.1% and ankle extensor: 28.1%) and PT (knee extensor: 31.4% and ankle extensor: 13.7%). Overall, these results suggest that training specifically targeted to improve knee and ankle extension RTD, especially during the early phases of muscle contraction, may be effective for increasing maximal vertical jump performance.

The Elbow-EpiTrainer: a method of delivering graded resistance to the extensor carpi radialis brevis. Effectiveness of a prototype device in a healthy population.

PubMed

Navsaria, Rishi; Ryder, Dionne M; Lewis, Jeremy S; Alexander, Caroline M

2015-03-01

Tennis elbow or lateral epicondylopathy (LE) is experienced as the lateral elbow has a reported prevalence of 1.3%, with symptoms lasting up to 18 months. LE is most commonly attributed to tendinopathy involving the extensor carpi radialis brevis (ECRB) tendon. The aim of tendinopathy management is to alleviate symptoms and restore function that initially involves relative rest followed by progressive therapeutic exercise. To assess the effectiveness of two prototype exercises using commonly available clinical equipment to progressively increase resistance and activity of the ECRB. Eighteen healthy participants undertook two exercise progressions. Surface electromyography was used to record ECRB activity during the two progressions, involving eccentric exercises of the wrist extensors and elbow pronation exercises using a prototype device. The two progressions were assessed for their linearity of progression using repeated ANOVA and linear regression analysis. Five participants repeated the study to assess reliability. The exercise progressions led to an increase in ECRB electromyographic (EMG) activity (p<0.001). A select progression of exercises combining the two protocols increased EMG activity in a linear fashion (p<0.001). The ICC values indicated good reliability (ICC>0.7) between the first and second tests for five participants. Manipulation of resistance and leverage with the prototype exercises was effective in creating significant increases of ECRB normalised EMG activity in a linear manner that may, with future research, become useful to clinicians treating LE. In addition, between trial reliability for the device to generate a consistent load was acceptable. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Embryonic development of the innervation of the locust extensor tibiae muscle by identified neurons: formation and elimination of inappropriate axon branches.

PubMed

Myers, C M; Whitington, P M; Ball, E E

1990-01-01

Intracellular dye fills have been used to reveal the pattern of embryonic growth of each of the four neurons which innervate the extensor tibiae muscle (ETi) of the hind leg of the locust. The growth cone of the slow extensor tibiae motoneuron (SETi), the first of the four neurons to leave the central nervous system, pioneers nerve 3 (N3). The fast extensor motoneuron (FETi), the next neuron to grow out, follows earlier outgrowing motoneurons into the periphery in nerve 5 (N5) and then rejoins SETi in N3. As it transfers from N5 to N3, it is transiently dye-coupled to the Tr1 pioneer neuron which spans the gap between the two nerves. It then follows SETi onto the ETi muscle in the femur. The common inhibitory neuron and the dorsal unpaired median neuron (DUMETi) follow SETi and FETi in nerves 3B2 and 5B1, respectively. SETi's growth cone requires almost twice as long to reach ETi as those of the three later motoneurons, all of which follow preexisting neural pathways. At least three of the four developing motoneurons form one or more axon branches not found in the adult. These branches may occur (1) at segmental boundaries; (2) where the nerve, which the growth cone is following, itself branches or the growth cone encounters another nerve; or (3) when the axon continues to grow beyond its target muscle. These findings contrast with the apparent absence of inappropriate axon branches in another developing locust neuromuscular system and during the innervation of zebrafish myotomes, but resemble in some ways the transient production of inappropriate axonal branches reported for embryonic leech motoneurons.

Variability in common synaptic input to motor neurons modulates both force steadiness and pegboard time in young and older adults.

PubMed

Feeney, Daniel F; Mani, Diba; Enoka, Roger M

2018-06-07

We investigated the associations between grooved pegboard times, force steadiness (coefficient of variation for force), and variability in an estimate of the common synaptic input to motor neurons innervating the wrist extensor muscles during steady contractions performed by young and older adults. The discharge times of motor units were derived from recordings obtained with high-density surface electrodes while participants performed steady isometric contractions at 10% and 20% of maximal voluntary contraction (MVC) force. The steady contractions were performed with a pinch grip and wrist extension, both independently (single action) and concurrently (double action). The variance in common synaptic input to motor neurons was estimated with a state-space model of the latent common input dynamics. There was a statistically significant association between the coefficient of variation for force during the steady contractions and the estimated variance in common synaptic input in young (r 2 = 0.31) and older (r 2 = 0.39) adults, but not between either the mean or the coefficient of variation for interspike interval of single motor units with the coefficient of variation for force. Moreover, the estimated variance in common synaptic input during the double-action task with the wrist extensors at the 20% target was significantly associated with grooved pegboard time (r 2 = 0.47) for older adults, but not young adults. These findings indicate that longer pegboard times of older adults were associated with worse force steadiness and greater fluctuations in the estimated common synaptic input to motor neurons during steady contractions. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Muscular control of a learned movement: the speed control system hypothesis.

PubMed

Enoka, R M

1983-01-01

The "speed control system" hypothesis, which represents an attempt to identify an invariant characteristic of learned movements, postulates that movements of variable extent are controlled by regulating the intensity of muscle contractions such that the contraction duration remains constant. The contingency set originally utilized to develop this hypothesis was expanded by examining a movement that was multidirectional and multiarticular, and executed by large muscle groups generating near maximum torques. The investigation focused on the techniques utilized by weightlifters to control lower extremity displacement during the initial phase of the double knee bend execution of the "clean" in Olympic weightlifting. The combination of the quantified muscle activity and the angular velocity, both about the knee joint, revealed a sequence of shortening-lengthening muscle contractions throughout the movement. The first two periods of net muscular activity, one extensor and the other flexor, were utilized to examine the movement for invariant characteristics. As predicted by the speed control system hypothesis, the duration of the first period of net muscle torque activity (extensor) did not vary significantly, for either group of subjects, over the relative loads examined. The duration of the second period of activity (resultant flexor muscle torque), however, was not constant across loads, and further, the direction of the change depended upon the level of expertise. The more capable lifters tended to increase the duration of the resultant flexor involvement while the less skilled athletes utilized the reverse strategy when the load was increased. Conversely, the intensity of the muscle activity for both groups of subjects and both the extensor and flexor periods covaried with load, as predicted by the hypothesis. The speed control system hypothesis, therefore, provided an appropriate explanation for the first component of the movement, the period of extensor dominated (shortening contraction) muscle torque, but was inappropriate for the subsequent interval, a resultant flexor (largely lengthening contraction) muscle torque.

Strength deficits identified with concentric action of the hip extensors and eccentric action of the hamstrings predispose to hamstring injury in elite sprinters.

PubMed

Sugiura, Yusaku; Saito, Tomoyuki; Sakuraba, Keishoku; Sakuma, Kazuhiko; Suzuki, Eiichi

2008-08-01

Prospective cohort study. In this prospective cohort study of elite sprinters, muscle strength of the hip extensors, as well as of the knee extensors and flexors, was measured to determine a possible relationship between strength deficits and subsequent hamstring injury within 12 months of testing. The method used for testing muscle strength simulated the specific muscle action during late swing and early contact phases when sprinting. There have been no prospective studies in elite sprinters that examine the concentric and eccentric isokinetic strength of the hip extensors and the quadriceps and hamstring muscles in a manner that reflects their actions in late swing or early contact phases of sprinting. Consequently, the causal relationship between hip and thigh muscle strength and hamstring injury in elite sprinters may not be fully understood. Isokinetic testing was performed on 30 male elite sprinters to assess hip extensors, quadriceps, and hamstring muscle strength. The occurrence of hamstring injury among the subjects was determined during the year following the muscle strength measurements. The strength of the hip extensors, quadriceps, and hamstring muscles, as well as the hamstrings-quadriceps and hip extensors- quadriceps ratios were compared. Hamstring injury occurred in 6 subjects during the 1-year period. Isokinetic testing at a speed of 60 degrees /s revealed weakness of the injured limb with eccentric action of the hamstring muscles and during concentric action of the hip extensors. When performing a side-to-side comparison for the injured sprinters, the hamstring injury always occurred on the weaker side. Differences in the hamstrings-quadriceps and hip extensors-quadriceps strength ratios were also evident between uninjured and injured limbs, and this was attributable to deficits in hamstring strength. Hamstring injury in elite sprinters was associated with weakness during eccentric action of the hamstrings and weakness during concentric action of the hip extensors, but only when tested at the slower speed of 60 degrees /s.

Knee extension range of motion and self-report physical function in total knee arthroplasty: mediating effects of knee extensor strength

PubMed Central

2013-01-01

Background Knee extensor strength and knee extension range of motion (ROM) are important predictors of physical function in patients with a total knee arthroplasty (TKA). However, the relationship between the two knee measures remains unclear. The purpose of this study was to examine whether changes in knee extensor strength mediate the association between changes in knee extension ROM and self-report physical function. Methods Data from 441 patients with a TKA were collected preoperatively and 6 months postoperatively. Self-report measure of physical function was assessed by the Short Form 36 (SF-36) questionnaire. Knee extensor strength was measured by handheld dynamometry and knee extension ROM by goniometry. A bootstrapped cross product of coefficients approach was used to evaluate mediation effects. Results Mediation analyses, adjusted for clinicodemographic measures, revealed that the association between changes in knee extension ROM and SF-36 physical function was mediated by changes in knee extensor strength. Conclusions In patients with TKA, knee extensor strength mediated the influence of knee extension ROM on physical function. These results suggest that interventions to improve the range of knee extension may be useful in improving knee extensor performance. PMID:23332039

Sagittal-Plane Knee Moment During Gait and Knee Cartilage Thickness.

PubMed

Schmitz, Randy J; Harrison, David; Wang, Hsin-Min; Shultz, Sandra J

2017-06-02

  Understanding the factors associated with thicker cartilage in a healthy population is important when developing strategies aimed at minimizing the cartilage thinning associated with knee osteoarthritis progression. Thicker articular cartilage is commonly thought to be healthier cartilage, but whether the sagittal-plane biomechanics important to gait are related to cartilage thickness is unknown.   To determine the relationship of a weight-bearing region of the medial femoral condyle's cartilage thickness to sagittal gait biomechanics in healthy individuals.   Descriptive laboratory study.   Laboratory.   Twenty-eight healthy participants (15 women: age = 21.1 ± 2.1 years, height = 1.63 ± 0.07 m, weight = 64.6 ± 9.9 kg; 13 men: age = 22.1 ± 2.9 years, height = 1.79 ± 0.05 m, weight = 75.2 ± 9.6 kg).   Tibiofemoral angle (°) was obtained via goniometric assessment, thickness of the medial femoral condyle cartilage (mm) was obtained via ultrasound imaging, and peak internal knee-extensor moment (% body weight · height) was measured during 10 trials of over-ground walking at a self-selected pace. We used linear regression to examine the extent to which peak internal knee-extensor moment predicted cartilage thickness after accounting for tibiofemoral angle and sex.   Sex and tibiofemoral angle (12.3° ± 3.2°) were entered in the initial step as control factors (R 2 = 0.01, P = .872). In the final step, internal knee-extensor moment (1.5% ± 1.3% body weight · height) was entered, which resulted in greater knee-extensor moment being related to greater cartilage thickness (2.0 ± 0.3 mm; R 2 Δ = 0.31, PΔ = .003).   Individuals who walked with a greater peak internal knee-extensor moment during gait had a cartilage structure that is generally considered beneficial in a healthy population. Our study offers promising findings that a potentially modifiable biomechanical factor is associated with cartilage status in a healthy population. Establishing these baseline relationships in uninjured populations may help us to better understand potential factors related to maladaptive gait patterns that predispose a person to adverse changes in the cartilage environment.

Effects of Postmortem Freezing on Passive Properties of Rabbit Extensor Digtorum Longus Muscle Tendon Complex

DTIC Science & Technology

1993-06-14

AD-A266 429 INSTITUTE REPORT NO. 483 Effects of Postmortem Freezing on Passive Properties of Rabbit Extensor Digtorum Longus Muscle Tendon Complex D...Extensor Digtorum Longus Muscle Tendon Complex -- Paul H. Leitschuh, Tammy J. Doherty, Dean C. Taylor, Daniel E. Brooks, John B. Ryan This document has...ABSTRACT The tensile properties of the extensor digitorum longus muscle tendon unit (EDL MTU) were studied in 16 white male New Zealand rabbits in both

Soreness-related changes in three-dimensional running biomechanics following eccentric knee extensor exercise.

PubMed

Paquette, Max R; Peel, Shelby A; Schilling, Brian K; Melcher, Dan A; Bloomer, Richard J

2017-06-01

Runners often experience delayed onset muscle soreness (DOMS), especially of the knee extensors, following prolonged running. Sagittal knee joint biomechanics are altered in the presence of knee extensor DOMS but it is unclear how muscle soreness affects lower limb biomechanics in other planes of motion. The purpose of this study was to assess the effects of knee extensor DOMS on three-dimensional (3D) lower limb biomechanics during running. Thirty-three healthy men (25.8 ± 6.8 years; 84.1 ± 9.2 kg; 1.77 ± 0.07 m) completed an isolated eccentric knee extensor damaging protocol to elicit DOMS. Biomechanics of over-ground running at a set speed of 3.35 m s -1 ±5% were measured before eccentric exercise (baseline) and, 24 h and 48 h following exercise in the presence of knee extensor DOMS. Knee flexion ROM was reduced at 48 h (P = 0.01; d = 0.26), and peak knee extensor moment was reduced at 24 h (P = 0.001; d = 0.49) and 48 h (P < 0.001; d = 0.68) compared to baseline. Frontal and transverse plane biomechanics were unaffected by the presence of DOMS (P > 0.05). Peak positive ankle and knee joint powers and, peak negative knee joint power were all reduced from baseline to 24 h and 48 h (P < 0.05). These findings suggest that knee extensor DOMS greatly influences sagittal knee joint angular kinetics and, reduces sagittal power production at the ankle joint. However, knee extensor DOMS does not affect frontal and transverse plane lower limb joint biomechanics during running.

Impact of Fat Infiltration in Cervical Extensor Muscles on Cervical Lordosis and Neck Pain: A Cross-Sectional Study.

PubMed

Kim, Choong-Young; Lee, Sang-Min; Lim, Seong-An; Choi, Yong-Soo

2018-06-01

Weakness of cervical extensor muscles causes loss of cervical lordosis, which could also cause neck pain. The aim of this study was to investigate the impact of fat infiltration in cervical extensor muscles on cervical lordosis and neck pain. Fifty-six patients who suffered from neck pain were included in this study. Fat infiltration in cervical extensor muscles was measured at each level of C2-3 and C6-7 using axial magnetic resonance imaging. The visual analogue scale (VAS), 12-Item Short Form Health Survey (SF-12), and Neck Disability Index (NDI) were used for clinical assessment. The mean fat infiltration was 206.3 mm 2 (20.3%) at C2-3 and 240.6 mm 2 (19.5%) at C6-7. Fat infiltration in cervical extensor muscles was associated with high VAS scores at both levels ( p = 0.047 at C2-3; p = 0.009 at C6-7). At C2-3, there was a negative correlation between fat infiltration of the cervical extensor muscles and cervical lordosis (r = -0.216; p = 0.020). At C6-7, fat infiltration in the cervical extensor muscles was closely related to NDI ( p = 0.003) and SF-12 ( p > 0.05). However, there was no significant correlation between cervical lordosis and clinical outcomes (VAS, p = 0.112; NDI, p = 0.087; and SF-12, p > 0.05). These results suggest that fat infiltration in the upper cervical extensor muscles has relevance to the loss of cervical lordosis, whereas fat infiltration in the lower cervical extensor muscles is associated with cervical functional disability.

Tendon injuries of the hand

PubMed Central

Schöffl, Volker; Heid, Andreas; Küpper, Thomas

2012-01-01

Tendon injuries are the second most common injuries of the hand and therefore an important topic in trauma and orthopedic patients. Most injuries are open injuries to the flexor or extensor tendons, but less frequent injuries, e.g., damage to the functional system tendon sheath and pulley or dull avulsions, also need to be considered. After clinical examination, ultrasound and magnetic resonance imaging have proved to be important diagnostic tools. Tendon injuries mostly require surgical repair, dull avulsions of the distal phalanges extensor tendon can receive conservative therapy. Injuries of the flexor tendon sheath or single pulley injuries are treated conservatively and multiple pulley injuries receive surgical repair. In the postoperative course of flexor tendon injuries, the principle of early passive movement is important to trigger an “intrinsic” tendon healing to guarantee a good outcome. Many substances were evaluated to see if they improved tendon healing; however, little evidence was found. Nevertheless, hyaluronic acid may improve intrinsic tendon healing. PMID:22720265

Effect of 7-days dry immersion in combination with mechanical stimulation of foot support zones upon resistance to fatigue of knee extensors and flexors

NASA Astrophysics Data System (ADS)

Netreba, A. I.; Khusnutdiniva, D. R.; Vinogradova, O. L.; Kozlovskaya, I. B.

2005-08-01

The aim of investigation was to reveal the effect of supportlessness in combination with artificial stimulation of foot support zones on fatigue resistance of knee extensors and flexors in static and rhythmic tests. 10 volunteers were exposed to 7 days dry immersion (DI). 4 of them were subjected to mechanical stimulation of foot support zones. 7-day DI did not evoke any changes in fatigue resistance during rhythmic contractions of knee extensors and flexors in both groups. Static test revealed significant decrease of fatigue resistance of both knee flexors and extensors. In the group with stimulation of support zones unfavorable effects of immersion were minimized for knee extensors but not for flexors. Thus support withdrawal is associated with a decrease of fatigue resistance for both knee flexors and extensors only under conditions of static tension. Artificial stimulation of support zones of the foot selectively affects the posture muscles.

The variation of the strength of neck extensor muscles and semispinalis capitis muscle size with head and neck position.

PubMed

Rezasoltani, A; Nasiri, R; Faizei, A M; Zaafari, G; Mirshahvelayati, A S; Bakhshidarabad, L

2013-04-01

Semispinalis capitis muscle (SECM) is a massive and long cervico-thoracic muscle which functions as a main head and neck extensor muscle. The aim of this study was to detect the effect of head and neck positions on the strength of neck extensor muscles and size of SECM in healthy subjects. Thirty healthy women students voluntarily participated in this study. An ultrasonography apparatus (Hitachi EUB 525) and a system of tension-meter were used to scan the right SECM at the level of third cervical spine and to measure the strength of neck extensor muscles at three head and neck positions. Neck extensor muscles were stronger in neutral than flexion or than extension positions while the size of SECM was larger in extension than neutral or than flexion position. The force generation capacity of the main neck extensor muscle was lower at two head and neck flexion and extension positions than neutral position. Copyright © 2012 Elsevier Ltd. All rights reserved.

Correlation of the Y-Balance Test with Lower-limb Strength of Adult Women

PubMed Central

Lee, Dong-Kyu; Kim, Gyoung-Mo; Ha, Sung-Min; Oh, Jae-Seop

2014-01-01

[Purpose] The purpose of this study was to elucidate the relationship between Y-balance test (YBT) distance and the lower-limb strength of adult women. [Subjects] Forty women aged 45 to 80 years volunteered for this study. [Methods] The participants were tested for maximal muscle strength of the lower limbs (hip extensors, hip flexors, hip abductors, knee extensors, knee flexors, and ankle dorsiflexors) and YBT distances in the anterior, posteromedial, and posterolateral directions. Pearson’s correlation coefficient was used to quantify the linear relationships between YBT distances and lower-limb strength. [Results] Hip extensor and knee flexor strength were positively correlated with YBT anterior distance. Hip extensor, hip abductor, and knee flexor strength were positively correlated with the YBT posteromedial distance. Hip extensor and knee flexor strength were positively correlated with YBT posterolateral distance. [Conclusion] There was a weak correlation between lower-limb strength (hip extensors, hip abductors, and knee flexors) and dynamic postural control as measured by the YBT. PMID:24926122

Infantile spasms.

PubMed

Hrachovy, Richard A; Frost, James D

2013-01-01

Infantile spasms are a unique disorder of infancy and early childhood. The average age at onset of infantile spasms is 6 months and the average incidence of the disorder is approximately 0.31 per 1000 live births. Approximately one-quarter of patients will spontaneously stop having spasms within 1 year of onset. There are three main types of epileptic spasms: flexor, extensor, and mixed flexor-extensor. Spasms frequently occur in clusters and commonly occur upon arousal from sleep. The motor spasms are frequently confused with other normal and abnormal infant behaviors. Typically, the interictal EEG reveals hypsarrhythmia or one of its variants. A variety of ictal EEG patterns may be seen, the most common of which is a generalized slow-wave transient followed by an attenuation of the background activity in all regions. The primary treatment objective is to improve the EEG and stop the spasms as soon as possible and to avoid prolonged treatment durations with any form of therapy. Currently, there is no conclusive evidence that medical or surgical treatment of infantile spasms significantly alters long-term outcome. Although the pathophysiological mechanism underlying infantile spasms is unknown, several animal models of infantile spasms have been developed in recent years. Copyright © 2013 Elsevier B.V. All rights reserved.

Function and structure of the deep cervical extensor muscles in patients with neck pain.

PubMed

Schomacher, Jochen; Falla, Deborah

2013-10-01

The deep cervical extensors are anatomically able to control segmental movements of the cervical spine in concert with the deep cervical flexors. Several investigations have confirmed changes in cervical flexor muscle control in patients with neck pain and as a result, effective evidence-based therapeutic exercises have been developed to address such dysfunctions. However, knowledge on how the deep extensor muscles behave in patients with neck pain disorders is scare. Structural changes such as higher concentration of fat within the muscle, variable cross-sectional area and higher proportions of type II fibres have been observed in the deep cervical extensors of patients with neck pain compared to healthy controls. These findings suggest that the behaviour of the deep extensors may be altered in patients with neck pain. Consistent with this hypothesis, a recent series of studies confirm that patients display reduced activation of the deep cervical extensors as well as less defined activation patterns. This article provides an overview of the various different structural and functional changes in the deep neck extensor muscles documented in patients with neck pain. Relevant recommendations for the management of muscle dysfunction in patients with neck pain are presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

MR imaging of patients with lateral epicondylitis of the elbow: is the common extensor tendon an isolated lesion?

PubMed

Qi, Liang; Zhu, Zheng-Feng; Li, Feng; Wang, Ren-Fa

2013-01-01

To investigate whether an injury of the common extensor tendon (CET) is associated with other abnormalities in the elbow joint and find the potential relationships between these imaging features by using a high-resolution magnetic resonance imaging (MRI). Twenty-three patients were examined with 3.0 T MR. Two reviewers were recruited for MR images evaluation. Image features were recorded in terms of (1) the injury degree of CET; (2) associated injuries in the elbow joint. Spearman's rank correlation analysis was performed to analyze the relationships between the injury degree of CET and associated abnormalities of the elbow joint, correlations were considered significant at p<0.05. Total 24 elbows in 23 patients were included. Various degrees of injuries were found in total 24 CETs (10 mild, 7 moderate and 7 severe). Associated abnormalities were detected in accompaniments of the elbow joints including ligaments, tendons, saccussynovialis and muscles. A significantly positive correlation (r = 0.877,p<0.01) was found in injuries of CET and lateral ulnar collateral ligament (LUCL). Injury of the CET is not an isolated lesion for lateral picondylitis, which is mostly accompanied with other abnormalities, of which the LUCL injury is the most commonly seen in lateral epicondylitis, and there is a positive correlation between the injury degree in CET and LUCL.

Computer simulations of neural mechanisms explaining upper and lower limb excitatory neural coupling

PubMed Central

2010-01-01

Background When humans perform rhythmic upper and lower limb locomotor-like movements, there is an excitatory effect of upper limb exertion on lower limb muscle recruitment. To investigate potential neural mechanisms for this behavioral observation, we developed computer simulations modeling interlimb neural pathways among central pattern generators. We hypothesized that enhancement of muscle recruitment from interlimb spinal mechanisms was not sufficient to explain muscle enhancement levels observed in experimental data. Methods We used Matsuoka oscillators for the central pattern generators (CPG) and determined parameters that enhanced amplitudes of rhythmic steady state bursts. Potential mechanisms for output enhancement were excitatory and inhibitory sensory feedback gains, excitatory and inhibitory interlimb coupling gains, and coupling geometry. We first simulated the simplest case, a single CPG, and then expanded the model to have two CPGs and lastly four CPGs. In the two and four CPG models, the lower limb CPGs did not receive supraspinal input such that the only mechanisms available for enhancing output were interlimb coupling gains and sensory feedback gains. Results In a two-CPG model with inhibitory sensory feedback gains, only excitatory gains of ipsilateral flexor-extensor/extensor-flexor coupling produced reciprocal upper-lower limb bursts and enhanced output up to 26%. In a two-CPG model with excitatory sensory feedback gains, excitatory gains of contralateral flexor-flexor/extensor-extensor coupling produced reciprocal upper-lower limb bursts and enhanced output up to 100%. However, within a given excitatory sensory feedback gain, enhancement due to excitatory interlimb gains could only reach levels up to 20%. Interconnecting four CPGs to have ipsilateral flexor-extensor/extensor-flexor coupling, contralateral flexor-flexor/extensor-extensor coupling, and bilateral flexor-extensor/extensor-flexor coupling could enhance motor output up to 32%. Enhancement observed in experimental data exceeded 32%. Enhancement within this symmetrical four-CPG neural architecture was more sensitive to relatively small interlimb coupling gains. Excitatory sensory feedback gains could produce greater output amplitudes, but larger gains were required for entrainment compared to inhibitory sensory feedback gains. Conclusions Based on these simulations, symmetrical interlimb coupling can account for much, but not all of the excitatory neural coupling between upper and lower limbs during rhythmic locomotor-like movements. PMID:21143960

Validity and test–retest reliability of a novel simple back extensor muscle strength test

PubMed Central

Harding, Amy T; Weeks, Benjamin Kurt; Horan, Sean A; Little, Andrew; Watson, Steven L; Beck, Belinda Ruth

2017-01-01

Objectives: To develop and determine convergent validity and reliability of a simple and inexpensive clinical test to quantify back extensor muscle strength. Methods: Two testing sessions were conducted, 7 days apart. Each session involved three trials of standing maximal isometric back extensor muscle strength using both the novel test and isokinetic dynamometry. Lumbar spine bone mineral density was examined by dual-energy X-ray absorptiometry. Validation was examined with Pearson correlations (r). Test–retest reliability was examined with intraclass correlation coefficients and limits of agreement. Pearson correlations and intraclass correlation coefficients are presented with corresponding 95% confidence intervals. Linear regression was used to examine the ability of peak back extensor muscle strength to predict indices of lumbar spine bone mineral density and strength. Results: A total of 52 healthy adults (26 men, 26 women) aged 46.4 ± 20.4 years were recruited from the community. A strong positive relationship was observed between peak back extensor strength from hand-held and isokinetic dynamometry (r = 0.824, p < 0.001). For the novel back extensor strength test, short- and long-term reliability was excellent (intraclass correlation coefficient = 0.983 (95% confidence interval, 0.971–0.990), p < 0.001 and intraclass correlation coefficient = 0.901 (95% confidence interval, 0.833–0.943), p < 0.001, respectively). Limits of agreement for short-term repeated back extensor strength measures with the novel back extensor strength protocol were −6.63 to 7.70 kg, with a mean bias of +0.71 kg. Back extensor strength predicted 11% of variance in lumbar spine bone mineral density (p < 0.05) and 9% of lumbar spine index of bone structural strength (p < 0.05). Conclusion: Our novel hand-held dynamometer method to determine back extensor muscle strength is quick, relatively inexpensive, and reliable; demonstrates initial convergent validity in a healthy population; and is associated with bone mass at a clinically important site. PMID:28255442

Ultrasound definition of tendon damage in patients with rheumatoid arthritis. Results of a OMERACT consensus-based ultrasound score focussing on the diagnostic reliability.

PubMed

Bruyn, George A W; Hanova, Petra; Iagnocco, Annamaria; d'Agostino, Maria-Antonietta; Möller, Ingrid; Terslev, Lene; Backhaus, Marina; Balint, Peter V; Filippucci, Emilio; Baudoin, Paul; van Vugt, Richard; Pineda, Carlos; Wakefield, Richard; Garrido, Jesus; Pecha, Ondrej; Naredo, Esperanza

2014-11-01

To develop the first ultrasound scoring system of tendon damage in rheumatoid arthritis (RA) and assess its intraobserver and interobserver reliability. We conducted a Delphi study on ultrasound-defined tendon damage and ultrasound scoring system of tendon damage in RA among 35 international rheumatologists with experience in musculoskeletal ultrasound. Twelve patients with RA were included and assessed twice by 12 rheumatologists-sonographers. Ultrasound examination for tendon damage in B mode of five wrist extensor compartments (extensor carpi radialis brevis and longus; extensor pollicis longus; extensor digitorum communis; extensor digiti minimi; extensor carpi ulnaris) and one ankle tendon (tibialis posterior) was performed blindly, independently and bilaterally in each patient. Intraobserver and interobserver reliability were calculated by κ coefficients. A three-grade semiquantitative scoring system was agreed for scoring tendon damage in B mode. The mean intraobserver reliability for tendon damage scoring was excellent (κ value 0.91). The mean interobserver reliability assessment showed good κ values (κ value 0.75). The most reliable were the extensor digiti minimi, the extensor carpi ulnaris, and the tibialis posterior tendons. An ultrasound reference image atlas of tenosynovitis and tendon damage was also developed. Ultrasound is a reproducible tool for evaluating tendon damage in RA. This study strongly supports a new reliable ultrasound scoring system for tendon damage. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Pedicled unipolar latissimus dorsi flap for reconstruction of finger extensor *

PubMed Central

Takahashi, Mitsuhiko; Kasai, Tokio; Hibino, Naohito; Ishii, Seiji; Mitsuhashi, Tadashi

2017-01-01

Abstract We describe the use of a pedicled unipolar latissimus dorsi flap to restore finger extension. The patient had large defects in the radial nerve and extensor musculature. A long-tailed, 50-cm-long flap was prepared, which enabled the end of the flap to be sutured to the extensor digitorum. PMID:28470032

The Effects of High-Intensity versus Low-Intensity Resistance Training on Leg Extensor Power and Recovery of Knee Function after ACL-Reconstruction

PubMed Central

Aue Sobol, Nanna; Andersen, Lars L.; Kiel, Peter; Løfholm, Peter; Magnusson, S. Peter; Krogsgaard, Michael R.

2014-01-01

Objective. Persistent weakness is a common problem after anterior cruciate ligament- (ACL-) reconstruction. This study investigated the effects of high-intensity (HRT) versus low-intensity (LRT) resistance training on leg extensor power and recovery of knee function after ACL-reconstruction. Methods. 31 males and 19 females were randomized to HRT (n = 24) or LRT (n = 26) from week 8–20 after ACL-reconstruction. Leg extensor power, joint laxity, and self-reported knee function were measured before and 7, 14, and 20 weeks after surgery. Hop tests were assessed before and after 20 weeks. Results. Power in the injured leg was 90% (95% CI 86–94%) of the noninjured leg, decreasing to 64% (95% CI 60–69%) 7 weeks after surgery. During the resistance training phase there was a significant group by time interaction for power (P = 0.020). Power was regained more with HRT compared to LRT at week 14 (84% versus 73% of noninjured leg, resp.; P = 0.027) and at week 20 (98% versus 83% of noninjured leg, resp.; P = 0.006) without adverse effects on joint laxity. No other between-group differences were found. Conclusion. High-intensity resistance training during rehabilitation after ACL-reconstruction can improve muscle power without adverse effects on joint laxity. PMID:24877078

Comparison of joint kinetics during free weight and flywheel resistance exercise.

PubMed

Chiu, Loren Z F; Salem, George J

2006-08-01

The most common modality for resistance exercise is free weight resistance. Alternative methods of providing external resistance have been investigated, in particular for use in microgravity environments such as space flight. One alternative modality is flywheel inertial resistance, which generates resistance as a function of the mass, distribution of mass, and angular acceleration of the flywheel. The purpose of this investigation was to characterize net joint kinetics of multijoint exercises performed with a flywheel inertial resistance device in comparison to free weights. Eleven trained men and women performed the front squat, lunge, and push press on separate days with free weight or flywheel resistance, while instrumented for biomechanical analysis. Front squats performed with flywheel resistance required greater contribution of the hip and ankle, and less contribution of the knee, compared to free weight. Push presses performed with flywheel resistance had similar impulse requirements at the knee compared to free weight, but greater impulse requirement at the hip and ankle. As used in this investigation, flywheel inertial resistance increases the demand on the hip extensors and ankle plantarflexors and decreases the mechanical demand on the knee extensors for lower extremity exercises such as the front squat and lunge. Exercises involving dynamic lower and upper extremity actions, such as the push press, may benefit from flywheel inertial resistance, due to the increased mechanical demand on the knee extensors.

Effects of strength training program on hip extensors and knee extensors strength of lower limb in children with spastic diplegic cerebral palsy.

PubMed

Aye, Thanda; Thein, Soe; Hlaing, Thaingi

2016-01-01

[Purpose] The purpose of this study was to determine whether strength training programs for hip extensors and knee extensors improve gross motor function of children with cerebral palsy in Myanmar. [Subjects and Methods] Forty children (25 boys and 15 girls, mean age: 6.07 ± 2.74 years) from National Rehabilitation Hospital, Yangon, Myanmar, who had been diagnosed with spastic diplegic cerebral palsy, Gross Motor Classification System I and II participated in a 6-week strength training program (45 minutes per day, 3 days per week) on hip and knee extensors. Assessment was made, before and after intervention, of the amount of training weight in pounds, as well as Gross Motor Function Measure (GMFM) dimensions D (standing) and E (walking, running, jumping). [Results] All scores had increased significantly after the strength-training program. [Conclusion] A simple method of strength-training program for hip and knee extensors might lead to improved muscle strength and gross motor function in children with spastic diplegic cerebral palsy.

Effects of strength training program on hip extensors and knee extensors strength of lower limb in children with spastic diplegic cerebral palsy

PubMed Central

Aye, Thanda; Thein, Soe; Hlaing, Thaingi

2016-01-01

[Purpose] The purpose of this study was to determine whether strength training programs for hip extensors and knee extensors improve gross motor function of children with cerebral palsy in Myanmar. [Subjects and Methods] Forty children (25 boys and 15 girls, mean age: 6.07 ± 2.74 years) from National Rehabilitation Hospital, Yangon, Myanmar, who had been diagnosed with spastic diplegic cerebral palsy, Gross Motor Classification System I and II participated in a 6-week strength training program (45 minutes per day, 3 days per week) on hip and knee extensors. Assessment was made, before and after intervention, of the amount of training weight in pounds, as well as Gross Motor Function Measure (GMFM) dimensions D (standing) and E (walking, running, jumping). [Results] All scores had increased significantly after the strength-training program. [Conclusion] A simple method of strength-training program for hip and knee extensors might lead to improved muscle strength and gross motor function in children with spastic diplegic cerebral palsy. PMID:27065561

Ultrasonographic diagnostics of pain in the lateral cubital compartment and proximal forearm

PubMed Central

Nowicki, Paweł

2012-01-01

Pain in the lateral compartment of the elbow joint and decreased strength of the extensor muscle constitute a fairly common clinical problem. These symptoms, occurring in such movements as inverting and converting the forearm, pushing, lifting and pulling, mostly affect people who carry out daily activities with an intense use of wrist, e.g. work on computer. Strains in this area often result from persistent overload and degeneration processes of the common extensor tendon and the radial collateral ligament. Similar symptoms resulting from the compression of deep branch of the radial nerve in radial nerve tunnel should be remembered as well. It happens that both conditions occur simultaneously. A proper diagnosis is essential in undertaking an effective treatment. Ultrasonography is a non-invasive method and the application of high-end apparatus with heads of frequencies exceeding 12 MHz allows for a precise evaluation of joint structures, tendons and nerves. In case of the so-called tennis elbow, the examination allows for evaluation of the degree and extent of injury to the radial collateral ligament and common extensor tendon, in addition to the presence of blood vessels in inflicted area. Administration of autologous blood platelets concentrate containing growth factors, used in treatment of tennis elbow, is performed under ultrasound image control conditions. This allows for a precise incision of scar whilst keeping a healthy (unaffected) tissue margin to form fine channels enabling the penetration of growth factors. Post-surgery medical check-up allows for the evaluation of treatment effectiveness. In radial nerve tunnel syndrome, the ultrasound examination can reveal abnormalities in the deep branch of the radial nerve and within the anatomical structures adjacent to the nerve in the radial nerve tunnel. Furthermore, the ultrasound examination allows for detection of other articular and extraarticular pathologies, which affect the compression of the deep branch of radial nerve, such as skeletal deformations, post-traumatic changes, arthritis, and the presence of tumors. The ultrasonography is also helpful in differentiation of symptoms arising from cervical radiculopathy or brachial plexus injury. PMID:26674710

Nonparetic Knee Extensor Strength Is the Determinant of Exercise Capacity of Community-Dwelling Stroke Survivors

PubMed Central

Wang, Wei-Te; Huang, Ling-Tzu; Chou, Ya-Hui; Wei, Ta-Sen; Lin, Chung-Che

2014-01-01

Objective. To investigate the relationship among walking speed, exercise capacity, and leg strength in community dwelling stroke subjects and to evaluate which one was the leading determinant factor of them. Design. This is a descriptive, cross-sectional study. Thirty-five chronic stroke patients who were able to walk independently in their community were enrolled. Walking speed was evaluated by using the 12-meter walking test. A maximal exercise test was used to determine the stroke subjects' exercise capacity. Knee extensor strength, measured as isokinetic torque, was assessed by isokinetic dynamometer. Results. The main walking speed of our subjects was 0.52 m/s. Peak oxygen uptake (VO2 peak) was 1.21 ± 0.43 L/min. Knee extensor strength, no matter whether paretic or nonparetic side, was significantly correlated to 12-meter walking speed and exercise capacity. Linear regression also showed the strength of the affected knee extensor was the determinant of walking speed and that of the nonparetic knee extensor was the determinant of exercise capacity in community dwelling stroke subjects. Conclusions. Walking speed and peak oxygen uptake were markedly decreased after stroke. Knee extensor strength of nonparetic leg was the most important determinant of exercise capacity of the community-dwelling stroke subjects. Knee extensor strengthening should be emphasized to help stroke patient to achieve optimal community living. PMID:25197712

Nonparetic knee extensor strength is the determinant of exercise capacity of community-dwelling stroke survivors.

PubMed

Wang, Wei-Te; Huang, Ling-Tzu; Chou, Ya-Hui; Wei, Ta-Sen; Lin, Chung-Che

2014-01-01

To investigate the relationship among walking speed, exercise capacity, and leg strength in community dwelling stroke subjects and to evaluate which one was the leading determinant factor of them. This is a descriptive, cross-sectional study. Thirty-five chronic stroke patients who were able to walk independently in their community were enrolled. Walking speed was evaluated by using the 12-meter walking test. A maximal exercise test was used to determine the stroke subjects' exercise capacity. Knee extensor strength, measured as isokinetic torque, was assessed by isokinetic dynamometer. The main walking speed of our subjects was 0.52 m/s. Peak oxygen uptake (VO₂ peak) was 1.21 ± 0.43 L/min. Knee extensor strength, no matter whether paretic or nonparetic side, was significantly correlated to 12-meter walking speed and exercise capacity. Linear regression also showed the strength of the affected knee extensor was the determinant of walking speed and that of the nonparetic knee extensor was the determinant of exercise capacity in community dwelling stroke subjects. Walking speed and peak oxygen uptake were markedly decreased after stroke. Knee extensor strength of nonparetic leg was the most important determinant of exercise capacity of the community-dwelling stroke subjects. Knee extensor strengthening should be emphasized to help stroke patient to achieve optimal community living.

Rate of Torque Development and Feedforward Control of the Hip and Knee Extensors: Gender Differences.

PubMed

Stearns-Reider, Kristen M; Powers, Christopher M

2017-10-06

The purpose of this study was to determine whether women demonstrate decreased rate of torque development (RTD) of the hip and knee extensors and altered onset timing of the vastus lateralis and gluteus maximus during a drop-jump task when compared with men. On average, women demonstrated significantly lower normalized RTD of the hip extensors (women: 11.6 ± 1.3 MVT.s -1 , men: 13.1 ± 0.9 MVT.s -1 ; p ≤ .01); however, there was no significant difference in knee extensor RTD. Women also demonstrated significantly earlier activation of their vastus lateralis (women: 206.0 ± 130.6 ms, men: 80.9 ± 69.6 ms; p ≤ .01) and gluteus maximus (women: 85.7 ± 58.6 ms, men: 54.5 ± 35.4 ms; p = .02). In both men and women, there was a significant negative correlation between the hip extensor RTD and the vastus lateralis electromyographic onset time (men: r = -.386, p = .046; women: r = -.531, p = .008). The study findings suggest that women may utilize a feedforward control strategy in which they activate their knee extensors earlier than men to compensate for deficits in hip extensor RTD. The impaired capacity to rapidly stabilize the hip and knee joints during dynamic maneuvers may contribute to the increased risk of anterior cruciate ligament injury observed in women.

Extensor Tendon Instability Due to Sagittal Band Injury in a Martial Arts Athlete: A Case Report.

PubMed

Kochevar, Andrew; Rayan, Ghazi

2017-03-01

A Taekwondo participant sustained a hand injury from punching an opponent that resulted in painful instability of the ring finger extensor digitorum communis tendon due to sagittal band damage. His symptoms resolved after reconstructive surgery on the sagittal band (SB) with stabilization of the extensor tendon over the metacarpophalangeal joint.

Transposition of branches of radial nerve innervating supinator to posterior interosseous nerve for functional reconstruction of finger and thumb extension in 4 patients with middle and lower trunk root avulsion injuries of brachial plexus.

PubMed

Wu, Xia; Cong, Xiao-Bing; Huang, Qi-Shun; Ai, Fang-Xin; Liu, Yu-Tian; Lu, Xiao-Cheng; Li, Jin; Weng, Yu-Xiong; Chen, Zhen-Bing

2017-12-01

This study aimed to investigate the reconstruction of the thumb and finger extension function in patients with middle and lower trunk root avulsion injuries of the brachial plexus. From April 2010 to January 2015, we enrolled in this study 4 patients diagnosed with middle and lower trunk root avulsion injuries of the brachial plexus via imaging tests, electrophysiological examinations, and clinical confirmation. Muscular branches of the radial nerve, which innervate the supinator in the forearm, were transposed to the posterior interosseous nerve to reconstruct the thumb and finger extension function. Electrophysiological findings and muscle strength of the extensor pollicis longus and extensor digitorum communis, as well as the distance between the thumb tip and index finger tip, were monitored. All patients were followed up for 24 to 30 months, with an average of 27.5 months. Motor unit potentials (MUP) of the extensor digitorum communis appeared at an average of 3.8 months, while MUP of the extensor pollicis longus appeared at an average of 7 months. Compound muscle action potential (CMAP) appeared at an average of 9 months in the extensor digitorum communis, and 12 months in the extensor pollicis longus. Furthermore, the muscle strength of the extensor pollicis longus and extensor digitorum communis both reached grade III at 21 months. Lastly, the average distance between the thumb tip and index finger tip was 8.8 cm at 21 months. In conclusion, for patients with middle and lower trunk injuries of the brachial plexus, transposition of the muscular branches of the radial nerve innervating the supinator to the posterior interosseous nerve for the reconstruction of thumb and finger extension function is practicable and feasible.

Comparison of physical fitness between rice farmers with and without chronic low back pain: a cross-sectional study.

PubMed

Taechasubamorn, Panada; Nopkesorn, Tawesak; Pannarunothai, Supasit

2010-12-01

To compare physical fitness between rice farmers with chronic low back pain (CLBP) and a healthy control group. Sixty-eight rice farmers with CLBP were matched according to age and sex with healthy farmers. All subjects underwent nine physical fitness tests for body composition, lifting capacity, static back extensor endurance, leg strength, static abdominal endurance, handgrip strength, hamstring flexibility, posterior leg and back muscles flexibility and abdominal flexibility. There was no significant difference between CLBP and healthy groups for all tests, except the static back extensor endurance. The back extensor endurance times of the CLBP group was significantly lower than that of the control group (p = 0.002). Static back extensor endurance is the deficient physical fitness in CLBP rice farmers. Back extensor endurance training should be emphasized in both prevention and rehabilitation programs.

[Exercise program for chronic low back pain based on common clinical characteristics of patients].

PubMed

Grgić, Vjekoslav

2014-01-01

1. To determine which clinical characteristics are common in patients with chronic low back pain (CLBP) and 2. To present an exercise program for CLBP composed on the basis of the common clinical characteristics of patients. In the prospective study, we have included 420 patients with nonspecific CLBP (group A), 420 patients with CLBP (with or without radicular pain) and degenerative changes of lumbosacral (LS) spine (group B) and 80 patients with CLBP after a lumbar disc herniation surgery (group C). The clinical characteristics of patients and especially the characteristics of the most important parameters for the selection of exercises have been evaluated by means of physiatric and manual functional examination. The vast majority of patients had these common clinical characteristics: 1. hypertonic/shortened lumbar extensors (A: 89,5%, B: 92%, C: 92,5%), 2. hypertonic/shortened psoas muscles (A: 83%, B: 90,5%, C: 92,5%), 3. restricted active (A: 71,4%, B: 89%, C: 94%) and passive (segmental) mobility (A: 86,4%, B: 92%, C: 95%) of LS spine, 4. painful active movements of LS spine (A: 44%, B: 88,6%, C: 95%), 5. scoliotic posture (more rarely scoliosis) usually in a combination with reduced/flattened lumbar lordosis (A: 87%, B: 89%, C: 90%), 6. hypotonic/ weak gluteal (A: 51,2%, B: 68%, C: 82,5%) and abdominal muscles (A: 33,8%, B: 56,5%, C: 60%) and 7. shortened hamstrings (A: 70,7%; hamstrings flexibility testing in patients from groups B and C is unreliable because of a frequently positive Lasegue's sign). In 6,7% of examinees from the group A, 4,8% examinees from the group B and 2,5% examinees from the group C, we have found LS spine hypermobility. Our exercise program for CLBP composed on the basis of the common clinical characteristics of the patients includes: 1. Stretching exercises for lumbar extensors, 2. Stretching exercises for psoas muscles, 3. Stretching exercises for hamstrings, 4. Strengthening exercises for abdominal muscles, 5. Strengthening exercises for gluteal muscles and 6. Flexion exercises for improvement of LS spine mobility. Our exercise program for CLBP comes unavoidably as a program of first choice in CLBP treatment. The main advantage of our program compared to standard programs is reflected in the targeted action on dysfunctional muscles and hypomobile facet joints. According to the results of our study, extension exercises for strengthening of lumbar extensors and hyperextension exercises for improvement of LS spine mobility are not appropriate for the majority of patients with CLBP.

Clinical Sign for Missed Decompression of a Separate Extensor Pollicis Brevis Compartment in de Quervain's Disease.

PubMed

Benatar, Niels

2017-08-01

Persistent pain despite previous surgery for de Quervain's disease might be due to an overlooked septum between the abductor pollicis longus tendon slips and the extensor pollicis brevis tendon, or an overlooked completely separate compartment for the extensor pollicis brevis tendon alone. In both of these instances, extension of the MP joint of the thumb against resistance elicits pain at the distal level of the first extensor compartment of the wrist. When this sign is positive, revisional surgery and decompression of the remaining septum or separate compartment is indicated. © Georg Thieme Verlag KG Stuttgart · New York.

Rupture of the extensor hood of the fifth toe: a rare injury.

PubMed

Venturini, Sara; Gaba, Suchi; Mangwani, Jitendra

2017-02-27

Closed injuries of the extensor hood of the lesser toes are rare and seldom reported in the literature. We present the case of a woman aged 25 years who presented to the orthopaedic fracture clinic with a 2-week history of pain in the left fifth toe and inability to extend following a ballet dancing session. Investigations showed no fracture on plain radiographs, but an ultrasound scan demonstrated rupture to the extensor hood of the little toe. Successful surgical repair of the extensor hood was performed, and the patient made a good recovery with return to dancing activities. 2017 BMJ Publishing Group Ltd.

Measurement of fatigue in knee flexor and extensor muscles.

PubMed

Kawabata, Y; Senda, M; Oka, T; Yagata, Y; Takahara, Y; Nagashima, H; Inoue, H

2000-04-01

In order to examine fatigue of the knee flexor and extensor muscles and to investigate the characteristics of muscular fatigue in different sports, a Cybex machine was used to measure muscle fatigue and recovery during isokinetic knee flexion and extension. Eighteen baseball players, 12 soccer players and 13 marathon runners were studied. Each subject was tested in the sitting position and made to perform 50 consecutive right knee bends and stretches at maximum strength. This was done 3 times with an interval of 10 min between each series. The peak torque to body weight ratio and the fatigue rate were determined in each case. In all subjects, the peak torque to body weight ratio was higher for extensors than flexors. Over the 3 trials, the fatigue rate of extensors showed little change, while that of flexors had a tendency to increase. In each subject, knee extensors showed a high fatigue rate but a quick recovery, while knee flexors showed a low fatigue rate but a slow recovery. As the marathon runners had the smallest fatigue rates for both flexors and extensors, we concluded that marathon runners had more stamina than baseball players and soccer players.

The influence of lumbar extensor muscle fatigue on lumbar-pelvic coordination during weightlifting.

PubMed

Hu, Boyi; Ning, Xiaopeng

2015-01-01

Lumbar muscle fatigue is a potential risk factor for the development of low back pain. In this study, we investigated the influence of lumbar extensor muscle fatigue on lumbar-pelvic coordination patterns during weightlifting. Each of the 15 male subjects performed five repetitions of weightlifting tasks both before and after a lumbar extensor muscle fatiguing protocol. Lumbar muscle electromyography was collected to assess fatigue. Trunk kinematics was recorded to calculate lumbar-pelvic continuous relative phase (CRP) and CRP variability. Results showed that fatigue significantly reduced the average lumbar-pelvic CRP value (from 0.33 to 0.29 rad) during weightlifting. The average CRP variability reduced from 0.17 to 0.15 rad, yet this change ws statistically not significant. Further analyses also discovered elevated spinal loading during weightlifting after the development of lumbar extensor muscle fatigue. Our results suggest that frequently experienced lumbar extensor muscle fatigue should be avoided in an occupational environment. Lumbar extensor muscle fatigue generates more in-phase lumbar-pelvic coordination patterns and elevated spinal loading during lifting. Such increase in spinal loading may indicate higher risk of back injury. Our results suggest that frequently experienced lumbar muscle fatigue should be avoided to reduce the risk of LBP.

Sagittal-Plane Knee Moment During Gait and Knee Cartilage Thickness

PubMed Central

Harrison, David; Wang, Hsin-Min; Shultz, Sandra J.

2017-01-01

Context:  Understanding the factors associated with thicker cartilage in a healthy population is important when developing strategies aimed at minimizing the cartilage thinning associated with knee osteoarthritis progression. Thicker articular cartilage is commonly thought to be healthier cartilage, but whether the sagittal-plane biomechanics important to gait are related to cartilage thickness is unknown. Objective:  To determine the relationship of a weight-bearing region of the medial femoral condyle's cartilage thickness to sagittal gait biomechanics in healthy individuals. Design:  Descriptive laboratory study. Setting:  Laboratory. Patients or Other Participants:  Twenty-eight healthy participants (15 women: age = 21.1 ± 2.1 years, height = 1.63 ± 0.07 m, weight = 64.6 ± 9.9 kg; 13 men: age = 22.1 ± 2.9 years, height = 1.79 ± 0.05 m, weight = 75.2 ± 9.6 kg). Main Outcome Measure(s):  Tibiofemoral angle (°) was obtained via goniometric assessment, thickness of the medial femoral condyle cartilage (mm) was obtained via ultrasound imaging, and peak internal knee-extensor moment (% body weight · height) was measured during 10 trials of over-ground walking at a self-selected pace. We used linear regression to examine the extent to which peak internal knee-extensor moment predicted cartilage thickness after accounting for tibiofemoral angle and sex. Results:  Sex and tibiofemoral angle (12.3° ± 3.2°) were entered in the initial step as control factors (R2 = 0.01, P = .872). In the final step, internal knee-extensor moment (1.5% ± 1.3% body weight · height) was entered, which resulted in greater knee-extensor moment being related to greater cartilage thickness (2.0 ± 0.3 mm; R2Δ = 0.31, PΔ = .003). Conclusion:  Individuals who walked with a greater peak internal knee-extensor moment during gait had a cartilage structure that is generally considered beneficial in a healthy population. Our study offers promising findings that a potentially modifiable biomechanical factor is associated with cartilage status in a healthy population. Establishing these baseline relationships in uninjured populations may help us to better understand potential factors related to maladaptive gait patterns that predispose a person to adverse changes in the cartilage environment. PMID:28653865

Effects of Lumbar Strengthening Exercise in Lower-Limb Amputees With Chronic Low Back Pain.

PubMed

Shin, Min Kyung; Yang, Hee Seung; Yang, Hea-Eun; Kim, Dae Hyun; Ahn, Bo Ram; Kwon, Hyup; Lee, Ju Hwan; Jung, Suk; Choi, Hyun Chul; Yun, Sun Keaung; Ahn, Dong Young; Sim, Woo Sob

2018-02-01

To analyze the effect of lumbar strengthening exercise in lower-limb amputees with chronic low back pain. We included in this prospective study 19 lower-limb amputees who had experienced low back pain for longer than 6 months. Participants were treated with 30-minute lumbar strengthening exercises, twice weekly, for 8 weeks. We used the visual analog scale (VAS), and Oswestry low back pain disability questionnaire, and measured parameters such as iliopsoas length, abdominal muscle strength, back extensor strength, and back extensor endurance. In addition, we assessed the isometric peak torque and total work of the trunk flexors and extensors using isokinetic dynamometer. The pre- and post-exercise measurements were compared. Compared with the baseline, abdominal muscle strength (from 4.4±0.7 to 4.8±0.6), back extensor strength (from 2.6±0.6 to 3.5±1.2), and back extensor endurance (from 22.3±10.7 to 46.8±35.1) improved significantly after 8 weeks. The VAS decreased significantly from 4.6±2.2 to 2.6±1.6 after treatment. Furthermore, the peak torque and total work of the trunk flexors and extensors increased significantly (p<0.05). Lumbar strengthening exercise in lower-limb amputees with chronic low back pain resulted in decreased pain and increased lumbar extensor strength. The lumbar strengthening exercise program is very effective for lower-limb amputees with chronic low back pain.

Monkey extensor digitorum communis motoneuron pool: Proximal dendritic trees and small motoneurons.

PubMed

Jenny, Arthur B; Cheney, Paul D; Jenny, Andrew K

2018-05-14

Transverse sections of the monkey cervical spinal cord from a previous study (Jenny and Inukai, 1983) were reanalyzed using Neurolucida to create a three-dimensional display of extensor digitorum communis (EDC) motoneurons and proximal dendrites that had been labeled with horse radish peroxidase (HRP). The EDC motoneuron pool was located primarily in the C8 and T1 segments of the spinal cord. Small motoneurons (cell body areas less than 500 μm 2 and presumed to be gamma motoneurons) comprised about ten percent of the motoneurons and were located throughout the length of the motoneuron pool. Most small motoneurons were oblong in shape and had one or two major dendrites originating from the cell body in the transverse plane of section. The majority of the HRP labeled dendritic trees were directed either superiorly, dorsal-medially to the mid zone area between the base of the dorsal horn and the upper portion of the ventral horn, or medially to the ventromedial gray matter. The longer HRP labeled dendrites usually continued in the same radial direction as when originating from the cell body. As such we considered the radial direction of the longer proximal HRP labeled dendrites to be a reasonable estimate of the radial direction of the more distal dendritic tree. Our data suggest that the motoneuron dendritic tree as seen in transverse section has direction-oriented dendrites that extend toward functional terminal regions. Copyright © 2018 Elsevier B.V. All rights reserved.

Key characteristics of low back pain and disability in college-aged adults: a pilot study.

PubMed

Handrakis, John P; Friel, Karen; Hoeffner, Frank; Akinkunle, Ola; Genova, Vito; Isakov, Edward; Mathew, Jerrill; Vitulli, Frank

2012-07-01

To identify which factors commonly associated with low back pain (LBP) and disability differ between college-aged persons with LBP and with no or minimal LBP. Clinical measurement, observational study. Subjects were assessed for LBP with the visual analog scale (VAS) and for disability from LBP using the Oswestry Disability Index (ODI). Subjects were measured for variables commonly associated with LBP and were grouped by both VAS (minimum [min]/no pain, pain) and ODI (no disability, disability) scores. College campus at a university. A convenience sample (N=84) of English-speaking students (34 men, 50 women) between 18 and 30 years of age. Not applicable. Sports activity (sports activity score of the Baecke Physical Activity Questionnaire), depression, hamstring and hip flexor range of motion, low back extensor endurance, abdominal strength and endurance. A significant main effect of group was found for both pain (P=.019) and disability groups (P=.006). The min/no pain and pain groups differed in back endurance (114.2±38.8s vs 94.5±44.5s, respectively; P=.04). The no disability and disability groups differed in back endurance (116.3±35.9s vs 97.1±45.7s, respectively; P=.03) and the sports activity score of the Baecke Physical Activity Questionnaire (2.98±.95 vs 2.48±.85, respectively; P=.01). Subjects with hyperkyphotic postures compared with the normative thoracic group had higher depression scores (49 vs 38.5, respectively; P=.03) and less hamstring flexibility (30.5 vs 49.9, respectively; P<.001). Back extensor endurance was consistently different between both the pain and disability groups. Addressing limited low back extensor endurance and low levels of physical activity in young adults may have clinical relevance for the prevention and treatment of LBP and disability. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The Incidence of Acute Traumatic Tendon Injuries in the Hand and Wrist: A 10-Year Population-based Study

PubMed Central

de Jong, Johanna P.; Nguyen, Jesse T.; Sonnema, Anne J. M.; Nguyen, Emily C.; Amadio, Peter C.

2014-01-01

Background Acute traumatic tendon injuries of the hand and wrist are commonly encountered in the emergency department. Despite the frequency, few studies have examined the true incidence of acute traumatic tendon injuries in the hand and wrist or compared the incidences of both extensor and flexor tendon injuries. Methods We performed a retrospective population-based cohort study of all acute traumatic tendon injuries of the hand and wrist in a mixed urban and rural Midwest county in the United States between 2001-2010. A regional epidemiologic database and medical codes were used to identify index cases. Epidemiologic information including occupation, year of injury, mechanism of injury and the injured tendon and zone were recorded. Results During the 10-year study period there was an incidence rate of 33.2 injuries per 100,000 person-years. There was a decreasing rate of injury during the study period. Highest incidence of injury occurred at 20-29 years of age. There was significant association between injury rate and age, and males had a higher incidence than females. The majority of cases involved a single tendon, with extensor tendon injuries occurring more frequently than flexor tendons. Typically, extensor tendon injuries involved zone three of the index finger, while flexor tendons involved zone two of the index finger. Work-related injuries accounted for 24.9% of acute traumatic tendon injuries. The occupations of work-related injuries were assigned to major groups defined by the 2010 Standard Occupational Classification structure. After assigning these patients' occupations to respective major groups, the most common groups work-related injuries occurred in construction and extraction occupations (44.2%), food preparation and serving related occupations (14.4%), and transportation and material moving occupations (12.5%). Conclusions Epidemiology data enhances our knowledge of injury patterns and may play a role in the prevention and treatment of future injuries, with an end result of reducing lost work time and economic burden. PMID:24900902

Finger drop sign-Characteristic pattern of distal weakness in Guillain-Barré Syndrome: A case report and review of the literature.

PubMed

Chee, Yong Chuan; Ong, Beng Hooi

2018-01-01

Guillain-Barré Syndrome is an acquired acute autoimmune polyradiculoneuropathy that commonly presents with limb weakness and occasional cranial nerve, respiratory and autonomic involvement. Although the classic description of Guillain-Barré Syndrome is that of a demyelinating neuropathy with ascending weakness, predominant bilateral finger drop as presenting feature has rarely been reported. A characteristic pattern of weakness involving the extensor components of the fingers known as "finger drop sign" has been first described to be specific in acute motor axonal neuropathy form of Guillain-Barré Syndrome in the literature. We report a case of acute motor-sensory axonal neuropathy, which showed characteristic pattern of predominant finger extensor weakness, and provide a summary of all reported cases to date. While previous reports suggested that this is a sign that carries good prognosis, our case report suggested otherwise as the patient succumbed to respiratory and autonomic complications. Further studies are needed to evaluate the clinical significance of this peculiar sign.

Effects of Progressive Resistance Strength Training on Knee Biomechanics During Single Leg Step-up in Persons with Mild Knee Osteoarthritis

PubMed Central

McQuade, Kevin James; de Oliveira, Anamaria Siriani

2011-01-01

Background The goal of this study was to determine if increasing strength in primary knee extensors and flexors would directly affect net knee joint moments during a common functional task in persons with knee osteoarthritis. Methods An exploratory single sample clinical trial with pre-post treatment measures was used to study volunteers with clinical diagnosis of mild knee OA in one knee. Subjects participated in an individually supervised training program 3 times a week for eight weeks consisting of progressive resistive exercises for knee extensors and knee flexors. Pre and post training outcome assessments included: 1. Net internal knee joint moments, 2. Electromyography of primary knee extensors and flexors, and 3. Self-report measures of knee pain and function. The distribution of lower extremity joint moments as a percent of the total support moment was also investigated. Findings Pain, symptoms, activities of daily life, quality of life, stiffness, and function scores showed significant improvement following strength training. Knee internal valgus and hip internal rotation moments showed increasing but non-statistically significant changes post-training. There were no significant differences in muscle co-contraction activation of the Quadriceps and Hamstrings. Interpretations While exercise continues to be an important element of OA management, the results of this study suggest improvements in function, pain, and other symptoms, as a result of strength training may not be causally related to specific biomechanical changes in net joint moments. PMID:21514018

Lower extremity muscle functions during full squats.

PubMed

Robertson, D G E; Wilson, Jean-Marie J; St Pierre, Taunya A

2008-11-01

The purpose of this research was to determine the functions of the gluteus maximus, biceps femoris, semitendinosus, rectus femoris, vastus lateralis, soleus, gastrocnemius, and tibialis anterior muscles about their associated joints during full (deep-knee) squats. Muscle function was determined from joint kinematics, inverse dynamics, electromyography, and muscle length changes. The subjects were six experienced, male weight lifters. Analyses revealed that the prime movers during ascent were the monoarticular gluteus maximus and vasti muscles (as exemplified by vastus lateralis) and to a lesser extent the soleus muscles. The biarticular muscles functioned mainly as stabilizers of the ankle, knee, and hip joints by working eccentrically to control descent or transferring energy among the segments during scent. During the ascent phase, the hip extensor moments of force produced the largest powers followed by the ankle plantar flexors and then the knee extensors. The hip and knee extensors provided the initial bursts of power during ascent with the ankle extensors and especially a second burst from the hip extensors adding power during the latter half of the ascent.

The first metatarsal web space: its applied anatomy and usage in tracing the first dorsal metatarsal artery in thumb reconstruction.

PubMed

Xu, Yong-Qing; Li, Jun; Zhong, Shi-Zhen; Xu, Da-Chuan; Xu, Xiao-Shan; Guo, Yuan-Fa; Wang, Xin-Min; Li, Zhu-Yi; Zhu, Yue-Liang

2004-12-01

To clarify the anatomical relationship of the structures in the first toe webbing space for better dissection of toes in thumb reconstruction. The first dorsal metatarsal artery, the first deep transverse metatarsal ligament and the extensor expansion were observed on 42 adult cadaveric lower extremities. Clinically the method of tracing the first dorsal metatarsal artery around the space of the extensor expansion was used in 36 cases of thumb reconstruction. The distal segments of the first dorsal metatarsal artery of Gilbert types I and II were located superficially to the extensor expansion. The harvesting time of a toe was shortened from 90 minutes to 50 minutes with 100% survival of reconstructed fingers. The distal segment of the first dorsal metatarsal artery lies constantly at the superficial layer of the extensor expansion. Most of the first metatarsal arteries of Gilbert types I and II can be easily located via the combined sequential and reverse dissection around the space of the extensor expansion.

Mildly disabled persons with multiple sclerosis use similar net joint power strategies as healthy controls when walking speed increases.

PubMed

Brincks, John; Christensen, Lars Ejsing; Rehnquist, Mette Voigt; Petersen, Jesper; Sørensen, Henrik; Dalgas, Ulrik

2018-01-01

To improve walking in persons with multiple sclerosis (MS), it is essential to understand the underlying mechanisms of walking. This study examined strategies in net joint power generated or absorbed by hip flexors, hip extensors, hip abductors, knee extensors, and plantar flexors in mildly disabled persons with MS and healthy controls at different walking speeds. Thirteen persons with MS and thirteen healthy controls participated and peak net joint power was calculated using 3D motion analysis. In general, no differences were found between speed-matched healthy controls and persons with MS, but the fastest walking speed was significantly higher in healthy controls (2.42 m/s vs. 1.70 m/s). The net joint power increased in hip flexors, hip extensors, hip abductors, knee extensors and plantar flexors in both groups, when walking speed increased. Significant correlations between changes in walking speed and changes in net joint power of plantar flexors, hip extensors and hip flexors existed in healthy controls and persons with MS, and in net knee extensor absorption power of persons with MS only. In contrast to previous studies, these findings suggest that mildly disabled persons with MS used similar kinetic strategies as healthy controls to increase walking speed.

Early reduction in toe flexor strength is associated with physical activity in elderly men.

PubMed

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Yokochi, Takashi

2016-05-01

[Purpose] To compare the toe flexor, hand grip and knee extensor strengths of young and elderly men, and to examine the association between toe flexor strength and physical activity or inactivity levels. [Subjects and Methods] Young (n=155, 18-23 years) and elderly (n=60, 65-88 years) men participated in this study. Toe flexor, hand grip, and knee extensor strength were measured. Physical activity (time spent standing/walking per day) and inactivity (time spent sitting per day) were assessed using a self-administered questionnaire. [Results] Toe flexor, hand grip, and knee extensor strength of the elderly men were significantly lower than those of the young men. Standing/walking and sitting times of the elderly men were lower than those of the young men. Toe flexor strength correlated with hand grip and knee extensor strength in both groups. In elderly men, toe flexor strength correlated with standing/walking time. In comparison to the young men's mean values, toe flexor strength was significantly lower than knee extensor and hand grip strength in the elderly group. [Conclusion] The results suggest that age-related reduction in toe flexor strength is greater than those of hand grip and knee extensor strengths. An early loss of toe flexor strength is likely associated with reduced physical activity in elderly men.

Is the Sørensen test valid to assess muscle fatigue of the trunk extensor muscles?

PubMed

Demoulin, Christophe; Boyer, Mathieu; Duchateau, Jacques; Grosdent, Stéphanie; Jidovtseff, Boris; Crielaard, Jean-Michel; Vanderthommen, Marc

2016-01-01

Very few studies have quantified the degree of fatigue characterized by the decline in the maximal voluntary contraction (MVC) force of the trunk extensors induced by the widely used Sørensen test. Measure the degree of fatigue of the trunk extensor muscles induced by the Sørensen test. Eighty young healthy subjects were randomly divided into a control group (CG) and an experimental group (EG), each including 50% of the two genders. The EG performed an isometric MVC of the trunk extensors (pre-fatigue test) followed by the Sørensen test, the latter being immediately followed by another MVC (post-fatigue test). The CG performed only the pre- and post-fatigue tests without any exertion in between. The comparison of the pre- and post-fatigue tests revealed a significant (P< 0.05) decrease in MVC force normalized by body mass (-13%) in the EG, whereas a small increase occurred in the CG (+2.7%, P= 0.001). This study shows that the Sørensen test performed until failure in a young healthy population results in a reduced ability of the trunk extensor muscles to generate maximal force, and indicates that this test is valid for the assessment of fatigue in trunk extensor muscles.

The effects of two different frequencies of whole-body vibration on knee extensors strength in healthy young volunteers: a randomized trial

PubMed Central

Esmaeilzadeh, S.; Akpinar, M.; Polat, S.; Yildiz, A.; Oral, A.

2015-01-01

The aim of this study was to investigate the effects of two different frequencies of whole-body vibration (WBV) training on knee extensors muscle strength in healthy young volunteers. Twenty-two eligible healthy untrained young women aged 22-31 years were allocated randomly to the 30-Hz (n=11) and 50-Hz (n=11) groups. They participated in a supervised WBV training program that consisted of 24 sessions on a synchronous vertical vibration platform (peak-to-peak displacement: 2-4 mm; type of exercises: semi-squat, one-legged squat, and lunge positions on right leg; set numbers: 2-24) three times per week for 8 weeks. Isometric and dynamic strength of the knee extensors were measured prior to and at the end of the 8-week training. In the 30-Hz group, there was a significant increase in the maximal voluntary isometric contraction (p=0.039) and the concentric peak torque (p=0.018) of knee extensors and these changes were significant (p<0.05) compared with the 50-Hz group. In addition, the eccentric peak torque of knee extensors was increased significantly in both groups (p<0.05); however, there was no significant difference between the two groups (p=0.873). We concluded that 8 weeks WBV training in 30 Hz was more effective than 50 Hz to increase the isometric contraction and dynamic strength of knee extensors as measured using peak concentric torque and equally effective with 50 Hz in improving eccentric torque of knee extensors in healthy young untrained women. PMID:26636279

Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis.

PubMed

Pua, Yong-Hao; Liang, Zhiqi; Ong, Peck-Hoon; Bryant, Adam L; Lo, Ngai-Nung; Clark, Ross A

2011-12-01

Knee extensor strength is an important correlate of physical function in patients with knee osteoarthritis; however, it remains unclear whether standing balance is also a correlate. The purpose of this study was to evaluate the cross-sectional associations of knee extensor strength, standing balance, and their interaction with physical function. One hundred four older adults with end-stage knee osteoarthritis awaiting a total knee replacement (mean ± SD age 67 ± 8 years) participated. Isometric knee extensor strength was measured using an isokinetic dynamometer. Standing balance performance was measured by the center of pressure displacement during quiet standing on a balance board. Physical function was measured by the self-report Short Form 36 (SF-36) questionnaire and by the 10-meter fast-pace gait speed test. After adjustment for demographic and knee pain variables, we detected significant knee strength by standing balance interaction terms for both SF-36 physical function and fast-pace gait speed. Interrogation of the interaction revealed that standing balance in the anteroposterior plane was positively related to physical function among patients with lower knee extensor strength. Conversely, among patients with higher knee extensor strength, the standing balance-physical function associations were, or tended to be, negative. These findings suggest that although standing balance was related to physical function in patients with knee osteoarthritis, this relationship was complex and dependent on knee extensor strength level. These results are of importance in developing intervention strategies and refining theoretical models, but they call for further study. Copyright © 2011 by the American College of Rheumatology.

Pre/Post Data Analysis - Simple or Is It?

NASA Technical Reports Server (NTRS)

Feiveson, Al; Fiedler, James; Ploutz-Snyder, Robert

2011-01-01

This slide presentation reviews some of the problems of data analysis in analyzing pre and post data. Using as an example, ankle extensor strength (AES) experiments, to measure bone density loss during bed rest, the presentation discusses several questions: (1) How should we describe change? (2) Common analysis methods for comparing post to pre results. (3) What do we mean by "% change"? and (4) What are we testing when we compare % changes?

Small flake, big problem: an unreported cause of extensor pollicis longus tendon rupture.

PubMed

Durrant, C A T; Bantick, G

2010-01-01

Fracture of the base of the third metacarpal with associated avulsion of the extensor carpi radialis brevis tendon is a rare injury. We report such a fracture and the unusual resulting complication of division of the extensor pollicis longus tendon by the avulsed bony fragment. Careful monitoring using lateral radiographs is needed to make the diagnosis and displacement of the avulsed fragment warrants open reduction and internal fixation.

Salvage of the lower limb after a full thickness burn with loss of the knee extensor mechanism: a case report.

PubMed

Sarraf, Khaled M; Atherton, Duncan D; Jayaweera, Asantha R; Gibbons, Charles E; Jones, Isabel

2013-04-01

We report on a 79-year-old woman who underwent salvage of the knee and lower leg using a Whichita Fusion Nail for knee arthrodesis, combined with a medial gastrocnemius muscle flap for a 3% contact burn that resulted in loss of the extensor mechanism. This provided an alternative to above-knee amputation when extensor mechanism reconstruction was not feasible.

Fracture of the proximal tibia after revision total knee arthroplasty with an extensor mechanism allograft.

PubMed

Klein, Gregg R; Levine, Harlan B; Sporer, Scott M; Hartzband, Mark A

2013-02-01

Extensor mechanism reconstruction with an extensor mechanism allograft (EMA) remains one of the most reliable methods for treating the extensor mechanism deficient total knee arthroplasty. We report 3 patients who were treated with an EMA who sustained a proximal tibial shaft fracture. In all 3 cases, a short tibial component was present that ended close to the level of the distal extent of the bone block. When performing an EMA, it is important to recognize that the tibial bone block creates a stress riser and revision to a long-stemmed tibial component should be strongly considered to bypass this point to minimize the risk of fracture. Copyright © 2013 Elsevier Inc. All rights reserved.

The neuromuscular fatigue induced by repeated scrums generates instability that can be limited by appropriate recovery.

PubMed

Morel, B; Hautier, C A

2017-02-01

The aim of this study was to evaluate the influence of the fatigue on the machine scrum pushing sagittal forces during repeated scrums and to determine the origin of the knee extensor fatigue. Twelve elite U23 rugby union front row players performed six 6-s scrums every 30 s against a dynamic scrum machine with passive or active recovery. The peak, average, and the standard deviation of the force were measured. A neuromuscular testing procedure of the knee extensors was carried out before and immediately after the repeated scrum protocol including maximal voluntary force, evoked force, and voluntary activation. The average and peak forces did not decrease after six scrums with passive recovery. The standard deviation of the force increased by 70.2 ± 42.7% (P < 0.001). Maximal voluntary/evoked force and voluntary activation decreased (respectively 25.1 ± 7.0%, 14.6 ± 5.5%, and 24 ± 9.9%; P < 0.001). The standard deviation of the force did not increase with active recovery and was associated with lower decrease of maximal voluntary/evoked force and voluntary activation (respectively 12.8 ± 7.9%, 4.9 ± 6.5%, and 7.6 ± 4.1%; all P < 0.01). As a conclusion repeated scrummaging induced an increased machine scrum pushing instability associated with central and peripheral fatigue of the knee extensors. Active recovery seems to limit all these manifestations of fatigue. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Anatomic relationship of the proximal nail matrix to the extensor hallucis longus tendon insertion.

PubMed

Palomo López, P; Becerro de Bengoa Vallejo, R; López López, D; Prados Frutos, J C; Alfonso Murillo González, J; Losa Iglesias, M E

2015-10-01

The purpose of this study was to delineate the relationship of the terminal extensor hallucis longus tendon insertion to the proximal limit of the nail matrix of the great toe. Fifty fresh-frozen human cadaver great toes with no evidence of trauma (average age, 62.5 years; 29 males and 21 females) were used for this study. Under 25X magnification, the proximal limit of the nail matrix and the terminal bony insertion of the extensor hallucis longus tendons were identified. The distance from the terminal tendon insertion to the nail matrix was ascertained using precision calipers, an optical microscope, and autocad(®) software for windows. Twenty-five great toes were placed in a neutral formalin solution and further analysed by histological longitudinal-sections. The specimens were stained with haematoxylin and eosin and examined microscopically to determine the presence of the extensor hallucis longus tendon along the dorsal aspect of the distal phalanx of each great toe. The main result we found in great toes was that the extensor tendon is between the matrix and the phalanx and extends dorsally to the distal aspect of the distal phalanx in all, 100%, specimens. The nail matrix of the great toe is not attached to the periosteum of the dorsal aspect of the base of the distal phalanx as is the case for fingers, because the extensor hallucis tendon is plantar or directly underneath the nail matrix and the tendon is dorsal to the bone. We have found that the extensor tendon is between the matrix and the phalanx and extends dorsally to the distal aspect of the distal phalanx. The nail matrix of the great toe is not attached to the periosteum of the dorsal aspect of the base of distal phalanx as is the case in fingers, because the extensor hallucis tendon is plantar or directly underneath the nail matrix and the tendon is dorsal to the bone. Our anatomic study demonstrates that the proximal limit of the matrix and nail bed of the human great toe are dorsal and overlapping the terminal extensor hallucis longus tendon until its distal bony insertion in all specimens. © 2015 European Academy of Dermatology and Venereology.

Relationships between Isometric Muscle Strength, Gait Parameters, and Gross Motor Function Measure in Patients with Cerebral Palsy

PubMed Central

Shin, Hyung-Ik; Sung, Ki Hyuk; Chung, Chin Youb; Lee, Kyoung Min; Lee, Seung Yeol; Lee, In Hyeok

2016-01-01

Purpose This study investigated the correlation between isometric muscle strength, gross motor function, and gait parameters in patients with spastic cerebral palsy and to find which muscle groups play an important role for gait pattern in a flexed knee gait. Materials and Methods Twenty-four ambulatory patients (mean age, 10.0 years) with spastic cerebral palsy who were scheduled for single event multilevel surgery, including distal hamstring lengthening, were included. Preoperatively, peak isometric muscle strength was measured for the hip flexor, hip extensor, knee flexor, and knee extensor muscle groups using a handheld dynamometer, and three-dimensional (3D) gait analysis and gross motor function measure (GMFM) scoring were also performed. Correlations between peak isometric strength and GMFM, gait kinematics, and gait kinetics were analyzed. Results Peak isometric muscle strength of all muscle groups was not related to the GMFM score and the gross motor function classification system level. Peak isometric strength of the hip extensor and knee extensor was significantly correlated with the mean pelvic tilt (r=-0.588, p=0.003 and r=-0.436, p=0.033) and maximum pelvic obliquity (r=-0.450, p=0.031 and r=-0.419, p=0.041). There were significant correlations between peak isometric strength of the knee extensor and peak knee extensor moment in early stance (r=0.467, p=0.021) and in terminal stance (r=0.416, p=0.043). Conclusion There is no correlation between muscle strength and gross motor function. However, this study showed that muscle strength, especially of the extensor muscle group of the hip and knee joints, might play a critical role in gait by stabilizing pelvic motion and decreasing energy consumption in a flexed knee gait. PMID:26632404

Relationships between Isometric Muscle Strength, Gait Parameters, and Gross Motor Function Measure in Patients with Cerebral Palsy.

PubMed

Shin, Hyung Ik; Sung, Ki Hyuk; Chung, Chin Youb; Lee, Kyoung Min; Lee, Seung Yeol; Lee, In Hyeok; Park, Moon Seok

2016-01-01

This study investigated the correlation between isometric muscle strength, gross motor function, and gait parameters in patients with spastic cerebral palsy and to find which muscle groups play an important role for gait pattern in a flexed knee gait. Twenty-four ambulatory patients (mean age, 10.0 years) with spastic cerebral palsy who were scheduled for single event multilevel surgery, including distal hamstring lengthening, were included. Preoperatively, peak isometric muscle strength was measured for the hip flexor, hip extensor, knee flexor, and knee extensor muscle groups using a handheld dynamometer, and three-dimensional (3D) gait analysis and gross motor function measure (GMFM) scoring were also performed. Correlations between peak isometric strength and GMFM, gait kinematics, and gait kinetics were analyzed. Peak isometric muscle strength of all muscle groups was not related to the GMFM score and the gross motor function classification system level. Peak isometric strength of the hip extensor and knee extensor was significantly correlated with the mean pelvic tilt (r=-0.588, p=0.003 and r=-0.436, p=0.033) and maximum pelvic obliquity (r=-0.450, p=0.031 and r=-0.419, p=0.041). There were significant correlations between peak isometric strength of the knee extensor and peak knee extensor moment in early stance (r=0.467, p=0.021) and in terminal stance (r=0.416, p=0.043). There is no correlation between muscle strength and gross motor function. However, this study showed that muscle strength, especially of the extensor muscle group of the hip and knee joints, might play a critical role in gait by stabilizing pelvic motion and decreasing energy consumption in a flexed knee gait.

Knee Extensor Strength and Risk of Structural, Symptomatic, and Functional Decline in Knee Osteoarthritis: A Systematic Review and Meta-Analysis.

PubMed

Culvenor, Adam G; Ruhdorfer, Anja; Juhl, Carsten; Eckstein, Felix; Øiestad, Britt Elin

2017-05-01

To perform a systematic review and meta-analysis on the association between knee extensor strength and the risk of structural, symptomatic, or functional deterioration in individuals with or at risk of knee osteoarthritis (KOA). We systematically identified and methodologically appraised all longitudinal studies (≥1-year followup) reporting an association between knee extensor strength and structural (tibiofemoral, patellofemoral), symptomatic (self-reported, knee replacement), or functional (subjective, objective) decline in individuals with or at risk of radiographic or symptomatic KOA. Results were pooled for each of the above associations using meta-analysis, or if necessary, summarized according to a best-evidence synthesis. Fifteen studies were included, evaluating >8,000 participants (51% female), with a followup time between 1.5 and 8 years. Meta-analysis revealed that lower knee extensor strength was associated with an increased risk of symptomatic (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] pain: odds ratio [OR] 1.35, 95% confidence interval [95% CI] 1.10-1.67) and functional decline (WOMAC function: OR 1.38, 95% CI 1.00-1.89, and chair-stand task: OR 1.03, 95% CI 1.03-1.04), but not increased risk of radiographic tibiofemoral joint space narrowing (JSN) (OR 1.15, 95% CI 0.84-1.56). No trend in risk was observed for KOA status (present versus absent). Best-evidence synthesis showed inconclusive evidence for lower knee extensor strength being associated with increased risk of patellofemoral deterioration. Meta-analysis showed that lower knee extensor strength is associated with an increased risk of symptomatic and functional deterioration, but not tibiofemoral JSN. The risk of patellofemoral deterioration in the presence of knee extensor strength deficits is inconclusive. © 2016, American College of Rheumatology.

Knee extensor strength and body weight in adolescent men and the risk of knee osteoarthritis by middle age.

PubMed

Turkiewicz, Aleksandra; Timpka, Simon; Thorlund, Jonas Bloch; Ageberg, Eva; Englund, Martin

2017-10-01

To assess the extent to which knee extensor strength and weight in adolescence are associated with knee osteoarthritis (OA) by middle age. We studied a cohort of 40 121 men who at age 18 years in 1969/1970 underwent mandatory conscription in Sweden. We retrieved data on isometric knee extensor strength, weight, height, smoking, alcohol consumption, parental education and adult occupation from Swedish registries. We identified participants diagnosed with knee OA or knee injury from 1987 to 2010 through the National Patient Register. We estimated the HR of knee OA using multivariable-adjusted Cox proportional regression model. To assess the influence of adult knee injury and occupation, we performed a formal mediation analysis. The mean (SD) knee extensor strength was 234 (47) Nm, the mean (SD) weight was 66 (9.3) kg. During 24 years (median) of follow-up starting at the age of 35 years, 2049 persons were diagnosed with knee OA. The adjusted HR (95% CI) of incident knee OA was 1.12 (1.06 to 1.18) for each SD of knee extensor strength and 1.18 (1.15 to 1.21) per 5 kg of body weight. Fifteen per cent of the increase in OA risk due to higher knee extensor strength could be attributed to knee injury and adult occupation. Higher knee extensor strength in adolescent men was associated with increased risk of knee OA by middle age, challenging the current tenet of low muscle strength being a risk factor for OA. We confirmed higher weight to be a strong risk factor for knee OA. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effect of Superimposed Electromyostimulation on Back Extensor Strengthening: A Pilot Study.

PubMed

Park, Jae Hyeon; Seo, Kwan Sik; Lee, Shi-Uk

2016-09-01

Park, JH, Seo, KS, and Lee, S-U. Effect of superimposed electromyostimulation on back extensor strengthening: a pilot study. J Strength Cond Res 30(9): 2470-2475, 2016-Electromyostimulation (EMS) superimposed on voluntary contraction (VC) can increase muscle strength. However, no study has examined the effect of superimposing EMS on back extensor strengthening. The purpose of this study was to determine the effect of superimposed EMS on back extensor strengthening in healthy adults. Twenty healthy men, 20-29 years of age, without low-back pain were recruited. In the EMS group, electrodes were attached to bilateral L2 and L4 paraspinal muscles. Stimulation intensity was set for maximally tolerable intensity. With VC, EMS was superimposed for 10 seconds followed by a 20-second rest period. The same protocol was used in the sham stimulation (SS) group, except that the stimulation intensity was set at the lowest intensity (5 mA). All subjects performed back extension exercise using a Swiss ball, with 10 repetitions per set, 2 sets each day, 5 times a week for 2 weeks. The primary outcome measure was the change in isokinetic strength of the back extensor using an isokinetic dynamometer. Additionally, endurance was measured using the Sorensen test. After 2 weeks of back extension exercise, the peak torque and endurance increased significantly in both groups (p ≤ 0.05). Effect size between the EMS group and the SS group was medium in strength and endurance. However, there was no statistically significant difference between 2 groups. In conclusion, 2 weeks of back extensor strengthening exercise was effective for strength and endurance. Superimposing EMS on back extensor strengthening exercise could provide an additional effect on increasing strength.

Anatomical association between wrist extensor musculature and topographical pain sensitivity maps of the elbow area.

PubMed

Prados-Frutos, Juan Carlos; Ruiz-Ruiz, Beatriz; De-la-Llave-Rincón, Ana Isabel; Arendt-Nielsen, Lars; Madeleine, Pascal; Fernández-de-Las-Peñas, César

2012-06-01

High-density topographical sensitivity maps have been developed to visualize nonuniformity deep tissue pain sensitivity in, for example, lateral epicondylitis (LE). The aim of this cadaveric study was to determine the anatomical association between the topographical sensitivity maps over the elbow area and wrist extensor musculature. A topographical pressure sensitivity map consisting of 12 points forming a 3 × 4 matrix: 4 points in the superior part, 4 points in the middle, and 4 points in the lower part around the lateral epicondyle was marker on a 50-year embalmed cadaver. Color marker pins were inserted into each point. Pins were removed during the process of dissection, but the small holes created by their removal assured accurate relocation. Progressive dissection revealed that points 1 to 4 (superior line) were placed over the musculotendinous junction and belly of the extensor carpi radialis brevis (ECRB) muscle, points 6 to 8 (middle line) were placed over the musculotendinous junction and belly of the extensor digitorum communis muscle, and points 9 to 12 (inferior line) were located over the musculotendinous junction and belly of the extensor carpi ulnaris muscle. It was also observed that the superficial branch of the radial nerve runs between the belly of the ECRB and extensor digitorum communis muscles. This study confirmed that anatomical location previously assumed supporting the important wrist extensor muscles, particularly the ECRB, in patients with LE as depicted by pressure pain sensitivity maps. This study also suggests a potential role of the superficial branch of the radial nerve in LE. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Age Differences in Dynamic Fatigability and Variability of Arm and Leg Muscles: Associations with Physical Function

PubMed Central

Senefeld, Jonathon; Yoon, Tejin; Hunter, Sandra K.

2016-01-01

Introduction It is not known whether the age-related increase in fatigability of fast dynamic contractions in lower limb muscles also occurs in upper limb muscles. We compared age-related fatigability and variability of maximal-effort repeated dynamic contractions in the knee extensor and elbow flexor muscles; and determined associations between fatigability, variability of velocity between contractions and functional performance. Methods 35 young (16 males; 21.0±2.6 years) and 32 old (18 males; 71.3±6.2 years) adults performed a dynamic fatiguing task involving 90 maximal-effort, fast, concentric, isotonic contractions (1 contraction/3 s) with a load equivalent to 20% maximal voluntary isometric contraction (MVIC) torque with the elbow flexor and knee extensor muscles on separate days. Old adults also performed tests of balance and walking endurance. Results Old adults had greater fatigue-related reductions in peak velocity compared with young adults for both the elbow flexor and knee extensor muscles (P<0.05) with no sex differences (P>0.05). Old adults had greater variability of peak velocity during the knee extensor, but not during the elbow flexor fatiguing task. The age difference in fatigability was greater for the knee extensor muscles (35.9%) compared with elbow flexor muscles (9.7%, P<0.05). Less fatigability of the knee extensor muscles was associated with greater walking endurance (r=−0.34, P=0.048) and balance (r=−0.41, P=0.014) among old adults. Conclusions An age-related increase in fatigability of a dynamic fatiguing task was greater for the knee extensor compared with the elbow flexor muscles in males and females, and greater fatigability was associated with lesser walking endurance and balance. PMID:27989926

Isometric elbow extensors strength in supine- and prone-lying positions.

PubMed

Abdelzaher, Ibrahim E; Ababneh, Anas F; Alzyoud, Jehad M

2013-01-01

The purpose of this study was to compare isometric strength of elbow extensors measured in supine- and prone-lying positions at elbow flexion angles of 45 and 90 degrees. Twenty-two male subjects under single-blind procedures participated in the study. Each subject participated in both supine-lying and prone-lying measuring protocols. Calibrated cable tensiometer was used to measure isometric strength of the right elbow extensors and a biofeedback electromyography was used to assure no substitution movements from shoulder girdle muscles. The mean values of isometric strength of elbow extensors measured from supine-lying position at elbow flexion angles of 45 and 90 degrees were 11.1  ±  4.2 kg and 13.1  ±  4.6 kg, while those measured from prone-lying position were 9.9  ±  3.6 kg and 12  ±  4.2 kg, respectively. There is statistical significant difference between the isometric strength of elbow extensors measured from supine-lying position at elbow flexion angles of 45 and 90 degrees compared to that measured from prone-lying position (p  <  0.05). The results suggest that in manual muscle testing starting position can affect the isometric strength of elbow extensors since supine-lying starting position is better than prone-lying starting position.

Isokinetic knee joint evaluation in track and field events.

PubMed

Deli, Chariklia K; Paschalis, Vassilis; Theodorou, Anastasios A; Nikolaidis, Michalis G; Jamurtas, Athanasios Z; Koutedakis, Yiannis

2011-09-01

The purpose of this study was to evaluate maximal torque of the knee flexors and extensors, flexor/extensor ratios, and maximal torque differences between the 2 lower extremities in young track and field athletes. Forty male track and field athletes 13-17 years old and 20 male nonathletes of the same age participated in the study. Athletes were divided into 4 groups according to their age and event (12 runners and 10 jumpers 13-15 years old, 12 runners and 6 jumpers 16-17 years old) and nonathletes into 2 groups of the same age. Maximal torque evaluation of knee flexors and extensors was performed on an isokinetic dynamometer at 60°·s(-1). At the age of 16-17 years, jumpers exhibited higher strength values at extension than did runners and nonathletes, whereas at the age of 13-15 years, no significant differences were found between events. Younger athletes were weaker than older athletes at flexion. Runners and jumpers were stronger than nonathletes in all relative peak torque parameters. Nonathletes exhibited a higher flexor/extensor ratio compared with runners and jumpers. Strength imbalance in athletes was found between the 2 lower extremities in knee flexors and extensors and also at flexor/extensor ratio of the same extremity. Young track and field athletes exhibit strength imbalances that could reduce their athletic performance, and specific strength training for the weak extremity may be needed.

Early reduction in toe flexor strength is associated with physical activity in elderly men

PubMed Central

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Yokochi, Takashi

2016-01-01

[Purpose] To compare the toe flexor, hand grip and knee extensor strengths of young and elderly men, and to examine the association between toe flexor strength and physical activity or inactivity levels. [Subjects and Methods] Young (n=155, 18–23 years) and elderly (n=60, 65–88 years) men participated in this study. Toe flexor, hand grip, and knee extensor strength were measured. Physical activity (time spent standing/walking per day) and inactivity (time spent sitting per day) were assessed using a self-administered questionnaire. [Results] Toe flexor, hand grip, and knee extensor strength of the elderly men were significantly lower than those of the young men. Standing/walking and sitting times of the elderly men were lower than those of the young men. Toe flexor strength correlated with hand grip and knee extensor strength in both groups. In elderly men, toe flexor strength correlated with standing/walking time. In comparison to the young men’s mean values, toe flexor strength was significantly lower than knee extensor and hand grip strength in the elderly group. [Conclusion] The results suggest that age-related reduction in toe flexor strength is greater than those of hand grip and knee extensor strengths. An early loss of toe flexor strength is likely associated with reduced physical activity in elderly men. PMID:27313353

Analysis of elbow muscle strength parameters in Brazilian jiu-jitsu practitioners.

PubMed

Follmer, Bruno; Dellagrana, Rodolfo André; de Lima, Luis Antonio Pereira; Herzog, Walter; Diefenthaeler, Fernando

2017-12-01

Upper-body dynamic and isometric maximum strength are essential components for success in Brazilian jiu-jitsu (BJJ). This study was aimed at analysing strength parameters in the elbow flexor and extensor muscles of BJJ practitioners. Participants (n = 28) performed maximum isometric contractions of elbow flexors and extensors to determine peak torque (PT), rate of force development (RFD), and the torque-angle (T-A) relationship at elbow angles of 45°, 60°, 75°, 90°, 105°, and 120°. Additionally, concentric and eccentric PTs were measured at 1.04 rad·s -1 . Student t-test and ANOVA were performed using α = 0.05. Elbow flexors were stronger isometrically (P < 0.001, ES = 1.23) but weaker concentrically (P < 0.05, ES = 0.54) than extensor muscles, possibly because of the extensive grip disputes and pushing of opponents in BJJ. The T-A relationship had an inverted "U"-shape. Torque differences across elbow angles were moderate (ES = 0.62) for the extensor and large (ES = 0.92) for the flexor muscles. Isometric torque was greatest for elbow angles of 105° and 75° and smallest for 45° and 120° for extensor and flexor muscles, respectively. Elbow flexors had a greater RFD than extensors, regardless of elbow angle. The present study provides comprehensive results for elbow muscle strength in BJJ practitioners.

Analysis of muscle fiber conduction velocity during finger flexion and extension after stroke.

PubMed

Conrad, Megan O; Qiu, Dan; Hoffmann, Gilles; Zhou, Ping; Kamper, Derek G

2017-05-01

Stroke survivors experience greater strength deficits during finger extension than finger flexion. Prior research indicates relatively little observed weakness is directly attributable to muscle atrophy. Changes in other muscle properties, however, may contribute to strength deficits. This study measured muscle fiber conduction velocity (MFCV) in a finger flexor and extensor muscle to infer changes in muscle fiber-type after stroke. Conduction velocity was measured using a linear EMG surface electrode array for both extensor digitorum communis and flexor digitorum superficialis in 12 stroke survivors with chronic hand hemiparesis and five control subjects. Measurements were made in both hands for all subjects. Stroke survivors had either severe (n = 5) or moderate (n = 7) hand impairment. Absolute MFCV was significantly lower in the paretic hand of severely impaired stroke patients compared to moderately impaired patients and healthy control subjects. The relative MFCV between the two hands, however, was quite similar for flexor muscles across all subjects and for extensor muscles for the neurologically intact control subjects. However, MFCV for finger extensors was smaller in the paretic as compared to the nonparetic hand for both groups of stroke survivors. One explanation for reduced MFCV may be a type-II to type-I muscle fiber, especially in extrinsic extensors. Clinically, therapists may use this information to develop therapeutic exercises targeting loss of type-II fiber in extensor muscles.

Elbow flexor and extensor muscle weakness in lateral epicondylalgia.

PubMed

Coombes, Brooke K; Bisset, Leanne; Vicenzino, Bill

2012-05-01

To evaluate whether deficits of elbow flexor and extensor muscle strength exist in lateral epicondylalgia (LE) in comparison with a healthy control population. Cross-sectional study. 150 participants with unilateral LE were compared with 54 healthy control participants. Maximal isometric elbow flexion and extension strength were measured bilaterally using a purpose-built standing frame such that gripping was avoided. The authors found significant side differences in elbow extensor (-6.54 N, 95% CI -11.43 to -1.65, p=0.008, standardised mean difference (SMD) -0.45) and flexor muscle strength (-11.26 N, 95% CI -19.59 to -2.94, p=0.009, SMD -0.46) between LE and control groups. Within the LE group, only elbow extensor muscle strength deficits between sides was significant (affected-unaffected: -2.94 N, 95% CI -5.44 to -0.44). Small significant deficits of elbow extensor and flexor muscle strength exist in the affected arm of unilateral LE in comparison with healthy controls. Notably, comparing elbow strength between the affected and unaffected sides in unilateral epicondylalgia is likely to underestimate these deficits. Trial Registration Australian New Zealand Clinical Trials Register ACTRN12609000051246.

V1 and V2b interneurons secure the alternating flexor-extensor motor activity mice require for limbed locomotion

PubMed Central

Zhang, Jingming; Lanuza, Guillermo M.; Britz, Olivier; Wang, Zhi; Siembab, Valerie C.; Zhang, Ying; Velasquez, Tomoko; Alvarez, Francisco J.; Frank, Eric; Goulding, Martyn

2014-01-01

SUMMARY The reciprocal activation of flexor and extensor muscles constitutes the fundamental mechanism that tetrapod vertebrates use for locomotion and limb-driven reflex behaviors. This aspect of motor coordination is controlled by inhibitory neurons in the spinal cord; however, the identity of the spinal interneurons that serve this function is not known. Here we show that the production of an alternating flexor-extensor motor rhythm depends on the composite activities of two classes of ventrally-located inhibitory neurons, V1 and V2b interneurons (INs). Abrogating V1 and V2b IN-derived neurotransmission in the isolated spinal cord results in a synchronous pattern of L2 flexor-related and L5 extensor-related locomotor activity. Mice lacking V1 and V2b inhibition are unable to articulate their limb joints and display marked deficits in limb-driven reflex movements. Taken together, these findings identify V1- and V2b-derived neurons as the core interneuronal components of the limb central pattern generator (CPG) that coordinate flexor-extensor motor activity. PMID:24698273

Tendon rupture associated with excessive smartphone gaming.

PubMed

Gilman, Luke; Cage, Dori N; Horn, Adam; Bishop, Frank; Klam, Warren P; Doan, Andrew P

2015-06-01

Excessive use of smartphones has been associated with injuries. A 29-year-old, right hand-dominant man presented with chronic left thumb pain and loss of active motion from playing a Match-3 puzzle video game on his smartphone all day for 6 to 8 weeks. On physical examination, the left extensor pollicis longus tendon was not palpable, and no tendon motion was noted with wrist tenodesis. The thumb metacarpophalangeal range of motion was 10° to 80°, and thumb interphalangeal range of motion was 30° to 70°. The clinical diagnosis was rupture of the left extensor pollicis longus tendon. The patient subsequently underwent an extensor indicis proprius (1 of 2 tendons that extend the index finger) to extensor pollicis longus tendon transfer. During surgery, rupture of the extensor pollicis longus tendon was seen between the metacarpophalangeal and wrist joints. The potential for video games to reduce pain perception raises clinical and social considerations about excessive use, abuse, and addiction. Future research should consider whether pain reduction is a reason some individuals play video games excessively, manifest addiction, or sustain injuries associated with video gaming.

Extensor Tendon Injuries

MedlinePlus

... the Hand. Find a hand surgeon near you. Videos Figures Figure 1 - Extensor tendons, located on the ... or "in." Also, avoid using media types like "video," "article," and "picture." Tip 4: Your results can ...

Tennis elbow: a biomechanical and therapeutic approach.

PubMed

Schnatz, P; Steiner, C

1993-07-01

Lateral epicondylitis, one of the most common lesions of the arm, affects some 50% of tennis players. This condition poses a problem in clinical management because treatment is dependent not only on proper medical therapy but also on correction of the improper on-court biomechanics. The most common flaw is a late contact on the backhand groundstroke, forcing the player to extend the wrist with the extensor muscles. This action predisposes to trauma of the tendon fibers at the lateral epicondyle. Understanding the biomechanics will better prepare the physician to advise the patient and to communicate with a tennis teaching professional to facilitate long-term relief.

Dorsal Arthroscopic Approach and Intra-Articular Anatomy of the Bovine Antebrachiocarpal and Middle Carpal Joints.

PubMed

Lardé, Hélène; Nichols, Sylvain; Babkine, Marie; Desrochers, André

2016-07-01

To determine arthroscopic approaches to the dorsal synovial compartments of the antebrachiocarpal and middle carpal joints in adult cattle, and to describe the arthroscopic intra-articular anatomy from each approach. Ex vivo study. Six fresh adult bovine cadavers. Two carpi were injected with latex and dissected to determine the ideal location for arthroscopic portals. Arthroscopy of the antebrachiocarpal and middle carpal joints of 10 carpi was then performed. The dorsolateral approach was made between the extensor carpi radialis and common digital extensor tendons. The dorsomedial approach was made medial to the extensor carpi radialis tendon, midway between the distal radius and proximal row of carpal bones (antebrachiocarpal joint) and midway between the two rows of carpal bones (middle carpal joint), with the joint in flexion. Arthroscopy of the antebrachiocarpal joint allowed visualization of the distal radius, proximal aspect of the radial, intermediate and ulnar carpal bones, and a palmar ligament located between the radius and the intermediate carpal bone. The approach to the middle carpal joint allowed visualization of the distal aspect of the radial, intermediate, and ulnar carpal bones, the proximal aspect of the fourth and fused second and third carpal bones and an interosseous ligament. The most lateral articular structures (lateral glenoid cavity of the distal radius, ulnar carpal and fourth carpal bones) were difficult to assess. Dorsal approaches to the antebrachiocarpal and middle carpal joints allowed visualization of most intra-articular dorsal structures in adult cattle. © Copyright 2016 by The American College of Veterinary Surgeons.

A Newly Designed Tennis Elbow Orthosis With a Traditional Tennis Elbow Strap in Patients With Lateral Epicondylitis

PubMed Central

Saremi, Hossein; Chamani, Vahid; Vahab-Kashani, Reza

2016-01-01

Background Lateral epicondylitis is a common cause of pain and upper limb dysfunction. The use of counterforce straps for treatment of lateral epicondylitis is widespread. This kind of orthosis can be modified to have a greater effect on relieving pain by reducing tension on the origin of the extensor pronator muscles. Objectives To determine the immediate effects of a newly designed orthosis on pain and grip strength in patients with lateral epicondylitis. Materials and Methods Twelve participants (six men and six women) were recruited (mean age = 41 ± 6.7 years) and evaluated for pain and grip strength in three sessions. A 48-hour break was taken between each session. The first session was without any orthosis, the second session was with the new modified tennis elbow orthosis, and the third session was with a conventional tennis elbow strap. Results Both counterforce straps were effective. However, significantly more improvement was observed in pain and grip strength after using the newly modified orthosis (P < 0.05). Conclusions The newly designed strap reduces pain more effectively and improves grip strength by causing greater localized pressure on two regions with different force applications (two component vectors versus one). PMID:28180116

Multiple variations of the tendons of the anatomical snuffbox.

PubMed

Thwin, San San; Fazlin, Fazlin; Than, Myo

2014-01-01

Multiple tendons of the abductor pollicis longus (APL) in the anatomical snuffbox of the wrist can lead to the development of de Quervain's syndrome, which is caused by stenosing tenosynovitis. A cadaveric study was performed to establish the variations present in the tendons of the anatomical snuffbox in a Malaysian population, in the hope that this knowledge would aid clinical investigation and surgical treatment of de Quervain's tenosynovitis. Routine dissection of ten upper limbs was performed to determine the variations in the tendons of the anatomical snuffbox of the wrist. In all the dissected upper limbs, the APL tendon of the first extensor compartment was found to have several (3-14) tendon slips. The insertion of the APL tendon slips in all upper limbs were at the base of the first metacarpal bone, trapezium and fascia of the opponens pollicis muscle; however, in seven specimens, they were also found to be attached to the fleshy belly of the abductor pollicis brevis muscle. In two specimens, double tendons of the extensor pollicis longus located in the third extensor compartment were inserted into the capsule of the proximal interphalangeal joints before being joined to the extensor expansion. In two other specimens, the first extensor compartment had two osseofibrous tunnels divided by a septum that separated the APL tendon from the extensor pollicis brevis tendon. Multiple variations were found in the anatomical snuffbox region of the dissected upper limbs. Knowledge of these variations would be useful in interventional radiology and orthopaedic surgery.

Relationship between leg extensor muscle strength and knee joint loading during gait before and after total knee arthroplasty.

PubMed

Vahtrik, Doris; Gapeyeva, Helena; Ereline, Jaan; Pääsuke, Mati

2014-01-01

The aim of the present study was to evaluate an isometric maximal voluntary contraction (MVC) force of the leg extensor muscles and its relationship with knee joint loading during gait prior and after total knee arthroplasty (TKA). Custom-made dynamometer was used to assess an isometric MVC force of the leg extensor muscles and 3-D motion analysis system was used to evaluate the knee joint loading during gait in 13 female patients (aged 49-68 years) with knee osteoarthritis. Patients were evaluated one day before, and three and six months following TKA in the operated and non-operated leg. Six months after TKA, MVC force of the leg extensor muscles for the operated leg did not differ significantly as compared to the preoperative level, whereas it remained significantly lower for the non-operated leg and controls. The knee flexion moment and the knee joint power during mid stance of gait was improved six months after TKA, remaining significantly lowered compared with controls. Negative moderate correlation between leg extensor muscles strength and knee joint loading for the operated leg during mid stance was noted three months after TKA. The correlation analysis indicates that due to weak leg extensor muscles, an excessive load is applied to knee joint during mid stance of gait in patients, whereas in healthy subjects stronger knee-surrounding muscles provide stronger knee joint loading during gait. III (correlational study). Copyright © 2013 Elsevier B.V. All rights reserved.

Relationship between lower extremity isometric muscle strength and standing balance in patients with multiple sclerosis.

PubMed

Citaker, Seyit; Guclu-Gunduz, Arzu; Yazici, Gokhan; Bayraktar, Deniz; Nazliel, Bijen; Irkec, Ceyla

2013-01-01

Muscle strength and standing balance decrease in patients with Multiple Sclerosis (MS). The aim of the present study was to investigate the relationship between the lower extremity isometric muscle strength and standing balance in patients with MS. Forty-seven patients with MS and 10 healthy volunteers were included. Neurological disability level was assessed using Expanded Disability Status Scale (EDSS). Isometric strength of seven lower extremity muscles (hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor) was assessed using hand-held dynamometer. Duration of static one-leg standing balance was measured using digital chronometer. Hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor isometric muscle strength, and duration of one-leg standing balance were decreased in patients with MS when compared with controls (p < 0.05). All assessed lower extremity isometric muscle strength and EDSS level was related duration of one-leg standing balance in patients with MS. All assessed lower extremity isometric muscle strength (except ankle dorsal flexor) was related with EDSS. Hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor isometric muscle strength decreases in ambulatory MS patients. Lower extremity muscle weakness and neurological disability level are related with imbalance in MS population. Hip and knee region muscles weakness increases the neurological disability level. For the better balance and decrease neurological disability level whole lower extremity muscle strengthening should be included in rehabilitation programs.

Neck Flexor and Extensor Muscle Endurance in Subclinical Neck Pain: Intrarater Reliability, Standard Error of Measurement, Minimal Detectable Change, and Comparison With Asymptomatic Participants in a University Student Population.

PubMed

Lourenço, Ana S; Lameiras, Carina; Silva, Anabela G

2016-01-01

The aims of this study were to assess intrarater reliability and to calculate the standard error of measurement (SEM) and minimal detectable change (MDC) for deep neck flexor and neck extensor muscle endurance tests, and compare the results between individuals with and without subclinical neck pain. Participants were students of the University of Aveiro reporting subclinical neck pain and asymptomatic participants matched for sex and age to the neck pain group. Data on endurance capacity of the deep neck flexors and neck extensors were collected by a blinded assessor using the deep neck flexor endurance test and the extensor endurance test, respectively. Intraclass correlation coefficients (ICCs), SEM, and MDC were calculated for measurements taken within a session by the same assessor. Differences between groups for endurance capacity were investigated using a Mann-Whitney U test. The deep neck flexor endurance test (ICC = 0.71; SEM = 6.91 seconds; MDC = 19.15 seconds) and neck extensor endurance test (ICC = 0.73; SEM = 9.84 minutes; MDC = 2.34 minutes) are reliable. No significant differences were found between participants with and without neck pain for both tests of muscle endurance (P > .05). The endurance capacity of the deep neck flexors and neck extensors can be reliably measured in participants with subclinical neck pain. However, the wide SEM and MDC might limit the sensitivity of these tests. Copyright © 2016. Published by Elsevier Inc.

The effects of trunk extensor and abdominal muscle fatigue on postural control and trunk proprioception in young, healthy individuals.

PubMed

Larson, Dennis J; Brown, Stephen H M

2018-02-01

The purpose of this study was to induce both trunk extensor and abdominal muscle fatigue, on separate occasions, and compare their effects on standing postural control and trunk proprioception, as well as look at the effects of a recovery period on these outcome measures. A total of 20 individuals participated, with 10 (5 males and 5 females) completing either a standing postural control or lumbar axial repositioning protocol. Participants completed their randomly assigned protocol on two occasions, separated by at least 4  days, with either their trunk extensor or abdominal muscles being fatigued on either day. Postural control centre of pressure variables and trunk proprioception errors were compared pre- and post-fatigue. Results showed that both trunk extensor and abdominal muscle fatigue significantly degraded standing postural control immediately post-fatigue, with recovery occurring within 2 min post-fatigue. In general, these degradative effects on postural control appeared to be greater when the trunk extensor muscles were fatigued compared to the abdominal muscles. No statistically significant changes in trunk proprioception were found after either fatigue protocol. The present findings demonstrate our body's ability to quickly adapt and reweight somatosensory information to maintain postural control and trunk proprioception, as well as illustrate the importance of considering the abdominal muscles, along with the trunk extensor muscles, when considering the impact of fatigue on trunk movement and postural control. Copyright © 2017 Elsevier B.V. All rights reserved.

Delayed recovery of the affected finger extensors at chronic stage in a stroke patient: A case report.

PubMed

Jang, Sung Ho; Lee, Han Do

2017-10-01

A 33-year-old male presented with complete weakness of the right extremities due to corona radiata infarct. The main concerns of the patient is recovery of hand function especially related to finger extension. Right corona radiata infarct. He underwent physical therapy and occupational therapy at the outpatient clinic of the rehabilitation department of the same university hospital until 2 years after onset. In addition, he underwent neuromuscular electrical stimulation for the right finger extensors continuously until 4 years after onset. At 6 months after onset, the weakness of his right side recovered to subnormal state except for the right finger extensors which were completely weak. At 1.5 years after onset, the right finger extensors began to show slow and continuous recovery. At 4 years after onset, the patient showed motor recovery in the right finger extensors to the extent that he was able to move against gravity. Discontinuation of the left corticospinal tract was observed on 2-month diffusion tensor tractography (DTT); however, the integrity of this discontinuation had recovered to the primary motor cortex on 4-year DTT. On 2-month transcranial magnetic stimulation (TMS), no motor-evoked potential was evoked; in contrast, motor-evoked potentials were obtained at the right-hand muscle on 4-year TMS study. We demonstrated unusual delayed and long-term recovery of the affected finger extensors in a patient with corona radiata infarct using DTT and TMS.

Evaluation of the marsh deer stifle joint by imaging studies and gross anatomy.

PubMed

Shigue, D A; Rahal, S C; Schimming, B C; Santos, R R; Vulcano, L C; Linardi, J L; Teixeira, C R

2015-12-01

This study aimed to evaluate the stifle joint of marsh deer using imaging studies and in comparison with gross anatomy. Ten hindlimbs from 5 marsh deer (Blastocerus dichotomus) were used. Radiography, computed tomography (CT) and magnetic resonance imaging (MRI) were performed in each stifle joint. Two hindlimbs were dissected to describe stifle gross anatomy. The other limbs were sectioned in sagittal, dorsal or transverse planes. In the craniocaudal radiographic view, the lateral femoral condyle was broader than the medial femoral condyle. The femoral trochlea was asymmetrical. Subsequent multiplanar reconstruction revealed in the cranial view that the external surface of the patella was roughened, the medial trochlea ridge was larger than the lateral one, and the extensor fossa at the lateral condyle was next to the lateral ridge. The popliteal fossa was better visualized via the lateral view. Sagittal MRI images identified lateral and medial menisci, caudolateral and craniomedial bundles of cranial cruciate ligament, caudal cruciate ligament, patellar ligament and common extensor tendon. In conclusion, the marsh deer stifle presents some anatomical characteristics of the ovine stifle joint. © 2014 Blackwell Verlag GmbH.

The intersection syndrome: Ultrasound findings and their diagnostic value

PubMed Central

Montechiarello, S.; Miozzi, F.; D’Ambrosio, I.; Giovagnorio, F.

2010-01-01

Introduction The intersection syndrome is a well-known overuse syndrome of the distal forearm. It is characterized by noninfectious, inflammatory changes involving the area of intersection of the first (abductor pollicis longus and extensor pollicis brevis) and second (extensor carpi radialis longus and extensor carpi radialis brevis) extensor compartments in the dorsoradial aspect of the distal forearm. Imaging modalities used to diagnosis this syndrome include ultrasonography (US) and magnetic resonance imaging. The purpose of this report is to describe typical US findings in the intersection syndrome and to demonstrate the diagnostic value of this approach. Materials and methods We reviewed US findings in 4 patients (mean age 40 years) referred to our staff for symptoms suggestive of the intersection syndrome (pain, swelling, erythema, and edema of the wrist). Results In all 4 cases, the US examination revealed peritendinous edema and synovial fluid within the tendon sheaths at the intersection between the first and the second dorsal extensor tendon compartments. Discussion Our experience shows that the intersection syndrome is associated with typical signs on US. This imaging modality can be considered a reliable tool for diagnosing this syndrome and may eliminate the need for other more expensive tests. PMID:23396515

Trunk extensor muscle fatigue influences trunk muscle activities.

PubMed

Hoseinpoor, Tahere Seyed; Kahrizi, Sedighe; Mobini, Bahram

2015-01-01

Trunk muscles fatigue is one of the risk factors in workplaces and daily activities. Loads would be redistributed among active and passive tissues in a non-optimal manner in fatigue conditions. Therefore, a single tissue might be overloaded with minimal loads and as a result the risk of injury would increase. The goal of this paper was to assess the electromyographic response of trunk extensor and abdominal muscles after trunk extensor muscles fatigue induced by cyclic lifting task. This was an experimental study that twenty healthy women participated. For assessing automatic response of trunk extensor and abdominal muscles before and after the fatigue task, electromyographic activities of 6 muscles: thorasic erector spine (TES), lumbar erector spine (LES), lumbar multifidus (LMF), transverse abdominis/ internal oblique (TrA/IO), rectus abdominis (RA) and external oblique (EO) were recorded in standing position with no load and symmetric axial loads equal to 25% of their body weights. Statistical analysis showed that all the abdominal muscles activity decreased with axial loads after performing fatigue task but trunk extensor activity remained constant. Results of the current study indicated that muscle recruitment strategies changed with muscle fatigue and load bearing, therefore risks of tissue injury may increase in fatigue conditions.

V1 and v2b interneurons secure the alternating flexor-extensor motor activity mice require for limbed locomotion.

PubMed

Zhang, Jingming; Lanuza, Guillermo M; Britz, Olivier; Wang, Zhi; Siembab, Valerie C; Zhang, Ying; Velasquez, Tomoko; Alvarez, Francisco J; Frank, Eric; Goulding, Martyn

2014-04-02

Reciprocal activation of flexor and extensor muscles constitutes the fundamental mechanism that tetrapod vertebrates use for locomotion and limb-driven reflex behaviors. This aspect of motor coordination is controlled by inhibitory neurons in the spinal cord; however, the identity of the spinal interneurons that serve this function is not known. Here, we show that the production of an alternating flexor-extensor motor rhythm depends on the composite activities of two classes of ventrally located inhibitory neurons, V1 and V2b interneurons (INs). Abrogating V1 and V2b IN-derived neurotransmission in the isolated spinal cord results in a synchronous pattern of L2 flexor-related and L5 extensor-related locomotor activity. Mice lacking V1 and V2b inhibition are unable to articulate their limb joints and display marked deficits in limb-driven reflex movements. Taken together, these findings identify V1- and V2b-derived neurons as the core interneuronal components of the limb central pattern generator (CPG) that coordinate flexor-extensor motor activity. Copyright © 2014 Elsevier Inc. All rights reserved.

Handgrip strength deficits best explain limitations in performing bimanual activities after stroke.

PubMed

Basílio, Marluce Lopes; de Faria-Fortini, Iza; Polese, Janaine Cunha; Scianni, Aline A; Faria, Christina Dcm; Teixeira-Salmela, Luci Fuscaldi

2016-04-01

[Purpose] To evaluate the relationships between residual strength deficits (RSD) of the upper limb muscles and the performance in bimanual activities and to determine which muscular group would best explain the performance in bimanual activities of chronic stroke individuals. [Subjects and Methods] Strength measures of handgrip, wrist extensor, elbow flexor/extensor, and shoulder flexor muscles of 107 subjects were obtained and expressed as RSD. The performance in bimanual activities was assessed by the ABILHAND questionnaire. [Results] The correlations between the RSD of handgrip and wrist extensor muscles with the ABILHAND scores were negative and moderate, whereas those with the elbow flexor/extensor and shoulder flexor muscles were negative and low. Regression analysis showed that the RSD of handgrip and wrist extensor muscles explained 38% of the variance in the ABILHAND scores. Handgrip RSD alone explained 33% of the variance. [Conclusion] The RSD of the upper limb muscles were negatively associated with the performance in bimanual activities and the RSD of handgrip muscles were the most relevant variable. It is possible that stroke subjects would benefit from interventions aiming at improving handgrip strength, when the goal is to increase the performance in bimanual activities.

Asymmetric Operation of the Locomotor Central Pattern Generator in the Neonatal Mouse Spinal Cord

PubMed Central

Endo, Toshiaki; Kiehn, Ole

2008-01-01

The rhythmic voltage oscillations in motor neurons (MNs) during locomotor movements reflect the operation of the pre-MN central pattern generator (CPG) network. Recordings from MNs can thus be used as a method to deduct the organization of CPGs. Here, we use continuous conductance measurements and decomposition methods to quantitatively assess the weighting and phase tuning of synaptic inputs to different flexor and extensor MNs during locomotor-like activity in the isolated neonatal mice lumbar spinal cord preparation. Whole cell recordings were obtained from 22 flexor and 18 extensor MNs in rostral and caudal lumbar segments. In all flexor and the large majority of extensor MNs the extracted excitatory and inhibitory synaptic conductances alternate but with a predominance of inhibitory conductances, most pronounced in extensors. These conductance changes are consistent with a “push–pull” operation of locomotor CPG. The extracted excitatory and inhibitory synaptic conductances varied between 2 and 56% of the mean total conductance. Analysis of the phase tuning of the extracted synaptic conductances in flexor and extensor MNs in the rostral lumbar cord showed that the flexor-phase–related synaptic conductance changes have sharper locomotor-phase tuning than the extensor-phase–related conductances, suggesting a modular organization of premotor CPG networks consisting of reciprocally coupled, but differently composed, flexor and extensor CPG networks. There was a clear difference between phase tuning in rostral and caudal MNs, suggesting a distinct operation of CPG networks in different lumbar segments. The highly asymmetric features were preserved throughout all ranges of locomotor frequencies investigated and with different combinations of locomotor-inducing drugs. The asymmetric nature of CPG operation and phase tuning of the conductance profiles provide important clues to the organization of the rodent locomotor CPG and are compatible with a multilayered and distributed structure of the network. PMID:18829847

A dynamic traction splint for the management of extrinsic tendon tightness.

PubMed

Dovelle, S; Heeter, P K; Phillips, P D

1987-02-01

The dynamic traction splint designed by therapists at Walter Reed Army Medical Center is used for the management of extrinsic extensor tendon tightness commonly seen in brachial plexus injuries and traumatic soft tissue injuries of the upper extremity. The two components of the splint allow for simultaneous maximum flexion of the MCP and IP joints. This simple and economical splint provides an additional modality to any occupational therapy service involved in the management of upper extremity disorders.

[Patella fractures in knee arthroplasty].

PubMed

Roth, A; Ghanem, M; Fakler, J

2016-05-01

Periprosthetic patella fractures occur both with and without retropatellar joint replacement. A non-operative treatment yields satisfactory results with low morbidity. It can be applied in minimally displaced fractures that have an intact retropatellar component and an intact extensor mechanism, combined with an initial immobilization. The surgical treatment is associated with relatively poor results and with high complication rates. There was only minor improvement of functional results, no matter which surgical technique was used. Surgical intervention is still required in fractures with a loosening of the patellar component, considerable dislocations of fragments, and damage to or rupture of the extensor mechanism. In particular, type II fractures require repair of the extensor mechanism and the fracture or patellectomy. Type III fractures require a revision or resection of the patella, a patelloplasty or total patellectomy. In addition, early or late reconstruction using allograft to restore the extensor mechanism can be taken in consideration.

Muscle Strength Imbalance in the Hip Joint Caused by Fast Movements

NASA Astrophysics Data System (ADS)

Pontaga, I.

2003-07-01

Eleven male sportsmen at the age of 24.3 ± 4.5 were examined. Their hip joint flexors and extensors were tested by an "REV-9000" Technogym dynamometer system during isokinetic movements at angular velocities of 100 (low) and 200 (high) °/s. The range of hip joint movements was from 30 (in flexion) to 130° (in extension). Torque values and their ratios for hip flexors and extensors at different angular positions were obtained and compared. It is shown that, at high speeds, the flexion movement significantly raises ( p < 0.001) the torque ratios of flexors and extensors in flexion positions of the hip (50 and 60°). These ratios approximately twofold exceed their values at moderate velocities. The weakness of hip joint extensors in extreme flexion positions of the hip may cause injury of this group of muscles at fast movements.

Intra-operative monitoring of the common peroneal nerve during total knee replacement.

PubMed Central

Unwin, A J; Thomas, M

1994-01-01

We present a method allowing intra-operative monitoring of the common peroneal nerve during total knee arthroplasty using a magnetic stimulator. Previous reports have shown no pre-operative method successful in selecting those patients prone to develop a post-operative palsy. The device, placed beneath the lumbar spine, stimulates the cauda equina; common peroneal nerve function is assessed via the response in extensor digitorum brevis. There is a loss of signal from the nerve with the use of a tourniquet 25 min following its application. The protocol therefore requires that a tourniquet is used at least only for fixation of the prosthetic components. The method is quick, safe, non-invasive and reproducible, and is of use both in at-risk patients and in research work. Images Figure 6. PMID:7837197

Electromyographic activity of the trunk extensor muscles: effect of varying hip position and lumbar posture during Roman chair exercise.

PubMed

Mayer, John M; Verna, Joe L; Manini, Todd M; Mooney, Vert; Graves, James E

2002-11-01

To evaluate the effect of hip position and lumbar posture on the surface electromyographic activity of the trunk extensors during Roman chair exercise. Descriptive, repeated measures. University-based musculoskeletal research laboratory. Twelve healthy volunteers (7 men, 5 women; age range, 18-35y) without a history of low back pain were recruited from a university setting. Not applicable. Surface electromyographic activity was recorded from the lumbar extensor, gluteal, and hamstring musculature during dynamic Roman chair exercise. For each muscle group, electromyographic activity (mV/rep) was compared among exercises with internal hip rotation and external hip rotation and among exercises by using a typical lumbar posture (nonbiphasic) and a posture that accentuated lumbar lordosis (biphasic). For the lumbar extensors, electromyographic activity during exercise was 18% greater with internal hip rotation than external hip rotation (P< or =.05) and was 25% greater with a biphasic posture than with a nonbiphasic posture (P< or =.05). For the gluteals and hamstrings, there was no difference in electromyographic activity between internal and external hip rotation or between biphasic and nonbiphasic postures (P >.05). The level of recruitment of the lumbar extensors can be modified during Roman chair exercise by altering hip position and lumbar posture. Clinicians can use these data to develop progressive exercise protocols for the lumbar extensors with a variety of resistance levels without the need for complex equipment. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Identification of human-generated forces on wheelchairs during total-body extensor thrusts.

PubMed

Hong, Seong-Wook; Patrangenaru, Vlad; Singhose, William; Sprigle, Stephen

2006-10-01

Involuntary extensor thrust experienced by wheelchair users with neurological disorders may cause injuries via impact with the wheelchair, lead to the occupant sliding out of the seat, and also damage the wheelchair. The concept of a dynamic seat, which allows movement of a seat with respect to the wheelchair frame, has been suggested as a potential solution to provide greater freedom and safety. Knowledge of the human-generated motion and forces during unconstrained extensor thrust events is of great importance in developing more comfortable and effective dynamic seats. The objective of this study was to develop a method to identify human-generated motions and forces during extensor thrust events. This information can be used to design the triggering system for a dynamic seat. An experimental system was developed to automatically track the motions of the wheelchair user using a video camera and also measure the forces at the footrest. An inverse dynamic approach was employed along with a three-link human body model and the experimental data to predict the human-generated forces. Two kinds of experiments were performed: the first experiment validated the proposed model and the second experiment showed the effects of the extensor thrust speed, the footrest angle, and the seatback angle. The proposed method was tested using a sensitivity analysis, from which a performance index was deduced to help indicate the robust region of the force identification. A system to determine human-generated motions and forces during unconstrained extensor thrusts was developed. Through experiments and simulations, the effectiveness and reliability of the developed system was established.

Multiple variations of the tendons of the anatomical snuffbox

PubMed Central

Thwin, San San; Zaini, Fazlin; Than, Myo

2014-01-01

INTRODUCTION Multiple tendons of the abductor pollicis longus (APL) in the anatomical snuffbox of the wrist can lead to the development of de Quervain's syndrome, which is caused by stenosing tenosynovitis. A cadaveric study was performed to establish the variations present in the tendons of the anatomical snuffbox in a Malaysian population, in the hope that this knowledge would aid clinical investigation and surgical treatment of de Quervain's tenosynovitis. METHODS Routine dissection of ten upper limbs was performed to determine the variations in the tendons of the anatomical snuffbox of the wrist. RESULTS In all the dissected upper limbs, the APL tendon of the first extensor compartment was found to have several (3–14) tendon slips. The insertion of the APL tendon slips in all upper limbs were at the base of the first metacarpal bone, trapezium and fascia of the opponens pollicis muscle; however, in seven specimens, they were also found to be attached to the fleshy belly of the abductor pollicis brevis muscle. In two specimens, double tendons of the extensor pollicis longus located in the third extensor compartment were inserted into the capsule of the proximal interphalangeal joints before being joined to the extensor expansion. In two other specimens, the first extensor compartment had two osseofibrous tunnels divided by a septum that separated the APL tendon from the extensor pollicis brevis tendon. CONCLUSION Multiple variations were found in the anatomical snuffbox region of the dissected upper limbs. Knowledge of these variations would be useful in interventional radiology and orthopaedic surgery. PMID:24452976

The posterior transtriceps approach for elbow arthrography: a forgotten technique?

PubMed

Lohman, M; Borrero, C; Casagranda, B; Rafiee, B; Towers, J

2009-05-01

To evaluate the technical feasibility of performing elbow MR arthrography via a posterior approach through the triceps. The images of 19 patients with elbow MR arthrography via a posterior transtriceps approach were retrospectively studied. The injections were performed by four musculoskeletal radiologists, using fluoroscopic guidance and a 22- or 25-gauge needle. The fluoroscopic and subsequent MR images were reviewed by two musculoskeletal radiologists and evaluated for adequacy of joint capsular distention, degree and location of contrast leakage, and presence of gas bubbles. The injection was diagnostic in all 19 patients, with a sufficient amount of contrast agent seen in the elbow joint. No significant contrast leakage occurred in 12 patients who received injections of 8 cc or less of contrast agent, but moderate contrast leakage occurred in 6/7 patients who received injections of greater than 8 cc. Contrast leakage generally occurred within the triceps myotendinous junction. No gas bubbles were identified in the injected joints. Patients often present for MR arthrography of the elbow with medial or lateral elbow pain. Contrast leakage during a radiocapitellar approach may complicate evaluation of the lateral collateral ligament or the common extensor tendon origin. Transtriceps MR arthrography offers an alternative to the more commonly used radiocapitellar approach. With injected volumes not exceeding 8 cc, the risk of significant contrast leakage is small. An advantage of the transtriceps injection is that contrast leakage through the posterior needle tract does not interfere with evaluation of the lateral structures.

Constraint-induced movement therapy after stroke.

PubMed

Kwakkel, Gert; Veerbeek, Janne M; van Wegen, Erwin E H; Wolf, Steven L

2015-02-01

Constraint-induced movement therapy (CIMT) was developed to overcome upper limb impairments after stroke and is the most investigated intervention for the rehabilitation of patients. Original CIMT includes constraining of the non-paretic arm and task-oriented training. Modified versions also apply constraining of the non-paretic arm, but not as intensive as original CIMT. Behavioural strategies are mostly absent for both modified and original CIMT. With forced use therapy, only constraining of the non-paretic arm is applied. The original and modified types of CIMT have beneficial effects on motor function, arm-hand activities, and self-reported arm-hand functioning in daily life, immediately after treatment and at long-term follow-up, whereas there is no evidence for the efficacy of constraint alone (as used in forced use therapy). The type of CIMT, timing, or intensity of practice do not seem to affect patient outcomes. Although the underlying mechanisms that drive modified and original CIMT are still poorly understood, findings from kinematic studies suggest that improvements are mainly based on adaptations through learning to optimise the use of intact end-effectors in patients with some voluntary motor control of wrist and finger extensors after stroke. Copyright © 2015 Elsevier Ltd. All rights reserved.

Gap junction protein expression and cellularity: comparison of immature and adult equine digital tendons

PubMed Central

Stanley, Rachael L; Fleck, Roland A; Becker, David L; Goodship, Allen E; Ralphs, Jim R; Patterson-Kane, Janet C

2007-01-01

Injury to the energy-storing superficial digital flexor tendon is common in equine athletes and is age-related. Tenocytes in the superficial digital flexor tendon of adult horses appear to have limited ability to respond adaptively to exercise or prevent the accumulation of strain-induced microdamage. It has been suggested that conditioning exercise should be introduced during the growth period, when tenocytes may be more responsive to increased quantities or intensities of mechanical strain. Tenocytes are linked into networks by gap junctions that allow coordination of synthetic activity and facilitate strain-induced collagen synthesis. We hypothesised that there are reductions in cellular expression of the gap junction proteins connexin (Cx) 43 and 32 during maturation and ageing of the superficial digital flexor tendon that do not occur in the non-injury-prone common digital extensor tendon. Cryosections from the superficial digital flexor tendon and common digital extensor tendon of 5 fetuses, 5 foals (1–6 months), 5 young adults (2–7 years) and 5 old horses (18–33 years) were immunofluorescently labelled and quantitative confocal laser microscopy was performed. Expression of Cx43 and Cx32 protein per tenocyte was significantly higher in the fetal group compared with all other age groups in both tendons. The density of tenocytes was found to be highest in immature tissue. Higher levels of cellularity and connexin protein expression in immature tendons are likely to relate to requirements for tissue remodelling and growth. However, if further studies demonstrate that this correlates with greater gap junctional communication efficiency and synthetic responsiveness to mechanical strain in immature compared with adult tendons, it could support the concept of early introduction of controlled exercise as a means of increasing resistance to later injury. PMID:17848160

Endoscopic-assisted Repair of Neglected Rupture or Rerupture After Primary Repair of Extensor Hallucis Longus Tendon.

PubMed

Lui, Tun Hing; Chang, Joseph Jeremy; Maffulli, Nicola

2016-03-01

Rerupture of the extensor hallucis longus tendon after primary repair and neglected rupture of the tendon poses surgical challenges to orthopedic surgeons. Open exploration and repair of the tendon ends usually requires large incision and extensive dissection. This may induce scarring and adhesion around the repaired tendon. Endoscopic-assisted repair has the advantage of minimally invasive surgery including less soft tissue trauma and scar formation and better cosmetic result. The use of Krackow locking suture and preservation of the extensor retinacula allow early mobilization of the great toe.

A Reconstructive Stabilization Technique for Nontraumatic or Chronic Traumatic Extensor Tendon Subluxation.

PubMed

Lee, Jae Hoon; Baek, Jong Hun; Lee, Jung Seok

2017-01-01

Subluxation of the extensor tendon results from a disruption to the sagittal band at the metacarpophalangeal joint. When conservative treatment fails to correct the subluxation, surgical treatment may be necessary. Surgical techniques for chronic cases vary in graft source and graft pathway. We present a surgical technique to recentralize and stabilize the extensor tendon using a residual ruptured sagittal band. This technique is simple and effective without donor site morbidity and seems to provide potential biomechanical advantages by restoring nearly normal anatomy. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Reliability and Validity of a New Method for Isometric Back Extensor Strength Evaluation Using A Hand-Held Dynamometer.

PubMed

Park, Hee-Won; Baek, Sora; Kim, Hong Young; Park, Jung-Gyoo; Kang, Eun Kyoung

2017-10-01

To investigate the reliability and validity of a new method for isometric back extensor strength measurement using a portable dynamometer. A chair equipped with a small portable dynamometer was designed (Power Track II Commander Muscle Tester). A total of 15 men (mean age, 34.8±7.5 years) and 15 women (mean age, 33.1±5.5 years) with no current back problems or previous history of back surgery were recruited. Subjects were asked to push the back of the chair while seated, and their isometric back extensor strength was measured by the portable dynamometer. Test-retest reliability was assessed with intraclass correlation coefficient (ICC). For the validity assessment, isometric back extensor strength of all subjects was measured by a widely used physical performance evaluation instrument, BTE PrimusRS system. The limit of agreement (LoA) from the Bland-Altman plot was evaluated between two methods. The test-retest reliability was excellent (ICC=0.82; 95% confidence interval, 0.65-0.91). The Bland-Altman plots demonstrated acceptable agreement between the two methods: the lower 95% LoA was -63.1 N and the upper 95% LoA was 61.1 N. This study shows that isometric back extensor strength measurement using a portable dynamometer has good reliability and validity.

Effects of training and weight support on muscle activation in Parkinson's disease.

PubMed

Rose, Martin H; Løkkegaard, Annemette; Sonne-Holm, Stig; Jensen, Bente R

2013-12-01

The aim of this study was to investigate the effect of high-intensity locomotor training on knee extensor and flexor muscle activation and adaptability to increased body-weight (BW) support during walking in patients with Parkinson's disease (PD). Thirteen male patients with idiopathic PD and eight healthy participants were included. The PD patients completed an 8-week training program on a lower-body, positive-pressure treadmill. Knee extensor and flexor muscles activation during steady treadmill walking (3 km/h) were measured before, at the mid-point, and after training. Increasing BW support decreased knee extensor muscle activation (normalization) and increased knee flexor muscle activation (abnormal) in PD patients when compared to healthy participants. Training improved flexor peak muscle activation adaptability to increased (BW) support during walking in PD patients. During walking without BW support shorter knee extensor muscle off-activation time and increased relative peak muscle activation was observed in PD patients and did not improve with 8 weeks of training. In conclusion, patients with PD walked with excessive activation of the knee extensor and flexor muscles when compared to healthy participants. Specialized locomotor training may facilitate adaptive processes related to motor control of walking in PD patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

Hip abductor, trunk extensor and ankle plantar flexor endurance in females with and without patellofemoral pain.

PubMed

Van Cant, Joachim; Pitance, Laurent; Feipel, Véronique

2017-01-01

Previous studies have reported strength deficit in hip abduction, extension and external rotation in females with patellofemoral pain (PFP) when compared with healthy control; however, there is conflicting evidence for a decrease in hip muscle endurance. Therefore, it seems important to evaluate hip muscle endurance in females with PFP. Moreover, trunk extensor and ankle plantar flexor endurance have not yet been evaluate in females with PFP. To compare hip abductor, trunk extensor and ankle plantar flexor endurance between females with and without PFP. Twenty females with PFP (mean age, 21.1 years) and 76 healthy females (mean age, 20.5 years) were recruited. Subject performed three endurance clinical tests: (1) The hip abductor isometric endurance test, (2) The Sorensen test and (3) The heel rise test. Group differences were assessed using an independent t tests, or Mann-Whitney U tests for non-normally distributed data. Subjects with PFP exhibited significantly lower hip abductor, trunk extensor and ankle plantar flexor endurance than healthy controls. On average, subjects with PFP had deficits of 16% in hip abduction, 14% in trunk extension and 26% in ankle plantar flexion. Females with PFP exhibited diminished hip abductor, trunk extensor and ankle plantar flexor endurance compared to healthy controls.

Muscle torque and its relation to technique, tactics, sports level and age group in judo contestants.

PubMed

Lech, Grzegorz; Chwała, Wiesław; Ambroży, Tadeusz; Sterkowicz, Stanisław

2015-03-29

The aim of this study was to perform a comparative analysis of maximal muscle torques at individual stages of development of athletes and to determine the relationship between muscle torques, fighting methods and the level of sports performance. The activity of 25 judo contestants during judo combats and the effectiveness of actions were evaluated. Maximum muscle torques in flexors/extensors of the body trunk, shoulder, elbow, hip and knee joints were measured. The level of significance was set at p≤0.05; for multiple comparisons the Mann-Whitney U test, p≤0.016, was used. Intergroup differences in relative torques in five muscle groups studied (elbow extensors, shoulder flexors, knee flexors, knee extensors, hip flexors) were not significant. In cadets, relative maximum muscle torques in hip extensors correlated with the activity index (Spearman's r=0.756). In juniors, maximum relative torques in elbow flexors and knee flexors correlated with the activity index (r=0.73 and r=0.76, respectively). The effectiveness of actions correlated with relative maximum torque in elbow extensors (r=0.67). In seniors, the relative maximum muscle torque in shoulder flexors correlated with the activity index during the second part of the combat (r=0.821).

Reduced servo-control of fatigued human finger extensor and flexor muscles.

PubMed Central

Hagbarth, K E; Bongiovanni, L G; Nordin, M

1995-01-01

1. In healthy human subjects holding the index finger semi-extended at the metacarpophalangeal joint against a moderate load, electromyographic (EMG) activity was recorded from the finger extensor and flexor muscles during different stages of muscle fatigue. The aim was to study the effect of muscle fatigue on the level of background EMG activity and on the reflex responses to torque pulses causing sudden extensor unloadings. Paired comparisons were made between the averaged EMG and finger deflection responses under two conditions: (1) at a stage of fatigue (following a sustained co-contraction) when great effort was required to maintain the finger position, and (2) under non-fatigue conditions while the subject tried to produce similar background EMG levels to those in the corresponding fatigue trials. 2. Both the unloading reflex in the extensor and the concurrent stretch reflex in the flexor were significantly less pronounced and had a longer latency in the fatigue trials. Consequently, the finger deflections had a larger amplitude and were arrested later in the fatigue trials. 3. It is concluded that--with avoidance of 'automatic gain compensation', i.e. reflex modifications attributable to differences in background EMG levels--the servo-like action of the unloading and stretch reflexes is reduced in fatigued finger extensor and flexor muscles. PMID:7562624

Muscle Torque and its Relation to Technique, Tactics, Sports Level and Age Group in Judo Contestants

PubMed Central

Lech, Grzegorz; Chwała, Wiesław; Ambroży, Tadeusz; Sterkowicz, Stanisław

2015-01-01

The aim of this study was to perform a comparative analysis of maximal muscle torques at individual stages of development of athletes and to determine the relationship between muscle torques, fighting methods and the level of sports performance. The activity of 25 judo contestants during judo combats and the effectiveness of actions were evaluated. Maximum muscle torques in flexors/extensors of the body trunk, shoulder, elbow, hip and knee joints were measured. The level of significance was set at p≤0.05; for multiple comparisons the Mann-Whitney U test, p≤0.016, was used. Intergroup differences in relative torques in five muscle groups studied (elbow extensors, shoulder flexors, knee flexors, knee extensors, hip flexors) were not significant. In cadets, relative maximum muscle torques in hip extensors correlated with the activity index (Spearman’s r=0.756). In juniors, maximum relative torques in elbow flexors and knee flexors correlated with the activity index (r=0.73 and r=0.76, respectively). The effectiveness of actions correlated with relative maximum torque in elbow extensors (r=0.67). In seniors, the relative maximum muscle torque in shoulder flexors correlated with the activity index during the second part of the combat (r=0.821). PMID:25964820

Electromyographic activity associated with spontaneous functional recovery after spinal cord injury in rats.

PubMed

Kaegi, Sibille; Schwab, Martin E; Dietz, Volker; Fouad, Karim

2002-07-01

This investigation was designed to study the spontaneous functional recovery of adult rats with incomplete spinal cord injury (SCI) at thoracic level during a time course of 2 weeks. Daily testing sessions included open field locomotor examination and electromyographic (EMG) recordings from a knee extensor (vastus lateralis, VL) and an ankle flexor muscle (tibialis anterior, TA) in the hindlimbs of treadmill walking rats. The BBB score (a locomotor score named after Basso et al., 1995, J. Neurotrauma, 12, 1-21) and various measures from EMG recordings were analysed (i.e. step cycle duration, rhythmicity of limb movements, flexor and extensor burst duration, EMG amplitude, root-mean-square, activity overlap between flexor and extensor muscles and hindlimb coupling). Directly after SCI, a marked drop in locomotor ability occurred in all rats with subsequent partial recovery over 14 days. The recovery was most pronounced during the first week. Significant changes were noted in the recovery of almost all analysed EMG measures. Within the 14 days of recovery, many of these measures approached control levels. Persistent abnormalities included a prolonged flexor burst and increased activity overlap between flexor and extensor muscles. Activity overlap between flexor and extensor muscles might be directly caused by altered descending input or by maladaptation of central pattern generating networks and/or sensory feedback.

Procedure Oriented Torsional Anatomy of the Forearm for Spasticity Injection.

PubMed

Chiou-Tan, Faye; Cianca, John; John, Joslyn; Furr-Stimming, Erin; Pandit, Sindhu; Taber, Katherine H

2015-01-01

: This is the second in a series of articles related to the concept of "torsional" anatomy. The objective of this article is to provide musculoskeletal ultrasound (MSKUS) anatomy of the forearm in the position of hemispastic flexion as a reference relevant to needle procedures. The MSKUS images were obtained in a healthy human subject. Marker dots were placed over common injection sites in the forearm for spasticity. The MSKUS probe was centered over each dot to obtain a cross-sectional view. A pair of MSKUS images was recorded for each site: the first in anatomic neutral and second in hemiparetic spastic position. The images were compared side to side. In addition, a video recording was made at each site to track the movement of the muscles and nerves during internal rotation. The pronator teres (PT) rotated medially and the brachialis and biceps tendon rotated in view. In addition, the median nerve became more superficial. The flexor carpi radialis rotated medially and was replaced by PT and the median nerve. The flexor carpi ulnaris and flexor digitorum profundus rotated medially and were replaced by the flexor carpi radialis, PT and median nerve. The flexor digitorum superficialis was replaced by the brachioradialis, extensor carpi radialis brevis, and radial nerve. The brachioradialis was replaced by the extensor carpi radialis brevis and extensor digitorum communis. Intended muscle targets rotate out of view and injection range. These are replaced by other muscles and nerves that could inadvertently be injected. This potentially could result in both increased complications and decreased efficacy of the procedure. It is hoped that this series of images will increase the accuracy and safety of needle placement for spasticity injections in the forearm.

Collagen fibrils in functionally distinct tendons have differing structural responses to tendon rupture and fatigue loading.

PubMed

Herod, Tyler W; Chambers, Neil C; Veres, Samuel P

2016-09-15

In this study we investigate relationships between the nanoscale structure of collagen fibrils and the macroscale functional response of collagenous tissues. To do so, we study two functionally distinct classes of tendons, positional tendons and energy storing tendons, using a bovine forelimb model. Molecular-level assessment using differential scanning calorimetry (DSC), functional crosslink assessment using hydrothermal isometric tension (HIT) analysis, and ultrastructural assessment using scanning electron microscopy (SEM) were used to study undamaged, ruptured, and cyclically loaded samples from the two tendon types. HIT indicated differences in both crosslink type and crosslink density, with flexor tendons having more thermally stable crosslinks than the extensor tendons (higher TFmax of >90 vs. 75.1±2.7°C), and greater total crosslink density than the extensor tendons (higher t1/2 of 11.5±1.9 vs. 3.5±1.0h after NaBH4 treatment). Despite having a lower crosslink density than flexor tendons, extensor tendons were significantly stronger (37.6±8.1 vs. 23.1±7.7MPa) and tougher (14.3±3.6 vs. 6.8±3.4MJ/m(3)). SEM showed that collagen fibrils in the tougher, stronger extensor tendons were able to undergo remarkable levels of plastic deformation in the form of discrete plasticity, while those in the flexor tendons were not able to plastically deform. When cyclically loaded, collagen fibrils in extensor tendons accumulated fatigue damage rapidly in the form of kink bands, while those in flexor tendons did not accumulate significant fatigue damage. The results demonstrate that collagen fibrils in functionally distinct tendons respond differently to mechanical loading, and suggests that fibrillar collagens may be subject to a strength vs. fatigue resistance tradeoff. Collagen fibrils-nanoscale biological cables-are the fundamental load-bearing elements of all structural human tissues. While all collagen fibrils share common features, such as being composed of a precise quarter-staggered polymeric arrangement of triple-helical collagen molecules, their structure can vary significantly between tissue types, and even between different anatomical structures of the same tissue type. To understand normal function, homeostasis, and disease of collagenous tissues requires detailed knowledge of collagen fibril structure-function. Using anatomically proximate but structurally distinct tendons, we show that collagen fibrils in functionally distinct tendons have differing susceptibilities to damage under both tensile overload and cyclic fatigue loading. Our results suggest that the structure of collagen fibrils may lead to a strength versus fatigue resistance tradeoff, where high strength is gained at the expense of fatigue resistance, and vice versa. Copyright © 2016 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Muscle mechanical advantage of human walking and running: implications for energy cost.

PubMed

Biewener, Andrew A; Farley, Claire T; Roberts, Thomas J; Temaner, Marco

2004-12-01

Muscular forces generated during locomotion depend on an animal's speed, gait, and size and underlie the energy demand to power locomotion. Changes in limb posture affect muscle forces by altering the mechanical advantage of the ground reaction force (R) and therefore the effective mechanical advantage (EMA = r/R, where r is the muscle mechanical advantage) for muscle force production. We used inverse dynamics based on force plate and kinematic recordings of humans as they walked and ran at steady speeds to examine how changes in muscle EMA affect muscle force-generating requirements at these gaits. We found a 68% decrease in knee extensor EMA when humans changed gait from a walk to a run compared with an 18% increase in hip extensor EMA and a 23% increase in ankle extensor EMA. Whereas the knee joint was extended (154-176 degrees) during much of the support phase of walking, its flexed position (134-164 degrees) during running resulted in a 5.2-fold increase in quadriceps impulse (time-integrated force during stance) needed to support body weight on the ground. This increase was associated with a 4.9-fold increase in the ground reaction force moment about the knee. In contrast, extensor impulse decreased 37% (P < 0.05) at the hip and did not change at the ankle when subjects switched from a walk to a run. We conclude that the decrease in limb mechanical advantage (mean limb extensor EMA) and increase in knee extensor impulse during running likely contribute to the higher metabolic cost of transport in running than in walking. The low mechanical advantage in running humans may also explain previous observations of a greater metabolic cost of transport for running humans compared with trotting and galloping quadrupeds of similar size.

Are Females More Resistant to Extreme Neuromuscular Fatigue?

PubMed

Temesi, John; Arnal, Pierrick J; Rupp, Thomas; Féasson, Léonard; Cartier, Régine; Gergelé, Laurent; Verges, Samuel; Martin, Vincent; Millet, Guillaume Y

2015-07-01

Despite interest in the possibility of females outperforming males in ultraendurance sporting events, little is known about the sex differences in fatigue during prolonged locomotor exercise. This study investigated possible sex differences in central and peripheral fatigue in the knee extensors and plantar flexors resulting from a 110-km ultra-trail-running race. Neuromuscular function of the knee extensors and plantar flexors was evaluated via transcranial magnetic stimulation (TMS) and electrical nerve stimulation before and after an ultra-trail-running race in 20 experienced ultraendurance trail runners (10 females and 10 males matched by percent of the winning time by sex) during maximal and submaximal voluntary contractions and in relaxed muscle. Maximal voluntary knee extensor torque decreased more in males than in females (-38% vs -29%, P = 0.006) although the reduction in plantar flexor torque was similar between sexes (-26% vs -31%). Evoked mechanical plantar flexor responses decreased more in males than in females (-23% vs -8% for potentiated twitch amplitude, P = 0.010), indicating greater plantar flexor peripheral fatigue in males. Maximal voluntary activation assessed by TMS and electrical nerve stimulation decreased similarly in both sexes for both muscle groups. Indices of knee extensor peripheral fatigue and corticospinal excitability and inhibition changes were also similar for both sexes. Females exhibited less peripheral fatigue in the plantar flexors than males did after a 110-km ultra-trail-running race and males demonstrated a greater decrease in maximal force loss in the knee extensors. There were no differences in the magnitude of central fatigue for either muscle group or TMS-induced outcomes. The lower level of fatigue in the knee extensors and peripheral fatigue in the plantar flexors could partly explain the reports of better performance in females in extreme duration running races as race distance increases.

Adaptation of skeletal muscle to spaceflight: Cosmos rhesus project. Cosmos 2044 and 2229

NASA Technical Reports Server (NTRS)

Bodine-Fowler, Sue

1994-01-01

The proposed experiments were designed to determine the effects of the absence of weight support on hindlimb muscles of the monkey: an ankle flexor (tibialis anterior, TA), two ankle extensors (medial gastrocnemius, MG and soleus, SOL), and a knee extensor (vastus lateralis, VL). These effects were assessed by examining the biochemical and morphological properties of muscle fibers obtained from biopsies in young Rhesus monkeys (3-4 Kg). Biopsies taken from ground base experiments were analyzed to determine: (1) the effects of chair restraint at 1 G on muscle properties and (2) the growth rate of flexor and extensor muscles in the Rhesus. In addition, two sets of biopsies were taken from monkeys which were in the flight pool and the four monkeys that flew on the Cosmos 2044 and 2229 biosatellite missions. Based on data collected in rats it is generally assumed that extensors atrophy to a greater extent than flexors in response to spaceflight or hindlimb suspension. Consequently, the finding that fibers in the TA (a fast flexor) of the flight monkeys atrophied, whereas fibers in the Sol (a predominantly slow extensor) and MG (a fast extensor) grew after a 14-day spaceflight (Cosmos 2044) and 12-day spaceflight (Cosmos 2229) was unexpected. In Cosmos 2044, the TA in both flight monkeys had a 21 percent decrease in fiber size, whereas the Sol and MG both had a 79 percent increase in fiber size. In Cosmos 2229, the TA in both flight monkeys showed significant atrophy, whereas the Sol and MG showed slight growth in one monkey (906) and slight atrophy in the other monkey (151).

Knee Extensor Strength and Gait Characteristics After Minimally Invasive Unicondylar Knee Arthroplasty vs Minimally Invasive Total Knee Arthroplasty: A Nonrandomized Controlled Trial.

PubMed

Braito, Matthias; Giesinger, Johannes M; Fischler, Stefan; Koller, Arnold; Niederseer, David; Liebensteiner, Michael C

2016-08-01

In light of the existing lack of evidence, it was the aim of this study to compare gait characteristics and knee extensor strength after medial unicondylar knee arthroplasty (MUKA) with those after total knee arthroplasty (TKA), given the same standardized minimally invasive surgery (MIS) approach in both groups. Patients scheduled for MIS-MUKA or MIS-TKA as part of clinical routine were invited to participate. A posterior cruciate ligament-retaining total knee design was used for all MIS-TKA. A 3-dimensional gait analysis was performed preoperatively with a VICON system and at 8 weeks postoperative to determine temporospatial parameters, ground reaction forces, joint angles, and joint moments. At the same 2 times, isokinetic tests were performed to obtain peak values of knee extensor torque. A multivariate analysis of variance was conducted and included the main effects time (before and after surgery) and surgical group and the group-by-time interaction effect. Fifteen MIS-MUKA patients and 17 MIS-TKA patients were eligible for the final analysis. The groups showed no differences regarding age, body mass index, sex, side treated, or stage of osteoarthritis. We determined neither intergroup differences nor time × group interactions for peak knee extensor torque or any gait parameters (temporospatial, ground reaction forces, joint angles, and joint moments). It is concluded that MUKA is not superior to TKA with regard to knee extensor strength or 3-dimensional gait characteristics at 8 weeks after operation. As gait characteristics and knee extensor strength are only 2 of the various potential outcome parameters (knee scores, activity scores…) and quadriceps strength might take a longer time to recover, our findings should be interpreted with caution. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Evaluation of cranial tibial and extensor carpi radialis reflexes before and after anesthetic block in cats.

PubMed

Tudury, Eduardo Alberto; de Figueiredo, Marcella Luiz; Fernandes, Thaiza Helena Tavares; Araújo, Bruno Martins; Bonelli, Marília de Albuquerque; Diogo, Camila Cardoso; Silva, Amanda Camilo; Santos, Cássia Regina Oliveira; Rocha, Nadyne Lorrayne Farias Cardoso

2017-02-01

Objectives This study aimed to test the extensor carpi radialis and cranial tibial reflexes in cats before and after anesthetic block of the brachial and lumbosacral plexus, respectively, to determine whether they depend on a myotatic reflex arc. Methods Fifty-five cats with a normal neurologic examination that were referred for elective gonadectomy were divided into group 1 (29 cats) for testing the extensor carpi radialis reflex, and group 2 (26 cats) for testing the cranial tibial reflex. In group 1, the extensor carpi radialis reflex was tested after anesthetic induction and 15 mins after brachial plexus block with lidocaine. In group 2, the cranial tibial, withdrawal and patellar reflexes were elicited in 52 hindlimbs and retested 15 mins after epidural anesthesia. Results In group 1, before the anesthetic block, 55.17% of the cats had a decreased and 44.83% had a normal extensor carpi radialis reflex. After the block, 68.96% showed a decreased and 27.59% a normal reflex. No cat had an increased or absent reflex before anesthetic block. In group 2, prior to the anesthetic block, 15.38% of the cats had a decreased cranial tibial reflex and 84.62% had a normal response, whereas after the block it was decreased in 26.92% and normal in 73.08% of the cats. None of the cats had an increased or absent reflex. Regarding the presence of both reflexes before and after anesthetic block, there was no significant difference at 1% ( P = 0.013). Conclusions and relevance The extensor carpi radialis and cranial tibial reflexes in cats are not strictly myotatic reflexes, as they are independent of the reflex arc, and may be idiomuscular responses. Therefore, they are not reliable for neurologic examination in this species.

Effects of dexamethasone treatment on insulin-stimulated rates of glycolysis and glycogen synthesis in isolated incubated skeletal muscles of the rat.

PubMed Central

Leighton, B; Challiss, R A; Lozeman, F J; Newsholme, E A

1987-01-01

1. Rats were treated with dexamethasone for 4 days before measurement of the rates of lactate formation [which is an index of hexose transport; see Challiss, Lozeman, Leighton & Newsholme (1986) Biochem. J. 233, 377-381] and glycogen synthesis in response to various concentrations of insulin in isolated incubated soleus and extensor digitorum longus muscle preparations. 2. The concentration of insulin required to stimulate these processes half-maximally in soleus and extensor digitorum longus muscles isolated from control rats was about 100 muunits/ml. 3. Dexamethasone increases the concentration of insulin required to stimulate glycolysis half-maximally in soleus and extensor digitorum longus preparations to 250 and 300 muunits/ml respectively. The respective insulin concentrations necessary to stimulate glycogen synthesis half-maximally were about 430 and 370 muunits/ml for soleus and extensor digitorum longus muscle preparations isolated from steroid-treated rats. 5. Dexamethasone treatment did not change the amount of insulin bound to soleus muscle. PMID:3318810

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome: ultrasonography as a diagnostic tool.

PubMed

Agarwal, Vikas; Dabra, Ajay Kumar; Kaur, Ravinder; Sachdev, Atul; Singh, Ram

2005-09-01

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome is characterized by symmetrical synovitis and swelling of both the upper and lower extremities. The anatomical determinant of RS3PE is predominantly extensor tenosynovitis as revealed by magnetic resonance imaging (MRI). Given the cost constraints, time, and expertise required in carrying out MRI and ease in diagnosing tenosynovitis by ultrasound, we utilized high-frequency ultrasonography (USG) for evidence of tenosynovitis of the distal tendons in patients with RS3PE. Diagnosis of tenosynovitis was made on the basis of anechoic or hypoechoic signals around the tendon sheaths in both transverse and longitudinal planes. Flexor and extensor tendons at the wrist and metacarpal heads and extensor digitorum longus (EDL) tendons at the ankle were evaluated with a 7.5-10-MHz linear probe. There were ten patients (seven males) with a mean age of 59.5 years (range: 52-78 years) and mean disease duration of 6.1 months (range: 1.5-12 months). Disease onset was acute in all of the cases. Pitting edema of the hands was present in all except two patients whereas four patients, in addition, had edema of the feet. Edema was symmetrical in seven patients. Inability to make a complete fist was noted in all. Tenosynovitis of extensor and flexor tendons at the wrist and the metacarpal heads was documented in all patients with edema of the hands. In seven cases extensor tendon tenosynovitis was more prominent compared to the flexor tendons. Tenosynovitis of EDL tendons was detected in six cases. Dramatic relief with low-dose prednisolone was noted in all patients within 6 weeks of therapy. At a mean follow-up of 10.1 months all patients had marked relief in edema of extremities and improvement in the grip strength. Our study confirms that tenosynovitis of both flexor and extensor tendons at the wrist and extensor tendons of the feet is the hallmark of RS3PE syndrome. USG is a reliable and cost-effective modality for evaluation of patients with suspected RS3PE.

[Musculature of the pelvic limb of the American weasel (Mustela nigripes, Audubon and Bachman)].

PubMed

Bisaillon, A

1976-01-01

The origins and insertions of the muscles of the pelvic limb of the black-footed ferret (Mustela nigripes) are illustrated and described. The results based on the dissection of two adult specimens are compared with those of other investigations on the myology of the Mustelids. The musculature of the pelvic limb of Mustela nigripes is substantially similar to that of other Mustelids investigated except for slight differences of individual muscles. The most obvious differences involve the tendons of the mm. fibularis longus, fibularis brevis and extensor digitalis lateralis. The tendon of the m. fibularis longus contains a small sesamoid bone.

Late extensor pollicis longus rupture following plate fixation in Galeazzi fracture dislocation

PubMed Central

Sabat, Dhananjaya; Dabas, Vineet; Dhal, Anil

2014-01-01

Late rupture of extensor pollicis longus (EPL) tendon after Galeazzi fracture dislocation fixation is an unknown entity though it is a well-established complication following distal radius fractures. We report the case of a 55-year old male who presented with late EPL tendon rupture 4 months following internal fixation of Galeazzi fracture dislocation with a Locking Compression Plate (LCP). He was managed with extensor indicis proprius (EIP) transfer to restore thumb extension. At 4 years followup, functional result of the transfer was good. We identify possible pitfalls with this particular patient and discuss how to avoid them in future. PMID:25143650

Experiment K-7-33: Functional Neuromuscular Adaptation to Spaceflight

NASA Technical Reports Server (NTRS)

Edgerton, V. R.; Bodine-Fowler, S.; Hodgson, J. A.; Roy, R. R.; Kozlovskaya, I. B.

1994-01-01

The following data were collected from two Rhesus monkeys (782 and 2483) that were flown aboard a 14-day biosatellite mission (COSMOS 2044). The proposed study was designed to determine the effects of the absence of weight support on flexor and extensor muscles of the hindlimb. These effects were assessed morphologically and biochemically from muscle biopsies taken from a slow extensor, the soleus; a fast extensor, the medial gastrocnemius; and a fast flexor, the tibialis anterior. A second objective of this study was to determine the relative importance of activity (as determined by intramuscular electromyography, and force (as determined by joint torque) on the adaptation of muscle.

Rhythmic Isometric Fatigue Patterns of the Elbow Flexors and Knee Extensors

ERIC Educational Resources Information Center

Ordway, George A.; And Others

1977-01-01

During a rhythmic, all-out task, the rates of fatigue experienced by elbow flexor and knee extendor muscle groups tend to differ, with the elbow flexors fatiguing more rapidly initially, but reaching a plateau at a relatively higher level than the knee extensors. (Author)

THE ASSOCIATIONS BETWEEN HIP STRENGTH AND HIP KINEMATICS DURING A SINGLE LEG HOP IN RECREATIONAL ATHLETES POST ACL RECONSTRUCTION COMPARED TO HEALTHY CONTROLS.

PubMed

Tate, Jeremiah; Suckut, Tell; Wages, Jensen; Lyles, Heather; Perrin, Benjamin

2017-06-01

Only a small amount of evidence exists linking hip abductor weakness to dynamic knee valgus during static and dynamic activities. The associations of hip extensor strength and hip kinematics during the landing of a single leg hop are not known. Purpose: To determine if relationships exist between hip extensor and abductor strength and hip kinematics in both involved and uninvolved limb during the landing phase of a single leg hop in recreational athletes post anterior cruciate ligament (ACL) reconstruction. The presence of similar associations was also evaluated in healthy recreational athletes. Controlled Laboratory Study; Cross-sectional. Twenty-four recreational college-aged athletes participated in the study (12 post ACL reconstruction; 12 healthy controls). Sagittal and frontal plane hip kinematic data were collected for five trials during the landing of a single leg hop. Hip extensor and abductor isometric force production was measured using a hand-held dynamometer and normalized to participants' height and weight. Dependent and independent t-tests were used to analyze for any potential differences in hip strength or kinematics within and between groups, respectively. Pearson's r was used to demonstrate potential associations between hip strength and hip kinematics for both limbs in the ACL group and the right limb in the healthy control group. Independent t-tests revealed that participants post ACL reconstruction exhibited less hip extensor strength (0.18 N/Ht*BW vs. 0.25 N/Ht*BW, p=<.01) and landed with greater hip adduction (9.0 º vs. 0.8 º, p=<.01) compared with their healthy counterparts. In the ACL group, Pearson's r demonstrated a moderate and indirect relationship ( r =-.62, p=.03) between hip extensor strength and maximum hip abduction/adduction angle in the involved limb. A moderate and direct relationship between hip abductor strength and maximum hip flexion angle was demonstrated in the both the involved ( r =.62) and uninvolved limb ( r =.65, p=.02). No significant associations were demonstrated between hip extensor or abductor strength and hip flexion and/or abduction/adduction angles in the healthy group. The results suggest that hip extensors may play a role in minimizing hip adduction in the involved limb while the hip abductors seem to play a role in facilitating hip flexion during the landing phase of a single leg hop for both limbs following ACL reconstruction. Researchers and clinicians alike should consider the importance of the hip extensors in playing a more prominent role in contributing to frontal plane motion. Level 2a.

"Pollical palmar interosseous muscle" (musculus adductor pollicis accessorius): attachments, innervation, variations, phylogeny, and implications for human evolution and medicine.

PubMed

Bello-Hellegouarch, Gaelle; Aziz, M Ashraf; Ferrero, Eva M; Kern, Michael; Francis, Nadia; Diogo, Rui

2013-03-01

Most atlases and textbooks dealing with human anatomy do not refer to the "pollical palmar interosseous" (PPI) muscle of Henle. In order to undertake a fresh and detailed study of this muscle and to thus better understand human comparative anatomy and evolution, we: 1) analyze the frequency of the PPI in a large sample of human hands; 2) describe the attachments, innervation and varieties of the PPI in these hands; 3) compare the data obtained with the information available in the literature; and 4) discuss the phylogenetic origin of the PPI and the implications of our observations and comparisons for medicine and for the understanding of human evolutionary history. Within the 72 hands dissected by us, the PPI is present in 67 hands (93%), commonly having a single muscular branch, originating from the medial side of the base of metacarpal I only, inserting onto the medial side of the base of the pollical proximal phalanx and/or surrounding structures (e.g., ulnar sesamoid bone, wing tendon of extensor apparatus), and passing at least partially, and usually mainly, medial to the princeps pollicis artery. A careful study of the human PPI, as well as a detailed comparison with other mammals, strongly suggest that the muscle is evolutionarily derived from the adductor pollicis, and namely from its oblique head. Therefore, we propose that PPI should be designated by the name musculus adductor pollicis accessorius, which indicates that the muscle is most likely a de novo structure derived from the adductor pollicis. Copyright © 2012 Wiley Periodicals, Inc.

Decrements in knee extensor and flexor strength are associated with performance fatigue during simulated basketball game-play in adolescent, male players.

PubMed

Scanlan, Aaron T; Fox, Jordan L; Borges, Nattai R; Delextrat, Anne; Spiteri, Tania; Dalbo, Vincent J; Stanton, Robert; Kean, Crystal O

2018-04-01

This study quantified lower-limb strength decrements and assessed the relationships between strength decrements and performance fatigue during simulated basketball. Ten adolescent, male basketball players completed a circuit-based, basketball simulation. Sprint and jump performance were assessed during each circuit, with knee flexion and extension peak concentric torques measured at baseline, half-time, and full-time. Decrement scores were calculated for all measures. Mean knee flexor strength decrement was significantly (P < 0.05) related to sprint fatigue in the first half (R = 0.65), with dominant knee flexor strength (R = 0.67) and dominant flexor:extensor strength ratio (R = 0.77) decrement significantly (P < 0.05) associated with sprint decrement across the entire game. Mean knee extensor strength (R = 0.71), dominant knee flexor strength (R = 0.80), non-dominant knee flexor strength (R = 0.75), mean knee flexor strength (R = 0.81), non-dominant flexor:extensor strength ratio (R = 0.71), and mean flexor:extensor strength ratio (R = 0.70) decrement measures significantly (P < 0.05) influenced jump fatigue during the entire game. Lower-limb strength decrements may exert an important influence on performance fatigue during basketball activity in adolescent, male players. Consequently, training plans should aim to mitigate lower-limb fatigue to optimise sprint and jump performance during game-play.

Reliability and Validity of a New Method for Isometric Back Extensor Strength Evaluation Using A Hand-Held Dynamometer

PubMed Central

2017-01-01

Objective To investigate the reliability and validity of a new method for isometric back extensor strength measurement using a portable dynamometer. Methods A chair equipped with a small portable dynamometer was designed (Power Track II Commander Muscle Tester). A total of 15 men (mean age, 34.8±7.5 years) and 15 women (mean age, 33.1±5.5 years) with no current back problems or previous history of back surgery were recruited. Subjects were asked to push the back of the chair while seated, and their isometric back extensor strength was measured by the portable dynamometer. Test-retest reliability was assessed with intraclass correlation coefficient (ICC). For the validity assessment, isometric back extensor strength of all subjects was measured by a widely used physical performance evaluation instrument, BTE PrimusRS system. The limit of agreement (LoA) from the Bland-Altman plot was evaluated between two methods. Results The test-retest reliability was excellent (ICC=0.82; 95% confidence interval, 0.65–0.91). The Bland-Altman plots demonstrated acceptable agreement between the two methods: the lower 95% LoA was −63.1 N and the upper 95% LoA was 61.1 N. Conclusion This study shows that isometric back extensor strength measurement using a portable dynamometer has good reliability and validity. PMID:29201818

Discharge behavior of motor units in knee extensors during the initial stage of constant-force isometric contraction at low force level.

PubMed

Kamo, Mifuyu

2002-03-01

To elucidate the strategy of the activity of motor units (MUs) to maintain a constant-force isometric contraction, I examined the behavior of MUs in knee extensor muscles [(vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF)] during a sustained contraction at 5% of maximal voluntary contraction for 5 min. In all cases, the spike interval exhibited an elongating trend, and two discharge patterns were observed, continuous discharge and decruitment. In continuous-discharge MUs, the trend slope was steep immediately after the onset of constant force (steep phase), and then became gentle (gentle phase). Decruitments were observed frequently during each phase, and additional MU recruitment was observed throughout the contraction. The mean value of recruitment threshold force did not differ among the extensors. The mean spike interval at the onset of constant-force isometric contractions was shorter in RF than in VL. However, there were no differences in the duration and extent of the elongating trend, decruitment time and recruitment time among the extensors. The electromyogram of the antagonist biceps femoris muscle revealed no compensatory change for extensor activity. These results indicated that at a low force level, the strategy employed by the central nervous system to maintain constant force appears to involve cooperation among elongating trends in the spike interval, decruitment following elongation, and additional MU recruitment in synergistic muscles.

Influences of the extensor portion of the gluteus maximus muscle on pelvic tilt before and after the performance of a fatigue protocol.

PubMed

Alvim, Felipe C; Peixoto, Jennifer G; Vicente, Eduardo J D; Chagas, Paula S C; Fonseca, Diogo S

2010-01-01

There is a lack of data in the literature for determining the influences of the extensor portion of the gluteus maximus muscle on pelvic tilting and, thus, on lumbar stability. To assess the influences of the extensor portion of the gluteus maximus muscle on pelvic tilt. Ten healthy young subjects were recruited, with a body mass index (BMI) below 24.9 kg/m(2) and leg length discrepancy below 1 cm. The BMI, pelvic perimeter and lower-limb lengths were assessed and, subsequently, the degrees of hemi-pelvic tilt and asymmetry between them were analyzed using lateral view photographs of the subjects in a standing position, using SAPO (Software for Postural Assessment). Next, fatigue was induced in the extensor portion of the gluteus maximus muscle on the dominant side, and after that the hemi-pelvic tilt and the asymmetry between the hemi-pelvises were reassessed. The Pearson r and Student t tests were conducted at the significance level of alpha=0.05. There were no significant correlations between the confounding variables and asymmetry of the hemi-pelvic angles. There were significant changes in the hemi-pelvic angle of the dominant side (t=3.760; p=0.004). Fatigue in the extensor portion of the gluteus maximus muscle can generate increases in the tilt angle of the ipsilateral pelvis.

[Pattern of paralysis and reconstructive operations after traumatic brachial plexus lesions].

PubMed

Rühmann, O; Schmolke, S; Carls, J; Wirth, C J

2002-12-01

The aim of this study was to evaluate persistent patterns of paralysis after traumatic brachial plexus lesions. As a result, consecutive reconstructive operations according to our differential therapy concept are presented. Between 04/1994 and 12/2000 in 104 patients with brachial plexus palsy, the grade of muscle power of the affected upper extremities was evaluated prospectively. The neuromuscular patterns of defect showed, in most cases, insufficient muscle power grades of 0-2 for the deltoid muscle (90%), supraspinatus muscle (82%), infraspinatus muscle (93%), elbow flexors (67% to 77%), hand and finger extensors (69% to 71%), and the abductor and extensors of the thumb (67% to 70%). In corresponding frequency, the following operations were performed between 04/1994 and 06/2002: shoulder arthrodesis (n 26), trapezius transfer (n 80), rotation osteotomy of humerus (n 10), triceps to biceps transposition (n 11), transposition of forearm flexors or extensors/Steindler operation (n 12), latissimus transfer (n 7), pectoralis transfer (n 1), teres major transfer (n 1), transposition of forearm flexors to the tendons of extensor digitorum (n 19) and of the extensor pollicis longus (n 9), and wrist arthrodesis (n 5). On malfunction of muscles following brachial plexus lesions, taking into account the individual neuromuscular defect, passive joint function, and bony deformities, different procedures such as muscle transposition, arthrodesis, and corrective osteotomy can be performed to improve function of the upper extremity.

Characterizing Knee Loading Asymmetry in Individuals Following Anterior Cruciate Ligament Reconstruction Using Inertial Sensors

PubMed Central

Sigward, Susan M.; Chan, Ming-Sheng M.; Lin, Paige E.

2016-01-01

Limitations in the ability to identify knee extensor loading deficits during gait in individuals following anterior cruciate ligament reconstruction (ACLr) may underlie their persistence. A recent study suggested that shank angular velocity, directly output from inertial sensors, differed during gait between individuals post-ACLr and controls. However, it is not clear if this kinematic variable relates to knee moments calculated using joint kinematics and ground reaction forces. Heel rocker mechanics during loading response of gait, characterized by rapid shank rotation, require knee extensor control. Measures of shank angular velocity may be reflective of knee moments. This study investigated the relationship between shank angular velocity and knee extensor moment during gait in individuals (n=19) 96.7±16.8 days post-ACLr. Gait was assessed concurrently using inertial sensors and a marker-based motion system with force platforms. Peak angular velocity and knee extensor moment were strongly correlated (r=0.75, p<0.001) and between limb ratios of angular velocity predicted between limb ratios of extensor moment (r2=0.57 ,p<0.001) in the absence of between limb differences in spatiotemporal gait parameters. The strength of these relationships indicate that shank kinematic data offer meaningful information regarding knee loading and provide a potential alternative to full motion analysis systems for identification of altered knee loading following ACLr PMID:27395452

Allograft-prosthesis composites after bone tumor resection at the proximal tibia.

PubMed

Biau, David Jean; Dumaine, Valérie; Babinet, Antoine; Tomeno, Bernard; Anract, Philippe

2007-03-01

The survival of irradiated allograft-prosthesis composites at the proximal tibia is mostly unknown. However, allograft-prosthesis composites have proved beneficial at other reconstruction sites. We presumed allograft-prosthesis composites at the proximal tibia would improve survival and facilitate reattachment of the extensor mechanism compared with that of conventional (megaprostheses) reconstructions. We retrospectively reviewed 26 patients who underwent resection of proximal tibia tumors followed by reconstruction with allo-graft-prosthesis composites. Patients received Guepar massive custom-made fully constrained prostheses. Allografts were sterilized with gamma radiation, and the stems were cemented into the allograft and host bone. The minimum followup was 6 months (median, 128 months; range, 6-195 months). Fourteen patients had one or more components removed. The median allograft-prosthesis composite survival was 102 months (95% confidence interval, 64.2-infinity). Of the 26 allografts, seven fractured, six showed signs of partial resorption, and six had infections develop. Seven allografts showed signs of fusion with the host bone. Six extensor mechanism reconstructions failed. Allograft-prosthesis composites sterilized by gamma radiation yielded poor results for proximal tibial reconstruction as complications and failures were common. We do not recommend irradiated allograft-prosthesis composites for proximal tibia reconstruction.

Telangiectatic osteosarcoma of the patella.

PubMed

Shehadeh, Ahmad M; Haiba, Moutaz A; Henshaw, Robert M; Lack, Ernest

2008-08-01

Although osteosarcoma is the most common primary malignancy of bone, it has only been reported to arise from the patella in a handful of cases. Telangiectatic osteosarcoma accounts for <5% of all osteosarcomas, and it is distinguished histologically by spaces, often blood filled, separated by septa containing highly malignant cells and radiographically by a predominately lytic and/or expansile component. Telangiectatic osteosarcoma can be radiologically confused with aneurysmal bone cyst or giant cell tumor. A 22-year-old otherwise healthy man presented with increasing pain, swelling, and limited flexion of the right knee after failing physical therapy for anterior knee pain. Standard anteroposterior and lateral radiographs demonstrated a diffuse destructive process involving the majority of the patella (including loss of the inferior patellar cortex) and a lytic lesion of the proximal tibia. Apparent osteoid matrix was visible in the soft tissue extension along the inferior pole of the patella. A computed tomography scan of the chest showed 2 pulmonary nodules consistent with metastatic disease. Evaluation of core needle biopsy showed osteosarcoma with telangiectatic features. Given that the majority of the tumor involved the patella/extensor mechanism, it was clear that the tumor originated in the patella. This case presents the first published report of a telangiectatic osteosarcoma arising from the patella.

A genetically defined asymmetry underlies the inhibitory control of flexor–extensor locomotor movements

PubMed Central

Britz, Olivier; Zhang, Jingming; Grossmann, Katja S; Dyck, Jason; Kim, Jun C; Dymecki, Susan; Gosgnach, Simon; Goulding, Martyn

2015-01-01

V1 and V2b interneurons (INs) are essential for the production of an alternating flexor–extensor motor output. Using a tripartite genetic system to selectively ablate either V1 or V2b INs in the caudal spinal cord and assess their specific functions in awake behaving animals, we find that V1 and V2b INs function in an opposing manner to control flexor–extensor-driven movements. Ablation of V1 INs results in limb hyperflexion, suggesting that V1 IN-derived inhibition is needed for proper extension movements of the limb. The loss of V2b INs results in hindlimb hyperextension and a delay in the transition from stance phase to swing phase, demonstrating V2b INs are required for the timely initiation and execution of limb flexion movements. Our findings also reveal a bias in the innervation of flexor- and extensor-related motor neurons by V1 and V2b INs that likely contributes to their differential actions on flexion–extension movements. DOI: http://dx.doi.org/10.7554/eLife.04718.001 PMID:26465208

Knee stabilisation following infected knee arthroplasty with bone loss and extensor mechanism impairment using a modular cemented nail.

PubMed

Rao, M C; Richards, O; Meyer, C; Jones, R Spencer

2009-12-01

Infected Total Knee Replacement with significant bone loss and loss of extensor mechanism poses a difficult management problem. Arthrodesis relying on bony union can be difficult to achieve and can result in significant limb shortening. We retrospectively looked at the outcome of seven patients with significant bone loss and extensor mechanism insufficiency following infected TKR who underwent knee stabilisation using a modular cemented nail. The nail relied on the strong coupling mechanism between the modular femoral and tibial components. Pain score improved from a mean of 7.9 pre-operatively to 1.5 post-operatively at a mean follow up of 39.6 months (range 7-68) months. Two patients underwent technically easy revision nailing for recurrent infection and aseptic loosening. The Endo-Model(R) Knee Fusion Nail (Newsplint, UK/Waldemar Link, GmbH & Co. KG, Hamburg, Germany) has good early results in terms of pain relief and provides a stable knee in cases with significant bone loss and extensor mechanism insufficiency following an infected TKR thus avoiding an above knee amputation.

Assessment of isokinetic knee strength in elite young female basketball players: correlation with vertical jump.

PubMed

Rouis, M; Coudrat, L; Jaafar, H; Filliard, J-R; Vandewalle, H; Barthelemy, Y; Driss, T

2015-12-01

To explore the isokinetic concentric strength of the knee muscle groups, and the relationship between the isokinetic knee extensors strength and the vertical jump performance in young elite female basketball players. Eighteen elite female basketball players performed a countermovement jump, and an isokinetic knee test using a Biodex dynamometer. The maximal isokinetic peak torque of the knee extensor and flexor muscles was recorded at four angular velocities (90°/s, 180°/s, 240°/s and 300°/s) for the dominant and non-dominant legs. The conventional hamstring/quadriceps ratio (H/Q) was assessed at each angular velocity for both legs. There was no significant difference between dominant and non-dominant leg whatever the angular velocity (all P>0.05). However, the H/Q ratio enhanced as the velocity increased from 180°/s to 300°/s (P<0.05). Furthermore, low to high significant positive correlations were detected between the isokinetic measures of the knee extensors and the vertical jump height. The highest one was found for the knee extensors peak torque at a velocity of 240°/s (r=0.88, P<0.001). The results accounted for an optimal velocity at which a strong relationship could be obtained between isokinetic knee extensors strength and vertical jump height. Interestingly, the H/Q ratio of the young elite female basketball players in the present study was unusual as it was close to that generally observed in regular sportsmen.

THE INFLUENCE OF SEX AND MATURATION ON LANDING BIOMECHANICS: IMPLICATIONS FOR ACL INJURY

PubMed Central

Sigward, S. M.; Pollard, C. D.; Powers, C. M.

2010-01-01

During landing and cutting, females exhibit greater frontal plane moments at the knee (internal knee adductor moments or external knee abduction moments) and favor use of the knee extensors over the hip extensors to attenuate impact forces when compared to males. However, it is not known when this biomechanical profile emerges. The purpose of this study was to compare landing biomechanics between sexes across maturation levels. One hundred and nineteen male and female soccer players (9–22 years) participated. Subjects were grouped based on maturational development. Lower extremity kinematics and kinetics were obtained during a drop-land task. Dependent variables included the average internal knee adductor moment and sagittal plane knee/hip moment and energy absorption ratios during the deceleration phase of landing. When averaged across maturation levels, females demonstrated greater internal knee adductor moments (0.06±0.03 vs. 0.01±0.02 Nm/kg*m; P<0.005), knee/hip extensor moment ratios (2.0±0.1 vs. 1.4±0.1 Nm/kg*m; P<0.001), and knee/hip energy absorption ratios (2.9±0.1 vs. 1.96±0.1 Nm/kg*m; P<0.001) compared to males. Higher knee adductor moments combined with disproportionate use of knee extensors relative to hip extensors observed in females reflects a biomechanical pattern that increases ACL loading. This biomechanical strategy already was established in pre-pubertal female athletes. PMID:21210853

The Effect of Tibial Plateau Levelling Osteotomy on Stifle Extensor Mechanism Load: A Canine Ex Vivo Study.

PubMed

Drew, Jarrod O; Glyde, Mark R; Hosgood, Giselle L; Hayes, Alex J

2018-02-01

 To evaluate the effect of tibial plateau levelling osteotomy on stifle extensor mechanism load in an ex vivo cruciate-intact canine cadaveric model.   Ex vivo mechanical testing study.  Cadaveric canine pelvic limbs ( n  = 6).  A 21-mm tibial radial osteotomy was performed on pelvic limbs ( n  = 6) prior to being mounted into a load-bearing limb press. The proximal tibial segment was incrementally rotated until the anatomical tibial plateau angle had been rotated to at least 1°. The proportional change in stifle extensor mechanism load between the anatomical tibial plateau angle and the neutralized (∼6.5 degrees) and over-rotated (∼1°) tibial plateau angle was analysed using a one-sample t -test against a null hypothesis of no change. A p -value ≤0.05 was considered significant.  There was no significant change in the stifle extensor mechanism load from the anatomical tibial plateau angle (308 N [261-355 N]) to the neutralized tibial plateau angle (313 N [254-372 N]; p =.81), or from the anatomical tibial plateau angle to the over-rotated tibial plateau angle (303 N [254-352 N; p  = 0.67).  Tibial plateau levelling osteotomy does not significantly alter stifle extensor mechanism load at either a neutralized or over-rotated tibial plateau angle in our cruciate-intact model. Schattauer GmbH Stuttgart.

Effects of the forearm support band on wrist extensor muscle fatigue.

PubMed

Knebel, P T; Avery, D W; Gebhardt, T L; Koppenhaver, S L; Allison, S C; Bryan, J M; Kelly, A

1999-11-01

A crossover experimental design with repeated measures. To determine whether the forearm support band alters wrist extensor muscle fatigue. Fatigue of the wrist extensor muscles is thought to be a contributing factor in the development of lateral epicondylitis. The forearm support band is purported to reduce or prevent symptoms of lateral epicondylitis but the mechanism of action is unknown. Fifty unimpaired subjects (36 men, 14 women; mean age = 29 +/- 6 years) were tested with and without a forearm support band before and after a fatiguing bout of exercise. Peak wrist extension isometric force, peak isometric grip force, and median power spectral frequency for wrist extensor electromyographic activity were measured before and after exercise and with and without the forearm support band. A 2 x 2 repeated measures multivariate analysis of variance was used to analyze the data, followed by univariate analysis of variance and Tukey's multiple comparison tests. Peak wrist extension isometric force, peak grip isometric force, and median power spectral frequency were all reduced after exercise. However, there was a significant reduction in peak grip isometric force and peak wrist extension isometric force values for the with-forearm support band condition (grip force 28%, wrist extension force 26%) compared to the without-forearm support band condition (grip force 18%, wrist extension force 15%). Wearing the forearm support band increased the rate of fatigue in unimpaired individuals. Our findings do not support the premise that wearing the forearm support band reduces muscle fatigue in the wrist extensors.

Long-latency reflexes of elbow and shoulder muscles suggest reciprocal excitation of flexors, reciprocal excitation of extensors, and reciprocal inhibition between flexors and extensors

PubMed Central

Meriggi, Jenna; Parikh, Nidhi; Saad, Kenneth

2016-01-01

Postural corrections of the upper limb are required in tasks ranging from handling an umbrella in the changing wind to securing a wriggling baby. One complication in this process is the mechanical interaction between the different segments of the arm where torque applied at one joint induces motion at multiple joints. Previous studies have shown the long-latency reflexes of shoulder muscles (50–100 ms after a limb perturbation) account for these mechanical interactions by integrating information about motion of both the shoulder and elbow. It is less clear whether long-latency reflexes of elbow muscles exhibit a similar capability and what is the relation between the responses of shoulder and elbow muscles. The present study utilized joint-based loads tailored to the subjects' arm dynamics to induce well-controlled displacements of their shoulder and elbow. Our results demonstrate that the long-latency reflexes of shoulder and elbow muscles integrate motion from both joints: the shoulder and elbow flexors respond to extension at both joints, whereas the shoulder and elbow extensors respond to flexion at both joints. This general pattern accounts for the inherent flexion-extension coupling of the two joints arising from the arm's intersegmental dynamics and is consistent with spindle-based reciprocal excitation of shoulder and elbow flexors, reciprocal excitation of shoulder and elbow extensors, and across-joint inhibition between the flexors and extensors. PMID:26864766

Flexion Reflex Can Interrupt and Reset the Swimming Rhythm.

PubMed

Elson, Matthew S; Berkowitz, Ari

2016-03-02

The spinal cord can generate the hip flexor nerve activity underlying leg withdrawal (flexion reflex) and the rhythmic, alternating hip flexor and extensor activities underlying locomotion and scratching, even in the absence of brain inputs and movement-related sensory feedback. It has been hypothesized that a common set of spinal interneurons mediates flexion reflex and the flexion components of locomotion and scratching. Leg cutaneous stimuli that evoke flexion reflex can alter the timing of (i.e., reset) cat walking and turtle scratching rhythms; in addition, reflex responses to leg cutaneous stimuli can be modified during cat and human walking and turtle scratching. Both of these effects depend on the phase (flexion or extension) of the rhythm in which the stimuli occur. However, similar interactions between leg flexion reflex and swimming have not been reported. We show here that a tap to the foot interrupted and reset the rhythm of forward swimming in spinal, immobilized turtles if the tap occurred during the swim hip extensor phase. In addition, the hip flexor nerve response to an electrical foot stimulus was reduced or eliminated during the swim hip extensor phase. These two phase-dependent effects of flexion reflex on the swim rhythm and vice versa together demonstrate that the flexion reflex spinal circuit shares key components with or has strong interactions with the swimming spinal network, as has been shown previously for cat walking and turtle scratching. Therefore, leg flexion reflex circuits likely share key spinal interneurons with locomotion and scratching networks across limbed vertebrates generally. The spinal cord can generate leg withdrawal (flexion reflex), locomotion, and scratching in limbed vertebrates. It has been hypothesized that there is a common set of spinal cord neurons that produce hip flexion during flexion reflex, locomotion, and scratching based on evidence from studies of cat and human walking and turtle scratching. We show here that flexion reflex and swimming also share key spinal cord components based on evidence from turtles. Foot stimulation can reset the timing of the swimming rhythm and the response to each foot stimulation can itself be altered by the swim rhythm. Collectively, these studies suggest that spinal cord neuronal networks underlying flexion reflex, multiple forms of locomotion, and scratching share key components. Copyright © 2016 the authors 0270-6474/16/362819-08$15.00/0.

A test of the universal applicability of a commonly used principle of hoof balance.

PubMed

Caldwell, M N; Allan, L A; Pinchbeck, G L; Clegg, P D; Kissick, K E; Milner, P I

2016-01-01

This study used a UK trimming protocol to determine whether hoof balance is achieved (as defined by equivalence of geometric proportions) in cadaver limbs (n = 49) and two cohorts of horses (shod, n = 6, and unshod, n = 20; three trimming cycles). To determine equivalence, dorsal hoof wall length (DHWL), distance from the heel buttress to the centre of pressure (HBUT-COP) and distance from dorsal toe to centre of rotation (DT-COR) were calculated as a proportion of bearing border length (BBL) using digital photography. Geometric proportions were tested using Fieller's test of equivalence with limits of difference of 2.8%. In 22 cadaver limbs the location of external COR and COP was also mapped radiographically to the extensor process of the third phalanx and the centre of rotation of the distal interphalangeal joint. Equivalence of geometric proportions was not present following trimming in cadaver limbs or in the two cohorts. Although the dorsal hoof wall to heel wall ratio improved in cadaver and unshod horses after trimming, dorsal hoof wall and lateral heel parallelism was absent in all groups and COP was not consistently in line with the extensor process. Increased COP-COR distance occurred in shod horses and may relate to solar arch flattening. Palmar heel migration, however, occurred more in unshod horses. The study shows that equivalence of geometric proportions as a measure of static hoof balance was not commonly present and widely published measures and ratios of hoof balance rarely occurred in this sample population of horses. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of exercise on age-related changes in collagen fibril diameter distributions in the common digital extensor tendons of young horses.

PubMed

Edwards, Lindsey J; Goodship, Allen E; Birch, Helen L; Patterson-Kane, Janet C

2005-04-01

To determine whether specific treadmill exercise regimens would accelerate age-related changes in collagen fibril diameter distributions in the common digital extensor tendon (CDET) of the forelimbs of young Thoroughbreds. 24 female Thoroughbreds. Horses were trained for 18 weeks (6 horses; short term) or 18 months (5 horses; long term) on a high-speed treadmill; 2 age-matched control groups (6 horses/group) performed walking exercise only. Horses were (mean +/- SD) 24 +/- 1 months and 39 +/- 1 months old at termination of the short-term and long-term regimens, respectively. Midmetacarpal CDET specimens were obtained and processed for transmission electron microscopy. Diameter and area of at least 1,000 collagen fibrils/specimen were measured by use of computerized image analysis. Mass-average diameter (MAD) of collagen fibrils and collagen fibril index were calculated for each horse. Collagen fibril MAD for the older horses was significantly less than that for the younger horses. Exercise did not significantly affect fibril diameter or distributions in either age group, and collagen fibril index did not differ significantly between groups. Age-related reduction in collagen fibril MAD agreed with findings for other tendons and species. Training did not accelerate age-related change in the CDET in contrast to a reported decrease in collagen fibril MAD in the superficial digital flexor tendon of horses trained long term. Our results support the concept that the functionally distinct nature of the CDET and superficial digital flexor tendon in horses results in fundamentally different responses to high-speed exercise regimens.

The influence of Task-Related Training combined with Transcutaneous Electrical Nerve Stimulation on paretic upper limb muscle activation in patients with chronic stroke.

PubMed

Jung, Kyoungsim; Jung, Jinhwa; In, Taesung; Kim, Taehoon; Cho, Hwi-Young

2017-01-01

This study investigated the efficacy of Task-Related Training (TRT) Combined with Transcutaneous Electrical Nerve Stimulation (TENS) on the improvement of upper limb muscle activation in chronic stroke survivors with mild or moderate paresis. A single-blind, randomized clinical trial was conducted with 46stroke survivors with chronic paresis. They were randomly allocated two groups: the TRT+TENS group (n = 23) and the TRT+ placebo TENS (TRT+PLBO) group (n = 23). The TRT+TENS group received 30 minutes of high-frequency TENS on wrist and elbow extensors, while the TRT+PLBO group received placebo TENS that was not real ES. Both groups did 30 minutes of TRT after TENS application. Intervention was given five days a week for four weeks. The primary outcomes of upper limb muscle activation were measured by integrated EMG (IEMG), a digital manual muscle tester for muscle strength, active range of motion (AROM) and Fugl-Meyer Assessment of the upper extremity (FMA-UE). The measurements were performed before and after the 4 weeks intervention period. Both groups demonstrated significant improvements of outcomes in IEMG, AROM, muscle strength and FMA-UE during intervention period. When compared with the TRT+PLBO group, the TRT+TENS group showed significantly greater improvement in muscle activation (wrist extensors, P = 0.045; elbow extensors, P = 0.004), muscle strength (wrist extensors, P = 0.044; elbow extensors, P = 0.012), AROM (wrist extension, P = 0.042; elbow extensors, P = 0.040) and FMA-UE (total, P < 0.001; shoulder/elbow/forearm, P = 0.001; wrist, P = 0.002; coordination, P = 0.008) at the end of intervention. Our findings indicate that TRT Combined with TENS can improve paretic muscle activity in upper limb paresis, highlighting the benefits of somatosensory stimulation from TENS.

The relationship between EMG activity and extensor moment generation in the erector spinae muscles during bending and lifting activities.

PubMed

Dolan, P; Adams, M A

1993-01-01

The relationship between EMG activity and extensor moment generation in the erector spinae muscles was investigated under isometric and concentric conditions. The full-wave rectified and averaged EMG signal was recorded from skin-surface electrodes located over the belly of the erector spinae at the levels of T10 and L3, and compared with measurements of extensor moment. The effects of muscle length and contraction velocity were studied by measuring the overall curvature (theta) and rate of change of curvature (d theta/dt) of the lumbar spine in the sagittal plane, using the '3-Space Isotrak' system. Isometric contractions were investigated with the subjects pulling up on a load cell attached to the floor. Hand height was varied to produce different amounts of lumbar flexion, as indicated by changes in lumbar curvature. The extensor moment was found to be linearly related to EMG activity, and the 'gradient' and 'intercept' of the relationship were themselves dependent upon the lumbar curvature at the time of testing. Concentric contractions were investigated with the subjects extending from a seated toe-touching position, at various speeds, while the torque exerted on the arm of a Cybex dynamometer was continuously measured. Under these conditions the EMG signal (E) was higher than the isometric signal (E0) associated with the same torque. E and E0 were related as follows: E0 = E/(1 + A d theta/dt), where A = 0.0014 exp (0.045P) and P = percentage lumbar flexion. This equation was used to correct the EMG data for the effect of contraction velocity. The corrected data were then used, in conjunction with the results of the isometric calibrations, to calculate the extensor moment generated by the erector spinae muscles during bending and lifting activities. The extensor moment can itself be used to calculate the compressive force acting on the lumbar spine.

The effect of whole-body vibration therapy on bone metabolism, motor function, and anthropometric parameters in women with postmenopausal osteoporosis.

PubMed

Luo, Xiaotian; Zhang, Jifeng; Zhang, Chi; He, Chengqi; Wang, Pu

2017-11-01

To review the research literature on the effectiveness of whole-body vibration (WBV) therapy in women with postmenopausal osteoporosis. A systematic review was conducted by two independent reviewers. Mean differences (MDs), standardized mean differences (SMDs), and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed with the I 2 test. The Cochrane risk of bias tool was used to assess the methodological quality of the selected studies. Nine randomized controlled trials involving 625 patients met the inclusion criteria. No significant improvement was found in bone mineral density (BMD) (SMD = -0.06, 95%CI= -0.22-0.11, p = 0.50); bone turnover markers (MD = -0.25, 95%CI= -0.54-0.03, p = 0.08); anthropometric parameters, including muscle mass, fat mass, body mass index (BMI), and weight (SMD = 0.02, 95%CI= -0.16-0.21, p = 0.81); or maximal isotonic knee extensor strength (SMD = 0.16, 95%CI= -0.63-0.95, p = 0.69). However, maximal isometric knee extensor strength improved (SMD = 0.71, 95%CI = 0.34-1.08, p = 0.0002). WBV is beneficial for enhancing maximal isometric knee extensor strength, but it has no overall treatment effect on BMD, bone turnover markers, anthropometric parameters, or maximal isotonic knee extensor strength in women with postmenopausal osteoporosis. Implication of rehabilitation Osteoporosis is the leading underlying cause of fractures in postmenopausal women, whole body vibration (WBV) has received much attention as a potential intervention for the management of osteoporosis in recent years. Whole body vibration is beneficial for enhancing maximal isometric knee extensor strength in women with postmenopausal osteoporosis. Whole body vibration has no overall treatment effect on bone mineral density, bone turnover markers, anthropometric parameters and maximal isotonic knee extensor strength in women with postmenopausal osteoporosis.

Ballistic movements of jumping legs implemented as variable components of cricket behaviour.

PubMed

Hustert, R; Baldus, M

2010-12-01

Ballistic accelerations of a limb or the whole body require special joint mechanisms in many animals. Specialized joints can be moved by stereotypic or variable motor control during motor patterns with and without ballistic components. As a model of variable motor control, the specialized femur-tibia (knee) joints of cricket (Acheta domesticus) hindlegs were studied during ballistic kicking, jumping and swimming and in non-ballistic walking. In this joint the tendons of the antagonistic flexor and the extensor muscles attach at different distances from the pivot and the opposed lever arms form an angle of 120 deg. A 10:1 ratio of their effective lever arms at full knee flexion helps to prepare for most ballistic extensions: the tension of the extensor can reach its peak while it is restrained by flexor co-contraction. In kicks, preparatory flexion is rapid and the co-contraction terminates just before knee extensions. Therefore, mainly the stored tension of the extensor muscle accelerates the small mass of the tibia. Jumps are prepared with slower extensor-flexor co-contractions that flex both knees simultaneously and then halt to rotate both legs outward to a near horizontal level. From there, catapult extension of both knees accelerates the body, supported by continued high frequency motor activity to their tibia extensor muscles during the ongoing push-off from the substrate. Premature extension of one knee instantly takes load from the lagging leg that extends and catches up, which finally results in a straight jump. In swimming, synchronous ballistic power strokes of both hindlegs drive the tibiae on a ventral-to-posterior trajectory through the water, well coordinated with the swimming patterns of all legs. In walking, running and climbing the steps of the hindlegs range between 45 deg flexion and 125 deg extension and use non-ballistic, alternating activity of knee flexor and extensor muscles. Steep climbing requires longer bursts from the extensor tibiae muscles when they support the extended hindlegs against gravity forces when the body hangs over. All ballistic movements of cricket knees are elicited by a basic but variable motor pattern: knee flexions by co-contraction of the antagonists prepare catapult extensions with speeds and forces as required in the different behaviours.

THE ASSOCIATIONS BETWEEN HIP STRENGTH AND HIP KINEMATICS DURING A SINGLE LEG HOP IN RECREATIONAL ATHLETES POST ACL RECONSTRUCTION COMPARED TO HEALTHY CONTROLS

PubMed Central

Suckut, Tell; Wages, Jensen; Lyles, Heather; Perrin, Benjamin

2017-01-01

Background Only a small amount of evidence exists linking hip abductor weakness to dynamic knee valgus during static and dynamic activities. The associations of hip extensor strength and hip kinematics during the landing of a single leg hop are not known. Purpose: To determine if relationships exist between hip extensor and abductor strength and hip kinematics in both involved and uninvolved limb during the landing phase of a single leg hop in recreational athletes post anterior cruciate ligament (ACL) reconstruction. The presence of similar associations was also evaluated in healthy recreational athletes. Study Design Controlled Laboratory Study; Cross-sectional Methods Twenty-four recreational college-aged athletes participated in the study (12 post ACL reconstruction; 12 healthy controls). Sagittal and frontal plane hip kinematic data were collected for five trials during the landing of a single leg hop. Hip extensor and abductor isometric force production was measured using a hand-held dynamometer and normalized to participants’ height and weight. Dependent and independent t-tests were used to analyze for any potential differences in hip strength or kinematics within and between groups, respectively. Pearson's r was used to demonstrate potential associations between hip strength and hip kinematics for both limbs in the ACL group and the right limb in the healthy control group. Results Independent t-tests revealed that participants post ACL reconstruction exhibited less hip extensor strength (0.18 N/Ht*BW vs. 0.25 N/Ht*BW, p=<.01) and landed with greater hip adduction (9.0 º vs. 0.8 º, p=<.01) compared with their healthy counterparts. In the ACL group, Pearson's r demonstrated a moderate and indirect relationship (r=-.62, p=.03) between hip extensor strength and maximum hip abduction/adduction angle in the involved limb. A moderate and direct relationship between hip abductor strength and maximum hip flexion angle was demonstrated in the both the involved (r=.62) and uninvolved limb (r=.65, p=.02). No significant associations were demonstrated between hip extensor or abductor strength and hip flexion and/or abduction/adduction angles in the healthy group. Conclusion The results suggest that hip extensors may play a role in minimizing hip adduction in the involved limb while the hip abductors seem to play a role in facilitating hip flexion during the landing phase of a single leg hop for both limbs following ACL reconstruction. Researchers and clinicians alike should consider the importance of the hip extensors in playing a more prominent role in contributing to frontal plane motion. Levels of Evidence Level 2a PMID:28593088

The effect of oscillating-energy manual therapy on lateral epicondylitis: a randomized, placebo-control, double-blinded study.

PubMed

Nourbakhsh, Mohammad Reza; Fearon, Frank J

2008-01-01

Symptoms of lateral epicondylitis (LE) are attributed to degenerative changes and inflammatory reactions in the common extensor tendon induced by microscopic tears in the tissue after repetitive or overload functions of the wrist and hand extensor muscles. Conventional treatments, provided on the premise of inflammatory basis of LE, have shown 39-80% failure rate. An alternative approach suggests that symptoms of LE could be due to active tender points developed in the origin of hand and wrist extensor muscles after overuse or repetitive movements. Oscillating-energy Manual Therapy (OEMT), also known as V-spread, is a craniosacral manual technique that has been clinically used for treating tender points over the suture lines in the skull. Considering symptoms of LE may result from active tender points, the purpose of this study was to investigate the effect of OEMT on pain, grip strength, and functional abilities of subjects with chronic LE. Twenty-three subjects with chronic LE (>3mo) between ages of 24 and 72 years participated in this study. Before their participation, all subjects were screened to rule out cervical and other pathologies that could possibly contribute to their lateral elbow pain. Subjects who met the inclusion criteria were randomized into treatment and placebo treatment groups by a second (treating) therapist. Subjects were blinded to their group assignment. Subjects in the treatment group received OEMT for six sessions. During each treatment session, first a tender point was located through palpation. After proper hand placement, the therapist focused the direction of the oscillating energy on the localized tender point. Subjects in the placebo group underwent the same procedure, but the direction of the oscillating energy was directed to an area above or below the tender points, not covering the affected area. Jamar Dynamometer, Patient Specific Functional Scale (PSFS), and Numeric Rating Scale (NRS) were used to measure grip strength, functional status, and pain intensity and limited activity due to pain, respectively. The screening therapist who was blinded to the subjects' group assignment performed pretest, posttest, and six-month follow-up measurements. Subjects in the treatment group showed both clinically and statistically significant improvement in grip strength (p=0.03), pain intensity (p=0.006), function (p=0.003), and limited activity due to pain (p=0.025) compared with those in the placebo group. Follow-up data, collected after six months, showed no significant difference between posttest and follow-up measurements in functional activity (p=0.35), pain intensity (p=0.72), and activity limitation due to pain (p=0.34). Of all the subjects contacted for follow-up assessment, 91% maintained improved function and 73% remained pain free for at least six months. OEMT seems to be a viable, effective, and efficient alternative treatment for LE.

Physical Examination of the Knee: Meniscus, Cartilage, and Patellofemoral Conditions.

PubMed

Bronstein, Robert D; Schaffer, Joseph C

2017-05-01

The knee is one of the most commonly injured joints in the body. Its superficial anatomy enables diagnosis of the injury through a thorough history and physical examination. Examination techniques for the knee described decades ago are still useful, as are more recently developed tests. Proper use of these techniques requires understanding of the anatomy and biomechanical principles of the knee as well as the pathophysiology of the injuries, including tears to the menisci and extensor mechanism, patellofemoral conditions, and osteochondritis dissecans. Nevertheless, the clinical validity and accuracy of the diagnostic tests vary. Advanced imaging studies may be useful adjuncts.

Forearm Muscle Oxygenation Decreases During Low Levels of Brief, Isometric Contraction

NASA Technical Reports Server (NTRS)

Murthy Gita; Kahan, N. J.; Hargens, Alan R.; Rempel, D. M.; Hargens, Murthy G. (Technical Monitor)

1997-01-01

Regional muscle pain syndromes can be caused by repeated and sustained exertion of a specific muscle. Such exertion may elevate local tissue fluid pressure, reduce blood flow and tissue oxygenation (TO2), and cause fatigue, pain and functional deficits of the Involved muscle. Low levels (less than 20% maximum voluntary contraction (MVC)) of prolonged static contraction of the upper extremity are common In many occupational settings and May cause fatigue. The purpose of our Investigation was to determine whether TO2 decreases significantly at low levels of static contraction of the extensor carpi radialis brevis (ECRB).

Optimal early active mobilisation protocol after extensor tendon repairs in zones V and VI: A systematic review of literature.

PubMed

Collocott, Shirley Jf; Kelly, Edel; Ellis, Richard F

2018-03-01

Early mobilisation protocols after repair of extensor tendons in zone V and VI provide better outcomes than immobilisation protocols. This systematic review investigated different early active mobilisation protocols used after extensor tendon repair in zone V and VI. The purpose was to determine whether any one early active mobilisation protocol provides superior results. An extensive literature search was conducted to identify articles investigating the outcomes of early active mobilisation protocols after extensor tendon repair in zone V and VI. Databases searched were AMED, Embase, Medline, Cochrane and CINAHL. Studies were included if they involved participants with extensor tendon repairs in zone V and VI in digits 2-5 and described a post-operative rehabilitation protocol which allowed early active metacarpophalangeal joint extension. Study designs included were randomised controlled trials, observational studies, cohort studies and case series. The Structured Effectiveness Quality Evaluation Scale was used to evaluate the methodological quality of the included studies. Twelve articles met the inclusion criteria. Two types of early active mobilisation protocols were identified: controlled active motion protocols and relative motion extension splinting protocols. Articles describing relative motion extension splinting protocols were more recent but of lower methodological quality than those describing controlled active motion protocols. Participants treated with controlled active motion and relative motion extension splinting protocols had similar range of motion outcomes, but those in relative motion extension splinting groups returned to work earlier. The evidence reviewed suggested that relative motion extension splinting protocols may allow an earlier return to function than controlled active motion protocols without a greater risk of complication.

Genome-wide linkage scan for contraction velocity characteristics of knee musculature in the Leuven Genes for Muscular Strength Study.

PubMed

De Mars, Gunther; Windelinckx, An; Huygens, Wim; Peeters, Maarten W; Beunen, Gaston P; Aerssens, Jeroen; Vlietinck, Robert; Thomis, Martine A I

2008-09-17

The torque-velocity relationship is known to be affected by ageing, decreasing its protective role in the prevention of falls. Interindividual variability in this torque-velocity relationship is partly determined by genetic factors (h(2): 44-67%). As a first attempt, this genome-wide linkage study aimed to identify chromosomal regions linked to the torque-velocity relationship of the knee flexors and extensors. A selection of 283 informative male siblings (17-36 yr), belonging to 105 families, was used to conduct a genome-wide SNP-based (Illumina Linkage IVb panel) multipoint linkage analysis for the torque-velocity relationship of the knee flexors and extensors. The strongest evidence for linkage was found at 15q23 for the torque-velocity slope of the knee extensors (TVSE). Other interesting linkage regions with LOD scores >2 were found at 7p12.3 [logarithm of the odds ratio (LOD) = 2.03, P = 0.0011] for the torque-velocity ratio of the knee flexors (TVRF), at 2q14.3 (LOD = 2.25, P = 0.0006) for TVSE, and at 4p14 and 18q23 for the torque-velocity ratio of the knee extensors TVRE (LOD = 2.23 and 2.08; P = 0.0007 and 0.001, respectively). We conclude that many small contributing genes are involved in causing variation in the torque-velocity relationship of the knee flexor and extensor muscles. Several earlier reported candidate genes for muscle strength and muscle mass and new candidates are harbored within or in close vicinity of the linkage regions reported in the present study.

Low back and lower-limb muscle performance in male and female recreational runners with chronic low back pain.

PubMed

Cai, Congcong; Kong, Pui W

2015-06-01

Controlled laboratory study, cross-sectional. To compare lumbar extensor muscle fatigability, lumbar stabilizing muscle activation, and lower-limb strength between male and female runners with chronic low back pain (LBP) and healthy runners. Little is known about muscle performance in runners with chronic LBP. Eighteen recreational runners with chronic LBP (9 men, 9 women; mean age, 27.8 years) and 18 healthy recreational runners (9 men, 9 women; mean age, 24.6 years) were recruited. The median frequency slopes for bilateral iliocostalis and longissimus were calculated from electromyographic signals captured during a 2-minute Sorensen test. The thickness changes of the transversus abdominis and lumbar multifidus between resting and contraction were measured using an ultrasound scanner. Peak concentric torques of the bilateral hip extensors, hip abductors, and knee extensors were measured using an isokinetic dynamometer at 60°/s. The average values for both sides were used for statistical analysis. When averaged across sexes, peak knee extensor torque was 12.2% lower in the LBP group compared to the healthy group (mean difference, 0.29 Nm/kg; 95% confidence interval: 0.06, 0.53; P = .016). Male runners with chronic LBP exhibited smaller lumbar multifidus thickness changes compared to healthy male runners (mean difference, 0.13 cm; 95% confidence interval: 0.01, 0.25; P = .033). No other group differences were observed. Runners with chronic LBP exhibited diminished knee extensor strength compared to healthy runners. Male runners with chronic LBP demonstrated additional deficits in lumbar multifidus activation.

Effects of once weekly NMES training on knee extensors fatigue and body composition in a person with spinal cord injury.

PubMed

Gorgey, Ashraf S; Caudill, Caelb; Khalil, Refka E

2016-01-01

Single-subject case (male, 33 years of age, T6 SCI AIS A). To determine the effect of surface neuromuscular electrical stimulation (NMES) training conducted once weekly on improving fatigue resistance as well as regional and whole body composition in an individual with spinal cord injury (SCI). Laboratory setting within a SCI Center. Surface NMES resistance training (RT) of the paralyzed knee extensors was conducted once weekly for 12 weeks using ankle weights. Knee extensor fatigue index was determined by the number of repetitions (reps) achieved out of 30 reps. Total and regional body composition including percentage body fat (%BF), fat mass (FM), lean mass (LM) were conducted before the first session and one week after the last training session using whole-body dual-energy X-ray absorptiometry. The participant had a compliance rate of 83% and he was able to lift 6 and 2 lbs on the right and left legs, respectively. Right knee extensors showed greater fatigue resistance compared to the left one. Leg LM increased by 6% accompanied with decrease in arm, trunk and total body LM by -4.7%, -13%, -5%, respectively. The %BF increased by 8%, 7.3%, 15.5%, 11.5% for arm, legs, trunk and total body. Once weekly of NMES RT evokes local positive changes in leg LM without reciprocating the continuous loss in LM or gain in FM in other regions and total body. Training was effective in increasing strength as well as fatigue resistance of the trained knee extensors.

The influence of sex and maturation on landing biomechanics: implications for anterior cruciate ligament injury.

PubMed

Sigward, S M; Pollard, C D; Powers, C M

2012-08-01

During landing and cutting, females exhibit greater frontal plane moments at the knee (internal knee adductor moments or external knee abduction moments) and favor the use of the knee extensors over the hip extensors to attenuate impact forces when compared with males. However, it is not known when this biomechanical profile emerges. The purpose of this study was to compare landing biomechanics between sexes across maturation levels. One hundred and nineteen male and female soccer players (9-22 years) participated. Subjects were grouped based on maturational development. Lower extremity kinematics and kinetics were obtained during a drop-land task. Dependent variables included the average internal knee adductor moment and sagittal plane knee/hip moment and energy absorption ratios during the deceleration phase of landing. When averaged across maturation levels, females demonstrated greater internal knee adductor moments (0.06±0.03 vs 0.01±0.02 N m/kg m; P<0.005), knee/hip extensor moment ratios (2.0±0.1 vs 1.4±0.1 N m/kg m; P<0.001) and knee/hip energy absorption ratios (2.9±0.1 vs 1.96±0.1 N m/kg m; P<0.001) compared with males. Higher knee adductor moments combined with disproportionate use of knee extensors relative to hip extensors observed in females reflect a biomechanical pattern that increases anterior cruciate ligament loading. This biomechanical strategy already was established in pre-pubertal female athletes. © 2011 John Wiley & Sons A/S.

Effect of unilateral knee extensor fatigue on force and balance of the contralateral limb.

PubMed

Arora, Shruti; Budden, Shawn; Byrne, Jeannette M; Behm, David G

2015-10-01

Fatigue in one limb can decrease force production in the homologous muscle as well as other muscles of the non-fatigued limb affecting balance. The objective of the study was to examine the effect of unilateral knee extensor fatigue on the non-fatigued limb's standing balance, muscle force and activation. Sixteen healthy male subjects performed pre-fatigue balance trials, warm-up exercises, maximum voluntary isometric contractions, a knee extensors fatigue protocol, and post-fatigue balance trials. The fatigue protocol consisted of sets of 15 consecutive isometric contractions of 16 s each with 4 s recovery between repetitions, which were performed at 30% peak force for the dominant knee extensor muscles. Additional sets of contractions continued until a 50% decrease in MVIC knee extensor force was observed. Pre- and post-fatigue balance assessment consisted of transition from double to single leg standing and also single leg standing trials, which were performed bilaterally and in randomized order. The peak force and F100 were significantly decreased by 44.8% (ES = 2.54) and 39.9% (ES = 0.59), respectively, for the fatigued limb post-fatigue. There were no significant changes in the non-fatigued limb's muscle force, activation, muscle onset timing or postural stability parameters. While the lack of change in non-fatigued limb force production is in agreement with some of the previous literature in this area, the lack of effect on postural measures directly contradicts earlier work. It is hypothesized that discrepancies in the duration and the intensity of the fatigue protocol may have accounted for this discrepancy.

Fresh-frozen Complete Extensor Mechanism Allograft versus Autograft Reconstruction in Rabbits

PubMed Central

Chen, Guanyin; Zhang, Hongtao; Ma, Qiong; Zhao, Jian; Zhang, Yinglong; Fan, Qingyu; Ma, Baoan

2016-01-01

Different clinical results have been reported in the repair of extensor mechanism disruption using fresh-frozen complete extensor mechanism (CEM) allograft, creating a need for a better understanding of fresh-frozen CME allograft reconstruction. Here, we perform histological and biomechanical analyses of fresh-frozen CEM allograft or autograft reconstruction in an in vivo rabbit model. Our histological results show complete incorporation of the quadriceps tendon into the host tissues, patellar survival and total integration of the allograft tibia, with relatively fewer osteocytes, into the host tibia. Vascularity and cellularity are reduced and delayed in the allograft but exhibit similar distributions to those in the autograft. The infrapatellar fat pad provides the main blood supply, and the lowest cellularity is observed in the patellar tendon close to the tibia in both the allograft and autograft. The biomechanical properties of the junction of quadriceps tendon and host tissues and those of the allograft patellar tendon are completely and considerably restored, respectively. Therefore, fresh-frozen CEM allograft reconstruction is viable, but the distal patellar tendon and the tibial block may be the weak links of the reconstruction. These findings provide new insight into the use of allograft in repairing disruption of the extensor mechanism. PMID:26911538

Fresh-frozen Complete Extensor Mechanism Allograft versus Autograft Reconstruction in Rabbits.

PubMed

Chen, Guanyin; Zhang, Hongtao; Ma, Qiong; Zhao, Jian; Zhang, Yinglong; Fan, Qingyu; Ma, Baoan

2016-02-25

Different clinical results have been reported in the repair of extensor mechanism disruption using fresh-frozen complete extensor mechanism (CEM) allograft, creating a need for a better understanding of fresh-frozen CME allograft reconstruction. Here, we perform histological and biomechanical analyses of fresh-frozen CEM allograft or autograft reconstruction in an in vivo rabbit model. Our histological results show complete incorporation of the quadriceps tendon into the host tissues, patellar survival and total integration of the allograft tibia, with relatively fewer osteocytes, into the host tibia. Vascularity and cellularity are reduced and delayed in the allograft but exhibit similar distributions to those in the autograft. The infrapatellar fat pad provides the main blood supply, and the lowest cellularity is observed in the patellar tendon close to the tibia in both the allograft and autograft. The biomechanical properties of the junction of quadriceps tendon and host tissues and those of the allograft patellar tendon are completely and considerably restored, respectively. Therefore, fresh-frozen CEM allograft reconstruction is viable, but the distal patellar tendon and the tibial block may be the weak links of the reconstruction. These findings provide new insight into the use of allograft in repairing disruption of the extensor mechanism.

Muscular hypertrophy and atrophy in normal rats provoked by the administration of normal and denervated muscle extracts.

PubMed

Agüera, Eduardo; Castilla, Salvador; Luque, Evelio; Jimena, Ignacio; Leiva-Cepas, Fernando; Ruz-Caracuel, Ignacio; Peña, José

2016-12-01

This study was conducted to determine the effects of extracts obtained from both normal and denervated muscles on different muscle types. Wistar rats were used and were divided into a control group and four experimental groups. Each experimental group was treated intraperitoneally during 10 consecutive days with a different extract. These extracts were obtained from normal soleus muscle, denervated soleus, normal extensor digitorum longus, and denervated extensor digitorum longus. Following treatment, the soleus and extensor digitorum longus muscles were obtained for study under optic and transmission electron microscope; morphometric parameters and myogenic responses were also analyzed. The results demonstrated that the treatment with normal soleus muscle and denervated soleus muscle extracts provoked hypertrophy and increased myogenic activity. In contrast, treatment with extracts from the normal and denervated EDL had a different effect depending on the muscle analyzed. In the soleus muscle it provoked hypertrophy of type I fibers and increased myogenic activity, while in the extensor digitorum longus atrophy of the type II fibers was observed without changes in myogenic activity. This suggests that the muscular responses of atrophy and hypertrophy may depend on different factors related to the muscle type which could be related to innervation.

Does trampoline or hard surface jumping influence lower extremity alignment?

PubMed

Akasaka, Kiyokazu; Tamura, Akihiro; Katsuta, Aoi; Sagawa, Ayako; Otsudo, Takahiro; Okubo, Yu; Sawada, Yutaka; Hall, Toby

2017-12-01

[Purpose] To determine whether repetitive trampoline or hard surface jumping affects lower extremity alignment on jump landing. [Subjects and Methods] Twenty healthy females participated in this study. All subjects performed a drop vertical jump before and after repeated maximum effort trampoline or hard surface jumping. A three-dimensional motion analysis system and two force plates were used to record lower extremity angles, moments, and vertical ground reaction force during drop vertical jumps. [Results] Knee extensor moment after trampoline jumping was greater than that after hard surface jumping. There were no significant differences between trials in vertical ground reaction force and lower extremity joint angles following each form of exercise. Repeated jumping on a trampoline increased peak vertical ground reaction force, hip extensor, knee extensor moments, and hip adduction angle, while decreasing hip flexion angle during drop vertical jumps. In contrast, repeated jumping on a hard surface increased peak vertical ground reaction force, ankle dorsiflexion angle, and hip extensor moment during drop vertical jumps. [Conclusion] Repeated jumping on the trampoline compared to jumping on a hard surface has different effects on lower limb kinetics and kinematics. Knowledge of these effects may be useful in designing exercise programs for different clinical presentations.

Does trampoline or hard surface jumping influence lower extremity alignment?

PubMed Central

Akasaka, Kiyokazu; Tamura, Akihiro; Katsuta, Aoi; Sagawa, Ayako; Otsudo, Takahiro; Okubo, Yu; Sawada, Yutaka; Hall, Toby

2017-01-01

[Purpose] To determine whether repetitive trampoline or hard surface jumping affects lower extremity alignment on jump landing. [Subjects and Methods] Twenty healthy females participated in this study. All subjects performed a drop vertical jump before and after repeated maximum effort trampoline or hard surface jumping. A three-dimensional motion analysis system and two force plates were used to record lower extremity angles, moments, and vertical ground reaction force during drop vertical jumps. [Results] Knee extensor moment after trampoline jumping was greater than that after hard surface jumping. There were no significant differences between trials in vertical ground reaction force and lower extremity joint angles following each form of exercise. Repeated jumping on a trampoline increased peak vertical ground reaction force, hip extensor, knee extensor moments, and hip adduction angle, while decreasing hip flexion angle during drop vertical jumps. In contrast, repeated jumping on a hard surface increased peak vertical ground reaction force, ankle dorsiflexion angle, and hip extensor moment during drop vertical jumps. [Conclusion] Repeated jumping on the trampoline compared to jumping on a hard surface has different effects on lower limb kinetics and kinematics. Knowledge of these effects may be useful in designing exercise programs for different clinical presentations. PMID:29643592

Reoperations following proximal interphalangeal joint nonconstrained arthroplasties.

PubMed

Pritsch, Tamir; Rizzo, Marco

2011-09-01

To retrospectively analyze the reasons for reoperations following primary nonconstrained proximal interphalangeal (PIP) joint arthroplasty and review clinical outcomes in this group of patients with 1 or more reoperations. Between 2001 and 2009, 294 nonconstrained (203 pyrocarbon and 91 metal-plastic) PIP joint replacements were performed in our institution. A total of 76 fingers (59 patients) required reoperation (50 pyrocarbon and 26 metal-plastic). There were 40 women and 19 men with an average age of 51 years (range, 19-83 y). Primary diagnoses included osteoarthritis in 35, posttraumatic arthritis in 24, and inflammatory arthritis in 17 patients. There were 21 index, 27 middle, 18 ring, and 10 small fingers. The average number of reoperations per PIP joint was 1.6 (range, 1-4). A total of 45 joints had 1 reoperation, 19 had 2, 11 had 3, and 1 had 4. Extensor mechanism dysfunction was the most common reason for reoperation; it involved 51 of 76 fingers and was associated with Chamay or tendon-reflecting surgical approaches. Additional etiologies included component loosening in 17, collateral ligament failure in 10, and volar plate contracture in 8 cases. Inflammatory arthritis was associated with collateral ligament failure. Six fingers were eventually amputated, 9 had PIP joint arthrodeses, and 2 had resection arthroplasties. The arthrodesis and amputation rates correlated with the increased number of reoperations per finger. Clinically, most patients had no or mild pain at the most recent follow-up, and the PIP joint range-of-motion was not significantly different from preoperative values. Pain levels improved with longer follow-up. Reoperations following primary nonconstrained PIP joint arthroplasties are common. Extensor mechanism dysfunction was the most common reason for reoperation. The average reoperation rate was 1.6, and arthrodesis and amputation are associated with an increasing number of operations. Overall clinical outcomes demonstrated no significant change in range of motion, and most patients had mild or no pain. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Intrinsic rhythm and basic tonus in insect skeletal muscle.

PubMed

Hoyle, G

1978-04-01

The jumping muscle of orthopterous insects contains fibres that possess an intrinsic rhythm (IR) of slow contraction. The contributing fibres are generally synchronized, but as many as three or four pacemakers are present. The frequency, amplitude and duration of IR contractions fluctuate erratically over a 24 h period. Metathoracic DUM neurone bursts suppress IR for a few minutes. Other, unidentified dorsal neurones enhance its amplitude. In addition to IR, the extensor tibiae shows intrinsic basic tonus (BT). BT is relaxed for several s by low-frequency burst output from unidentified metathoracic dorsal neurones. DUM neurone bursts may enhance extensor BT, relax it, or leave it unaffected. The effects on IR of various regimes of activity in the slow extensor tibiae (SETi) and the common inhibitor (CI) axons were examined. CI affects IR when stimulated at frequencies above 2 Hz. It causes amplitude depression and reduced duration of individual IR contractions as well as increased frequency. At 30 Hz and above, CI completely suppresses IR. An enhanced IR contraction starts within a few milliseconds of the termination of a CI train. At low frequencies (below 10 Hz) SETi causes increased frequency and decreased amplitude of IR, with a depressed IR contraction following cessation of the SETi burst. At frequencies above 15 Hz the SETi-evoked contraction dominates tension development, though IR summates with it during the rising phase. In quiescent preparations not showing IR, SETi stimulation at 10 Hz often started up IR. Single SETi or FETi impulses can initiate an IR contraction, and cause altered phasing, with up to a quintupling of frequency. After a critical period has elapsed following the onset of an IR contraction, a single single impulse in any one of the three axons will terminate it abruptly. The early termination is followed by a reduced interval which is proportional to the reduced IR contraction time. The rhythm of accumulated readiness to go into an IR contraction is independent of the pacemaker rhythm that initiates the contraction.

Volume and fat infiltration of spino-pelvic musculature in adults with spinal deformity

PubMed Central

Moal, Bertrand; Bronsard, Nicolas; Raya, José G; Vital, Jean Marc; Schwab, Frank; Skalli, Wafa; Lafage, Virginie

2015-01-01

AIM: To investigate fat infiltration and volume of spino-pelvic muscles in adults spinal deformity (ASD) with magnetic resonance imaging (MRI) and 3D reconstructions. METHODS: Nineteen female ASD patients (mean age 60 ± 13) were included prospectively and consecutively and had T1-weighted Turbo Spin Echo sequence MRIs with Dixon method from the proximal tibia up to T12 vertebra. The Dixon method permitted to evaluate the proportion of fat inside each muscle (fat-water ratio). In order to investigate the accuracy of the Dixon method for estimating fat vs water, the same MRI acquisition was performed on phantoms of four vials composed of different proportion of fat vs water. With Muscl’X software, 3D reconstructions of 17 muscles or group of muscles were obtained identifying the muscle’s contour on a limited number of axial images [Deformation of parametric specific objects (DPSO) Method]. Musclar volume (Vmuscle), infiltrated fat volume (Vfat) and percentage of fat infiltration [Pfat, calculated as follow: Pfat = 100 × (Vfat/Vmuscle)] were characterized by extensor or flexor function respectively for the spine, hip and knee and theirs relationship with demographic data were investigated. RESULTS: Phantom acquisition demonstrated a non linear relation between Dixon fat-water ratio and the real fat-water ratio. In order to correct the Dixon fat-water ratio, the non linear relation was approximated with a polynomial function of degree three using the phantom acquisition. On average, Pfat was 13.3% ± 5.3%. Muscles from the spinal extensor group had a Pfat significantly greater than the other muscles groups, and the largest variability (Pfat = 31.9% ± 13.8%, P < 0.001). Muscles from the hip extensor group ranked 2nd in terms of Pfat (14% ± 8%), and were significantly greater than those of the knee extensor (P = 0.030). Muscles from the knee extensor group demonstrated the least Pfat (12% ± 8%). They were also the only group with a significant correlation between Vmuscle and Pfat (r = -0.741, P < 0.001), however this correlation was lacking in the other groups. No correlation was found between the Vmuscle total and age or body mass index. Except for the spine flexors, Pfat was correlated with age. Vmuscle and Vfat distributions demonstrated that muscular degeneration impacted the spinal extensors most. CONCLUSION: Mechanisms of fat infiltration are not similar among the muscle groups. Degeneration impacted the spinal and hip extensors most, key muscles of the sagittal alignment. PMID:26495250

Constraint-Induced Movement Therapy after Stroke

PubMed Central

Kwakkel, Gert; Veerbeek, Janne M.; van Wegen, Erwin E.H.; Wolf, Steven L.

2015-01-01

Constraint-induced movement therapy (CIMT) was developed to overcome upper limb impairments after stroke and is the most investigated intervention for treating stroke patients in the previous decades. This review describes the current evidence regarding: original CIMT and modified versions of CIMT (mCIMT). Meta-analysis showed strong evidence favoring both types of CIMT in terms of motor function, arm-hand activities and self-reported arm-hand functioning in daily life, immediately after treatment and at long-term follow-up, whereas no evidence was found for constraining alone (Forced Use (FU) therapy). No evidence was found that type of CIMT, intensity of practice or timing did affect outcome. Although the underlying mechanism that drive (m)CIMT is still poorly understood, recent kinematic conducted studies suggests that improvements introduced by original CIMT or mCIMT are mainly based on adaptation by learning to optimize the use of intact end-effectors by selecting patients with some voluntary motor control of wrist and finger extensors post stroke. PMID:25772900

Extensor tendon injury during cesarean delivery.

PubMed

Rinker, Brian

2011-01-01

Fetal laceration is a recognized complication of cesarean delivery; however, major injuries are rare. The case of a healthy newborn who sustained an injury to the extensor pollicis longus tendon during cesarean delivery is reported. The tendon was repaired surgically on the sixth day of life with good recovery of function. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Recovery Kinetics of Knee Flexor and Extensor Strength after a Football Match

PubMed Central

Draganidis, Dimitrios; Chatzinikolaou, Athanasios; Avloniti, Alexandra; Barbero-Álvarez, José C.; Mohr, Magni; Malliou, Paraskevi; Gourgoulis, Vassilios; Deli, Chariklia K.; Douroudos, Ioannis I.; Margonis, Konstantinos; Gioftsidou, Asimenia; Fouris, Andreas D.; Jamurtas, Athanasios Z.; Koutedakis, Yiannis; Fatouros, Ioannis G.

2015-01-01

We examined the temporal changes of isokinetic strength performance of knee flexor (KF) and extensor (KE) strength after a football match. Players were randomly assigned to a control (N = 14, participated only in measurements and practices) or an experimental group (N = 20, participated also in a football match). Participants trained daily during the two days after the match. Match and training overload was monitored with GPS devices. Venous blood was sampled and muscle damage was assessed pre-match, post-match and at 12h, 36h and 60h post-match. Isometric strength as well as eccentric and concentric peak torque of knee flexors and extensors in both limbs (dominant and non-dominant) were measured on an isokinetic dynamometer at baseline and at 12h, 36h and 60h after the match. Functional (KFecc/KEcon) and conventional (KFcon/KEcon) ratios were then calculated. Only eccentric peak torque of knee flexors declined at 60h after the match in the control group. In the experimental group: a) isometric strength of knee extensors and knee flexors declined (P<0.05) at 12h (both limbs) and 36h (dominant limb only), b) eccentric and concentric peak torque of knee extensors and flexors declined (P<0.05) in both limbs for 36h at 60°/s and for 60h at 180°/s with eccentric peak torque of knee flexors demonstrating a greater (P<0.05) reduction than concentric peak torque, c) strength deterioration was greater (P<0.05) at 180°/s and in dominant limb, d) the functional ratio was more sensitive to match-induced fatigue demonstrating a more prolonged decline. Discriminant and regression analysis revealed that strength deterioration and recovery may be related to the amount of eccentric actions performed during the match and athletes' football-specific conditioning. Our data suggest that recovery kinetics of knee flexor and extensor strength after a football match demonstrate strength, limb and velocity specificity and may depend on match physical overload and players' physical conditioning level. PMID:26043222

Measurement of maximal isometric torque and muscle quality of the knee extensors and flexors in healthy 50- to 70-year-old women.

PubMed

Francis, Peter; Toomey, Clodagh; Mc Cormack, William; Lyons, Mark; Jakeman, Philip

2017-07-01

Muscle quality is defined as strength per unit muscle mass. The aim of this study was to measure the maximal voluntary isometric torque of the knee extensor and flexor muscle groups in healthy older women and to develop an index of muscle quality based on the combined knee extensor and flexor torque per unit lean tissue mass (LTM) of the upper leg. One hundred and thirty-six healthy 50- to 70-year-old women completed an initial measurement of isometric peak torque of the knee extensors and flexors (Con-Trex MJ; CMV AG, Dubendorf, Switzerland) that was repeated 7 days later. Subsequently, 131 women returned for whole- and regional-body composition analysis (iDXA ™ ; GE Healthcare, Chalfont St Giles, Buckinghamshire, UK). Isometric peak torque demonstrated excellent within-assessment reliability for both the knee extensors and flexors (ICC range: 0·991-1·000). Test-retest reliability was lower (ICC range: 0·777-0·828) with an observed mean increase of 5% in peak torque [6·2 (17·2) N m] on the second day of assessment (P<0·001). The relative mean decrease in combined isometric peak torque (-12·2%; P = 0·001) was double that of the relative, non-significant, median difference in upper leg LTM (-5·3%; P = 0·102) between those in the 5th and 6th decade. The majority of difference in peak isometric torque came from the knee extensors (15·1 N m, P<0·001 versus 2·4 N m, P = 0·234). Isometric peak torque normalized for upper leg LTM (muscle quality) was 8% lower between decades (P = 0·029). These findings suggest strength per unit tissue may provide a better indication of age-related differences in muscle quality prior to change in LTM. © 2016 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Clinical, Radiologic, and Legal Significance of "Extensor Response" in Posttraumatic Coma.

PubMed

Firsching, Raimund; Woischneck, Dieter; Langejürgen, Alexander; Parreidt, Andreas; Bondar, Imre; Skalej, Martin; Röhl, Friedrich; Voellger, Benjamin

2015-11-01

The timely detection of neurologic deterioration can be critical for the survival of a neurosurgical patient following head injury. Because little reliable evidence is available on the prognostic value of the clinical sign "extensor response" in comatose posttraumatic patients, we investigated the correlation of this clinical sign with outcome and with early radiologic findings from magnetic resonance imaging (MRI). This retrospective analysis of prospectively obtained data included 157 patients who had remained in a coma for a minimum of 24 hours after traumatic brain injury. All patients received a 1.5-T MRI within 10 days (median: 2 days) of the injury. The correlations between clinical findings 12 and 24 hours after the injury-in particular, extensor response and pupillary function, MRI findings, and outcome after 1 year-were investigated. Statistical analysis included contingency tables, Fisher exact test, odds ratios (ORs) with confidence intervals (CIs), and weighted κ values. There were 48 patients with extensor response within the first 24 hours after the injury. Patients with extensor response (World Federation of Neurosurgical Societies coma grade III) statistically were significantly more likely to harbor MRI lesions in the brainstem when compared with patients in a coma who had no further deficiencies (coma grade I; p = 0.0004 by Fisher exact test, OR 10.8 with 95% CI, 2.7-42.5) and patients with unilateral loss of pupil function (coma grade II; p = 0.0187, OR 2.8 with 95% CI, 1.2-6.5). The correlation of brainstem lesions as found by MRI and outcome according to the Glasgow Outcome Scale after 1 year was also highly significant (p ≤ 0.016). The correlation of extensor response and loss of pupil function with an unfavorable outcome and with brainstem lesions revealed by MRI is highly significant. Their sudden onset may be associated with the sudden onset of brainstem dysfunction and should therefore be regarded as one of the most fundamental warning signs in the clinical monitoring of comatose patients. Georg Thieme Verlag KG Stuttgart · New York.

Activation amplitude and temporal synchrony among back extensor and abdominal muscles during a controlled transfer task: comparison of men and women.

PubMed

Hubley-Kozey, Cheryl L; Butler, Heather L; Kozey, John W

2012-08-01

Muscle synergies are important for spinal stability, but few studies examine temporal responses of spinal muscles to dynamic perturbations. This study examined activation amplitudes and temporal synergies among compartments of the back extensor and among abdominal wall muscles in response to dynamic bidirectional moments of force. We further examined whether responses were different between men and women. 19 women and 18 men performed a controlled transfer task. Surface electromyograms from bilateral sites over 6 back extensor compartments and 6 abdominal wall muscle sites were analyzed using principal component analysis. Key features were extracted from the measured electromyographic waveforms capturing amplitude and temporal variations among muscle sites. Three features explained 97% of the variance. Scores for each feature were computed for each measured waveform and analysis of variance found significant (p<.05) muscle main effects and a sex by muscle interaction. For the back extensors, post hoc analysis revealed that upper and more medial sites were recruited to higher amplitudes, medial sites responded to flexion moments, and the more lateral sites responded to lateral flexion moments. Women had more differences among muscle sites than men for the lateral flexion moment feature. For the abdominal wall muscles the oblique muscles responded with synergies related to fiber orientation, with women having higher amplitudes and more responsiveness to the lateral flexion moment than men. Synergies between the abdominal and back extensor sites as the moment demands change are discussed. These findings illustrate differential activation among erector spinae compartments and abdominal wall muscle sites supporting a highly organized pattern of response to bidirectional external moments with asynchronies more apparent in women. Copyright © 2012 Elsevier B.V. All rights reserved.

Hip Strength in Patients with Quadriceps Strength Deficits after ACL Reconstruction.

PubMed

Bell, David R; Trigsted, Stephanie M; Post, Eric G; Walden, Courtney E

2016-10-01

Quadriceps strength deficits persist for years after anterior cruciate ligament (ACL) reconstruction, and patients with these deficits often shift torque demands away from the knee extensors to the hip during functional tasks. However, it is not clear how quadriceps strength deficits may affect hip strength. Therefore, the purpose of this study was to investigate differences in lower extremity strength in individuals with ACL reconstruction with differing levels of quadriceps strength asymmetry. Isometric strength was recorded bilaterally in 135 participants (73 control and 62 with unilateral ACL reconstruction, time from surgery = 30.9 ± 17.6 months) from the knee extensors and flexors, hip extensors and abductors, and hip internal and external rotator muscle groups. Symmetry indices (limb symmetry index (LSI)) were created based on quadriceps strength, and subjects with ACL reconstruction were subdivided (high quadriceps (LSI ≥ 90%), n = 37; low quadriceps (LSI < 85%), n = 18). Individual group (control vs high quadriceps vs low quadriceps) by limb (reconstructed/nondominant vs healthy/dominant) repeated-measures ANOVA was used to compare strength (%BW) for each of the six joint motions of interest (knee extensors/flexors, hip abductors/extensors/external, and internal rotators) while controlling for time from surgery. An interaction was observed for quadriceps strength (P < 0.001), and the reconstructed limb in the low quadriceps group was weaker than all other limbs. A main effect for group was observed with the low quadriceps group having greater hip extension (P = 0.007) strength in both limbs compared with the other groups. Knee flexion strength was weaker in the reconstructed limb of the high quadriceps group (P = 0.047) compared with all other groups and limbs. Individuals with ACL reconstruction and involved limb quadriceps weakness have greater hip extension strength in both limbs compared with patients with bilateral strength symmetry and controls.

High-intensity aerobic interval training can lead to improvement in skeletal muscle power among in-hospital patients with advanced heart failure.

PubMed

Taya, Masanobu; Amiya, Eisuke; Hatano, Masaru; Maki, Hisataka; Nitta, Daisuke; Saito, Akihito; Tsuji, Masaki; Hosoya, Yumiko; Minatsuki, Shun; Nakayama, Atsuko; Fujiwara, Takayuki; Konishi, Yuto; Yokota, Kazuhiko; Watanabe, Masafumi; Morita, Hiroyuki; Haga, Nobuhiko; Komuro, Issei

2018-01-15

This study investigated the effectiveness and safety of interval training during in-hospital treatment of patients with advanced heart failure. Twenty-four consecutive patients with advanced symptomatic heart failure who were referred for cardiac transplant evaluation were recruited. After performing aerobic exercise for approximate intensity, high-intensity interval training (HIIT) was performed. The protocol consisted of 3 or 4 sessions of 1-min high-intensity exercise aimed at 80% of peak VO 2 or 80% heart rate reserve, followed by 4-min recovery periods of low intensity. In addition to the necessary laboratory data, hand grip strength and knee extensor strength were evaluated at the start of exercise training and both at the start and the end of HIIT. Knee extensor strength was standardized by body weight. The BNP level at the start of exercise training was 432 (812) pg/mL and it significantly decreased to 254 (400) pg/mL (p < 0.001) at the end of HIIT. Hand grip strength did not change during course. By contrast, knee extensor strength significantly increased during HIIT [4.42 ± 1.43 → 5.28 ± 1.45 N/kg, p < 0.001], whereas the improvement of knee extensor strength was not significant from the start of exercise training to the start of HIIT. In addition, the change in knee extensor strength during HIIT was significantly associated with the hemoglobin A1c level at the start of exercise (R = - 0.55; p = 0.015). HIIT has a positive impact on skeletal muscle strength among in-hospital patients with advanced heart failure.

Superior Effects of Eccentric to Concentric Knee Extensor Resistance Training on Physical Fitness, Insulin Sensitivity and Lipid Profiles of Elderly Men

PubMed Central

Chen, Trevor Chung-Ching; Tseng, Wei-Chin; Huang, Guan-Ling; Chen, Hsin-Lian; Tseng, Kuo-Wei; Nosaka, Kazunori

2017-01-01

It has been reported that eccentric training of knee extensors is effective for improving blood insulin sensitivity and lipid profiles to a greater extent than concentric training in young women. However, it is not known whether this is also the case for elderly individuals. Thus, the present study tested the hypothesis that eccentric training of the knee extensors would improve physical function and health parameters (e.g., blood lipid profiles) of older adults better than concentric training. Healthy elderly men (60–76 years) were assigned to either eccentric training or concentric training group (n = 13/group), and performed 30–60 eccentric or concentric contractions of knee extensors once a week. The intensity was progressively increased over 12 weeks from 10 to 100% of maximal concentric strength for eccentric training and from 50 to 100% for concentric training. Outcome measures were taken before and 4 days after the training period. The results showed that no sings of muscle damage were observed after any sessions. Functional physical fitness (e.g., 30-s chair stand) and maximal concentric contraction strength of the knee extensors increased greater (P ≤ 0.05) after eccentric training than concentric training. Homeostasis model assessment, oral glucose tolerance test and whole blood glycosylated hemoglobin showed improvement of insulin sensitivity only after eccentric training (P ≤ 0.05). Greater (P ≤ 0.05) decreases in fasting triacylglycerols, total, and low-density lipoprotein cholesterols were evident after eccentric training than concentric training, and high-density lipoprotein cholesterols increased only after eccentric training. These results support the hypothesis and suggest that it is better to focus on eccentric contractions in exercise medicine. PMID:28443029

Interactive effects of growth hormone and exercise on muscle mass in suspended rats

NASA Technical Reports Server (NTRS)

Grindeland, Richard E.; Roy, Roland R.; Edgerton, V. Reggie; Grossman, Elena J.; Mukku, Venkat R.; Jiang, Bian; Pierotti, David J.; Rudolph, Ingrid

1994-01-01

Measures to attenuate muscle atrophy in rats in response to simulated microgravity (hindlimb suspension (HS)) have been only partially successful. In the present study, hypophysectomized rats were in HS for 7 days, and the effects of recombinant human growth hormone (GH), exercise (Ex), or GH+Ex on the weights, protein concentrations, and fiber cross-sectional areas (CSAs) of hindlimb muscles were determined. The weights of four extensor muscles, i.e., the soleus (Sol), medial (MG) and lateral (LG) gastrocnemius, and plantaris (Plt), and one adductor, i.e., the adductor longus (AL), were decreased by 10-22% after HS. Fiber CSAs were decreased by 34% in the Sol and by 1 17% in the MG after HS. In contrast, two flexors, i.e., the tibialis anterior (TA) and extensor digitorum longus (EDL), did not atrophy. In HS rats, GH treatment alone maintained the weights of the fast extensors (MG, LG, Plt) and flexors (TA, EDL) at or above those of control rats. This effect was not observed in the slow extensor (Sol) or AL. Exercise had no significant effect on the weight of any muscle in HS rats. A combination of GH and Ex treatments yielded a significant increase in the weights of the fast extensors and in the CSA of both fast and slow fibers of the MG and significantly increased Sol weight and CSA of the slow fibers of the Sol. The AL was not responsive to either GH or Ex treatments. Protein concentrations of the Sol and MG were higher only in the Sol of Ex and GH+Ex rats. These results suggest that while GH treatment or intermittent high intensity exercise alone have a minimal effect in maintaining the mass of unloaded muscle, there is a strong interactive effect of these two treatments.

The role of muscle strengthening in exercise therapy for knee osteoarthritis: A systematic review and meta-regression analysis of randomized trials.

PubMed

Bartholdy, Cecilie; Juhl, Carsten; Christensen, Robin; Lund, Hans; Zhang, Weiya; Henriksen, Marius

2017-08-01

To analyze if exercise interventions for patients with knee osteoarthritis (OA) following the American College of Sports Medicine (ACSM) definition of muscle strength training differs from other types of exercise, and to analyze associations between changes in muscle strength, pain, and disability. A systematic search in 5 electronic databases was performed to identify randomized controlled trials comparing exercise interventions with no intervention in knee OA, and reporting changes in muscle strength and in pain or disability assessed as standardized mean differences (SMD) with 95% confidence intervals (95% CI). Interventions were categorized as ACSM interventions or not-ACSM interventions and compared using stratified random effects meta-analysis models. Associations between knee extensor strength gain and changes in pain/disability were assessed using meta-regression analyses. The 45 eligible trials with 4699 participants and 56 comparisons (22 ACSM interventions) were included in this analysis. A statistically significant difference favoring the ACSM interventions with respect to knee extensor strength was found [SMD difference: 0.448 (95% CI: 0.091-0.805)]. No differences were observed regarding effects on pain and disability. The meta-regressions indicated that increases in knee extensor strength of 30-40% would be necessary for a likely concomitant beneficial effect on pain and disability, respectively. Exercise interventions following the ACSM criteria for strength training provide superior outcomes in knee extensor strength but not in pain or disability. An increase of less than 30% in knee extensor strength is not likely to be clinically beneficial in terms of changes in pain and disability (PROSPERO: CRD42014015344). Copyright © 2017 Elsevier Inc. All rights reserved.

Sex Comparison of Knee Extensor Size, Strength and Fatigue Adaptation to Sprint Interval Training.

PubMed

Bagley, Liam; Al-Shanti, Nasser; Bradburn, Steven; Baig, Osamah; Slevin, Mark; McPhee, Jamie S

2018-03-12

Regular sprint interval training (SIT) improves whole-body aerobic capacity and muscle oxidative potential, but very little is known about knee extensor anabolic or fatigue resistance adaptations, or whether effects are similar for males and females. The purpose of this study was to compare sex-related differences in knee extensor size, torque-velocity relationship and fatigability adaptations to 12 weeks SIT. Sixteen males and fifteen females (mean (SEM) age: 41 (±2.5) yrs) completed measurements of total body composition assessed by DXA, quadriceps muscle cross-sectional area (CSAQ) assessed by MRI, the knee extensor torque-velocity relationship (covering 0 - 240°·sec) and fatigue resistance, which was measured as the decline in torque from the first to the last of 60 repeated concentric knee extensions performed at 180°·sec. SIT consisted of 4 x 20 second sprints on a cycle ergometer set at an initial power output of 175% of power at VO2max, three times per week for 12 weeks. CSAQ increased by 5% (p=0.023) and fatigue resistance improved 4.8% (p=0.048), with no sex differences in these adaptations (sex comparisons: p=0.140 and p=0.282, respectively). Knee extensor isometric and concentric torque was unaffected by SIT in both males and females (p>0.05 for all velocities). 12 weeks SIT, totalling 4 minutes very intense cycling per week, significantly increased fatigue resistance and CSAQ similarly in males and females, but did not significantly increase torque in males or females. These results suggest that SIT is a time-effective training modality for males and females to increase leg muscle size and fatigue resistance.

Contributory factors to unsteadiness during walking up and down stairs in patients with diabetic peripheral neuropathy.

PubMed

Handsaker, Joseph C; Brown, Steven J; Bowling, Frank L; Cooper, Glen; Maganaris, Constantinos N; Boulton, Andrew J M; Reeves, Neil D

2014-11-01

Although patients with diabetic peripheral neuropathy (DPN) are more likely to fall than age-matched controls, the underlying causative factors are not yet fully understood. This study examines the effects of diabetes and neuropathy on strength generation and muscle activation patterns during walking up and down stairs, with implications for fall risk. Sixty-three participants (21 patients with DPN, 21 diabetic controls, and 21 healthy controls) were examined while walking up and down a custom-built staircase. The speed of strength generation at the ankle and knee and muscle activation patterns of the ankle and knee extensor muscles were analyzed. Patients with neuropathy displayed significantly slower ankle and knee strength generation than healthy controls during stair ascent and descent (P < 0.05). During ascent, the ankle and knee extensor muscles were activated significantly later by patients with neuropathy and took longer to reach peak activation (P < 0.05). During descent, neuropathic patients activated the ankle extensors significantly earlier, and the ankle and knee extensors took significantly longer to reach peak activation (P < 0.05). Patients with DPN are slower at generating strength at the ankle and knee than control participants during walking up and down stairs. These changes, which are likely caused by altered activations of the extensor muscles, increase the likelihood of instability and may be important contributory factors for the increased risk of falling. Resistance exercise training may be a potential clinical intervention for improving these aspects and thereby potentially reducing fall risk. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Lean muscle volume of the thigh has a stronger relationship with muscle power than muscle strength in women with knee osteoarthritis.

PubMed

Davison, Michael J; Maly, Monica R; Keir, Peter J; Hapuhennedige, Sandani M; Kron, Amie T; Adachi, Jonathan D; Beattie, Karen A

2017-01-01

Thigh lean muscle and intramuscular fat have been implicated in the impairment of physical function observed in people with knee osteoarthritis. We investigated the relationships of quadriceps and hamstrings intramuscular fat fraction and lean muscle volume with muscle power and strength, controlling for neuromuscular activation, and physical performance in women with knee OA. Women (n=20) 55years or older with symptomatic, radiographic knee osteoarthritis underwent a 3.0T magnetic resonance imaging scan of the thigh of their most symptomatic knee. Axial fat-separated images were analyzed using software to quantify intramuscular fat and lean muscle volumes of the quadriceps and hamstrings. To quantify strength and power of the knee extensors and flexors, participants performed maximum voluntary isometric contraction and isotonic knee extensions and flexions, respectively. Electromyography of the quadriceps and hamstrings was measured. Participants also completed five physical performance tests. Quadriceps and hamstrings lean muscle volumes were related to isotonic knee extensor (B=0.624; p=0.017) and flexor (B=1.518; p=0.032) power, but not knee extensor (B=0.001; p=0.615) or flexor (B=0.001; p=0.564) isometric strength. Intramuscular fat fractions were not related to isotonic knee extensor or flexor power, nor isometric strength. No relationships were found between intramuscular fat or lean muscle volume and physical performance. Muscle power may be more sensitive than strength to lean muscle mass in women with knee osteoarthritis. Thigh lean muscle mass, but neither intramuscular nor intermuscular fat, is related to knee extensor and flexor power in women with knee osteoarthritis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of squat lift training and free weight muscle training on maximum lifting load and isolinetic peak torque of young adults without impairments.

PubMed

Yeung, S S; Ng, G Y

2000-06-01

Manual lifting is a frequent cause of back injury, and there is no evidence as to which training mode can provide the best training effect for lifting performance and muscle force. The purpose of this study was to examine the effects of a squat lift training and a free weight muscle training program on the maximum lifting load and isokinetic peak torque in subjects without known neuromuscular or musculoskeletal impairments. Thirty-six adults (20 male, 16 female) without known neuromuscular or musculoskeletal impairments participated. The subjects' mean age was 21.25 years (SD=1.16, range=20-24). Subjects were divided into 3 groups. Subjects in group 1 (n=12) performed squat lift training. Subjects in group 2 (n=12) participated in free weight resistance training of their shoulder abductors, elbow flexors, knee extensors and trunk extensors. Subjects in group 3 (n=12) served as controls. The maximum lifting load and isokinetic peak torques of the trunk extensors, knee extensors, elbow flexors, and shoulder abductors of each subject were measured before and after the study. Training was conducted on alternate days for 4 weeks, with an initial load of 80% of each subject's maximum capacity and with the load increased by 5% weekly. All groups were comparable for all measured variables before the study. After 4 weeks, subjects in groups 1 and 2 demonstrated more improvement in maximum lifting load and isokinetic peak torque of the back extensors compared with the subjects in group 3, but the 2 training groups were not different. The findings demonstrate that both squat lift and free weight resistance training are equally effective in improving the lifting load and isokinetic back extension performance of individuals without impairments.

A study of hyperelastic models for predicting the mechanical behavior of extensor apparatus.

PubMed

Elyasi, Nahid; Taheri, Kimia Karimi; Narooei, Keivan; Taheri, Ali Karimi

2017-06-01

In this research, the nonlinear elastic behavior of human extensor apparatus was investigated. To this goal, firstly the best material parameters of hyperelastic strain energy density functions consisting of the Mooney-Rivlin, Ogden, invariants, and general exponential models were derived for the simple tension experimental data. Due to the significance of stress response in other deformation modes of nonlinear models, the calculated parameters were used to study the pure shear and balance biaxial tension behavior of the extensor apparatus. The results indicated that the Mooney-Rivlin model predicts an unstable behavior in the balance biaxial deformation of the extensor apparatus, while the Ogden order 1 represents a stable behavior, although the fitting of experimental data and theoretical model was not satisfactory. However, the Ogden order 6 model was unstable in the simple tension mode and the Ogden order 5 and general exponential models presented accurate and stable results. In order to reduce the material parameters, the invariants model with four material parameters was investigated and this model presented the minimum error and stable behavior in all deformation modes. The ABAQUS Explicit solver was coupled with the VUMAT subroutine code of the invariants model to simulate the mechanical behavior of the central and terminal slips of the extensor apparatus during the passive finger flexion, which is important in the prediction of boutonniere deformity and chronic mallet finger injuries, respectively. Also, to evaluate the adequacy of constitutive models in simulations, the results of the Ogden order 5 were presented. The difference between the predictions was attributed to the better fittings of the invariants model compared with the Ogden model.

Humeral external rotation handling by using the Bobath concept approach affects trunk extensor muscles electromyography in children with cerebral palsy.

PubMed

Grazziotin Dos Santos, C; Pagnussat, Aline S; Simon, A S; Py, Rodrigo; Pinho, Alexandre Severo do; Wagner, Mário B

2014-10-20

This study aimed to investigate the electromyographic activity of cervical and trunk extensors muscles in children with cerebral palsy during two handlings according to the Bobath concept. A crossover trial involving 40 spastic diplegic children was conducted. Electromyography (EMG) was used to measure muscular activity at sitting position (SP), during shoulder internal rotation (IR) and shoulder external rotation (ER) handlings, which were performed using the elbow joint as key point of control. Muscle recordings were performed at the fourth cervical (C4) and at the tenth thoracic (T10) vertebral levels. The Gross Motor Function Classification System (GMFCS) was used to assess whether muscle activity would vary according to different levels of severity. Humeral ER handling induced an increase on EMG signal of trunk extensor muscles at the C4 (P=0.007) and T10 (P<0.001) vertebral levels. No significant effects were observed between SP and humeral IR handling at C4 level; However at T10 region, humeral IR handling induced an increase of EMG signal (P=0.019). Humeral ER resulted in an increase of EMG signal at both levels, suggesting increase of extensor muscle activation. Furthermore, the humeral ER handling caused different responses on EMG signal at T10 vertebra level, according to the GMFCS classification (P=0.017). In summary, an increase of EMG signal was observed during ER handling in both evaluated levels, suggesting an increase of muscle activation. These results indicate that humeral ER handling can be used for diplegic CP children rehabilitation to facilitate cervical and trunk extensor muscles activity in a GMFCS level-dependent manner. Copyright © 2014 Elsevier Ltd. All rights reserved.

Correction of severe postburn claw hand.

PubMed

Davami, Babak; Pourkhameneh, Golnar

2011-12-01

Burn scar contractures are perhaps the most frequent and most frustrating sequelae of thermal injuries to the hand. Unfortunately, stiffness occurs in the burned hand quickly. A week of neglect in the burned hand can lead to digital malpositioning and distortion that may be difficult to correct. The dorsal contracture is the most common of all the complications of the burned hand. It is the result of damage to the thin dorsal skin and scant subcutaneous tissue, which offers little protection to the deeper structures. Consequently, these injuries are deep resulting in a spectrum of deformities that has remained the bane of reconstructive surgery. Flap coverage will be required in the event of exposure of joints and tendons with absent paratenons. Multiple different flap types are available to treat complex severe postburn hand contractures. In our center, which is the largest regional burn center in northwest Iran, we have considerable experience in the treatment of thermal hand injuries. Between 2005 and 2010, we treated 53 consecutive patients with 65 severe postburn hand deformities. There were 35 men and 18 women with a mean age of 35±3 years. Flame injury was the inciting traumatic event in each patient. The severity of original injury and inadequate early treatment resulted in all of the fingers developing a severe extension contracture with scarred and adherent extensor tendons and subluxed metacarpophalangeal joints. In 36 cases, the injury was in the patients' dominant hand. We first incised the dorsal aspect of the contracted hands where there was maximum tension, then tenolysed the extensor tendons and released the volar capsules, collateral ligaments, and volar plate in all cases. In 30 cases, we also tenolysed the flexor tendons. We reduced the subluxed metacarpophalangeal joints and fixed them with Kirschner wires in 70 to 90 degrees flexion. Then, we planned and performed axial groin flaps to reconstruct the defects in all of them. In all of these patients, there was availability of intact skin in the territory of groin flap. However, in case of burn scars in this region, we had other options such as posterior interosseous flap in mind. Six patients experienced superficial necrosis at the distal margin of the flap, which was successfully treated with local wound care and dressing changes. There were no other complications. Physical therapy was initiated after Kirschner wire removal.

Analysis of Muscle Force-Velocity Parameter Changes in Elderly Women Resulting from Physical Activity--In Continuous Examinations

ERIC Educational Resources Information Center

Skrzek, Anna; Stefanska, Malgorzata

2012-01-01

The aim of the paper was to evaluate changes in muscle force-velocity parameters (F-v) in elderly women subjected to physical exercise. The examinations encompassed 20 women, aged 62-71, who were students at the University of the Third Age in Wroclaw. The evaluation of flexors and extensors of the knee joint, as well as flexors and extensors of…

Sit-to-Stand Movement in Children with Hemiplegic Cerebral Palsy: Relationship with Knee Extensor Torque and Social Participation

ERIC Educational Resources Information Center

dos Santos, Adriana Neves; Pavao, Silvia Leticia; Santiago, Paulo Roberto Pereira; Salvini, Tania de Fatima; Rocha, Nelci Adriana Cicuto Ferreira

2013-01-01

This study aimed to investigate the relationship between sit-to-stand (STS) movement, knee extensor torque and social participation in children with cerebral palsy (CP). Seven spastic hemiplegic CP patients (8.0 plus or minus 2.2 years), classified by the Gross Motor Function Classification System as I and II, and 18 typical children (8.4 plus or…

Elbow flexor fatigue modulates central excitability of the knee extensors.

PubMed

Aboodarda, Saied Jalal; Copithorne, David B; Power, Kevin E; Drinkwater, Eric; Behm, David G

2015-09-01

The present study investigated the effects of exercise-induced elbow flexor fatigue on voluntary force output, electromyographic (EMG) activity and motoneurone excitability of the nonexercised knee extensor muscles. Eleven participants attended 3 testing sessions: (i) control, (ii) unilateral fatiguing elbow flexion and (iii) bilateral fatiguing elbow flexion (BiFlex). The nonfatigued knee extensor muscles were assessed with thoracic motor evoked potentials (TMEPs), maximal compound muscle action potential (Mmax), knee extensor maximal voluntary contractions (MVCs), and normalized EMG activity before and at 30 s, 3 min, and 5 min postexercise. BiFlex showed significantly lower (Δ = -18%, p = 0.03) vastus lateralis (VL) normalized EMG activity compared with the control session whereas knee extension MVC force did not show any statistical difference between the 3 conditions (p = 0.12). The TMEP·Mmax(-1) ratio measured at the VL showed a significantly higher value (Δ = +46%, p = 0.003) following BiFlex compared with the control condition at 30 s postexercise. The results suggest that the lower VL normalized EMG following BiFlex might have been due to a reduction in supraspinal motor output because spinal motoneuronal responses demonstrated substantially higher value (30 s postexercise) and peripheral excitability (compound muscle action potential) showed no change following BiFelex than control condition.

Sex comparisons of non-local muscle fatigue in human elbow flexors and knee extensors

PubMed Central

Ye, Xin; Beck, Travis W.; Wages, Nathan P.; Carr, Joshua C.

2018-01-01

Objectives: To examine non-local muscle fatigue (NLMF) in both contralateral homologous and non-related heterogonous muscles for both sexes. Methods: Ten men and nine women participated in this study. After the familiarization visit, subjects completed four separate randomly sequenced experimental visits, during which the fatiguing interventions (six sets of 30-second maximal isometric contractions) were performed on either their right elbow flexors or knee extensors. Before (Pre-) and after (Post-) the fatiguing interventions, the isometric strength and the corresponding surface electromyographic (EMG) amplitude were measured for the non-exercised left elbow flexors or knee extensors. Results: For the non-exercised elbow flexors, the isometric strength decreased for both sexes (sex combined mean±SE: Pre vs. Post=339.67±18.02 N vs. 314.41±16.37 N; p<0.001). For the non-exercised knee extensors, there is a time ´ sex interaction (p=0.025), showing a decreased isometric knee extension strength for men (Pre vs. Post =845.02±66.26 N vs. 817.39±67.64 N; p=0.019), but not for women. Conclusions: The presence of NMLF can be affected by factors such as sex and muscle being tested. Women are less likely to demonstrate NLMF in lower body muscle groups. PMID:29504584

Effects of 17-day spaceflight on knee extensor muscle function and size

NASA Technical Reports Server (NTRS)

Tesch, Per A.; Berg, Hans E.; Bring, Daniel; Evans, Harlan J.; LeBlanc, Adrian D.

2005-01-01

It is generally held that space travelers experience muscle dysfunction and atrophy during exposure to microgravity. However, observations are scarce and reports somewhat inconsistent with regard to the time course, specificity and magnitude of such changes. Hence, we examined four male astronauts (group mean approximately 43 years, 86 kg and 183 cm) before and after a 17-day spaceflight (Space Transport System-78). Knee extensor muscle function was measured during maximal bilateral voluntary isometric and iso-inertial concentric, and eccentric actions. Cross-sectional area (CSA) of the knee extensor and flexor, and gluteal muscle groups was assessed by means of magnetic resonance imaging. The decrease in strength (P<0.05) across different muscle actions after spaceflight amounted to 10%. Eight ambulatory men, examined on two occasions 20 days apart, showed unchanged (P>0.05) muscle strength. CSA of the knee extensor and gluteal muscles, each decreased (P<0.05) by 8%. Knee flexor muscle CSA showed no significant (P>0.05) change. The magnitude of these changes concord with earlier results from ground-based studies of similar duration. The results of this study, however, do contrast with the findings of no decrease in maximal voluntary ankle plantar flexor force previously reported in the same crew.

Activity patterns of extrinsic finger flexors and extensors during movements of instructed and non-instructed fingers.

PubMed

van Beek, Nathalie; Stegeman, Dick F; van den Noort, Josien C; H E J Veeger, DirkJan; Maas, Huub

2018-02-01

The fingers of the human hand cannot be controlled fully independently. This phenomenon may have a neurological as well as a mechanical basis. Despite previous studies, the neuromechanics of finger movements are not fully understood. The aims of this study were (1) to assess the activation and coactivation patterns of finger specific flexor and extensor muscle regions during instructed single finger flexion and (2) to determine the relationship between enslaved finger movements and respective finger muscle activation. In 9 healthy subjects (age 22-29), muscle activation was assessed during single finger flexion using a 90 surface electromyography electrode grid placed over the flexor digitorum superficialis (FDS) and the extensor digitorum (ED). We found (1) no significant differences in muscle activation timing between fingers, (2) considerable muscle activity in flexor and extensor regions associated with the non-instructed fingers and (3) no correlation between the muscle activations and corresponding movement of non-instructed fingers. A clear disparity was found between the movement pattern of the non-instructed fingers and the activity pattern of the corresponding muscle regions. This suggests that mechanical factors, such as intertendinous and myofascial connections, may also affect finger movement independency and need to be taken into consideration when studying finger movement. Copyright © 2017 Elsevier Ltd. All rights reserved.

Relation between Peak Power Output in Sprint Cycling and Maximum Voluntary Isometric Torque Production.

PubMed

Kordi, Mehdi; Goodall, Stuart; Barratt, Paul; Rowley, Nicola; Leeder, Jonathan; Howatson, Glyn

2017-08-01

From a cycling paradigm, little has been done to understand the relationships between maximal isometric strength of different single joint lower body muscle groups and their relation with, and ability to predict PPO and how they compare to an isometric cycling specific task. The aim of this study was to establish relationships between maximal voluntary torque production from isometric single-joint and cycling specific tasks and assess their ability to predict PPO. Twenty male trained cyclists participated in this study. Peak torque was measured by performing maximum voluntary contractions (MVC) of knee extensors, knee flexors, dorsi flexors and hip extensors whilst instrumented cranks measured isometric peak torque from MVC when participants were in their cycling specific position (ISOCYC). A stepwise regression showed that peak torque of the knee extensors was the only significant predictor of PPO when using SJD and accounted for 47% of the variance. However, when compared to ISOCYC, the only significant predictor of PPO was ISOCYC, which accounted for 77% of the variance. This suggests that peak torque of the knee extensors was the best single-joint predictor of PPO in sprint cycling. Furthermore, a stronger prediction can be made from a task specific isometric task. Copyright © 2017 Elsevier Ltd. All rights reserved.

Hip and knee extensor moments predict vertical jump height in adolescent girls.

PubMed

Ford, Kevin R; Myer, Gregory D; Brent, Jensen L; Hewett, Timothy E

2009-07-01

Biomechanical factors, such as hip and knee extensor moments, related to drop jump (DJ) performance have not been investigated in adolescent girls. The purpose of this study was to determine the key independent biomechanical variables that predict overall vertical jump performance in adolescent girls. Sixteen high school adolescent girls from club-sponsored and high school-sponsored volleyball teams performed DJ at 3 different drop heights (15, 30, and 45 cm). A motion analysis system consisting of 10 digital cameras and a force platform was used to calculate vertical jump height, joint angles, and joint moments during the tasks. A multiple linear regression was used to determine the biomechanical parameters that were best predictive of vertical jump height at each box drop distance. The 2 predictor variables in all 3 models were knee and hip extensor moments. The models predicted 82.9, 81.9, and 88% of the vertical jump height variance in the 15, 30, and 45 cm trials, respectively. The results of the investigation indicate that knee and hip joint moments are the main contributors to vertical jump height during the DJ in adolescent girls. Strength and conditioning specialists attempting to improve vertical jump performance should target power and strength training to the hip and knee extensors in their athletes.

Neuromuscular plasticity in the locust after permanent removal of an excitatory motoneuron of the extensor tibiae muscle.

PubMed

Büschges, A; Djokaj, S; Bässler, D; Bässler, U; Rathmayer, W

2000-01-01

The capacity of the larval insect nervous system to compensate for the permanent loss of one of the two excitatory motoneurons innervating a leg muscle was investigated in the locust (Locusta migratoria). In the fourth instar, the fast extensor tibiae (FETi) motoneuron in the mesothoracic ganglion was permanently removed by photoinactivation with a helium-cadmium laser. Subsequently, the animals were allowed to develop into adulthood. When experimental animals were tested as adults after final ecdysis, fast-contracting fibers in the most proximal region of the corresponding extensor muscle, which are normally predominantly innervated by FETi only, uniformly responded to activity of the slow extensor tibiae (SETi) neuron. In adult operated animals, single pulses to SETi elicited large junctional responses in the fibers which resulted in twitch contractions of these fibers similar to the responses to FETi activity in control animals. The total number of muscle fibers, their properties as histochemically determined contractional types (fast and slow), and their distribution were not affected by photoinactivation of FETi. Possible mechanisms enabling the larval neuromuscular system to compensate for the loss of FETi through functionally similar innervation by a different motoneuron, i.e. SETi, are discussed. Copyright 2000 John Wiley & Sons, Inc.

Feed artery role in blood flow control to rat hindlimb skeletal muscles.

PubMed Central

Williams, D A; Segal, S S

1993-01-01

1. Vasomotor tone and reactivity were investigated in feed arteries of the extensor digitorum longus and soleus muscles. Feed arteries are located external to the muscle and give rise to the microcirculation within each muscle. Resting diameter was smaller in feed arteries of the soleus muscle. 2. Feed arteries of both muscles dilated to similar peak values with sodium nitroprusside. 3. Micropressure measurements demonstrated resistance to blood flow in the feed arteries supplying both muscles. Feed arteries supplying soleus muscle demonstrated greater resistance to blood flow compared to feed arteries of extensor digitorum longus muscle. 4. Greater resting tone and larger pressure drop for feed arteries of soleus muscle suggest greater range of flow control compared to feed arteries of extensor digitorum longus muscle. 5. In both muscles, feed artery diameter increased with muscle contraction (functional dilatation) and in response to transient ischaemia (reactive dilatation). The magnitude of these responses varied between muscles. 6. Feed arteries are active sites of blood flow control in extensor digitorum longus and soleus muscles of the rat. These muscles differ in fibre type and recruitment properties. Differences in feed artery reactivity may contribute to differences in blood flow between these muscles observed at rest and during exercise. Images Fig. 2 Fig. 3 Fig. 4 Fig. 5 PMID:8246199

Running from Paris to Beijing: biomechanical and physiological consequences.

PubMed

Millet, Guillaume Y; Morin, Jean-Benoît; Degache, Francis; Edouard, Pascal; Feasson, Léonard; Verney, Julien; Oullion, Roger

2009-12-01

The purpose of this study was to examine the physiological and biomechanical changes occurring in a subject after running 8,500 km in 161 days (i.e. 52.8 km daily). Three weeks before, 3 weeks after (POST) and 5 months after (POST+5) running from Paris to Beijing, energy cost of running (Cr), knee flexor and extensor isokinetic strength and biomechanical parameters (using a treadmill dynamometer) at different velocities were assessed in an experienced ultra-runner. At POST, there was a tendency toward a 'smoother' running pattern, as shown by (a) a higher stride frequency and duty factor, and a reduced aerial time without a change in contact time, (b) a lower maximal vertical force and loading rate at impact and (c) a decrease in both potential and kinetic energy changes at each step. This was associated with a detrimental effect on Cr (+6.2%) and a loss of strength at all angular velocities for both knee flexors and extensors. At POST+5, the subject returned to his original running patterns at low but not at high speeds and maximal strength remained reduced at low angular velocities (i.e. at high levels of force). It is suggested that the running pattern changes observed in the present study were a strategy adopted by the subject to reduce the deleterious effects of long distance running. However, the running pattern changes could partly be linked to the decrease in maximal strength.

Anatomy and histochemistry of spread-wing posture in birds. 3. Immunohistochemistry of flight muscles and the "shoulder lock" in albatrosses.

PubMed

Meyers, Ron A; Stakebake, Eric F

2005-01-01

As a postural behavior, gliding and soaring flight in birds requires less energy than flapping flight. Slow tonic and slow twitch muscle fibers are specialized for sustained contraction with high fatigue resistance and are typically found in muscles associated with posture. Albatrosses are the elite of avian gliders; as such, we wanted to learn how their musculoskeletal system enables them to maintain spread-wing posture for prolonged gliding bouts. We used dissection and immunohistochemistry to evaluate muscle function for gliding flight in Laysan and Black-footed albatrosses. Albatrosses possess a locking mechanism at the shoulder composed of a tendinous sheet that extends from origin to insertion throughout the length of the deep layer of the pectoralis muscle. This fascial "strut" passively maintains horizontal wing orientation during gliding and soaring flight. A number of muscles, which likely facilitate gliding posture, are composed exclusively of slow fibers. These include Mm. coracobrachialis cranialis, extensor metacarpi radialis dorsalis, and deep pectoralis. In addition, a number of other muscles, including triceps scapularis, triceps humeralis, supracoracoideus, and extensor metacarpi radialis ventralis, were found to have populations of slow fibers. We believe that this extensive suite of uniformly slow muscles is associated with sustained gliding and is unique to birds that glide and soar for extended periods. These findings suggest that albatrosses utilize a combination of slow muscle fibers and a rigid limiting tendon for maintaining a prolonged, gliding posture.

Body Composition, Neuromuscular Performance, and Mobility: Comparison Between Regularly Exercising and Inactive Older Women.

PubMed

Rava, Anni; Pihlak, Anu; Ereline, Jaan; Gapeyeva, Helena; Kums, Tatjana; Purge, Priit; Jürimäe, Jaak; Pääsuke, Mati

2017-01-01

The purpose of this study was to evaluate the differences in body composition, neuromuscular performance, and mobility in healthy, regularly exercising and inactive older women, and examine the relationship between skeletal muscle indices and mobility. Overall, 32 healthy older women participated. They were divided into groups according to their physical activity history as regularly exercising (n = 22) and inactive (n = 10) women. Body composition, hand grip strength, leg extensor muscle strength, rapid force development, power output, and mobility indices were assessed. Regularly exercising women had lower fat mass and higher values for leg extensor muscle strength and muscle quality, and also for mobility. Leg extensor muscle strength and power output during vertical jumping and appendicular lean mass per unit of body mass were associated with mobility in healthy older women. It was concluded that long-term regular exercising may have beneficial effects on body composition and physical function in older women.

Reduction-oxidation state and protein degradation in skeletal muscle of fasted and refed rats

NASA Technical Reports Server (NTRS)

Fagan, Julie M.; Tischler, Marc E.

1986-01-01

Redox state and protein degradation were measured in isolated muscles of fasted (up to 10 d) and refed (up to 4 d) 7- to 14-wk-old rats. Protein degradation in the extensor digitorum longus muscle, but not in the soleus muscle, was greater in the fasted rats than in weight-matched muscle from fed rats. The NAD couple was more oxidized in incubated and fresh extensor digitorum longus muscles and in some incubated soleus muscles of fasted rats than in weight-matched muscle from fed rats. In the extensor digitorum longus muscle of refed or prolonged fasted rats, protein degradation was slower and the NAD couple was more reduced than in the fed state. Therefore, oxidation of the NAD couple was associated with increased muscle breakdown during fasting, whereas reduction of the NAD couple was associated with muscle conservation and deposition.

Relation between functional mobility and dynapenia in institutionalized frail elderly.

PubMed

Soares, Antonio Vinicius; Marcelino, Elessandra; Maia, Késsia Cristina; Borges, Noé Gomes

2017-01-01

To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. A descriptive, correlational study involving 26 institutionalized elderly men and women, mean age 82.3±6 years. The instruments employed were the Mini Mental State Examination, the Geriatric Depression Scale, the International Physical Activity Questionnaire, the Timed Up and Go test, a handgrip dynamometer and a portable dynamometer for large muscle groups (shoulder, elbow and hip flexors, knee extensors and ankle dorsiflexors). Significant negative correlation between functional mobility levels assessed by the Timed Up and Go test and dynapenia was observed in all muscle groups evaluated, particularly in knee extensors (r -0.65). A significant negative correlation between muscle strength, particularly knee extensor strength, and functional mobility was found in institutionalized elderly. Data presented indicate that the higher the muscle strength, the shorter the execution time, and this could demonstrate better performance in this functional mobility test.

The effect of open kinetic chain knee extensor resistance training at different training loads on anterior knee laxity in the uninjured.

PubMed

Barcellona, Massimo G; Morrissey, Matthew C

2016-04-01

The commonly used open kinetic chain knee extensor (OKCKE) exercise loads the sagittal restraints to knee anterior tibial translation. To investigate the effect of different loads of OKCKE resistance training on anterior knee laxity (AKL) in the uninjured knee. non-clinical trial. Randomization into one of three supervised training groups occurred with training 3 times per week for 12 weeks. Subjects in the LOW and HIGH groups performed OKCKE resistance training at loads of 2 sets of 20 repetition maximum (RM) and 20 sets of 2RM, respectively. Subjects in the isokinetic training group (ISOK) performed isokinetic OKCKE resistance training using 2 sets of 20 maximal efforts. AKL was measured using the KT2000 arthrometer with concurrent measurement of lateral hamstrings muscle activity at baseline, 6 weeks and 12 weeks. Twenty six subjects participated (LOW n = 9, HIGH n = 10, ISOK n = 7). The main finding from this study is that a 12-week OKCKE resistance training programme at loads of 20 sets of 2RM, leads to an increase in manual maximal AKL. OKCKE resistance training at high loads (20 sets of 2RM) increases AKL while low load OKCKE resistance training (2 sets of 20RM) and isokinetic OKCKE resistance training at 2 sets of 20RM does not. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparison of electromyographic activity and range of neck motion in violin students with and without neck pain during playing.

PubMed

Park, Kyue-nam; Kwon, Oh-yun; Ha, Sung-min; Kim, Su-jung; Choi, Hyun-jung; Weon, Jong-hyuck

2012-12-01

Neck pain is common in violin students during a musical performance. The purpose of this study was to compare electromyographic (EMG) activity in superficial neck muscles with neck motion when playing the violin as well as neck range of motion (ROM) at rest, between violin students with and without neck pain. Nine violin students with neck pain and nine age- and gender-matched subjects without neck pain were recruited. Muscle activity of the bilateral upper trapezius, sternocleidomastoid, and superficial cervical extensor muscles was measured using surface EMG. Kinematic data on neck motion while playing and active neck ROM were also measured using a three-dimensional motion analysis system. Independent t-tests were used to compare EMG activity with kinematic data between groups. These analyses revealed that while playing, both the angle of left lateral bending and leftward rotation of the cervical spine were significantly greater in the neck pain group than among those without neck pain. Similarly, EMG activity of the left upper trapezius, both cervical extensors, and both sternocleidomastoid muscles were significantly greater in the neck pain group. The active ROM of left axial rotation was significantly lower in the neck pain group. These results suggest that an asymmetric playing posture and the associated increased muscle activity as well as decreased neck axial rotation may contribute to neck pain in violin students.

Do oarsmen have asymmetries in the strength of their back and leg muscles?

PubMed

Parkin, S; Nowicky, A V; Rutherford, O M; McGregor, A H

2001-07-01

The aim of this study was to establish whether asymmetry of the strength of the leg and trunk musculature is more prominent in rowers than in controls. Nineteen oarsmen and 20 male controls matched for age, height and body mass performed a series of isokinetic and isometric strength tests on an isokinetic dynamometer. These strength tests focused on the trunk and leg muscles. Comparisons of strength were made between and within groups for right and left symmetry patterns, hamstring: quadriceps ratios, and trunk flexor and extensor ratios. The results revealed no left and right asymmetries in either the knee extensor or flexor strength parameters (including both isometric and isokinetic measures). Knee extensor strength was significantly greater in the rowing population, but knee flexor strength was similar between the two groups. No difference was seen between the groups for the hamstring: quadriceps strength ratio. In the rowing population, stroke side had no influence on leg strength. No differences were observed in the isometric strength of the trunk flexors and extensors between groups, although EMG activity was significantly higher in the rowing population. Patterns of asymmetry of muscle activity were observed between the left and right erector spinae muscles during extension, which was significantly related to rowing side (P < 0.01). These observations could be related to the high incidence of low back pain in oarsmen.

Acute Effects of Different Agonist and Antagonist Stretching Arrangements on Static and Dynamic Range of Motion.

PubMed

Amiri-Khorasani, Mohammadtaghi; Kellis, Eleftherios

2015-12-01

Traditionally, stretching exercises are considered as basic components of warm up aiming to prepare the musculoskeletal system for performance and to prevent injuries. The purpose of this study was to examine the effects of different agonist and antagonist stretching arrangements within a pre-exercise warm-up on hip static (SROM) and dynamic range of motion (DROM). Sixty trained male subjects (Mean ± SD: height, 177.38 ± 6.92 cm; body mass, 68.4 ± 10.22 kg; age, 21.52 ± 1.17 years) volunteered to participate in this study. SROM was measured by V-sit test and DROM captured by a motion analysis system before and after (i) static stretching for both hip flexor and extensor muscles (SFSE), (ii) dynamic stretching for both hip flexor and extensor muscles (DFDE), (iii) static stretching for the hip flexors and dynamic stretching for hip extensors (SFDE), and (iv) dynamic stretching for the hip flexors and static stretching for hip extensors (DFSE). DFSE showed a significantly higher increase in DROM and SROM than the remainder of the stretching protocols (P < 0.05). There were significant differences between DFDE with SFSE and SFDE (P < 0.05) and SFSE showed significant increase as compared to SFDE (P < 0.05). In conclusion, DFSE is probably the best stretching arrangement due to producing more post activation potentiation on agonist muscles and less muscle stiffness in antagonist muscles.

Isometric strength ratios of the hip musculature in females with patellofemoral pain: a comparison to pain-free controls.

PubMed

Magalhães, Eduardo; Silva, Ana Paula M C C; Sacramento, Sylvio N; Martin, RobRoy L; Fukuda, Thiago Y

2013-08-01

The purpose of the study was to compare hip agonist-antagonist isometric strength ratios between females with patellofemoral pain (PFP) syndrome and pain-free control group. One hundred and twenty females between 15 and 40 years of age (control group: n = 60; PFP group: n = 60) participated in the study. Hip adductor, abductor, medial rotator, lateral rotator, flexor, and extensor isometric strength were measured using a hand-held dynamometer. Comparisons in the hip adductor/abductor and medial/lateral rotator and flexor/extensor strength ratios were made between groups using independent t-tests. Group comparisons also were made between the anteromedial hip complex (adductor, medial rotator, and flexor musculature) and posterolateral hip complex (abductor, lateral rotator, and extensor musculature). On average, the hip adductor/abductor isometric strength ratio in the PFP group was 23% higher when compared with the control group (p = 0.01). The anteromedial/posterolateral complex ratio also was significantly higher in the PFP group (average 8%; p = 0.04). No significant group differences were found for the medial/lateral rotator ratio and flexor/extensor strength ratios. The results of this study demonstrate that females with PFP have altered hip strength ratios when compared with asymptomatic controls. These strength imbalances may explain the tendency of females with PFP to demonstrate kinematic tendencies that increase loading on the patellofemoral joint (i.e., dynamic knee valgus).

Effects of long term Tai Chi practice and jogging exercise on muscle strength and endurance in older people.

PubMed

Xu, D Q; Li, J X; Hong, Y

2006-01-01

To investigate the influence of regular Tai Chi (TC) practice and jogging on muscle strength and endurance in the lower extremities of older people. Twenty one long term older TC practitioners were compared with 18 regular older joggers and 22 sedentary counterparts. Maximum concentric strength of knee flexors and extensors was tested at angular velocities of 30 degrees/s and 120 degrees/s. Ankle dorsiflexors and plantar flexors were tested at 30 degrees/s and the dynamic endurance of the knee flexors and extensors was assessed at a speed of 180 degrees/s. The differences in the muscle strength of the knee joint amongst the three experimental groups were significant at the higher velocity. The strengths of knee extensors and flexors in the control group were significantly lower than those in the jogging group and marginally lower than those in the TC group. For the ankle joint, the subjects in both the TC and jogging groups generated more torque in their ankle dorsiflexors. In addition, the muscle endurance of knee extensors was more pronounced in TC practitioners than in controls. Regular older TC practitioners and joggers showed better scores than the sedentary controls on most muscle strength and endurance measures. However, the magnitude of the exercise effects on muscles might depend on the characteristics of different types of exercise.

Poor correlation between handgrip strength and isokinetic performance of knee flexor and extensor muscles in community-dwelling elderly women.

PubMed

Felicio, Diogo Carvalho; Pereira, Daniele Sirineu; Assumpção, Alexandra Miranda; de Jesus-Moraleida, Fabianna Resende; de Queiroz, Barbara Zille; da Silva, Juscelio Pereira; de Brito Rosa, Naysa Maciel; Dias, João Marcos Domingues; Pereira, Leani Souza Máximo

2014-01-01

To investigate the correlation between handgrip strength and performance of knee flexor and extensor muscles determined using an isokinetic dynamometer in community-dwelling elderly women. This was a cross-sectional study. Sample selection for the study was made by convenience, and 221 (71.07 ± 4.93 years) community-dwelling elderly women were included. Knee flexor and extensor muscle performance was measured using an isokinetic dynamometer Biodex System 3 Pro. The isokinetic variables chosen for analysis were peak torque, peak torque/bodyweight, total work/bodyweight, total work, average power, and agonist/antagonist ratio at the angular velocities of 60°/s and 180°/s. Assessment of handgrip strength was carried out using the Jamar dynamometer. Spearman's correlation coefficient was calculated to identify intervariable correlations. Only knee flexor peak torque (60°/s) and average power (60°/s), and knee extensor peak torque (180°/s) and total work (180°/s) were significantly (P < 0.05), yet poorly, correlated with handgrip strength (r < 0.30). The majority of analyses did not show any correlation between variables assessed by isokinetic dynamometer and handgrip dynamometer. Caution is required when generalizing handgrip strength as a predictor of global muscle strength in community-dwelling elderly women. © 2013 Japan Geriatrics Society.

Acute effects of static and dynamic stretching on leg flexor and extensor isokinetic strength in elite women athletes.

PubMed

Sekir, U; Arabaci, R; Akova, B; Kadagan, S M

2010-04-01

The aim of this study was to explore the effects of static and dynamic stretching of the leg flexors and extensors on concentric and eccentric peak torque (PT) and electromyography (EMG) amplitude of the leg extensors and flexors in women athletes. Ten elite women athletes completed the following intervention protocol in a randomized order on separate days: (a) non-stretching (control), (b) static stretching, and (c) dynamic stretching. Stretched muscles were the quadriceps and hamstring muscles. Before and after the stretching or control intervention, concentric and eccentric isokinetic PT and EMG activity of the leg extensors and flexors were measured at 60 and 180 degrees/s. Concentric and eccentric quadriceps and hamstring muscle strength at both test speeds displayed a significant decrease following static stretching (P<0.01-0.001). In contrast, a significant increase was observed after dynamic stretching for these strength parameters (P<0.05-0.001). Parallel to this, normalized EMG amplitude parameters exhibited significant decreases following static (P<0.05-0.001) and significant increases following dynamic stretching (P<0.05-0.001) during quadriceps and hamstring muscle actions at both concentric and eccentric testing modes. Our findings suggest that dynamic stretching, as opposed to static or no stretching, may be an effective technique for enhancing muscle performance during the pre-competition warm-up routine in elite women athletes.

[Reconstruction of the extensor pollicis longus tendon by transposition of the extensor indicis tendon].

PubMed

Loos, A; Kalb, K; Van Schoonhoven, J; Landsleitner Dagger, B

2003-12-01

Rupture of the extensor pollicis longus-tendon (EPL) is a frequent complication after distal radius fractures. Other traumatic and non-traumatic reasons for this tendon lesion are known, including a theory about a disorder in the blood supply to the tendon itself. We examined 40 patients after reconstruction of the EPL-tendon in a mean follow-up time of 30 months. All patients were clinically examined and a DASH questionnaire was answered by all patients. The method to reconstruct the EPL-tendon was the transposition of the extensor indicis-tendon. After the operations the thumb was put in a splint for four weeks in a "hitch-hiker's-position". 31 ruptures of the tendon (77.5 %) were a result of trauma. In 20 of them (50 %) a distal radius fracture had occurred. Clinical examination included measurements of the movement of the thumb- and index-finger joints, the grip strength and the maximal span of the hand. Significant differences were not found. The isolated extension of the index finger was possible in all patients. But it was reduced in ten cases which represent 25 %. Our results were evaluated by the Geldmacher score to evaluate the reconstruction of the EPL-tendon. 20 % excellent, 65 % good, 12.5 % fair and 2.5 % poor results were reached. The Geldmacher score was used critically. We suggest its modification for the evaluation of thumb abduction. The DASH score reached a functional value of ten points which represents a very good result. In conclusion the extensor indicis-transposition is a safe method to reconstruct the EPL-tendon. Its substantial advantage is taking a healthy muscle as the motor, thereby avoiding the risk of using a degenerated muscle in late tendon reconstruction. A powerful extension of the index finger will be maintained by physical education. Generally, the loss of the extension of the index finger is negligible. It does not disturb the patients. But it has to be discussed with the patient before the operation.

Isokinetic Evaluation of the Hip Flexor and Extensor Muscles: A Systematic Review.

PubMed

Zapparoli, Fabricio Yuri; Riberto, Marcelo

2017-11-01

Isokinetic dynamometry testing is a safe and reliable method accepted as the "gold standard" in the evaluation of muscle strength in the open kinetic chain. Isokinetic hip examinations face problems in the standardization of the position of the equipment axis, in the individual being examined, and in the adjustment of the lever arm and in stabilization strategies for the patients during the tests. Identification of the methodologic procedures with best reproducibility is also needed. To review the literature to evaluate the parameters used for the isokinetic evaluation of the hip flexor and extensor muscles and its reproducibility. This is a systematic literature review of the Cochrane, LILACS, PEDro, PubMed, and SciELO databases. The inclusion criteria were articles on the evaluation of hip flexor and/or extensor muscular strength with an isokinetic dynamometer and articles that analyzed the ICC or Pearson's reproducibility. The information extracted was positioning of the patient; positioning of the dynamometer axis; positioning of the lever arm; angular speed; sample size, pathology; type of contraction; and ICC and Pearson's results. 204 articles were found, from which 14 were selected that evaluated hip flexor and extensor muscles, involving 550 individuals who were submitted to an isokinetic hip evaluation. Five articles obtained the best result in reproducibility and had their methodology analyzed. To obtain better reproducibility of the isokinetic evaluation of the hip flexor and extensor muscles, the following recommendations must be followed: the individual must be positioned in the supine position and the dynamometer axis must be aligned with the greater trochanter of the femur. The positioning of the lever arm must be in the most distal region of the thigh possible. The angular speed used to analyze torque peak and muscle work was 60°/s, and to evaluate the muscle power it was 180°/s, with concentric and eccentric contractions being analyzed.

Validity and reliability of an instrumented leg-extension machine for measuring isometric muscle strength of the knee extensors.

PubMed

Ruschel, Caroline; Haupenthal, Alessandro; Jacomel, Gabriel Fernandes; Fontana, Heiliane de Brito; Santos, Daniela Pacheco dos; Scoz, Robson Dias; Roesler, Helio

2015-05-20

Isometric muscle strength of knee extensors has been assessed for estimating performance, evaluating progress during physical training, and investigating the relationship between isometric and dynamic/functional performance. To assess the validity and reliability of an adapted leg-extension machine for measuring isometric knee extensor force. Validity (concurrent approach) and reliability (test and test-retest approach) study. University laboratory. 70 healthy men and women aged between 20 and 30 y (39 in the validity study and 31 in the reliability study). Intraclass correlation coefficient (ICC) values calculated for the maximum voluntary isometric torque of knee extensors at 30°, 60°, and 90°, measured with the prototype and with an isokinetic dynamometer (ICC2,1, validity study) and measured with the prototype in test and retest sessions, scheduled from 48 h to 72 h apart (ICC1,1, reliability study). In the validity analysis, the prototype showed good agreement for measurements at 30° (ICC2,1 = .75, SEM = 18.2 Nm) and excellent agreement for measurements at 60° (ICC2,1 = .93, SEM = 9.6 Nm) and at 90° (ICC2,1 = .94, SEM = 8.9 Nm). Regarding the reliability analysis, between-days' ICC1,1 were good to excellent, ranging from .88 to .93. Standard error of measurement and minimal detectable difference based on test-retest ranged from 11.7 Nm to 18.1 Nm and 32.5 Nm to 50.1 Nm, respectively, for the 3 analyzed knee angles. The analysis of validity and repeatability of the prototype for measuring isometric muscle strength has shown to be good or excellent, depending on the knee joint angle analyzed. The new instrument, which presents a relative low cost and easiness of transportation when compared with an isokinetic dynamometer, is valid and provides consistent data concerning isometric strength of knee extensors and, for this reason, can be used for practical, clinical, and research purposes.

Leg extensor muscle strength, postural stability, and fear of falling after a 2-month home exercise program in women with severe knee joint osteoarthritis.

PubMed

Rätsepsoo, Monika; Gapeyeva, Helena; Sokk, Jelena; Ereline, Jaan; Haviko, Tiit; Pääsuke, Mati

2013-01-01

BACKGROUND AND OBJECTIVE. The aim of this study was to compare the leg extensor muscle strength, the postural stability, and the fear of falling in the women with severe knee joint osteoarthritis (OA) before and after a 2-month home exercise program (HEP). MATERIAL AND METHODS. In total, 17 women aged 46-72 years with late-stage knee joint OA scheduled for total knee arthroplasty participated in this study before and after the 2-month HEP with strengthening, stretching, balance, and step exercises. The isometric peak torque (PT) of the leg extensors and postural stability characteristics when standing on a firm or a foam surface for 30 seconds were recorded. The fear of falling and the pain intensity (VAS) were estimated. RESULTS. A significant increase in the PT and the PT-to-body weight (PT-to-BW) ratio of the involved leg as well as the bilateral PT and the PT-to-BW ratio was found after the 2-month HEP compared with the data before the HEP (P<0.05). The PT and the PT-to-BW ratio of the involved leg were significantly lower compared with the uninvolved leg before the HEP (P<0.05). The center of the pressure sway length (foam surface) decreased significantly after the HEP (P<0.05). Significant correlations were found between the PT of the involved leg and the bilateral PT and the fear of falling and between the PT of the involved leg and the postural sway (foam surface) before the HEP. CONCLUSIONS. After the 2-month HEP, the leg extensor muscle strength increased and the postural sway length on a foam surface decreased. The results indicate that the increased leg extensor muscle strength improves postural stability and diminishes the fear of falling in women with late-stage knee joint OA.

Muscle-Specific Effective Mechanical Advantage and Joint Impulse in Weightlifting.

PubMed

Kipp, Kristof; Harris, Chad

2017-07-01

Kipp, K, and Harris, C. Muscle-specific effective mechanical advantage and joint impulse in weightlifting. J Strength Cond Res 31(7): 1905-1910, 2017-Lifting greater loads during weightlifting exercises may theoretically be achieved through increasing the magnitudes of net joint impulses or manipulating the joints' effective mechanical advantage (EMA). The purpose of this study was to investigate muscle-specific EMA and joint impulse as well as impulse-momentum characteristics of the lifter-barbell system across a range of external loads during the execution of the clean. Collegiate-level weightlifters performed submaximal cleans at 65, 75, and 85% of their 1-repetition maximum (1-RM), whereas data from a motion analysis system and a force plate were used to calculate lifter-barbell system impulse and velocity, as well as net extensor impulse generated at the hip, knee, and ankle joints and the EMA of the gluteus maximus, hamstrings, quadriceps, and triceps surae muscles. The results indicated that the lifter-barbell system impulse did not change as load increased, whereas the velocity of the lifter-barbell system decreased with greater load. In addition, the net extensor impulse at all joints increased as load increased. The EMA of all muscles did not, however, change as load increased. The load-dependent effects on the impulse-velocity characteristics of the lifter-barbell system may reflect musculoskeletal force-velocity behaviors, and may further indicate that the weightlifting performance is limited by the magnitude of ground reaction force impulse. In turn, the load-dependent effects observed at the joint level indicated that lifting greater loads were due to greater net extensor impulses generated at the joints of the lower extremity and not greater EMAs of the respective extensor muscles. In combination, these results suggest that lifting greater external loads during the clean is due to the ability to generate large extensor joint impulses, rather than manipulate EMA.

Vibration-evoked reciprocal inhibition between human wrist muscles.

PubMed

Cody, F W; Plant, T

1989-01-01

Reciprocal inhibition of the voluntarily contracting wrist extensor (extensor carpi radialis, ECR) evoked by proprioceptive afferent input from the flexor (flexor carpi radialis, FCR), was studied in healthy human subjects. Vibration of the FCR tendon was used to elicit Ia-dominated afferent discharge whilst inhibition of ECR was assessed as the reduction in asynchronous, on-going EMG. A small early phase of inhibition (I1) was evident in 25% of trials. The latency (ca. 25 ms) of this component suggested that it was mediated by an Ia oligosynaptic. possibly 'classical' disynaptic, inhibitory pathway. A later and apparently separate phase of reduced activity (I2, ca. 40 ms) was, however, far more consistently observed (96% of trials) and of greater magnitude. The I2 component was usually followed, some 20 ms later, by a phase of elevated activity (E1, 72% trials). Reductions in simultaneously recorded net extensor torque commenced at about 60 ms following the onset of flexor tendon vibration, i.e. some 20 ms after the main I2 EMG component. These mechanical responses must have almost exclusively resulted from reciprocal inhibition of extensor EMG since vibration of the relaxed FCR evoked minimal excitatory flexor activity. The reflex pattern, in any individual subject, was relatively unaffected by altering the duration of the vibration train between one and nineteen cycles (125 Hz). This suggests that the entire response complex resulted largely from the initial afferent volley. The sizes of both the I1 and I2 reductions in ECR activity increased with increasing voluntary extensor contraction so that their depths remained constant proportions of background EMG. Very similar results were obtained when reciprocal inhibition of FCR was produced by vibration of the belly of ECR. Thus, reciprocal inhibition between wrist muscles is mainly expressed as a rather stereotyped, short duration reduction in EMG whose depth is determined by the pre-existing level of motor activity. Some functional implications of this form of reflex behaviour are discussed.

MRI-determined lumbar muscle morphometry in man and sheep: potential biomechanical implications for ovine model to human spine translation.

PubMed

Valentin, Stephanie; Licka, Theresia F; Elliott, James

2015-10-01

The sheep is a commonly used animal model for human lumbar spine surgery, but only in vitro investigations comparing the human and ovine spine exist. Spinal musculature has previously not been compared between man and sheep. This additional knowledge could further indicate to what extent these species are biomechanically similar. Therefore, the purpose of the study was to investigate spinal muscle morphometric properties using magnetic resonance imaging (MRI) in different age groups of healthy human participants and sheep in vivo. Healthy human participants (n = 24) and sheep (n = 17) of different age groups underwent T1-weighted MRI of the lumbar spine. Regions of interest of the muscles erector spinae (ES), multifidus (M) and psoas (PS) were identified. The ratio of flexor to extensor volume, ratio of M to ES volume, and muscle fat relative to an area of intermuscular fat were calculated. Sheep M to ES ratio was significantly smaller than in the human participants (sheep 0.16 ± 0.02; human 0.37 ± 0.05; P < 0.001), although flexor to extensor ratio was not significantly different between species (human 0.39 ± 0.08; sheep 0.43 ± 0.05; P = 0.06). Age did not influence any muscle ratio outcome. Sheep had significantly greater extensor muscle fat compared with the human participants (M left human 40.64%, sheep 53.81%; M right human 39.17%, sheep 51.33%; ES left human 40.86%, sheep 51.29%; ES right human 35.93%, sheep 44.38%; all median values; all P < 0.001), although PS did not show any significant between-species differences (PS left human 36.89%, sheep 33.67%; PS right human 32.78%, sheep 30.09%; P < 0.05). The apparent differences in the size and shape of sheep and human lumbar spine muscles may indicate dissimilar biomechanical and functional demands, which is an important consideration when translating to human surgical models. © 2015 Anatomical Society.

ESCAPS study protocol: a feasibility randomised controlled trial of ‘Early electrical stimulation to the wrist extensors and wrist flexors to prevent the post-stroke complications of pain and contractures in the paretic arm’

PubMed Central

Fletcher-Smith, Joanna C; Walker, Dawn-Marie; Sprigg, Nikola; James, Marilyn; Walker, Marion F; Allatt, Kate; Mehta, Rajnikant; Pandyan, Anand D

2016-01-01

Introduction Approximately 70% of patients with stroke experience impaired arm function, which is persistent and disabling for an estimated 40%. Loss of function reduces independence in daily activities and impacts on quality of life. Muscles in those who do not recover functional movement in the stroke affected arm are at risk of atrophy and contractures, which can be established as early as 6 weeks following stroke. Pain is also common. This study aims to evaluate the feasibility of a randomised controlled trial to test the efficacy and cost-effectiveness of delivering early intensive electrical stimulation (ES) to prevent post-stroke complications in the paretic upper limb. Methods and analysis This is a feasibility randomised controlled trial (n=40) with embedded qualitative studies (patient/carer interviews and therapist focus groups) and feasibility economic evaluation. Patients will be recruited from the Stroke Unit at the Nottingham University Hospitals National Health Service (NHS) Trust within 72 h after stroke. Participants will be randomised to receive usual care or usual care and early ES to the wrist flexors and extensors for 30 min twice a day, 5 days a week for 3 months. The initial treatment(s) will be delivered by an occupational therapist or physiotherapist who will then train the patient and/or their nominated carer to self-manage subsequent treatments. Ethics and dissemination This study has been granted ethical approval by the National Research Ethics Service, East Midlands Nottingham1 Research Ethics Committee (ref: 15/EM/0006). To our knowledge, this is the first study of its kind of the early application (within 72 h post-stroke) of ES to both the wrist extensors and wrist flexors of stroke survivors with upper limb impairment. The results will inform the design of a definitive randomised controlled trial. Dissemination will include 2 peer-reviewed journal publications and presentations at national conferences. Trial registration number ISRCTN1648908; Pre-results. Clinicaltrials.gov ID: NCT02324634. PMID:26729394

Gender differences in the circadian variations in muscle strength assessed with and without superimposed electrical twitches.

PubMed

Giacomoni, Magali; Edwards, Ben; Bambaeichi, Effat

The circadian rhythm in muscle strength was analysed in 12 males (28 +/- 4 years, 79.6 +/- 12.3 kg, 1.80 +/- 0.05 m) and eight females (28 +/- 4 years, 60.3 +/- 5.5 kg, 1.61 +/- 0.08 m). After two familiarization sessions, participants were tested at six different times of the day (02:00, 06:00, 10:00, 14:00, 18:00 and 22:00 hours), the order of which was randomly assigned over 3-4 days. Rectal temperature (T(rec)) was measured over 30 min before each test. Peak isokinetic torques (PT) of knee extensors and flexors were then measured at 1.05 rad s(-1) and 3.14 rad s(-1) through a 90 degrees range of motion. Maximal isometric voluntary contraction (MVC) of knee extensors and flexors was measured at 60 degrees of knee flexion and the MVC of knee extensors was also assessed with superimposed electrical twitches (50 Hz, 250 V, 200 mus pulse width) in order to control for motivational effects. Three trials were performed in each condition, separated by 3 min recovery, and the highest values were retained for subsequent analyses. A significant circadian rhythm was observed for T(rec) in both males and females (acrophase, Phi, 17:29 and 16:40 hours; mesor, Me, 37.0 and 36.8 degrees C; amplitude, A, 0.28 and 0.33 degrees C for males and females, respectively). The mesor of T(rec) was higher in males than in females (p < 0.05). Significant circadian rhythms were observed for knee extensor PT at 3.14 rad s(-1) in males (Phi, 17:06 hours; Me, 178.2 N m; A, 4.7 N m) and for knee extensor PT at 1.05 rad s(-1) in females (Phi, 15:35 hours; Me, 128.7 N m; A, 3.7 N m). In males, the MVC of knee extensors demonstrated a significant circadian rhythm, but only when electrical twitches were superimposed (Phi, 16:17 h; Me, 302.1 N m; A, 13.6 N m). Acrophases of all indices of muscle strength were not statistically different between the two groups and were located in the afternoon (12:47 < Phi < 17:16 hours). The amplitude (percentage of mesor) of extensors MVC (electrically stimulated) was higher in males (6.4%) than in females (4.2%; p < 0.05). Significant circadian rhythms were not consistently observed for all indices of muscle strength whatever the gender. Our group of female subjects tended to show lower circadian amplitudes than the males. In males, maximal voluntary contraction of electrically stimulated muscles followed a circadian curve, which was not significant without the superimposed twitches. These results suggest that motivation could have a masking effect on the circadian rhythm in muscle performance and strengthen the view that peripheral factors are implicated in this rhythm.

The effect of corticosteroid versus platelet-rich plasma injection therapies for the management of lateral epicondylitis: A systematic review

PubMed Central

Ben-Nafa, Walid; Munro, Wendy

2018-01-01

Introduction: Lateral epicondylitis is a common musculoskeletal disorder of the upper limb. Corticosteroid injection has been widely used as a major mode of treatment. However, better understanding of the pathophysiology of the disease led to a major change in treating the disease, with new options including platelet-rich plasma (PRP) are currently used. Objectives/research aim: To systematically evaluate the effect of corticosteroid versus PRP injections for the treatment of LE. Hypothesis: PRP injections provide longer-term therapeutic effect and less rate of complications compared to corticosteroid injection. Level of evidence: Level 2 evidence (4 included studies are of level 1 evidence, 1 study of level 2 evidence). Design: Systematic Review (according to PRISMA guidelines). Methods: Eleven databases used to search for relevant primary studies comparing the effects of corticosteroid and PRP injections for the treatment of LE. Quality appraisal of studies performed using Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0, CASP Randomised Controlled Trial Checklist, and SIGN Methodology Checklist 2. Results: 732 papers were identified. Five randomised controlled trials (250 Patients) met the inclusion criteria. Clinical findings: Corticosteroid injections provided rapid symptomatic improvement with maximum effect at 6/8/8 weeks before symptoms recurrence, whereas PRP showed slower ongoing improvements up to 24/52/104 weeks(3 studies). Corticosteroid showed more rapid symptomatic improvement of symptoms compared to PRP up to the study end-point of 3 months(1 study). Comparable therapeutic effects of corticosteroid and PRP were observed at 6 weeks(1 study). Ultrasonographic Findings: (1) Doppler activity decreased more significantly in patients who received corticosteroid compared to PRP. (2) Reduced tendon thickness and more patients with cortical erosion noted in corticosteroid group whereas increased tendon thickness and less number of patients with common extensor tendon tears noted in PRP group. (3) Fewer patients reported Probe-induced tenderness and oedema in the common extensor tendon in both corticosteroid and PRP groups (2 studies). Conclusion: Corticosteroid injections provide rapid therapeutic effect in the short-term with recurrence of symptoms afterwards, compared to the relatively slower but longer-term effect of platelet-rich plasma. PMID:29561260

Position sense at the human forearm in the horizontal plane during loading and vibration of elbow muscles

PubMed Central

Ansems, G E; Allen, T J; Proske, U

2006-01-01

When blindfolded subjects match the position of their forearms in the vertical plane they rely on signals coming from the periphery as well as from the central motor command. The command signal provides a positional cue from the accompanying effort sensation required to hold the arm against gravity. Here we have asked, does a centrally generated effort signal contribute to position sense in the horizontal plane, where gravity cannot play a role? Blindfolded subjects were required to match forearm position for the unloaded arm and when flexors or extensors were bearing 10%, 25% or 40% of maximum loads. Before each match the reference arm was conditioned by contracting elbow muscles while the arm was held flexed or extended. For the unloaded arm conditioning led to a consistent pattern of errors which was attributed to signals from flexor and extensor muscle spindles. When elbow muscles were loaded the errors from conditioning converged, presumably because the spindles had become coactivated through the fusimotor system during the load-bearing contraction. However, this convergence was seen only when subjects supported a static load. When they moved the load differences in errors from conditioning persisted. Muscle vibration during load bearing or moving a load did not alter the distribution of errors. It is concluded that for position sense of an unloaded arm in the horizontal plane the brain relies on signals from muscle spindles. When the arm is loaded, an additional signal of central origin contributes, but only if the load is moved. PMID:16873408

Relation between functional mobility and dynapenia in institutionalized frail elderly

PubMed Central

Soares, Antonio Vinicius; Marcelino, Elessandra; Maia, Késsia Cristina; Borges, Noé Gomes

2017-01-01

ABSTRACT Objective To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. Methods A descriptive, correlational study involving 26 institutionalized elderly men and women, mean age 82.3±6 years. The instruments employed were the Mini Mental State Examination, the Geriatric Depression Scale, the International Physical Activity Questionnaire, the Timed Up and Go test, a handgrip dynamometer and a portable dynamometer for large muscle groups (shoulder, elbow and hip flexors, knee extensors and ankle dorsiflexors). Results Significant negative correlation between functional mobility levels assessed by the Timed Up and Go test and dynapenia was observed in all muscle groups evaluated, particularly in knee extensors (r -0.65). Conclusion A significant negative correlation between muscle strength, particularly knee extensor strength, and functional mobility was found in institutionalized elderly. Data presented indicate that the higher the muscle strength, the shorter the execution time, and this could demonstrate better performance in this functional mobility test. PMID:29091148

Myostatin dysfunction impairs force generation in extensor digitorum longus muscle and increases exercise-induced protein efflux from extensor digitorum longus and soleus muscles.

PubMed

Baltusnikas, Juozas; Kilikevicius, Audrius; Venckunas, Tomas; Fokin, Andrej; Bünger, Lutz; Lionikas, Arimantas; Ratkevicius, Aivaras

2015-08-01

Myostatin dysfunction promotes muscle hypertrophy, which can complicate assessment of muscle properties. We examined force generating capacity and creatine kinase (CK) efflux from skeletal muscles of young mice before they reach adult body and muscle size. Isolated soleus (SOL) and extensor digitorum longus (EDL) muscles of Berlin high (BEH) mice with dysfunctional myostatin, i.e., homozygous for inactivating myostatin mutation, and with a wild-type myostatin (BEH+/+) were studied. The muscles of BEH mice showed faster (P < 0.01) twitch and tetanus contraction times compared with BEH+/+ mice, but only EDL displayed lower (P < 0.05) specific force. SOL and EDL of age-matched but not younger BEH mice showed greater exercise-induced CK efflux compared with BEH+/+ mice. In summary, myostatin dysfunction leads to impairment in muscle force generating capacity in EDL and increases susceptibility of SOL and EDL to protein loss after exercise.

Age-Related Locomotion Characteristics in Association with Balance Function in Young, Middle-Aged, and Older Adults.

PubMed

Lee, Hwang-Jae; Chang, Won Hyuk; Hwang, Sun Hee; Choi, Byung-Ok; Ryu, Gyu-Ha; Kim, Yun-Hee

2017-04-01

The purpose of this study was to examine age-related gait characteristics and their associations with balance function in older adults. A total of 51 adult volunteers participated. All subjects underwent locomotion analysis using a 3D motion analysis and 12-channel dynamic electromyography system. Dynamic balance function was assessed by the Berg Balance Scale. Older adults showed a higher level of muscle activation than young adults, and there were significant positive correlations between increased age and activation of the trunk and thigh muscles in the stance and swing phase of the gait cycle. In particular, back extensor muscle activity was mostly correlated with the dynamic balance in older adults. Thus, back extensor muscle activity in walking may provide a clue for higher falling risk in older adults. This study demonstrates that the back extensor muscles play very important roles with potential for rehabilitation training to improve balance and gait in older adults.

How are tonic and phasic cardiovascular changes related to central motor command?

PubMed

Jennings, J R; van der Molen, M W; Brock, K; Somsen, R J

1993-07-01

We examined the influence of central motor command on heart rate, respiration, and peripheral vascular activity. Central command was enhanced or reduced using tendon vibration. Muscle tension was held constant permitting the examination of variation in central command. Experiment 1 demonstrated in 13 college-aged males an enhancement of heart rate and vascular responses to an isometric, extensor contraction when vibration of the flexor tendon was added. Experiment 2 asked whether changes in central command interacted with phasic cardiovascular changes such as stimulus-linked anticipatory cardiac deceleration. Twenty college-aged males performed either an isometric flexor or extensor contraction with or without flexor tendon vibration. As expected, vibration enhanced cardiovascular change with extensor contraction more than with flexor contraction. Relative to control contractions, however, the flexor change was not an absolute decrease in cardiovascular change. More importantly, tendon vibration failed to alter phasic cardiovascular changes. Force and central commands for force induce cardiovascular change, but this change seems independent of phasic changes induced by the anticipation and processing of environmental stimuli.

Initial experience with visualizing hand and foot tendons by dual-energy computed tomography.

PubMed

Deng, Kai; Sun, Cong; Liu, Cheng; Ma, Rui

2009-01-01

To assess the feasibility of visualizing hand and foot tendons by dual-energy computed tomography (CT). Twenty patients who suffered from hand or feet pains were scanned on dual-source CT (Definition, Forchheim, Germany) with dual-energy mode at tube voltages of 140 and 80 kV and a corresponding ratio of 1:4 between tube currents. The reconstructed images were postprocessed by volume rendering techniques (VRT) and multiplanar reconstruction (MPR). All of the suspected lesions were confirmed by surgery or follow-up studies. Twelve patients (total of 24 hands and feet, respectively) were found to be normal and the other eight patients (total of nine hands and feet, respectively) were found abnormal. Dual-energy techniques are very useful in visualizing tendons of the hands and feet, such as flexor pollicis longus tendon, flexor digitorum superficialis/profundus tendon, Achilles tendon, extensor hallucis longus tendon, and extensor digitorum longus tendon, etc. It can depict the whole shape of the tendons and their fixation points clearly. Peroneus longus tendon in the sole of the foot was not displayed very well. The distal ends of metacarpophalangeal joints with extensor digitoium tendon and extensor pollicis longus tendon were poorly shown. The lesions of tendons such as the circuitry, thickening, and adherence were also shown clearly. Dual-energy CT offers a new method to visualize tendons of the hand and foot. It could clearly display both anatomical structures and pathologic changes of hand and foot tendons.

The effects of Kinesio Taping on the trajectory of the forelimb and the muscle activity of the Musculus brachiocephalicus and the Musculus extensor carpi radialis in horses

PubMed Central

Zellner, Antonia; Bockstahler, Barbara; Peham, Christian

2017-01-01

Background information The present study aimed to investigate the effects of Kinesio Taping on the trajectory of the forelimb and the muscle activity of the M. brachiocephalicus and the M. extensor carpi radialis in horses. 19 horses and ponies of different breeds (body weight: 496±117 kg), gender (8 mares, 10 geldings and 3 stallions) and ages (14.9±6.9 years old) were analysed without Kinesio Tape (“no tape”), with Kinesio Tape (muscle facilitation application on both muscles of both sides, “with tape”) and immediately after Kinesio Taping (“post tape”) through kinematic motion analysis and surface electromyography on a treadmill at the walk (speed: 1.5±0.1 m/s) and trot (speed: 3.1±0.3 m/s). Results The results of the surface electromyography (maximum muscle activity at the walk and trot) and the kinematic motion analysis (maximum stride length and maximum height of the forelimbs flight arc at the walk and trot) showed that there were no significant differences between "no tape", "with tape" and "post tape". Conclusion To sum up, Kinesio Taping on the M. brachiocephalicus and the M. extensor carpi radialis does not affect (in a positive or negative manner) the trajectory of the forelimb or the muscle activity of the M. brachiocephalicus and the M. extensor carpi radialis in horses. PMID:29166657

Acute Effects of Different Agonist and Antagonist Stretching Arrangements on Static and Dynamic Range of Motion

PubMed Central

Amiri-Khorasani, Mohammadtaghi; Kellis, Eleftherios

2015-01-01

Background: Traditionally, stretching exercises are considered as basic components of warm up aiming to prepare the musculoskeletal system for performance and to prevent injuries. Objectives: The purpose of this study was to examine the effects of different agonist and antagonist stretching arrangements within a pre-exercise warm-up on hip static (SROM) and dynamic range of motion (DROM). Materials and Methods: Sixty trained male subjects (Mean ± SD: height, 177.38 ± 6.92 cm; body mass, 68.4 ± 10.22 kg; age, 21.52 ± 1.17 years) volunteered to participate in this study. SROM was measured by V-sit test and DROM captured by a motion analysis system before and after (i) static stretching for both hip flexor and extensor muscles (SFSE), (ii) dynamic stretching for both hip flexor and extensor muscles (DFDE), (iii) static stretching for the hip flexors and dynamic stretching for hip extensors (SFDE), and (iv) dynamic stretching for the hip flexors and static stretching for hip extensors (DFSE). Results: DFSE showed a significantly higher increase in DROM and SROM than the remainder of the stretching protocols (P < 0.05). There were significant differences between DFDE with SFSE and SFDE (P < 0.05) and SFSE showed significant increase as compared to SFDE (P < 0.05). Conclusions: In conclusion, DFSE is probably the best stretching arrangement due to producing more post activation potentiation on agonist muscles and less muscle stiffness in antagonist muscles. PMID:26715975

Net joint moments and muscle activation in barbell squats without and with restricted anterior leg rotation.

PubMed

Chiu, Loren Z F; vonGaza, Gabriella L; Jean, Liane M Y

2017-01-01

Muscle utilisation in squat exercise depends on technique. The purpose of this study was to compare net joint moments (NJMs) and muscle activation during squats without and with restricted leg dorsiflexion. Experienced men (n = 5) and women (n = 4) performed full squats at 80% one repetition maximum. 3D motion analysis, force platform and (EMG) data were collected. Restricting anterior leg rotation reduced anterior leg (P = 0.001) and posterior thigh (P < 0.001) rotations, resulting in a smaller knee flexion range of motion (P < 0.001). At maximum squat depth, ankle plantar flexor (P < 0.001) and knee extensor (P < 0.001) NJM were higher in unrestricted squats. Hip extensor NJM (P = 0.14) was not different between squat types at maximum squat depth. Vastus lateralis (P > 0.05), vastus medialis (P > 0.05) and rectus femoris (P > 0.05) EMG were not different between squat types. Unrestricted squats have higher ankle plantar flexor and knee extensor NJM than previously reported from jumping and landing. However, ankle plantar flexor and knee extensor NJM are lower in restricted squats than previous studies of jumping and landing. The high NJM in unrestricted squat exercise performed through a full range of motion suggests this squat type would be more effective to stimulate adaptations in the lower extremity musculature than restricted squats.

A Novel Two-Velocity Method for Elaborate Isokinetic Testing of Knee Extensors.

PubMed

Grbic, Vladimir; Djuric, Sasa; Knezevic, Olivera M; Mirkov, Dragan M; Nedeljkovic, Aleksandar; Jaric, Slobodan

2017-09-01

Single outcomes of standard isokinetic dynamometry tests do not discern between various muscle mechanical capacities. In this study, we aimed to (1) evaluate the shape and strength of the force-velocity relationship of knee extensors, as observed in isokinetic tests conducted at a wide range of angular velocities, and (2) explore the concurrent validity of a simple 2-velocity method. Thirteen physically active females were tested for both the peak and averaged knee extensor concentric force exerted at the angular velocities of 30°-240°/s recorded in the 90°-170° range of knee extension. The results revealed strong (0.960

Omega "Ω" Pulley Plasty for Surgical Management of DeQuervain's Disease.

PubMed

Bakhach, Joseph; Chaya, Bachar; Papazian, Nazareth

2018-06-01

DeQuervain tenosynovitis, refractory to medical conservative treatment, has been traditionally treated by a simple division of the pulley, a procedure associated with several complications. Many authors attempted to prevent these complications by describing techniques of pulley reconstruction after its release necessitating suturing the different flaps and subsequently promoting extensor tendons adhesions. The authors present an alternative procedure for the first extensor compartment pulley decompression: "Omegaplasty". 25 Patients with 29 DeQuervain tenosynovitis cases were enrolled in a prospective, nonrandomized clinical trial from 2012 to 2016. At enrollment they were offered the option of Omegaplasty as a surgical treatment modality for their cases. The procedure is based on liberating the anterior attachment of the pulley from the anterior lip of the styloïd process while respecting its continuity with the periosteal flap as well as promoting expansion of the tunnel volume. All operated patients were evaluated using the "Opposition Kapandji Score". The authors present the results of 29 different "Omegaplasty" procedures. Based on the Kapandji opposition score, twenty cases scored 10/10 while the remaining nine cases yielded an 8/10 score each. The described technique is simple, reliable and respects the extensor tendons gliding physiology and biodynamics. By preserving the anatomical continuity of the first extensor compartment pulley at the wrist, the risk of adhesion formation is reduced. The preliminary results are encouraging and provide the "Ω" plasty the potential to be considered as a surgical option for treatment of De Quervain Tenosynovitis.

Proximity of arthroscopic ankle stabilization procedures to surrounding structures: an anatomic study.

PubMed

Drakos, Mark; Behrens, Steve B; Mulcahey, Mary K; Paller, David; Hoffman, Eve; DiGiovanni, Christopher W

2013-06-01

To examine the anatomy of the lateral ankle after arthroscopic repair of the lateral ligament complex (anterior talofibular ligament [ATFL] and calcaneofibular ligament [CFL]) with regard to structures at risk. Ten lower extremity cadaveric specimens were obtained and were screened for gross anatomic defects and pre-existing ankle laxity. The ATFL and CFL were sectioned from the fibula by an open technique. Standard anterolateral and anteromedial arthroscopy portals were made. An additional portal was created 2 cm distal to the anterolateral portal. The articular surface of the fibula was identified, and the ATFL and CFL were freed from the superficial and deeper tissues. Suture anchors were placed in the fibula at the ATFL and CFL origins and were used to repair the origin of the lateral collateral structures. The distance from the suture knot to several local anatomic structures was measured. Measurements were taken by 2 separate observers, and the results were averaged. Several anatomic structures lie in close proximity to the ATFL and CFL sutures. The ATFL sutures entrapped 9 of 55 structures, and no anatomic structures were inadvertently entrapped by the CFL sutures. The proximity of the peroneus tertius and the extensor tendons to the ATFL makes them at highest risk of entrapment, but the proximity of the intermediate branch of the superficial peroneal nerve (when present) is a risk with significant morbidity. Our results indicate that the peroneus tertius and extensor tendons have the highest risk for entrapment and show the smallest mean distances from the anchor knot to the identified structure. Careful attention to these structures, as well as the superficial peroneal nerve, is mandatory to prevent entrapment of tendons and nerves when one is attempting arthroscopic lateral ankle ligament reconstruction. Defining the anatomic location and proximity of the intervening structures adjacent to the lateral ligament complex of the ankle may help clarify the anatomic safe zone through which arthroscopic repair of the lateral ligament complex can be safely performed. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Computed tomographic anatomy of the equine stifle joint.

PubMed

Vekens, Elke Van der; Bergman, Erik H J; Vanderperren, Katrien; Raes, Els V; Puchalski, Sarah M; Bree, Henri J J van; Saunders, Jimmy H

2011-04-01

To provide a detailed computed tomography (CT) reference of the anatomically normal equine stifle joint. Sample-16 hind limbs from 8 equine cadavers; no horses had evidence of orthopedic disease of the stifle joints. CT of the stifle joint was performed on 8 hind limbs. In all limbs, CT was also performed after intra-articular injection of 60 mL of contrast material (150 mg of iodine/mL) in the lateral and medial compartments of the femorotibial joint and 80 mL of contrast material in the femoropatellar joint (CT arthrography). Reformatted CT images in the transverse, parasagittal, and dorsal plane were matched with corresponding anatomic slices of the 8 remaining limbs. The femur, tibia, and patella were clearly visible. The patellar ligaments, common origin of the tendinous portions of the long digital extensor muscle and peroneus tertius muscle, collateral ligaments, tendinous portion of the popliteus muscle, and cranial and caudal cruciate ligaments could also be consistently evaluated. The cruciate ligaments and the meniscotibial ligaments could be completely assessed in the arthrogram sequences. Margins of the meniscofemoral ligament and the lateral and medial femoropatellar ligaments were difficult to visualize on the precontrast and postcontrast images. CT and CT arthrography were used to accurately identify and characterize osseous and soft tissue structures of the equine stifle joint. This technique may be of value when results from other diagnostic imaging techniques are inconclusive. The images provided will serve as a CT reference for the equine stifle joint.

Prevalence of and referred pain from myofascial trigger points in the forearm muscles in patients with lateral epicondylalgia.

PubMed

Fernández-Carnero, Josué; Fernández-de-Las-Peñas, César; de la Llave-Rincón, Ana Isabel; Ge, Hong-You; Arendt-Nielsen, Lars

2007-05-01

Referred pain and pain characteristics evoked from the extensor carpi radialis brevis, extensor carpi radialis longus, extensor digitorum communis, and brachioradialis muscles was investigated in 20 patients with lateral epicondylalgia (LE) and 20-matched controls. Both groups were examined for the presence of myofascial trigger points (TrPs) in a blinded fashion. The quality and location of the evoked referred pain, and the pressure pain threshold (PPT) at the lateral epicondyle on the right upper extremity (symptomatic side in patients, and dominant-side on controls) were recorded. Several lateral elbow pain parameters were also evaluated. Within the patient group, the elicited referred pain by manual exploration of 13 out of 20 (65%) extensor carpi radialis brevis muscles, 12/20 (70%) extensor carpi radialis longus muscles, 10/20 (50%) brachioradialis muscles, and 5/20 (25%) extensor digitorum communis muscles, shares similar pain patterns as their habitual lateral elbow and forearm pain. The mean number of muscles with TrPs for each patient was 2.9 [95% confidence interval (CI) 1,4] of which 2 (95% CI 1,3) were active, and 0.9 (95% CI 0,2) were latent TrPs. Control participants only had latent TrPs (mean: 0.4; 95% CI 0,2). TrP occurrence between the 2 groups was significantly different for active TrPs (P<0.001), but not for latent TrPs (P>0.05). The referred pain pattern was larger in patients than in controls, with pain referral to the lateral epicondyle (proximally) and to the dorso-lateral aspect of the forearm in the patients, and confined to the dorso-lateral aspect of the forearm in the controls. Patients with LE showed a significant (P<0.001) lower PPT (mean: 2.1 kg/cm; 95% CI 0.8, 4 kg/cm) as compared with controls (mean: 4.5 kg/cm; 95% CI 3, 7 kg/cm). Within the patient group, PPT at the lateral epicondyle was negatively correlated with both the total number of TrPs (rs=-0.63; P=0.003) and the number of active TrPs (rs=-0.5; P=0.02): the greater the number of active TrPs, the lower the PPT at the lateral epicondyle. Our results suggest that in patients with LE, the evoked referred pain and its sensory characteristics shared similar patterns as their habitual elbow and forearm pain, consistent with active TrPs. Lower PPT and larger referred pain patterns suggest that peripheral and central sensitization exists in LE.

Isovariant extensors and the characterization of equivariant homotopy equivalences

NASA Astrophysics Data System (ADS)

Ageev, Sergei M.

2012-10-01

We extend the well-known theorem of James-Segal to the case of an arbitrary family F of conjugacy classes of closed subgroups of a compact Lie group G: a G-map f\\colon{X}\\to{Y} of metric \\operatorname{Equiv}_{F}- {ANE}-spaces is a G-homotopy equivalence if and only if it is a weak G- F-homotopy equivalence. The proof is based on the theory of isovariant extensors, which is developed in this paper and enables us to endow F-classifying G-spaces with an additional structure.

New possibilities of improving the function of the hand of patients with spastic hemiplegia.

PubMed

Kiwerski, J

1984-01-01

The report presents a therapeutic proposal aiming at the improvement of the functions of the paretic hand in spastic hemiplegics. To achieve this aim the author suggests a combination of phenolization of the medial and ulnar nerves and the stimulation training of the wrist and fingers extensors. An implanted stimulator is used; the stimulator electrodes are fixed to the radial nerve. The strengthening of the extensors during the period of increased muscular tension of the flexors makes it possible to improve the functions of the paretic upper extremity.

Cold shivering activity after unilateral destruction of the vestibular apparatus

NASA Technical Reports Server (NTRS)

Kuzmina, G. I.

1980-01-01

The bioelectric activity of muscles (flexors and extensors of the forelimbs and hindlimbs) during cold shivering after unilateral destruction of the vestibular apparatus. It was found, that unilateral delabyrinthing produces bilateral facilitation of cold shivering in the flexor extremities more pronounced on the ipsilateral side. In the extensor muscles there was an absence of bioelectric activity both before and after delabyrinthing. Enhancement of cold shivering in the flexor extremities following intervention was evidently conditioned by removal of the inhibiting effect of the vestibulary apparatus on the function of special centers.

Congenital hypertrophy of multiple intrinsic muscles of the foot.

PubMed

Shiraishi, Tomohiro; Park, Susam; Niu, Atushi; Hasegawa, Hiromi

2014-12-01

Congenital hypertrophy of a single intrinsic muscle of the foot is rare, and as far as we know, only six cases have been reported. We describe a case of congenital anomaly that showed hypertrophy of multiple intrinsic muscles of the foot; the affected muscles were all the intrinsic muscles of the foot except the extensor digitorum brevis or extensor hallucis. Other tissues such as adipose tissue, nervous tissue, or osseous tissue showed no abnormalities. To reduce the volume of the foot we removed parts of the enlarged muscles.

Antigravity treadmill training during the early rehabilitation phase following unicompartmental knee arthroplasty: A case series.

PubMed

Huang, Chun-Hao; Schroeder, E Todd; Powers, Christopher

2018-02-26

Patients who have undergone unicompartmental knee arthroplasty (UKA) have been reported to exhibit altered gait 19-25 months post-surgery. The most common gait impairment in this population is inadequate knee flexion and a corresponding decrease in the knee extensor moment during loading response (i.e., quadriceps avoidance). The purpose of this case series was to determine whether incorporation of antigravity treadmill training into a standard physical therapy program can eliminate quadriceps avoidance gait during the early rehabilitation phase following UKA. Four females who underwent UKA were recruited for this study. Participants completed antigravity treadmill training three times per week for 12 weeks in addition to their standard physical therapy program. Instrumented gait analysis was performed at baseline (pre-intervention), week 6 (mid-intervention), and week 12 (post-intervention). We found that peak knee flexion and the peak knee extensor moment during the weight acceptance phase of gait increased to normal values following the 12-week intervention period (14.1 ± 6.5° to 20.6 ± 1.5° and 0.4 ± 0.3 to 0.7 ± 0.2 Nm/kg respectively). The findings of this case series suggest that a standard physical therapy program that incorporates early gait training using an antigravity treadmill may be beneficial in eliminating "quadriceps avoidance" during the early rehabilitation phase following UKA.

Hand Surgeon Reporting of Tendon Rupture Following Distal Radius Volar Plating

PubMed Central

Monaco, Nathan A.; Dwyer, C. Liam; Ferikes, Alex J.; Lubahn, John D.

2016-01-01

Background: Volar plate fixation with locked screws has become the preferred treatment of displaced distal radius fractures that cannot be managed nonoperatively. This treatment, however, is not without complication. The purpose of this study was to determine what percentage of hand surgeons, over a 12-month period, have experienced a tendon complication when using volar plates for the treatment of distal radius fractures. Methods: A total of 3022 hand surgeons were e-mailed a link to an online questionnaire regarding their observation and treatment of tendon injuries associated with volar plating of distal radius fractures. Responses were reported using descriptive statistics. Results: Of the 596 (20%) respondents, 199 (33%) surgeons reported encountering at least one flexor tendon injury after distal radius volar plating over the past year of practice. The flexor pollicis longus was the most commonly reported tendon injury (254, 75%). Palmaris longus grafting (118, 37%) and tendon transfer (114, 36%) were the most often reported treatments following this complication. A total of 216 respondents (36%) also encountered 324 cases of extensor tendon rupture after volar plating of distal radius fractures, with tendon transfer (88%) being the preferred treatment option. Conclusions: Both flexor and extensor tendon ruptures can be seen after volar plating of distal radius fractures. Surgeons should be aware of these complications. Critical assessment of hardware position at the time of index procedure is recommended to avoid complications. Long-term studies are needed to standardize approaches to managing tendon rupture following volar plating of distal radius fractures. PMID:27698628

Hand Surgeon Reporting of Tendon Rupture Following Distal Radius Volar Plating.

PubMed

Monaco, Nathan A; Dwyer, C Liam; Ferikes, Alex J; Lubahn, John D

2016-09-01

Background: Volar plate fixation with locked screws has become the preferred treatment of displaced distal radius fractures that cannot be managed nonoperatively. This treatment, however, is not without complication. The purpose of this study was to determine what percentage of hand surgeons, over a 12-month period, have experienced a tendon complication when using volar plates for the treatment of distal radius fractures. Methods: A total of 3022 hand surgeons were e-mailed a link to an online questionnaire regarding their observation and treatment of tendon injuries associated with volar plating of distal radius fractures. Responses were reported using descriptive statistics. Results: Of the 596 (20%) respondents, 199 (33%) surgeons reported encountering at least one flexor tendon injury after distal radius volar plating over the past year of practice. The flexor pollicis longus was the most commonly reported tendon injury (254, 75%). Palmaris longus grafting (118, 37%) and tendon transfer (114, 36%) were the most often reported treatments following this complication. A total of 216 respondents (36%) also encountered 324 cases of extensor tendon rupture after volar plating of distal radius fractures, with tendon transfer (88%) being the preferred treatment option. Conclusions: Both flexor and extensor tendon ruptures can be seen after volar plating of distal radius fractures. Surgeons should be aware of these complications. Critical assessment of hardware position at the time of index procedure is recommended to avoid complications. Long-term studies are needed to standardize approaches to managing tendon rupture following volar plating of distal radius fractures.

Ultrastructure of identified fast excitatory, slow excitatory and inhibitory neuromuscular junctions in the locust.

PubMed

Titmus, M J

1981-06-01

The specialized jumping muscle of the locust, the metathoracic extensor tibiae (ETi), is innervated by four physiologically different motoneurons, including FETi, a phasic excitor, SETi, a tonic excitor, and CI, a tonic common inhibitor. FETi neuromuscular junctions were examined in three phasic ETi bundles innervated by FETi. FETi terminals were characterized by patchy contacts on to granular sarcoplasm. The ETi accessory extensor, innervated by both SETi and CI, contains two morphologically different types of axon ending. When this muscle was soaked in horseradish peroxidase, stimulation of SETi led to selective uptake in vesicles in terminals similar to those of FETi axons but containing smaller vesicles, while stimulation by CI caused increased uptake into terminals with more extensive contact directly on to fibrillar sarcoplasm. As has been observed in excitatory and inhibitory synapses in some crustacean and vertebrate nervous systems, the synaptic vesicles in the locust excitatory endings are round and electron-lucent while those in the inhibitory endings are more irregular in shape. The tonic neuromuscular junctions, SETi and CI, are more densely packed with vesicles, larger in cross-sectional area and appear to be of more complex shape than the smaller, vesicle-sparse, phasic FETi terminals. Following long duration stimulation at 10 Hz, the tonic neuromuscular junctions showed little morphological change. FETi endings, which fatigue within minutes at the same stimulation frequency, showed a 20% decrease in synaptic vesicle density and an increase in irregularly shaped membrane inclusions.

Muscle force distribution of the lower limbs during walking in diabetic individuals with and without polyneuropathy.

PubMed

Gomes, Aline A; Ackermann, Marko; Ferreira, Jean P; Orselli, Maria Isabel V; Sacco, Isabel C N

2017-11-09

Muscle force estimation could advance the comprehension of the neuromuscular strategies that diabetic patients adopt to preserve walking ability, which guarantees their independence as they deal with their neural and muscular impairments due to diabetes and neuropathy. In this study, the lower limb's muscle force distribution during gait was estimated and compared in diabetic patients with and without polyneuropathy. Thirty individuals were evaluated in a cross-sectional study, equally divided among controls (CG) and diabetic patients with (DNG) and without (DG) polyneuropathy. The acquired ground reaction forces and kinematic data were used as input variables for a scaled musculoskeletal model in the OpenSim software. The maximum isometric force of the ankle extensors and flexors was reduced in the model of DNG by 30% and 20%, respectively. The muscle force was calculated using static optimization, and peak forces were compared among groups (flexors and extensors of hip, knee, and ankle; ankle evertors; and hip abductors) using MANOVAs, followed by univariate ANOVAs and Newman-Keuls post-hoc tests (p < 0.05). From the middle to late stance phase, DG showed a lower soleus muscle peak force compared to the CG (p=0.024) and the DNG showed lower forces in the gastrocnemius medialis compared to the DG (p=0.037). At the terminal swing phase, the semitendinosus and semimembranosus peak forces showed lower values in the DG compared to the CG and DNG. At the late stance, the DNG showed a higher peak force in the biceps short head, semimembranosus, and semitendinosus compared to the CG and DG. Peak forces of ankle (flexors, extensors, and evertors), knee (flexors and extensors), and hip abductors distinguished DNG from DG, and both of those from CG. Both diabetic groups showed alterations in the force production of the ankle extensors with reductions in the forces of soleus (DG) and gastrocnemius medialis (DNG) seen in both diabetic groups, but only DNG showed an increase in the hamstrings (knee flexor) at push-off. A therapeutic approach focused on preserving the functionality of the knee muscles is a promising strategy, even if the ankle dorsiflexors and plantarflexors are included in the resistance training.

Do patients with knee osteoarthritis perform sit-to-stand motion efficiently?

PubMed

Anan, Masaya; Shinkoda, Koichi; Suzuki, Kentaro; Yagi, Masahide; Ibara, Takuya; Kito, Nobuhiro

2015-02-01

The sit-to-stand motion (STS) is a frequently executed activity that is affected by weakness in the quadriceps femoris muscle and knee joint pain in patients with knee osteoarthritis (OA). We investigated whether patients with knee OA can efficiently perform STS through mechanical energy transfer assessments. Participants were 20 women with knee OA and 17 age-matched asymptomatic controls. The center of mass (COM), segment angles, joint moments, and powers during STS were measured. The negative mechanical work in the proximal portion of the shank, negative mean powers in the distal portion of the pelvis and proximal portion of the shank, and the positive mean power in the proximal and distal portions of the thigh were significantly lower in the knee OA group than in the control group. Patients with knee OA primarily performed thoracic forward lean movement, shifting their COM closer to the base of support provided by the feet alone, in an attempt to achieve stability at and after buttocks-off. However, control ability, which generates and absorbs kinetic energy quickly, was not enhanced in these patients, and their motion was unable to increase absorption of the mechanical energy in hip extensors and reduce the load on knee extensors. Furthermore, STS in patients with knee OA had reduced energy absorption in the knee extensors from the shank forward lean movement after buttocks-off, had reduced knee extensor efficiency, and made greater use of physiological energy. These findings suggest that, from the standpoint of mechanical energy transfer, patients with knee OA do not perform STS efficiently. Copyright © 2014 Elsevier B.V. All rights reserved.

ASSOCIATION OF ISOMETRIC STRENGTH OF HIP AND KNEE MUSCLES WITH INJURY RISK IN HIGH SCHOOL CROSS COUNTRY RUNNERS.

PubMed

Luedke, Lace E; Heiderscheit, Bryan C; Williams, D S Blaise; Rauh, Mitchell J

2015-11-01

High school cross country runners have a high incidence of overuse injuries, particularly to the knee and shin. As lower extremity strength is modifiable, identification of strength attributes that contribute to anterior knee pain (AKP) and shin injuries may influence prevention and management of these injuries. To determine if a relationship existed between isometric hip abductor, knee extensor and flexor strength and the incidence of AKP and shin injury in high school cross country runners. Sixty-eight high school cross country runners (47 girls, 21 boys) participated in the study. Isometric strength tests of hip abductors, knee extensors and flexors were performed with a handheld dynamometer. Runners were prospectively followed during the 2014 interscholastic cross country season for occurrences of AKP and shin injury. Bivariate logistic regression was used to examine risk relationships between strength values and occurrence of AKP and shin injury. During the season, three (4.4%) runners experienced AKP and 13 (19.1%) runners incurred a shin injury. Runners in the tertiles indicating weakest hip abductor (chi-square = 6.140; p=0.046), knee extensor (chi-square = 6.562; p=0.038), and knee flexor (chi-square = 6.140; p=0.046) muscle strength had a significantly higher incidence of AKP. Hip and knee muscle strength was not significantly associated with shin injury. High school cross country runners with weaker hip abductor, knee extensor and flexor muscle strength had a higher incidence of AKP. Increasing hip and knee muscle strength may reduce the likelihood of AKP in high school cross country runners. 2b.

A biomechanical comparison of back and front squats in healthy trained individuals.

PubMed

Gullett, Jonathan C; Tillman, Mark D; Gutierrez, Gregory M; Chow, John W

2009-01-01

The strength and stability of the knee plays an integral role in athletics and activities of daily living. A better understanding of knee joint biomechanics while performing variations of the squat would be useful in rehabilitation and exercise prescription. We quantified and compared tibiofemoral joint kinetics as well as muscle activity while executing front and back squats. Because of the inherent change in the position of the center of mass of the bar between the front and back squat lifts, we hypothesized that the back squat would result in increased loads on the knee joint and that the front squat would result in increased knee extensor and decreased back extensor muscle activity. A crossover study design was used. To assess the net force and torque placed on the knee and muscle activation levels, a combination of video and force data, as well as surface electromyographic data, were collected from 15 healthy trained individuals. The back squat resulted in significantly higher compressive forces and knee extensor moments than the front squat. Shear forces at the knee were small in magnitude, posteriorly directed, and did not vary between the squat variations. Although bar position did not influence muscle activity, muscle activation during the ascending phase was significantly greater than during the descending phase. The front squat was as effective as the back squat in terms of overall muscle recruitment, with significantly less compressive forces and extensor moments. The results suggest that front squats may be advantageous compared with back squats for individuals with knee problems such as meniscus tears, and for long-term joint health.

Cervical Musculoskeletal Impairments and Temporomandibular Disorders

PubMed Central

Magee, David

2012-01-01

ABSTRACT Objectives The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance) to determine cervical musculoskeletal impairments. Results A strong relationship between neck disability and jaw disability was found (r = 0.82). Craniocervical posture was statistically different between patients with myogenous Temporomandibular Disorders (TMD) and healthy subjects. However, the difference was too small (3.3º) to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (P = 0.07). However, clinically important effect sizes (0.42 - 0.82) were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Conclusions Subjects with Temporomandibular Disorders presented with impairments of the cervical flexors and extensors muscles. These results could help guide clinicians in the assessment and prescription of more effective interventions for individuals with Temporomandibular Disorders. PMID:24422022

The effect of knee extensor open kinetic chain resistance training in the ACL-injured knee.

PubMed

Barcellona, Massimo G; Morrissey, Matthew C; Milligan, Peter; Clinton, Melissa; Amis, Andrew A

2015-11-01

To investigate the effect of different loads of knee extensor open kinetic chain resistance training on anterior knee laxity and function in the ACL-injured (ACLI) knee. Fifty-eight ACLI subjects were randomised to one of three (12-week duration) training groups. The STAND group trained according to a standardised rehabilitation protocol. Subjects in the LOW and HIGH group trained as did the STAND group but with the addition of seated knee extensor open kinetic chain resistance training at loads of 2 sets of 20 repetition maximum (RM) and 20 sets of 2RM, respectively. Anterior knee laxity and measurements of physical and subjective function were performed at baseline, 6 and 12 weeks. Thirty-six subjects were tested at both baseline and 12 weeks (STAND n = 13, LOW n = 11, HIGH n = 12). The LOW group demonstrated a reduction in 133 N anterior knee laxity between baseline and 12 weeks testing when compared to the HIGH and the STAND groups (p = 0.009). Specifically, the trained-untrained knee laxity decreased an average of approximately 5 mm in the LOW group while remaining the same in the other two groups. Twelve weeks of knee extensor open kinetic chain resistance training at loads of 2 sets of 20RM led to a reduction in anterior knee laxity in the ACLI knee. This reduction in laxity does not appear to offer any significant short-term functional advantages when compared to a standard rehabilitation protocol. These results indicate that knee laxity can be decreased with resistance training of the thigh muscles. Randomised controlled trial, Level II.

Effect of Preactivation on Torque Enhancement by the Stretch-Shortening Cycle in Knee Extensors

PubMed Central

Fukutani, Atsuki; Misaki, Jun; Isaka, Tadao

2016-01-01

The stretch-shortening cycle is one of the most interesting topics in the field of sport sciences, because the performance of human movement is enhanced by the stretch-shortening cycle (eccentric contraction). The purpose of the present study was to examine whether the influence of preactivation on the torque enhancement by stretch-shortening cycle in knee extensors. Twelve men participated in this study. The following three conditions were conducted for knee extensors: (1) concentric contraction without preactivation (CON), (2) concentric contraction with eccentric preactivation (ECC), and (3) concentric contraction with isometric preactivation (ISO). Muscle contractions were evoked by electrical stimulation to discard the influence of neural activity. The range of motion of the knee joint was set from 80 to 140 degrees (full extension = 180 degrees). Angular velocities of the concentric and eccentric contractions were set at 180 and 90 degrees/s, respectively. In the concentric contraction phase, joint torques were recorded at 85, 95, and 105 degrees, and they were compared among the three conditions. In the early phase (85 degrees) of concentric contraction, the joint torque was larger in the ECC and ISO conditions than in the CON condition. However, these clear differences disappeared in the later phase (105 degrees) of concentric contraction. The results showed that joint torque was clearly different among the three conditions in the early phase whereas this difference disappeared in the later phase. Thus, preactivation, which is prominent in the early phase of contractions, plays an important role in torque enhancement by the stretch-shortening cycle in knee extensors. PMID:27414804

Relation between the Disability of the Arm, Shoulder and Hand Score and Muscle Strength in Post-Cardiac Surgery Patients.

PubMed

Izawa, Kazuhiro P; Kasahara, Yusuke; Hiraki, Koji; Hirano, Yasuyuki; Watanabe, Satoshi

2017-11-27

Background: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a valid and reliable patient-reported outcome measure. DASH can be assessed by self-reported upper extremity disability and symptoms. We aimed to examine the relationship between the physiological outcome of muscle strength and the DASH score after cardiac surgery. Methods: This cross-sectional study assessed 50 consecutive cardiac patients that were undergoing cardiac surgery. Physiological outcomes of handgrip strength and knee extensor muscle strength and the DASH score were measured at one month after cardiac surgery and were assessed. Results were analyzed using Spearman correlation coefficients. Results: The final analysis comprised 43 patients (men: 32, women: 11; age: 62.1 ± 9.1 years; body mass index: 22.1 ± 4.7 kg/m²; left ventricular ejection fraction: 53.5 ± 13.7%). Respective handgrip strength, knee extensor muscle strength, and DASH score were 27.4 ± 8.3 kgf, 1.6 ± 0.4 Nm/kg, and 13.3 ± 12.3, respectively. The DASH score correlated negatively with handgrip strength ( r = -0.38, p = 0.01) and with knee extensor muscle strength ( r = -0.32, p = 0.04). Conclusion: Physiological outcomes of both handgrip strength and knee extensor muscle strength correlated negatively with the DASH score. The DASH score appears to be a valuable tool with which to assess cardiac patients with poor physiological outcomes, particularly handgrip strength as a measure of upper extremity function, which is probably easier to follow over time than lower extremity function after patients complete cardiac rehabilitation.

Speed, not magnitude, of knee extensor torque production is associated with self-reported knee function early after anterior cruciate ligament reconstruction.

PubMed

Hsieh, Chao-Jung; Indelicato, Peter A; Moser, Michael W; Vandenborne, Krista; Chmielewski, Terese L

2015-11-01

To examine the magnitude and speed of knee extensor torque production at the initiation of advanced anterior cruciate ligament (ACL) reconstruction rehabilitation and the associations with self-reported knee function. Twenty-eight subjects who were 12 weeks post-ACL reconstruction and 28 age- and sex-matched physically active controls participated in this study. Knee extensor torque was assessed bilaterally with an isokinetic dynamometer at 60°/s. The variables of interest were peak torque, average rate of torque development, time to peak torque and quadriceps symmetry index. Knee function was assessed with the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF). Peak torque and average rate of torque development were lower on the surgical side compared to the non-surgical side and controls. Quadriceps symmetry index was lower in subjects with ACL reconstruction compared to controls. On the surgical side, average rate of torque development was positively correlated with IKDC-SKF score (r = 0.379) while time to peak torque was negatively correlated with IKDC-SKF score (r = -0.407). At the initiation of advanced ACL reconstruction rehabilitation, the surgical side displayed deficits in peak torque and average rate of torque development. A higher rate of torque development and shorter time to peak torque were associated with better self-reported knee function. The results suggest that the rate of torque development should be addressed during advanced ACL reconstruction rehabilitation and faster knee extensor torque generation may lead to better knee function. III.

Activation of plantar flexor muscles is constrained by multiple muscle synergies rather than joint torques

PubMed Central

Suzuki, Takahito; Kinugasa, Ryuta; Fukashiro, Senshi

2017-01-01

Behavioral evidence has suggested that a small number of muscle synergies may be responsible for activating a variety of muscles. Nevertheless, such dimensionality reduction may also be explained using the perspective of alternative hypotheses, such as predictions based on linear combinations of joint torques multiplied by corresponding coefficients. To compare the explanatory capacity of these hypotheses for describing muscle activation, we enrolled 12 male volunteers who performed isometric plantar flexor contractions at 10–100% of maximum effort. During each plantar flexor contraction, the knee extensor muscles were isometrically contracted at 0%, 50%, or 100% of maximum effort. Electromyographic activity was recorded from the vastus lateralis, medial gastrocnemius (MG), lateral gastrocnemius (LG), and soleus muscles and quantified using the average rectified value (ARV). At lower plantar flexion torque, regression analysis identified a clear linear relationship between the MG and soleus ARVs and between the MG and LG ARVs, suggesting the presence of muscle synergy (r2 > 0.65). The contraction of the knee extensor muscles induced a significant change in the slope of this relationship for both pairs of muscles (MG × soleus, P = 0.002; MG × LG, P = 0.006). Similarly, the slope of the linear relationship between the plantar flexion torque and the ARV of the MG or soleus changed significantly with knee extensor contraction (P = 0.031 and P = 0.041, respectively). These results suggest that muscle synergies characterized by non-mechanical constraints are selectively recruited according to whether contraction of the knee extensor muscles is performed simultaneously, which is relatively consistent with the muscle synergy hypothesis. PMID:29107958

Mobile input device type, texting style and screen size influence upper extremity and trapezius muscle activity, and cervical posture while texting.

PubMed

Kietrys, David M; Gerg, Michael J; Dropkin, Jonathan; Gold, Judith E

2015-09-01

This study aimed to determine the effects of input device type, texting style, and screen size on upper extremity and trapezius muscle activity and cervical posture during a short texting task in college students. Users of a physical keypad produced greater thumb, finger flexor, and wrist extensor muscle activity than when texting with a touch screen device of similar dimensions. Texting on either device produced greater wrist extensor muscle activity when texting with 1 hand/thumb compared with both hands/thumbs. As touch screen size increased, more participants held the device on their lap, and chose to use both thumbs less. There was also a trend for greater finger flexor, wrist extensor, and trapezius muscle activity as touch screen size increased, and for greater cervical flexion, although mean differences for cervical flexion were small. Future research can help inform whether the ergonomic stressors observed during texting are associated with musculoskeletal disorder risk. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

The Immediate Effect of Neuromuscular Joint Facilitation (NJF) Treatment on Hip Muscle Strength.

PubMed

Wang, Hongdan; Huo, Ming; Huang, Qiuchen; Li, Desheng; Maruyama, Hitoshi

2013-11-01

[Purpose] This study investigated the change in hip muscle strength of younger persons after neuromuscular joint facilitation (NJF) treatment. [Subjects] The subjects were 45 healthy young people, who were divided into two groups: a NJF group and a proprioceptive neuromuscular facilitation (PNF) group. The NJF group consisted of 21 subjects (11 males, 10 females), and the PNF group consisted of 24 subjects (11 males, 13 females). [Methods] Participants in the NJF group received NJF treatment. We measured the maximal flexor strength and the maximal extensor strength during isokinetic movement of the hip joint before and after intervention in both groups. The angular velocities used were 60°/sec and 180°/sec. [Results] The NJF group showed significant increases in the maximal flexor strength and the maximal extensor strength after the intervention at each angular velocity. In the PNF group, the maximal flexor strength of 60°/sec and the maximal extensor strength of 180°/sec were significant increases. [Conclusion] These results suggest that there is an immediate effect of NJF intervention on hip muscle strength.

Functional anatomy and muscle moment arms of the pelvic limb of an elite sprinting athlete: the racing greyhound (Canis familiaris)

PubMed Central

Williams, S B; Wilson, A M; Rhodes, L; Andrews, J; Payne, R C

2008-01-01

We provide quantitative anatomical data on the muscle–tendon architecture and geometry of the pelvic limb of an elite sprint athlete, the racing greyhound. Specifically, muscle masses, muscle lengths, fascicle lengths, pennation angles and muscle moment arms were measured. Maximum isometric force and power of muscles, the maximum muscle torque at joints and tendon stress and strain were estimated. We compare data with that published for a generalized breed of canid, and other cursorial mammals such as the horse and hare. The pelvic limb of the racing greyhound had a relatively large volume of hip extensor muscle, which is likely to be required for power production. Per unit body mass, some pelvic limb muscles were relatively larger than those in less specialized canines, and many hip extensor muscles had longer fascicle lengths. It was estimated that substantial extensor moments could be created about the tarsus and hip of the greyhound allowing high power output and potential for rapid acceleration. The racing greyhound hence possesses substantial specializations for enhanced sprint performance. PMID:18657259

Functional anatomy and muscle moment arms of the pelvic limb of an elite sprinting athlete: the racing greyhound (Canis familiaris).

PubMed

Williams, S B; Wilson, A M; Rhodes, L; Andrews, J; Payne, R C

2008-10-01

We provide quantitative anatomical data on the muscle-tendon architecture and geometry of the pelvic limb of an elite sprint athlete, the racing greyhound. Specifically, muscle masses, muscle lengths, fascicle lengths, pennation angles and muscle moment arms were measured. Maximum isometric force and power of muscles, the maximum muscle torque at joints and tendon stress and strain were estimated. We compare data with that published for a generalized breed of canid, and other cursorial mammals such as the horse and hare. The pelvic limb of the racing greyhound had a relatively large volume of hip extensor muscle, which is likely to be required for power production. Per unit body mass, some pelvic limb muscles were relatively larger than those in less specialized canines, and many hip extensor muscles had longer fascicle lengths. It was estimated that substantial extensor moments could be created about the tarsus and hip of the greyhound allowing high power output and potential for rapid acceleration. The racing greyhound hence possesses substantial specializations for enhanced sprint performance.

Fatigue and recovery from dynamic contractions in men and women differ for arm and leg muscles.

PubMed

Senefeld, Jonathon; Yoon, Tejin; Bement, Marie Hoeger; Hunter, Sandra K

2013-09-01

Whether there is a gender difference in fatigue and recovery from maximal velocity fatiguing contractions and across muscles is not understood. Sixteen men and 19 women performed 90 isotonic contractions at maximal voluntary shortening velocity (maximal velocity concentric contractions, MVCC) with the elbow flexor and knee extensor muscles (separate days) at a load equivalent to 20% maximal voluntary isometric contraction (MVIC). Power (from MVCCs) decreased similarly for men and women for both muscles (P > 0.05). Men and women had similar declines in MVIC of elbow flexors, but men had greater reductions in knee extensor MVIC force and MVIC electromyogram activity than women (P < 0.05). The decline in MVIC and power was greater, and force recovery was slower for the elbow flexors compared with knee extensors. The gender difference in muscle fatigue often observed during isometric tasks was diminished during fast dynamic contractions for upper and lower limb muscles. Copyright © Published 2013 by Wiley Periodicals, Inc. This article is a US Government wmusork and, as such, is in the public domain in the United States of America.

Treatment of chronic extensor tendons lesions of the fingers.

PubMed

Bellemère, P

2015-09-01

Chronic finger extensor apparatus injuries are the result of the initial acute treatment having failed or being flawed. Because of their chronic nature, these injuries present various amounts of tendon retraction, tendon callus lengthening, peritendinous scar adhesions, static and dynamic imbalances with the flexor apparatus and intrinsic muscles, and joint contractures. This article will review the anatomy of the extensor mechanism and then will outline by location, the various clinical pictures that are secondary to chronic tendon injury. The clinical presentation of these injuries can be highly variable but their symptomatology and treatment are very specific. Of the possible therapeutic strategies for chronic mallet finger with or without associated swan-neck deformity, chronic boutonniere deformity, chronic sagittal band injuries, old ruptures on the dorsum of the wrist and traumatic defects in multiple tissues, conservative treatment is often the main element. Secondary surgical repair is not free of complications, and the results are often lacking. Rehabilitation and orthotic bracing are an integral part of the management of these injuries, no matter which treatment method is being considered. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Conservative management of partial extensor tendon lacerations greater than half the width of the tendon in manual workers.

PubMed

Al-Qattan, Mohammad M

2015-04-01

Conservative management (without suturing or splints) of partial extensor tendon lacerations greater than half the width of the tendon has not been previously investigated. In this prospective study, a total of 45 injured tendons (with lacerations involving 55%-90% of the width of the tendon) in 39 patients were treated conservatively. Injury zones I, III, and V of the fingers; and zones I and III of the thumb were excluded. Immediate non-resistive active mobilization was initiated and continued for 4 weeks, followed by resistive exercises. Patients were allowed to go back to work after 6 weeks. There were no cases of ruptures, triggering, infection, or complex regional pain syndrome. At final follow-up (8-9 months after injury), all patients obtained full range of motion with no extension lags. All patients were able to go back to normal duties. We conclude that early active motion without the use of splints or sutures in major extensor tendon lacerations in zones II, IV, VI-VIII of the fingers; and zones II, IV, and V of the thumb is safe.

Octopamine mediated relaxation of maintained and catch tension in locust skeletal muscle.

PubMed

Evans, P D; Siegler, M V

1982-03-01

1. The modulatory actions of an identified octopaminergic neurone (DUMETi) that projects to the extensor-tibiae muscle of the locust hind leg depend upon the frequency of stimulation of the slow motoneurone (SETi) to this muscle. 2. At low frequencies of SETi stimulation (1Hz and below) the predominant modulatory effects are increases in the amplitude and relaxation rate of twitch tension. At higher frequencies, where twitches summate but tetanus is incomplete (up to 20 Hz), the reduction of maintained tension becomes considerably more important. 3. Both octopamine application and DUMETi stimulation reduce the amount of catch tension displayed by the extensor muscle when SETi is fired in a variety of different stimulus patterns. The extensor-tibiae muscle is itself 'pattern sensitive' since is shows a 'positive spacing effect' when SETi is stimulated at an average frequency of 1 Hz. 4. It is suggested that a primary function of DUMETi is to change the response of the muscle from one that favours maintenance of posture to one that favours rapid changes in joint position or force, such as might occur during locomotion.

Octopamine mediated relaxation of maintained and catch tension in locust skeletal muscle.

PubMed Central

Evans, P D; Siegler, M V

1982-01-01

1. The modulatory actions of an identified octopaminergic neurone (DUMETi) that projects to the extensor-tibiae muscle of the locust hind leg depend upon the frequency of stimulation of the slow motoneurone (SETi) to this muscle. 2. At low frequencies of SETi stimulation (1Hz and below) the predominant modulatory effects are increases in the amplitude and relaxation rate of twitch tension. At higher frequencies, where twitches summate but tetanus is incomplete (up to 20 Hz), the reduction of maintained tension becomes considerably more important. 3. Both octopamine application and DUMETi stimulation reduce the amount of catch tension displayed by the extensor muscle when SETi is fired in a variety of different stimulus patterns. The extensor-tibiae muscle is itself 'pattern sensitive' since is shows a 'positive spacing effect' when SETi is stimulated at an average frequency of 1 Hz. 4. It is suggested that a primary function of DUMETi is to change the response of the muscle from one that favours maintenance of posture to one that favours rapid changes in joint position or force, such as might occur during locomotion. PMID:6808122

Lateral Patellar Instability in the Skeletally Mature Patient: Evaluation and Surgical Management.

PubMed

Diduch, David R; Kandil, Abdurrahman; Burrus, M Tyrrell

2018-05-18

Lateral patellar instability is a common disease process that affects all types of patients. Depending on the patient's anatomy and the results of preoperative imaging, surgical management options include medial patellofemoral ligament reconstruction, tibial tubercle osteotomy, and sulcus-deepening trochleoplasty. Medial patellofemoral ligament reconstruction or repair is useful for almost all patients, whereas tibial tubercle osteotomy is helpful to correct a lateralized tibial tubercle and the associated elevated lateral pull of the extensor mechanism. For a select subset of patients with severe trochlear dysplasia, a sulcus-deepening trochleoplasty can be a useful option to prevent future patellar instability. Many technical considerations exist for each procedure, and in most situations, no consensus exists to direct surgeons on the superior technique.

Ultrasonographic Differentiation of Lateral Elbow Pain

PubMed Central

Obuchowicz, R.; Bonczar, M.

2016-01-01

Lateral elbow pain is often attributed to degenerative or posttraumatic impairment of the common extensor tendon. Ultrasonography assesses the soft tissue structures of the lateral elbow, allowing the differentiation between various underlying processes, including angiofibroblastic degeneration, hyaline degeneration, and inflammation, and exclusion of other possible causes of pain such as posterior interosseous and lateral antebrachial nerve compression. Furthermore, the real-time imaging nature of ultrasonography enables the detection of impingement of the lateral synovial fold, degenerative changes in the elbow recess, and elbow posterolateral instability during dynamic maneuvers. Ultrasonography is widely accessible and well tolerated by patients, making it a perfect method for establishing an initial diagnosis and monitoring the healing process. This review describes the possible causes of lateral elbow pain and their ultrasonographic differentiation. PMID:27689169

Differences in morphology and force/velocity relationship between Senegalese and Italian sprinters.

PubMed

Rahmani, Abderrehmane; Locatelli, Elio; Lacour, Jean-Rene

2004-04-01

In order to investigate whether the supremacy of African sprinters is related to the leg extensor force/velocity relationship or to leg morphology, two groups of elite sprinters originating respectively from Senegal (S) and Italy (I) were compared in this respect. The groups included 13 S and 15 I male sprinters. Their mean best performances over 100 m during the preceding track and field season were 10.66 (0.3) and 10.61 (0.3) s (NS), respectively. Age, height and mass were similar in the two groups. The force/velocity relationship of the leg extensors was assessed during maximal half-squats on a guided horizontal barbell with masses of 20-140 kg added on the shoulders. Leg morphology was assessed by relating the sub-ischial length to the standing height (L/H) and by measuring the inertia in the vertical (IZ in kg.cm2), antero-posterior (IY, kg.cm2) and medio-lateral (IX, kg.m2) planes. The two groups developed non-different force and power when lifting the heaviest loads. Inversely, the lighter the load, the lower the force and power developed by S, as compared to I (P<0.001). S demonstrated greater L/H (P<0.001), and 26% lower IZ (P<0.01), 15% lower IY (P=0.09), and 14% lower IX (P=0.10). These results suggest that S and I sprinters were similar as regards the muscle abilities involved in slow maximal contractions. However, S demonstrated lower values in muscle abilities related to high-speed contractions, suggesting that S sprinters had a lower percentage of fast twitch fibres. This is likely to be compensated for by the lower level of internal work due to longer and lighter legs.

Factors associated with operative treatment of enthesopathy of the extensor carpi radialis brevis origin.

PubMed

Kachooei, Amir Reza; Talaei-Khoei, Mojtaba; Faghfouri, Aram; Ring, David

2016-04-01

This study investigated the factors associated with variation in the rate of surgery for enthesopathy of the extensor carpi radialis brevis (eECRB). We used a large database from 3 academic hospitals including 5964 patients with the diagnosis of eECRB from 2001 to 2007. Of those, 244 patients (4%) had surgery for eECRB. We used the date of the first encounter as the date of diagnosis. We also recorded the date of the first cortisone injection and surgery for eECRB. We used Cox multivariable regression analysis to find factors associated with surgery. We considered the following explanatory factors: age, sex, race, diabetes, a diagnosis of major depression, a diagnosis of an anxiety disorder, hospital, provider (surgeon vs. nonsurgeon), corticosteroid injection, and the time from diagnosis to the first cortisone injection. The hazard ratio of having surgery was 12-times greater if the initial provider was an orthopedic surgeon rather a nonsurgeon and 1.7-times greater at 1 of the 2 hospitals. The rate of surgery varied substantially, ranging from 0% to 22%. Corticosteroid injection delayed the time to surgery but was ultimately associated with a higher rate of surgery. The majority (86%) of surgeries were done within 1 year of the first documented office visit. It seems likely that an emphasis on the preferences and values of the patient rather than the surgeon would decrease the variation in surgery rates for eECRB observed in this study. Methods for optimizing the influence of patient preferences and values on decision making (eg, decision aids) merit additional study. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Defects in oxygen supply to skeletal muscle of prediabetic ZDF rats

PubMed Central

Goldman, Daniel; Hanson, Madelyn; Stephenson, Alan H.; Milkovich, Stephanie; Benlamri, Amina; Ellsworth, Mary L.; Sprague, Randy S.

2010-01-01

In humans, prediabetes is characterized by marked increases in plasma insulin and near normal blood glucose levels as well as microvascular dysfunction of unknown origin. Using the extensor digitorum longus muscle of 7-wk inbred male Zucker diabetic fatty rats fed a high-fat diet as a model of prediabetes, we tested the hypothesis that hyperinsulinemia contributes to impaired O2 delivery in skeletal muscle. Using in vivo video microscopy, we determined that the total O2 supply to capillaries in the extensor digitorum longus muscle of prediabetic rats was reduced to 64% of controls with a lower O2 supply rate per capillary and higher O2 extraction resulting in a decreased O2 saturation at the venous end of the capillary network. These findings suggest a lower average tissue Po2 in prediabetic animals. In addition, we determined that insulin, at concentrations measured in humans and Zucker diabetic fatty rats with prediabetes, inhibited the O2-dependent release of ATP from rat red blood cells (RBCs). This inability to release ATP could contribute to the impaired O2 delivery observed in rats with prediabetes, especially in light of the finding that the endothelium-dependent relaxation of resistance arteries from these animals is not different from controls and is not altered by insulin. Computational modeling confirmed a significant 8.3-mmHg decrease in average tissue Po2 as well as an increase in the heterogeneity of tissue Po2, implicating a failure of a regulatory system for O2 supply. The finding that insulin attenuates the O2-dependent release of ATP from RBCs suggests that this defect in RBC physiology could contribute to a failure in the regulation of O2 supply to meet the demand in skeletal muscle in prediabetes. PMID:20207810

Eccentric activation and muscle damage: biomechanical and physiological considerations during downhill running.

PubMed Central

Eston, R G; Mickleborough, J; Baltzopoulos, V

1995-01-01

An eccentric muscle activation is the controlled lengthening of the muscle under tension. Functionally, most leg muscles work eccentrically for some part of a normal gait cycle, to support the weight of the body against gravity and to absorb shock. During downhill running the role of eccentric work of the 'anti-gravity' muscles--knee extensors, muscles of the anterior and posterior tibial compartments and hip extensors--is accentuated. The purpose of this paper is to review the relationship between eccentric muscle activation and muscle damage, particularly as it relates to running, and specifically, downhill running. PMID:7551767

[Upright posture of man and morphologic evolution of the musculi extensores digitorum pedis with reference to evolutionary myology. III].

PubMed

Kaneff, A

1986-01-01

The following anatomical objects were studied with regard to myology during evolution: M. extensor hallucis longus (MEHL), M. extensor digitorum longus (MEDL) with M. peroneus tertius (MP III), M. peroneus brevis (MPB) with M. peroneus digiti V (MPD V), M. extensor hallucis brevis (MEHB), M. extensor digitorum brevis (MEDB), and the Retinaculum musculorum extensorum imum (RMEI). The study was carried out by the preparation of 3 different groups of material. The 1st group consists of lower extremities of humans. The number of the extremities differs for the particular objects between 151 and 358 (see page 381). The 2nd group of material consists of 122 Membra pelvina from Marsupialia, Insectivora, and Primates. Table 1 shows as well the mammalian species as the number of the studied extremities. The extremities of the 1st and 2nd group were preserved in an manner suitable for a macroscopic preparation. The 3rd group of material consists of 71 lower extremities from embryos and fetus. The lower legs and feet were stained either according to the method described by Morel and Bassal with eosin added or according to Weigert. From this material, complete series of cross sections were prepared. Table 2 shows the age of the embryos (VCL [mm]) as well as the number of the studied extremities. It is important that up to the age of 46 mm VCL the difference in the age of the embryos usually amounts from 0.5 to 1.0 mm. This small difference in the age of the embryos and fetus allows a very good follow up of the changes in construction during the organogenesis. The comparison of the 3 different groups shows the following changes for the above mentioned muscles: The M. extensor hallucis longus (MEHL) is a muscle which is not split. The same result applies for its tendon which inserts at the distal phalanx of the hallux. This primitive form of the muscle amounts actually to 51.12% in human beings. In 48.88% of the cases, additional tendons and muscles are formed by the MEHL. Most of these supplements are positioned on the medial side of the main tendon, only a few lie to the lateral side. For the supplement tendons, the medial one as well as the lateral one occasionally possess a muscle belly. The muscle of the medial tendon is split off from the proximal margin of the MEHL. The muscle of the lateral tendon is split off from the distal margin of the MEHL.(ABSTRACT TRUNCATED AT 400 WORDS)

Evaluation of document location during computer use in terms of neck muscle activity and neck movement.

PubMed

Goostrey, Sonya; Treleaven, Julia; Johnston, Venerina

2014-05-01

This study evaluated the impact on neck movement and muscle activity of placing documents in three commonly used locations: in-line, flat desktop left of the keyboard and laterally placed level with the computer screen. Neck excursion during three standard head movements between the computer monitor and each document location and neck extensor and upper trapezius muscle activity during a 5 min typing task for each of the document locations was measured in 20 healthy participants. Results indicated that muscle activity and neck flexion were least when documents were placed laterally suggesting it may be the optimal location. The desktop option produced both the greatest neck movement and muscle activity in all muscle groups. The in-line document location required significantly more neck flexion but less lateral flexion and rotation than the laterally placed document. Evaluation of other holders is needed to guide decision making for this commonly used office equipment. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Acute and Chronic Lateral Ankle Instability Diagnosis, Management, and New Concepts.

PubMed

Shakked, Rachel; Sheskier, Steven

2017-01-01

Lateral ankle instability is a common entity that can result in degenerative arthritis if left untreated. Acute ligament injuries should primarily be treated nonoperatively with a course of physical therapy and functional bracing. Chronic ankle instability is defined as mechanical or functional and can be diagnosed using a combination of history, physical examination, stress radiographs, and magnetic resonance imaging. After failure of nonoperative treatment, surgical treatment with anatomic ligament repair and inferior extensor retinaculum augmentation has the best clinical outcomes. Patients with high athletic demands, ligamentous instability, and failure of initial surgical treatment may do better with an anatomic ligament reconstruction or combined ligament repair with peroneus brevis transfer. Those patients with underlying foot deformity benefit from deformity correction in addition to ligament repair or reconstruction. Ankle arthroscopy is an important component of ankle instability to treat the commonly associated intraarticular lesions; however, all-arthroscopic ligament repair is associated with a high complication rate, and techniques may not be perfected as of yet.

Evaluation and management of crouch gait.

PubMed

Kedem, Paz; Scher, David M

2016-02-01

Crouch gait is defined as excessive ankle dorsiflexion, knee and hip flexion during the stance phase. This gait disorder is common among patients with cerebral palsy. The present article brings an up-to-date literature review on the pathoanatomy, natural history, and treatment of this frequent gait abnormality. Hamstrings are often not shortened in patients with crouch. Patella alta must be addressed if surgery is performed. Surgical correction of joint contractures and lever arm dysfunction can be effectively achieved through a single-event multilevel surgery. Crouch gait is a common gait deviation, often seen among ambulatory diplegic and quadriplegic patients, once they reach the pubertal spurt, when weak muscles can no longer support a toe walking pattern because of rapidly increased weight. This form of gait is highly ineffective and might compromise walking ability over time. The anterior knee is overloaded; pain, extensor mechanism failure, and arthritis might develop. Its progressive nature often requires surgical intervention. The cause of crouch gait is multifactorial, and surgery should be tailored to meet the individual's specific anatomic and physiologic abnormalities.

Evaluation of patients presenting with knee pain: Part II. Differential diagnosis.

PubMed

Calmbach, Walter L; Hutchens, Mark

2003-09-01

Knee pain is a common presenting complaint with many possible causes. An awareness of certain patterns can help the family physician identify the underlying cause more efficiently. Teenage girls and young women are more likely to have patellar tracking problems such as patellar subluxation and patellofemoral pain syndrome, whereas teenage boys and young men are more likely to have knee extensor mechanism problems such as tibial apophysitis (Osgood-Schlatter lesion) and patellar tendonitis. Referred pain resulting from hip joint pathology, such as slipped capital femoral epiphysis, also may cause knee pain. Active patients are more likely to have acute ligamentous sprains and overuse injuries such as pes anserine bursitis and medial plica syndrome. Trauma may result in acute ligamentous rupture or fracture, leading to acute knee joint swelling and hemarthrosis. Septic arthritis may develop in patients of any age, but crystal-induced inflammatory arthropathy is more likely in adults. Osteoarthritis of the knee joint is common in older adults.

Common genetic variation in the IGF1 associates with maximal force output.

PubMed

Huuskonen, Antti; Lappalainen, Jani; Oksala, Niku; Santtila, Matti; Häkkinen, Keijo; Kyröläinen, Heikki; Atalay, Mustafa

2011-12-01

We clarified the effect of insulin-like growth factor-1 (IGF1), IGF-binding protein-3 (IGFBP3), interleukin-6 (IL6), and its receptor (IL6R) gene variants on muscular and aerobic performance, body composition, and on circulating levels of IGF-1 and IL-6. Single nucleotide polymorphisms (SNPs) may, in general, influence gene regulation or its expression, or the structure and function of the corresponding protein, and modify its biological effects. IGF-1 is involved in the anabolic pathways of skeletal muscle. IL-6 plays an important role in muscle energy homeostasis during strenuous physical exercise. Eight hundred forty-one healthy Finnish male subjects of Caucasian origin were genotyped for IGF1 (rs6220 and rs7136446), IGFBP3 (rs2854744), IL6 (rs1800795), and IL6R (rs4537545) SNPs, and studied for associations with maximal force of leg extensor muscles, maximal oxygen consumption, body fat percent, and IGF-1 and IL-6 levels. Analytic methods included dynamometer, bicycle ergometer, bioimpedance, ELISA, and polymerase chain reaction assays. All investigated SNPs conformed to Hardy-Weinberg equilibrium with allele frequencies validated against CEU population. Genotype CC of rs7136446 associated with higher body fat and increased maximal force production. Genotype CC of the IGFBP3 SNP rs2854744 and TT genotype of the IL6R SNP rs4537545 associated with higher IL-6 levels. In logistic regression analysis, allele C of the rs2854744 decreased odds for lower body fat. None of the studied SNPs associated with aerobic performance. Our data suggest that common variation in the IGF1 gene may affect maximal force production, which can be explained by the role of IGF-1 in the anabolic pathways of muscle and neurotrophy. Variations in the IGF1 and IGFBP3 gene may result in higher body fat and be related to alterations of IGF-1-mediated tissue growth.

Lumbar extensor muscle force control is associated with disability in people with chronic low back pain.

PubMed

Pranata, Adrian; Perraton, Luke; El-Ansary, Doa; Clark, Ross; Fortin, Karine; Dettmann, Tim; Brandham, Robert; Bryant, Adam

2017-07-01

The ability to control lumbar extensor force output is necessary for daily activities. However, it is unknown whether this ability is impaired in chronic low back pain patients. Similarly, it is unknown whether lumbar extensor force control is related to the disability levels of chronic low back pain patients. Thirty-three chronic low back pain and 20 healthy people performed lumbar extension force-matching task where they increased and decreased their force output to match a variable target force within 20%-50% maximal voluntary isometric contraction. Force control was quantified as the root-mean-square-error between participants' force output and target force across the entire, during the increasing and decreasing portions of the force curve. Within- and between-group differences in force-matching error and the relationship between back pain group's force-matching results and their Oswestry Disability Index scores were assessed using ANCOVA and linear regression respectively. Back pain group demonstrated more overall force-matching error (mean difference=1.60 [0.78, 2.43], P<0.01) and more force-matching error while increasing force output (mean difference=2.19 [1.01, 3.37], P<0.01) than control group. The back pain group demonstrated more force-matching error while increasing than decreasing force output (mean difference=1.74, P<0.001, 95%CI [0.87, 2.61]). A unit increase in force-matching error while decreasing force output is associated with a 47% increase in Oswestry score in back pain group (R 2 =0.19, P=0.006). Lumbar extensor muscle force control is compromised in chronic low back pain patients. Force-matching error predicts disability, confirming the validity of our force control protocol for chronic low back pain patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of rest interval on strength recovery in young and old women.

PubMed

Theou, Olga; Gareth, Jones R; Brown, Lee E

2008-11-01

This study compares the effects of rest intervals on isokinetic muscle torque recovery between sets of a knee extensor and flexor exercise protocol in physically active younger and older women. Twenty young (22.4 +/- 1.7 years) and 16 older (70.7 +/- 4.3 years) women performed three sets of eight maximum repetitions of knee extension/flexion at 60 degrees x s(-1). The rest interval between sets was 15, 30, and 60 seconds and was randomly assigned across three testing days. No significant interaction of rest by set by age group was observed. There was a significant decline in mean knee extensor torque when 15- and 30-second rest intervals were used between sets, but not when a 60-second rest interval was applied for both the young and the old women. No significant decline for mean knee flexor torque was observed in the older women when a 30-second rest interval was used, whereas a longer 60-second rest interval was required in younger women. Active younger and older women require similar rest intervals between sets of a knee extensor exercise (60 seconds) for complete recovery. However, older women recovered faster (30 seconds) than younger women (60 seconds) between sets of a knee flexor exercise. The exercise-to-rest ratio for knee extensors was similar for young and old women (1:2). Old women required only a 1:1 exercise-to-rest ratio for knee flexor recovery, whereas younger women required a longer 1:2 exercise-to-rest ratio. The results of the present study are specific to isokinetic testing and training and are more applicable in rehabilitation and research settings. Practitioners should consider age and gender when prescribing rest intervals between sets.

Neuromuscular Impairments Contributing to Persistently Poor and Declining Lower-Extremity Mobility Among Older Adults: New Findings Informing Geriatric Rehabilitation.

PubMed

Ward, Rachel E; Beauchamp, Marla K; Latham, Nancy K; Leveille, Suzanne G; Percac-Lima, Sanja; Kurlinski, Laura; Ni, Pengsheng; Goldstein, Richard; Jette, Alan M; Bean, Jonathan F

2016-08-01

To identify neuromuscular impairments most predictive of unfavorable mobility outcomes in late life. Longitudinal cohort study. Research clinic. Community-dwelling primary care patients aged ≥65 years (N=391) with self-reported mobility modifications, randomly selected from a research registry. Not applicable. Categories of decline in and persistently poor mobility across baseline, 1 and 2 years of follow-up in the Lower-Extremity Function scales of the Late-Life Function and Disability Instrument. The following categories of impairment were assessed as potential predictors of mobility change: strength (leg strength), speed of movement (leg velocity, reaction time, rapid leg coordination), range of motion (ROM) (knee flexion/knee extension/ankle ROM), asymmetry (asymmetry of leg strength and knee flexion/extension ROM measures), and trunk stability (trunk extensor endurance, kyphosis). The largest effect sizes were found for baseline weaker leg strength (odds ratio [95% confidence interval]: 3.45 [1.72-6.95]), trunk extensor endurance (2.98 [1.56-5.70]), and slower leg velocity (2.35 [1.21-4.58]) predicting a greater likelihood of persistently poor function over 2 years. Baseline weaker leg strength, trunk extensor endurance, and restricted knee flexion motion also predicted a greater likelihood of decline in function (1.72 [1.10-2.70], 1.83 [1.13-2.95], and 2.03 [1.24-3.35], respectively). Older adults exhibiting poor mobility may be prime candidates for rehabilitation focused on improving these impairments. These findings lay the groundwork for developing interventions aimed at optimizing rehabilitative care and disability prevention, and highlight the importance of both well-recognized (leg strength) and novel impairments (leg velocity, trunk extensor muscle endurance). Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effects of a salsa dance training on balance and strength performance in older adults.

PubMed

Granacher, Urs; Muehlbauer, Thomas; Bridenbaugh, Stephanie A; Wolf, Madeleine; Roth, Ralf; Gschwind, Yves; Wolf, Irene; Mata, Rui; Kressig, Reto W

2012-01-01

Deficits in static and particularly dynamic postural control and force production have frequently been associated with an increased risk of falling in older adults. The objectives of this study were to investigate the effects of salsa dancing on measures of static/dynamic postural control and leg extensor power in seniors. Twenty-eight healthy older adults were randomly assigned to an intervention group (INT, n = 14, age 71.6 ± 5.3 years) to conduct an 8-week progressive salsa dancing programme or a control group (CON, n = 14, age 68.9 ± 4.7 years). Static postural control was measured during one-legged stance on a balance platform and dynamic postural control was obtained while walking on an instrumented walkway. Leg extensor power was assessed during a countermovement jump on a force plate. Programme compliance was excellent with participants of the INT group completing 92.5% of the dancing sessions. A tendency towards an improvement in the selected measures of static postural control was observed in the INT group as compared to the CON group. Significant group × test interactions were found for stride velocity, length and time. Post hoc analyses revealed significant increases in stride velocity and length, and concomitant decreases in stride time. However, salsa dancing did not have significant effects on various measures of gait variability and leg extensor power. Salsa proved to be a safe and feasible exercise programme for older adults accompanied with a high adherence rate. Age-related deficits in measures of static and particularly dynamic postural control can be mitigated by salsa dancing in older adults. High physical activity and fitness/mobility levels of our participants could be responsible for the nonsignificant findings in gait variability and leg extensor power. Copyright © 2012 S. Karger AG, Basel.

ASSOCIATION OF KNEE PAIN WITH A REDUCTION IN THIGH MUSCLE STRENGTH – A CROSS-SECTIONAL ANALYSIS INCLUDING 4553 OSTEOARTHRITIS INITIATIVE PARTICIPANTS

PubMed Central

Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

2016-01-01

Objective To cross-sectionally determine the quantitative relationship of age-adjusted, sex-specific isometric knee extensor and flexor strength to patient-reported knee pain. Methods Difference of thigh muscle strength by age, and that of age-adjusted strength per unit increase on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee pain scale, was estimated from linear regression analysis of 4553 Osteoarthritis Initiative participants (58% women). Strata encompassing the minimal clinically important difference (MCID) in knee pain were compared to evaluate a potentially non-linear relationship between WOMAC pain levels and muscle strength. Results In Osteoarthritis Initiative participants without pain, the age-related difference in isometric knee extensor strength was −9.0%/−8.2% (women/men) per decade, and that of flexor strength was −11%/−6.9%. Differences in age-adjusted strength values for each unit of WOMAC pain (1/20) amounted to −1.9%/−1.6% for extensor and −2.5%/−1.7% for flexor strength. Differences in torque/weight for each unit of WOMAC pain ranged from −3.3 to − 2.1%. There was no indication of a non-linear relationship between pain and strength across the range of observed WOMAC values, and similar results were observed in women and men. Conclusion Each increase by 1/20 units in WOMAC pain was associated with a ~2% lower age-adjusted isometric extensor and flexor strength in either sex. As a reduction in muscle strength is known to prospectively increase symptoms in knee osteoarthritis and as pain appears to reduce thigh muscle strength, adequate therapy of pain and muscle strength is required in knee osteoarthritis patients to avoid a vicious circle of self-sustaining clinical deterioration. PMID:27836675

RELATIONSHIP BETWEEN ISOMETRIC THIGH MUSCLE STRENGTH AND MINIMAL CLINICALLY IMPORTANT DIFFERENCES (MCIDS) IN KNEE FUNCTION IN OSTEOARTHRITIS – DATA FROM THE OSTEOARTHRITIS INITIATIVE

PubMed Central

Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

2014-01-01

Objective To determine the relationship between thigh muscle strength and clinically relevant differences in self-assessed lower limb function. Methods Isometric knee extensor and flexor strength of 4553 Osteoarthritis Initiative participants (2651 women/1902 men) was related to Western Ontario McMasters Universities (WOMAC) physical function scores by linear regression. Further, groups of Male and female participant strata with minimal clinically important differences (MCIDs) in WOMAC function scores (6/68) were compared across the full range of observed values, and to participants without functional deficits (WOMAC=0). The effect of WOMAC knee pain and body mass index on the above relationships was explored using stepwise regression. Results Per regression equations, a 3.7% reduction in extensor and a 4.0% reduction in flexor strength were associated with an MCID in WOMAC function in women, and a 3.6%/4.8% reduction in men. For strength divided by body weight, reductions were 5.2%/6.7% in women and 5.8%/6.7% in men. Comparing MCID strata across the full observed range of WOMAC function confirmed the above estimates and did not suggest non-linear relationships across the spectrum of observed values. WOMAC pain correlated strongly with WOMAC function, but extensor (and flexor) muscle strength contributed significant independent information. Conclusion Reductions of approximately 4% in isometric muscle strength and of 6% in strength/weight were related to a clinically relevant difference in WOMAC functional disability. Longitudinal studies will need to confirm these relationships within persons. Muscle extensor (and flexor) strength (per body weight) provided significant independent information in addition to pain in explaining variability in lower limb function. PMID:25303012

Muscle group specific changes in the electromechanical delay following short-term resistance training.

PubMed

Stock, Matt S; Olinghouse, Kendra D; Mota, Jacob A; Drusch, Alexander S; Thompson, Brennan J

2016-09-01

The time delay between the onset of a muscle's electrical activity and force is believed to have important functional implications, and has been shown to decrease following resistance training in males. The purpose of this investigation was to examine changes in the voluntary electromechanical delay (EMD) for the leg extensors and flexors following a short-term resistance training intervention in females. Pretest/posttest control group experiment. Twenty-two previously untrained females (mean±SD age=21±2 years; mass=65.4±13.3kg) were randomly assigned to training (n=10) and control (n=12) groups. The training group performed barbell back squats and deadlifts twice per week for four weeks. EMD for the vastus lateralis (extensors) and biceps femoris (flexors) was examined during maximal voluntary contractions at pre- and posttesting. Data were examined using analyses of covariance (ANCOVAs) with the pretest and posttest scores serving as the covariate and dependent variable, respectively, and by evaluating the number of participants that exceeded the minimal difference statistic. For the leg extensors, the adjusted EMD posttest mean for the training group was significantly lower than that for the control group (74.3 vs. 91.8ms; p=0.015; ή(2)=0.275), and five training participants displayed decreases that exceeded the minimal difference. The ANCOVA for the leg flexors was not significant (adjusted means=98.0 vs. 90.0ms; p=0.487; ή(2)=.026). Four weeks of multi-joint resistance training resulted in decreased EMD for the leg extensors, but not the flexors. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Fatigue-related firing of muscle nociceptors reduces voluntary activation of ipsilateral but not contralateral lower limb muscles.

PubMed

Kennedy, David S; Fitzpatrick, Siobhan C; Gandevia, Simon C; Taylor, Janet L

2015-02-15

During fatiguing upper limb exercise, maintained firing of group III/IV muscle afferents can limit voluntary drive to muscles within the same limb. It is not known if this effect occurs in the lower limb. We investigated the effects of group III/IV muscle afferent firing from fatigued ipsilateral and contralateral extensor muscles and ipsilateral flexor muscles of the knee on voluntary activation of the knee extensors. In three experiments, we examined voluntary activation of the knee extensors by measuring changes in superimposed twitches evoked by femoral nerve stimulation. Subjects attended on 2 days for each experiment. On one day a sphygmomanometer cuff occluded blood flow of the fatigued muscles to maintain firing of group III/IV muscle afferents. After a 2-min extensor contraction (experiment 1; n = 9), mean voluntary activation was lower with than without maintained ischemia (47 ± 19% vs. 87 ± 8%, respectively; P < 0.001). After a 2-min knee flexor maximal voluntary contraction (MVC) (experiment 2; n = 8), mean voluntary activation was also lower with than without ischemia (59 ± 21% vs. 79 ± 9%; P < 0.01). After the contralateral (left) MVC (experiment 3; n = 8), mean voluntary activation of the right leg was similar with or without ischemia (92 ± 6% vs. 93 ± 4%; P = 0.65). After fatiguing exercise, activity in group III/IV muscle afferents reduces voluntary activation of the fatigued muscle and nonfatigued antagonist muscles in the same leg. However, group III/IV muscle afferents from the fatigued left leg had no effect on the unfatigued right leg. This suggests that any "crossover" of central fatigue in the lower limbs is not mediated by group III/IV muscle afferents. Copyright © 2015 the American Physiological Society.

Does insulin-like growth factor 1 genotype influence muscle power response to strength training in older men and women?

PubMed

Sood, Suchi; Hanson, Erik D; Delmonico, Matthew J; Kostek, Matthew C; Hand, Brian D; Roth, Stephen M; Hurley, Ben F

2012-02-01

The CA-repeat polymorphism in the insulin-like growth factor 1 (IGF1) gene promoter region has been associated with strength and circulating IGF-I protein levels. The purpose of the study was to determine if the IGF1 CA-repeat polymorphism influences muscle power at baseline and in response to ST in older adults. Knee extensor peak power (PP) was measured at 50, 60, and 70% of 1-RM strength before and after 10 weeks of unilateral knee extensor ST in older adults, aged 50-85 years, to determine the changes in absolute and relative PP with ST. Subjects (N = 114) were genotyped for the IGF1 CA-repeat polymorphism and grouped as homozygous for the 192 allele, heterozygous, or non-carriers of the 192 allele. The 192 homozygotes had significantly lower baseline PP at 50, 60, and 70% of 1-RM strength than the non-carriers when age, sex, and baseline fat-free mass were covaried (all P < 0.05). This same relationship was observed when the highest PP within these ranges was compared (e.g., 317.6 ± 13.5 for 192 homozygotes and 380.2 ± 16.3 for non-carriers of the 192 allele, P < 0.05). Both absolute and relative PP increased significantly with ST in all genotype groups as expected, but there were no significant relationships among IGF1 genotypes and any of the PP changes. Despite a significant relationship between IGF1 genotype and knee extensor peak power at baseline, IGF1 genotype does not appear to influence changes in knee extensor peak power with ST.

Hip kinematics and kinetics in persons with and without cam femoroacetabular impingement during a deep squat task.

PubMed

Bagwell, Jennifer J; Snibbe, Jason; Gerhardt, Michael; Powers, Christopher M

2016-01-01

Previous studies have indicated that hip and pelvis kinematics may be altered during functional tasks in persons with femoroacetabular impingement. The purpose of this study was to compare hip and pelvis kinematics and kinetics during a deep squat task between persons with cam femoroacetabular impingement and pain-free controls. Fifteen persons with cam femoroacetabular impingement and 15 persons without cam femoroacetabular impingement performed a deep squat task. Peak hip flexion, abduction, and internal rotation, and mean hip extensor, adductor, and external rotator moments were quantified. Independent t-tests (α<0.05) were used to evaluate between group differences. Compared to the control group, persons with cam femoroacetabular impingement demonstrated decreased peak hip internal rotation (15.2° (SD 9.5°) vs. 9.4° (SD 7.8°); P=0.041) and decreased mean hip extensor moments (0.56 (SD 0.12) Nm/kg vs. 0.45 (SD 0.15) Nm/kg; P=0.018). In addition persons in the cam femoroacetabular impingement group demonstrated decreased posterior pelvis tilt during squat descent compared to the control group, resulting in a more anteriorly tilted pelvis at the time peak hip flexion (12.5° (SD 17.1°) vs. 23.0° (SD 12.4°); P=0.024). The decreased hip internal rotation observed in persons with cam femoroacetabular impingement may be the result of bony impingement. Furthermore, the decrease in posterior pelvis tilt may contribute to impingement by further approximating the femoral head-neck junction with the acetabulum. Additionally, decreased hip extensor moments suggest that diminished hip extensor muscle activity may contribute to decreased posterior pelvis tilt. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cross-sectional association between muscle strength and self-reported physical function in 195 hip osteoarthritis patients.

PubMed

Hall, Michelle; Wrigley, Tim V; Kasza, Jessica; Dobson, Fiona; Pua, Yong Hao; Metcalf, Ben R; Bennell, Kim L

2017-02-01

This study aimed to evaluate associations between strength of selected hip and knee muscles and self-reported physical function, and their clinical relevance, in men and women with hip osteoarthritis (OA). Cross-sectional data from 195 participants with symptomatic hip OA were used. Peak isometric torque of hip extensors, flexors, and abductors, and knee extensors were measured, along with physical function using the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire. Separate linear regressions in men and women were used to determine the association between strength and physical function accounting for age, pain, and radiographic disease severity. Subsequently, magnitudes of strength associated with estimates of minimal clinically important improvement (MCII) in physical function were estimated according to severity of difficulty with physical function. For men, greater strength of the hip extensors, hip flexors and knee extensors were each associated with better physical function. For women, greater muscle strength of all tested muscles were each associated with better physical function. For men and women, increases in muscle strength between 17-32%, 133-223%, and 151-284% may be associated with estimates of MCII in physical function for those with mild, moderate, and severe physical dysfunction, respectively. Greater isometric strength of specific hip and thigh muscle groups may be associated with better self-reported physical function in men and women. In people with mild physical dysfunction, an estimate of MCII in physical function may be associated with attainable increases in strength. However, in patients with more severe dysfunction, greater and perhaps unattainable strength increases may be associated with an estimate of MCII in physical function. Longitudinal studies are required to validate these observations. Copyright © 2017 Elsevier Inc. All rights reserved.

Side Differences of Thigh Muscle Cross-Sectional Areas and Maximal Isometric Muscle Force in Bilateral Knees with the Same Radiographic Disease Stage, but Unilateral Frequent Pain – Data from the Osteoarthritis Initiative

PubMed Central

Sattler, Martina; Dannhauer, Torben; Hudelmaier, Martin; Wirth, Wolfgang; Sänger, Alexandra M.; Kwoh, C. Kent; Hunter, David J.; Eckstein, Felix

2012-01-01

Objective To determine whether anatomical thigh muscle cross-sectional areas (MCSAs) and strength differ between osteoarthritis (OA) knees with frequent pain compared with contralateral knees without pain, and to examine the correlation between MCSAs and strength in painful versus painless knees. Methods 48 subjects (31 women; 17 men; age 45–78 years) were drawn from 4796 Osteoarthritis Initiative (OAI) participants, in whom both knees displayed the same radiographic stage (KLG2 or 3), one with frequent pain (most days of the month within the past 12 months) and the contralateral one without pain. Axial MR images were used to determine MCSAs of extensors, flexors and adductors at 35% femoral length (distal to proximal) and in two adjacent 5 mm images. Maximal isometric extensor and flexor forces were used as provided from the OAI data base. Results Painful knees showed 5.2% lower extensor MCSAs (p=0.00003; paired t-test), and 7.8% lower maximal extensor muscle forces (p=0.003) than contra-lateral painless knees. There were no significant differences in flexor forces, or flexor and adductor MCSAs (p>0.39). Correlations between force and MCSAs were similar in painful and painless OA knees (0.44

Relationship between functional electrical stimulation duty cycle and fatigue in wrist extensor muscles of patients with hemiparesis.

PubMed

Packman-Braun, R

1988-01-01

The purpose of this study was to investigate, in a sample of patients with hemiparesis secondary to cerebrovascular accident, the relationship between the ratio of stimulus on time to off time and muscle fatigue using a commercial electrical stimulation unit. An experimental model was used to test the hypothesis that the smaller the stimulus off time relative to stimulus on time, the greater will be the muscle fatigue over time. The wrist extensor muscles of 18 patients with hemiparesis were stimulated electrically, and isometric force output was recorded continuously using an adapted strain gauge-recorder apparatus. For each testing session, peak on time of the electrical stimulus was set at 5 seconds, and off time was set at 5, 15, or 25 seconds. Six randomly assigned treatment groups participated in three separate treatment sessions in a different order at 48-hour intervals. Treatment sessions were continued either until wrist extensor muscle force output decreased to 50% of its initial value or for a maximum of 30 minutes. Data analysis revealed that significant differences in muscle tension developed among all duty cycles (p less than .01). Duty-cycle ratios of 1:1, 1:3, and 1:5 were shown to be progressively less fatiguing. Within the limits of this investigation, the 1:5 duty-cycle ratio was determined to be the best suited for initial use in programs of prolonged stimulation to the wrist extensor muscles of patients with hemiparesis. The hypothesis was accepted that the smaller the stimulus off time (rest interval) with respect to the stimulus on time, the greater will be the muscle fatigue over time.

Relation between the Disability of the Arm, Shoulder and Hand Score and Muscle Strength in Post-Cardiac Surgery Patients

PubMed Central

Kasahara, Yusuke; Hiraki, Koji; Hirano, Yasuyuki; Watanabe, Satoshi

2017-01-01

Background: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a valid and reliable patient-reported outcome measure. DASH can be assessed by self-reported upper extremity disability and symptoms. We aimed to examine the relationship between the physiological outcome of muscle strength and the DASH score after cardiac surgery. Methods: This cross-sectional study assessed 50 consecutive cardiac patients that were undergoing cardiac surgery. Physiological outcomes of handgrip strength and knee extensor muscle strength and the DASH score were measured at one month after cardiac surgery and were assessed. Results were analyzed using Spearman correlation coefficients. Results: The final analysis comprised 43 patients (men: 32, women: 11; age: 62.1 ± 9.1 years; body mass index: 22.1 ± 4.7 kg/m2; left ventricular ejection fraction: 53.5 ± 13.7%). Respective handgrip strength, knee extensor muscle strength, and DASH score were 27.4 ± 8.3 kgf, 1.6 ± 0.4 Nm/kg, and 13.3 ± 12.3, respectively. The DASH score correlated negatively with handgrip strength (r = −0.38, p = 0.01) and with knee extensor muscle strength (r = −0.32, p = 0.04). Conclusion: Physiological outcomes of both handgrip strength and knee extensor muscle strength correlated negatively with the DASH score. The DASH score appears to be a valuable tool with which to assess cardiac patients with poor physiological outcomes, particularly handgrip strength as a measure of upper extremity function, which is probably easier to follow over time than lower extremity function after patients complete cardiac rehabilitation. PMID:29186880

Vitamin D status and physical function in older Finnish people: A one-year follow-up study.

PubMed

Salminen, Marika; Saaristo, Pilvi; Salonoja, Maritta; Vaapio, Sari; Vahlberg, Tero; Lamberg-Allardt, Christel; Aarnio, Pertti; Kivelä, Sirkka-Liisa

2015-01-01

The aim was to describe vitamin D status and its association with changes in PF during 12 months in Finnish community-dwelling elderly (≥65 years). Baseline serum 25-hydroxyvitamin D (25OHD) concentration was measured by enzymeimmunoassay, and participants (n=518) were divided according to 25OHD to three groups (I <50 nmol/l, II 50-74.9 nmol/l, and III ≥75 nmol/l). PF (maximal isometric extension strength of right and left knee, and time in five-repetition sit-to-stand test (5STS) and 10-m walking test) was measured at baseline and after 12 months. 25OHD deficiency (<50 nmol/l) was found in 20.5% of the participants. During a 12-month follow-up, differences in changes in knee extensor strength of right (p=0.044) and left (p=0.010) lower extremity and in 10-m walking test (p=.040) between the groups were significant. According to further pairwise comparisons these differences were between groups I and III (right knee, p=0.036; left knee, p=0.009; 10-m walk, p=0.044), with the exception of left knee extensor strength in which there were also significant difference between groups I and II (p=0.039). All significant differences in changes were in favour of group II or III. Significant differences in changes in knee extensor strengths maintained after adjustments for group (intervention/control), parathyroid hormone, and baseline level of knee extensor strength. Prospective analyses showed low 25OHD concentrations (<50 nmol/l) to be associated with deterioration in PF during 12 months compared with high 25OHD concentrations (≥75 nmol/l). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The Influence of Robotic Assistance on Reducing Neuromuscular Effort and Fatigue during Extravehicular Activity Glove Use

NASA Technical Reports Server (NTRS)

Madden, Kaci E.; Deshpande, Ashish D.; Peters, Benjamin J.; Rogers, Jonathan M.; Laske, Evan A.; McBryan, Emily R.

2017-01-01

The three-layered, pressurized space suit glove worn by Extravehicular Activity (EVA) crew members during missions commonly causes hand and forearm fatigue. The Spacesuit RoboGlove (SSRG), a Phase VI EVA space suit glove modified with robotic grasp-assist capabilities, has been developed to augment grip strength in order to improve endurance and reduce the risk of injury in astronauts. The overall goals of this study were to i) quantify the neuromuscular modulations that occur in response to wearing a conventional Phase VI space suit glove (SSG) during a fatiguing task, and ii) determine the efficacy of Spacesuit RoboGlove (SSRG) in reversing the adverse neuromuscular modulations and restoring altered muscular activity to barehanded levels. Six subjects performed a fatigue sequence consisting of repetitive dynamic-gripping interspersed with isometric grip-holds under three conditions: barehanded, wearing pressurized SSG, and wearing pressurized SSRG. Surface electromyography (sEMG) from six forearm muscles (flexor digitorum superficialis (FDS), flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), extensor digitorum (ED), extensor carpi radialis longus (ECRL), and extensor carpi ulnaris (ECU)) and subjective fatigue ratings were collected during each condition. Trends in amplitude and spectral distributions of the sEMG signals were used to derive metrics quantifying neuromuscular effort and fatigue that were compared across the glove conditions. Results showed that by augmenting finger flexion, the SSRG successfully reduced the neuromuscular effort needed to close the fingers of the space suit glove in more than half of subjects during two types of tasks. However, the SSRG required more neuromuscular effort to extend the fingers compared to a conventional SSG in many subjects. Psychologically, the SSRG aided subjects in feeling less fatigued during short periods of intense work compared to the SSG. The results of this study reveal the promise of the SSRG as a grasp-assist device that can improve astronaut performance and reduce the risk of injury by offsetting neuromuscular effort. Modifications to the experimental protocol are needed, however, to improve the outcome of the neuromuscular fatigue metrics and determine the effectiveness of SSRG in increasing astronaut endurance. Nevertheless, these findings will improve the understanding of astronaut-spacesuit interaction and provide direction toward designing improved spacesuit gloves and robotic-assist devices, like the SSRG.

70° frontal visualization of lateral compartment of the elbow allows extensor carpi radialis brevis tendon release with preservation of the radial lateral collateral ligament.

PubMed

Arrigoni, Paolo; Fossati, Chiara; Zottarelli, Leonardo; Brady, Paul C; Cabitza, Paolo; Randelli, Pietro

2014-01-01

To determine whether the radial component of the lateral collateral ligament (R-LCL) and extensor carpi radialis brevis (ECRB) are consistently visible, using a 70° arthroscope, as parallel structures in the extra-articular space of the elbow, and to evaluate the clinical outcomes of these techniques in a series of patients. An arthroscopic ECRB tendon release was performed between 2008 and 2010. Eighteen patients were retrospectively evaluated at a minimum of 24 months' follow-up. The surgeon performed the ECRB release while protecting the R-LCL and viewing the structures extra-articularly with a 70° arthroscope through the anteromedial portal. Patients underwent surgery if they presented with localized tenderness and pain not responding to conservative treatment for 12 months and had magnetic resonance imaging scans indicating tendinopathy or degeneration. Arthritis, posterolateral rotatory instability, trauma, and previous surgeries were exclusion criteria. Intraoperative videos were reviewed and a clinical examination was performed by an independent reviewer at 24 months postoperatively. Patients were also evaluated with the Mayo Elbow Performance Score; Andrews-Carson score; and shortened Disabilities of the Arm, Shoulder and Hand questionnaire. Direct varus stress was applied in extension and flexion (40°), and the posterolateral pivot-shift and chair tests were performed. Visualization with the 70° arthroscope through the anteromedial portal was successful in all of the cases (100%). Visualization of the residual ECRB tendon stump, as well as the posterior common extensor tendon, was also achieved 94% of the time. The final mean Mayo Elbow Performance Score and Andrews-Carson score were 82.5 (range, 60 to 100) and 185.3 (range, 125 to 200), respectively. The mean postoperative score on the shortened Disabilities of the Arm, Shoulder and Hand questionnaire was 20.14 (range, 5 to 57.5). Clinical tests showed stability in all the cases. The 70° arthroscope allows visualization of the ECRB insertion and R-LCL frontally and in parallel. A surgical plane could be created between the structures. The clinical outcome was good or excellent in 78% of the cases. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Extensor Pollicis Longus Injury in Addition to De Quervain’s with Text Messaging on Mobile Phones

PubMed Central

Kumar, Bhaskaranand; Bhat, Anil K; Venugopal, Anand

2014-01-01

Objective: To do a clinical and ultrasonic evaluation of subjects with thumb pain with text messaging. Background: Thumbs are commonly used for text messaging, which are not as well designed for fine manipulative or dexterous work. Repetitive use as in text messaging can lead to the injury to the tendons of the thumb. Materials and Methods: Ninety eight students with symptoms of Repetitive Strain Type of injuries of the thumb were selected from a survey and evaluated both clinically and by ultrasound analysis of the musculotendinous unit of the thumb to note changes due to excessive use of the mobile phone. Age and sex matched controls were also subjected to ultrasound evaluation. Results: Clinical examination showed positive Finkelstein test in 40% of the cases, significant reduction in the lateral and tip pinch strengths in the cases. Ultrasound detected changes in the first and the third compartments in 19% of the cases. Conclusion: Isolated cases of pain in the thumb have been reported but this study noted changes both clinically and by ultrasound in the tendons of the thumb. These changes should be taken as warning signs of possible subclinical changes taking place in the soft tissues of the thumb in these subjects due to repetitive use of mobile phones and thus, making them prone for developing painful Musculoskeletal Disorders. Application: Repetitive use of mobile phones for text messaging can lead to the damage of Extensor pollicis longus of the thumb in addition to the tendons of the first compartment of the wrist. PMID:25584249

A study of the anatomy and injection techniques of the ovine stifle by positive contrast arthrography, computed tomography arthrography and gross anatomical dissection.

PubMed

Vandeweerd, Jean-Michel; Kirschvink, Nathalie; Muylkens, Benoit; Depiereux, Eric; Clegg, Peter; Herteman, Nicolas; Lamberts, Matthieu; Bonnet, Pierre; Nisolle, Jean-Francois

2012-08-01

Although ovine stifle models are commonly used to study osteoarthritis, meniscal pathology and cruciate ligament injuries and repair, there is little information about the anatomy of the joint or techniques for synovial injections. The objectives of this study were to improve anatomical knowledge of the synovial cavities of the ovine knee and to compare intra-articular injection techniques. Synovial cavities of 24 cadaver hind limbs from 12 adult sheep were investigated by intra-articular resin, positive-contrast arthrography, computed tomography (CT) arthrography and gross anatomical dissection. Communication between femoro-patellar, medial femoro-tibial and lateral femoro-tibial compartments occurred in all cases. The knee joint should be considered as one synovial structure with three communicating compartments. Several unreported features were observed, including a communication between the medial femoro-tibial and lateral femoro-tibial compartments and a latero-caudal recess of the lateral femoro-tibial compartment. No intermeniscal ligament was identified. CT was able to define many anatomical features of the stifle, including the anatomy of the tendinous synovial recess on the lateral aspect of the proximal tibia under the combined tendon of the peroneus tertius, extensor longus digitorum and extensor digiti III proprius. An approach for intra-articular injection into this recess (the subtendinous technique) was assessed and compared with the retropatellar and paraligamentous techniques. All three injection procedures were equally successful, but the subtendinous technique appeared to be most appropriate for synoviocentesis and for injections in therapeutic research protocols with less risk of damaging the articular cartilage. Copyright © 2012 Elsevier Ltd. All rights reserved.

Gait analysis of patients with an off-the-shelf total knee replacement versus customized bi-compartmental knee replacement.

PubMed

Wang, Henry; Foster, Jonathan; Franksen, Natasha; Estes, Jill; Rolston, Lindsey

2018-04-01

Newer TKR designs have been introduced to the market with the aim of overcoming common sizing problems with older TKR designs. Furthermore, since a sizable percentage of patients with OA present with disease limited to the medial/lateral knee compartment in addition to the patellofemoral joint, for whom, a customized bi-compartmental knee replacement (BKR) is available as a treatment option. To date, there is very little information regarding knee strength and mechanics during gait for patients implanted with these modern TKR and BKR designs. The purpose of the study was to evaluate knee strength and mechanics during walking for patients with either a modern off the shelf TKR or a customized BKR and compare these findings to a cohort of healthy controls. Twelve healthy controls, eight BKR, and nine TKR patients participated in the study. Maximal isometric knee strength was evaluated. 3D kinematic and kinetic analyses were conducted for level walking. The TKR knee exhibited less peak extensor torque when compared to, both the BKR and control limbs (p < 0.05). The TKR knee had less extensor moment at stance than both the BKR and control knees (p < 0.05). Both the BKR and control knees displayed larger internal rotation at stance than that of the TKR knee (p < 0.05). This study suggests that, for patients that exhibit isolated OA of the tibiofemoral joint, using a customized BKR implant is a viable treatment option and may contribute to superior mechanical advantages.

Joint Moment-Angle Properties of the Hip Extensors in Subjects With and Without Patellofemoral Pain.

PubMed

Kindel, Curtis; Challis, John

2018-04-01

Strength deficits of hip extension in individuals with patellofemoral syndrome are commonly reported in literature. No literature to date has examined these deficits with variable positions of the knee and hip; altering knee angle alters the length and therefore potentially the force produced by the biarticular muscles. Beyond strength, neuromuscular control can also be assessed through the analysis of isometric joint moment steadiness. Subjects consisted of a group of individuals with patellofemoral syndrome (n = 9), and a group of age- and size-matched controls with no symptoms (n = 9). Maximum isometric joint moments for hip extension were measured at 4 points within the joint's range of motion, at 2 different knee positions (0° and 90°) for each group. The joint moment signals were analyzed by computing signal Coefficient of Variation (CV). The results indicate that no significant differences were found between the groups of subjects for the hip extension moments when the knee was extended. However, there was a significant difference between the groups for the joint moments of hip extension with the knee flexed at all 4 hip positions. Results also showed hip extension CV values to be significantly higher in the patellofemoral group compared with the control group, indicating greater signal noise and therefore poorer neuromuscular control of the hip extensor musculature. This study demonstrated that individuals with patellofemoral syndrome have reduced hip extension strength and reduced neuromuscular control with the knee flexed compared with a control group. These results have implications for the etiology of patellofemoral syndrome and its rehabilitation.

A methodologic approach for normalizing angular work and velocity during isotonic and isokinetic eccentric training.

PubMed

Guilhem, Gaël; Cornu, Christophe; Guével, Arnaud

2012-01-01

Resistance exercise training commonly is performed against a constant external load (isotonic) or at a constant velocity (isokinetic). Researchers comparing the effectiveness of isotonic and isokinetic resistance-training protocols need to equalize the mechanical stimulus (work and velocity) applied. To examine whether the standardization protocol could be adjusted and applied to an eccentric training program. Controlled laboratory study. Controlled research laboratory. Twenty-one sport science male students (age = 20.6 ± 1.5 years, height = 178.0 ± 4.0 cm, mass = 74.5 ± 9.1 kg). Participants performed 9 weeks of isotonic (n = 11) or isokinetic (n = 10) eccentric training of knee extensors that was designed so they would perform the same amount of angular work at the same mean angular velocity. Angular work and angular velocity. The isotonic and isokinetic groups performed the same total amount of work (-185.2 ± 6.5 kJ and -184.4 ± 8.6 kJ, respectively) at the same angular velocity (21 ± 1°/s and 22°/s, respectively) with the same number of repetitions (8.0 and 8.0, respectively). Bland-Altman analysis showed that work (bias = 2.4%) and angular velocity (bias = 0.2%) were equalized over 9 weeks between the modes of training. The procedure developed allows angular work and velocity to be standardized over 9 weeks of isotonic and isokinetic eccentric training of the knee extensors. This method could be useful in future studies in which researchers compare neuromuscular adaptations induced by each type of training mode with respect to rehabilitating patients after musculoskeletal injury.

Measuring the motor output of the pontomedullary reticular formation in the monkey: do stimulus-triggered averaging and stimulus trains produce comparable results in the upper limbs?

PubMed

Herbert, Wendy J; Davidson, Adam G; Buford, John A

2010-06-01

The pontomedullary reticular formation (PMRF) of the monkey produces motor outputs to both upper limbs. EMG effects evoked from stimulus-triggered averaging (StimulusTA) were compared with effects from stimulus trains to determine whether both stimulation methods produced comparable results. Flexor and extensor muscles of scapulothoracic, shoulder, elbow, and wrist joints were studied bilaterally in two male M. fascicularis monkeys trained to perform a bilateral reaching task. The frequency of facilitation versus suppression responses evoked in the muscles was compared between methods. Stimulus trains were more efficient (94% of PMRF sites) in producing responses than StimulusTA (55%), and stimulus trains evoked responses from more muscles per site than from StimulusTA. Facilitation (72%) was more common from stimulus trains than StimulusTA (39%). In the overall results, a bilateral reciprocal activation pattern of ipsilateral flexor and contralateral extensor facilitation was evident for StimulusTA and stimulus trains. When the comparison was restricted to cases where both methods produced a response in a given muscle from the same site, agreement was very high, at 80%. For the remaining 20%, discrepancies were accounted for mainly by facilitation from stimulus trains when StimulusTA produced suppression, which was in agreement with the under-representation of suppression in the stimulus train data as a whole. To the extent that the stimulus train method may favor transmission through polysynaptic pathways, these results suggest that polysynaptic pathways from the PMRF more often produce facilitation in muscles that would typically demonstrate suppression with StimulusTA.

Arthroscopic approach and intra-articular anatomy of the dorsal and plantar synovial compartments of the bovine tarsocrural joint.

PubMed

Lardé, Hélène; Nichols, Sylvain; Babkine, Marie; Desrochers, André

2017-01-01

To determine arthroscopic approaches to the dorsal and plantar synovial compartments of the tarsocrural joint in adult cattle, and to describe the arthroscopic intra-articular anatomy from each approach. Ex vivo study. Fresh adult bovine cadavers (n = 7). Two tarsocrural joint were injected with latex to determine arthroscopic portal locations and arthroscopy of the tarsocrural joint of 12 tarsi was performed. The dorsolateral approach was made through the large pouch located between the long digital extensor and peroneus longus tendons. The dorsomedial approach was made just medial to the common synovial sheath of the tibialis cranialis, peroneus tertius, and long digital extensor tendons. The plantarolateral and plantaromedial approaches were made lateral and medial to the tarsal tendon sheath, respectively. Each approach allowed visualization of the distal tibia articulating with the proximal trochlea of the talus. Consistently observed structures included the distal intermediate ridge of the tibia, and the medial and lateral trochlear ridges and trochlear groove of the talus. Lateral and medial malleoli were best assessed from dorsal approaches. From the lateral approaches evaluation of the abaxial surface of the lateral trochlear ridge allowed visualization of the fibulocalcaneal joint. From the plantar approaches additional observed structures included the coracoid process of the calcaneus, plantar trochlea of the talus, and plantar talotibial and talofibular ligaments. In cattle, the dorsolateral and plantarolateral approaches allowed for the best evaluation of the dorsal and plantar aspects of the tarsocrural joint, respectively. © 2017 The American College of Veterinary Surgeons.

The effect of Tai Chi on four chronic conditions-cancer, osteoarthritis, heart failure and chronic obstructive pulmonary disease: a systematic review and meta-analyses.

PubMed

Chen, Yi-Wen; Hunt, Michael A; Campbell, Kristin L; Peill, Kortni; Reid, W Darlene

2016-04-01

Many middle-aged and older persons have more than one chronic condition. Thus, it is important to synthesise the effectiveness of interventions across several comorbidities. The aim of this systematic review was to summarise current evidence regarding the effectiveness of Tai Chi in individuals with four common chronic conditions-cancer, osteoarthritis (OA), heart failure (HF) and chronic obstructive pulmonary disease (COPD). 4 databases (MEDLINE, EMBASE, CINAHL and SPORTDiscus) were searched for original articles. Two reviewers independently screened the titles and abstracts and then conducted full-text reviews, quality assessment and finally data abstraction. 33 studies met the inclusion criteria. Meta-analyses were performed on disease-specific symptoms, physiological outcomes and physical performance of each chronic condition. Subgroup analyses on disease-specific symptoms were conducted by categorising studies into subsets based on the type of comparison groups. Meta-analyses showed that Tai Chi improved or showed a tendency to improve physical performance outcomes, including 6-min walking distance (6MWD) and knee extensor strength, in most or all four chronic conditions. Tai Chi also improved disease-specific symptoms of pain and stiffness in OA. The results demonstrated a favourable effect or tendency of Tai Chi to improve physical performance and showed that this type of exercise could be performed by individuals with different chronic conditions, including COPD, HF and OA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Wrist muscle activity of khatrah approach in Mameluke technique using traditional bow archery

NASA Astrophysics Data System (ADS)

Ariffin, Muhammad Shahimi; Rambely, Azmin Sham; Ariff, Noratiqah Mohd

2018-04-01

An investigation of khatrah technique in archery was carried out. An electromyography (EMG) experiment was conducted towards six wrist muscles which are flexor carpi radialis, extensor carpi ulnaris and extensor digitorum communis for both arms. The maximum voluntary contraction (MVC) and activity data were recorded. The bow arm produced a higher muscle force compared to draw arm muscles during release phase. However, the muscle forces produced by bow arm had a consistency in term of pattern throughout the phases. In conclusion, the forces generated by the professional archer produced a force benchmark at the wrist joint to alleviate the risk of injury.

Cross-spectral analysis of physiological tremor and muscle activity. I. Theory and application to unsynchronized electromyogram.

PubMed

Timmer, J; Lauk, M; Pfleger, W; Deuschl, G

1998-05-01

We investigate the relationship between the extensor electromyogram (EMG) and tremor times series in physiological hand tremor by cross-spectral analysis. Special attention is directed to the phase spectrum and the effects of observational noise. We calculate the theoretical phase spectrum for a second-order linear stochastic process and compare the results to measured tremor data recorded from subjects who did not show a synchronized EMG activity in the corresponding extensor muscle. The results show that physiological tremor is well described by the proposed model and that the measured EMG represents a Newtonian force by which the muscle acts on the hand.

Electrophysiological assessment of piano players' back extensor muscles on a regular piano bench and chair with back rest.

PubMed

Honarmand, Kavan; Minaskanian, Rafael; Maboudi, Seyed Ebrahim; Oskouei, Ali E

2018-01-01

[Purpose] Sitting position is the dominant position for a professional pianist. There are many static and dynamic forces which affect musculoskeletal system during sitting. In prolonged sitting, these forces are harmful. The aim of this study was to compare pianists' back extensor muscles activity during playing piano while sitting on a regular piano bench and a chair with back rest. [Subjects and Methods] Ten professional piano players (mean age 25.4 ± 5.28, 60% male, 40% female) performed similar tasks for 5 hours in two sessions: one session sitting on a regular piano bench and the other sitting on a chair with back rest. In each session, muscular activity was assessed in 3 ways: 1) recording surface electromyography of the back-extensor muscles at the beginning and end of each session, 2) isometric back extension test, and 3) musculoskeletal discomfort questionnaire. [Results] There were significantly lesser muscular activity, more ability to perform isometric back extension and better personal comfort while sitting on a chair with back rest. [Conclusion] Decreased muscular activity and perhaps fatigue during prolonged piano playing on a chair with back rest may reduce acquired musculoskeletal disorders amongst professional pianists.

Electrophysiological assessment of piano players’ back extensor muscles on a regular piano bench and chair with back rest

PubMed Central

Honarmand, Kavan; Minaskanian, Rafael; Maboudi, Seyed Ebrahim; Oskouei, Ali E.

2018-01-01

[Purpose] Sitting position is the dominant position for a professional pianist. There are many static and dynamic forces which affect musculoskeletal system during sitting. In prolonged sitting, these forces are harmful. The aim of this study was to compare pianists’ back extensor muscles activity during playing piano while sitting on a regular piano bench and a chair with back rest. [Subjects and Methods] Ten professional piano players (mean age 25.4 ± 5.28, 60% male, 40% female) performed similar tasks for 5 hours in two sessions: one session sitting on a regular piano bench and the other sitting on a chair with back rest. In each session, muscular activity was assessed in 3 ways: 1) recording surface electromyography of the back-extensor muscles at the beginning and end of each session, 2) isometric back extension test, and 3) musculoskeletal discomfort questionnaire. [Results] There were significantly lesser muscular activity, more ability to perform isometric back extension and better personal comfort while sitting on a chair with back rest. [Conclusion] Decreased muscular activity and perhaps fatigue during prolonged piano playing on a chair with back rest may reduce acquired musculoskeletal disorders amongst professional pianists. PMID:29410569

Proximal forearm extensor muscle strain is reduced when driving nails using a shock-controlled hammer.

PubMed

Buchanan, Kimberly A; Maza, Maria; Pérez-Vázquez, Carlos E; Yen, Thomas Y; Kijowski, Richard; Liu, Fang; Radwin, Robert G

2016-10-01

Repetitive hammer use has been associated with strain and musculoskeletal injuries. This study investigated if using a shock-control hammer reduces forearm muscle strain by observing adverse physiological responses (i.e. inflammation and localized edema) after use. Three matched framing hammers were studied, including a wood-handle, steel-handle, and shock-control hammer. Fifty volunteers were randomly assigned to use one of these hammers at a fatiguing pace of one strike every second, to seat 20 nails in a wood beam. Magnetic resonance imaging was used to scan the forearm muscles for inflammation before the task, immediately after hammering, and one to two days after. Electromyogram signals were measured to estimate grip exertions and localized muscle fatigue. High-speed video was used to calculate the energy of nail strikes. While estimated grip force was similar across the three hammers, the shock-control hammer had 40% greater kinetic energy upon impact and markedly less proximal extensor muscle edema than the wood-handle and steel-handle hammers, immediately after use (p<.05). Less edema observed for the shock-control hammer suggests that isolating handle shock can mitigate strain in proximal forearm extensor muscles. Copyright © 2016 Elsevier Ltd. All rights reserved.

Intrarater reliability of the Humac NORM isokinetic dynamometer for strength measurements of the knee and shoulder muscles.

PubMed

Habets, Bas; Staal, J Bart; Tijssen, Marsha; van Cingel, Robert

2018-01-10

To determine the intrarater reliability of the Humac NORM isokinetic dynamometer for concentric and eccentric strength tests of knee and shoulder muscles. 54 participants (50% female, average age 20.9 ± 3.1 years) performed concentric and eccentric strength measures of the knee extensors and flexors, and the shoulder internal and external rotators on two different Humac NORM isokinetic dynamometers, which were situated at two different centers. The knee extensors and flexors were tested concentrically at 60° and 180°/s, and eccentrically at 60° s. Concentric strength of the shoulder internal and external rotators, and eccentric strength of the external rotators were measured at 60° and 120°/s. We calculated intraclass correlation coefficients (ICCs), standard error of measurement, standard error of measurement expressed as a %, and the smallest detectable change to determine reliability and measurement error. ICCs for the knee tests ranged from 0.74 to 0.89, whereas ICC values for the shoulder tests ranged from 0.72 to 0.94. Measurement error was highest for the concentric test of the knee extensors and lowest for the concentric test of shoulder external rotators.

Estimation of muscle torque in various combat sports.

PubMed

Pędzich, Wioletta; Mastalerz, Andrzej; Sadowski, Jerzy

2012-01-01

The purpose of the research was to compare muscle torque of elite combat groups. Twelve taekwondo WTF athletes, twelve taekwondo ITF athletes and nine boxers participated in the study. Measurements of muscle torques were done under static conditions on a special stand which belonged to the Department of Biomechanics. The sum of muscle torque of lower right and left extremities of relative values was significantly higher for taekwondo WTF athletes than for boxers (16%, p < 0.001 for right and 10%, p < 0.05 for left extremities) and taekwondo ITF (10%, p < 0.05 for right and 8% for left extremities). Taekwondo ITF athletes attained significantly higher absolute muscle torque values than boxers for elbow flexors (20%, p < 0.05 for right and 11% for left extremities) and extensors (14% for right and 18%, p < 0.05 for left extremities) and shoulder flexors (10% for right and 12%, p < 0.05 for left extremities) and extensors (11% for right and 1% for left extremities). Taekwondo WTF and taekwondo ITF athletes obtained significantly different relative values of muscle torque of the hip flexors (16%, p < 0.05) and extensors (11%, p < 0.05) of the right extremities.

Motor strategy patterns study of diabetic neuropathic individuals while walking. A wavelet approach.

PubMed

Sacco, I C N; Hamamoto, A N; Onodera, A N; Gomes, A A; Weiderpass, H A; Pachi, C G F; Yamamoto, J F; von Tscharner, V

2014-07-18

The aim of this study was to investigate muscle׳s energy patterns and spectral properties of diabetic neuropathic individuals during gait cycle using wavelet approach. Twenty-one diabetic patients diagnosed with peripheral neuropathy, and 21 non-diabetic individuals were assessed during the whole gait cycle. Activation patterns of vastus lateralis, medial gastrocnemius and tibialis anterior were studied by means of bipolar surface EMG. The signal׳s energy and frequency were compared between groups using t-test. The energy was compared in each frequency band (7-542 Hz) using ANOVAs for repeated measures for each group and each muscle. The diabetic individuals displayed lower energies in lower frequency bands for all muscles and higher energies in higher frequency bands for the extensors׳ muscles. They also showed lower total energy of gastrocnemius and a higher total energy of vastus, considering the whole gait cycle. The overall results suggest a change in the neuromuscular strategy of the main extensor muscles of the lower limb of diabetic patients to compensate the ankle extensor deficit to propel the body forward and accomplish the walking task. Copyright © 2014 Elsevier Ltd. All rights reserved.

Rehabilitation of flexor and extensor tendon injuries in the hand: current updates.

PubMed

Howell, Julianne W; Peck, Fiona

2013-03-01

In recent years, a significant amount of research in the field of tendon injury in the hand has contributed to advances in both surgical and rehabilitation techniques. The introduction of early motion has improved tendon healing, reduced complications, and enhanced final outcomes. There is overwhelming evidence to show that carefully devised rehabilitation programs are critical to achieving favourable outcomes. Whatever the type, or level, of flexor or extensor injury, the ultimate goal of both the surgeon and therapist is to protect the repair, modify peritendinous adhesions, promote optimal tendon excursion and preserve joint motion. Early tendon motion regimens are initiated at surgery or within 5 days post repair. Intra-operative information from the surgeon to the therapist is vital to the choice of splint protected position to reduce repair rupture/gap forces, and to commencement of active, or splint controlled, motion for tendon excursion. Decisions should align with the phases of healing, the clinician's observations, frequent range of motion measurements and patient input. Clinical concepts pertinent to early motion rehabilitation decisions are presented by zone of injury for both flexor and extensor tendons during the early phases of healing. Copyright © 2013. Published by Elsevier Ltd.

Life-long calorie restriction in Fischer 344 rats attenuates age-related loss in skeletal muscle-specific force and reduces extracellular space.

PubMed

Payne, Anthony M; Dodd, Stephen L; Leeuwenburgh, Christiaan

2003-12-01

The decline in muscle function is associated with an age-related decrease in muscle mass and an age-related decline in strength. However, decreased strength is not solely due to decreased muscle mass. The age-related decline in muscle-specific force (force/muscle cross-sectional area), a measure of intrinsic muscle function, also contributes to age-related strength decline, and the mechanisms by which this occurs are only partially known. Moreover, changes in the extracellular space could have a profound effect on skeletal muscle function. Life-long calorie restriction in rodents has shown to be a powerful anti-aging intervention. In this study, we examine whether calorie restriction is able to attenuate the loss of muscle function and elevations in extracellular space associated with aging. We hypothesize that calorie restriction attenuates the age-associated decline in specific force and increases in extracellular space. Measurements of in vitro contractile properties of the extensor digitorum longus (type II) and soleus (type I) muscles from 12-mo and 26- to 28-mo-old ad libitum-fed, as well as 27- to 28-mo-old life-long calorie-restricted male Fischer 344 rats, were performed. We found that calorie restriction attenuated the age-associated decline in muscle mass-to-body mass ratio (mg/g) and strength-to-body mass ratio (N/kg) in the extensor digitorum longus muscle (P < 0.05) but not in the soleus muscle (P > 0.05). Importantly, muscle-specific force (N/cm2) in the extensor digitorum longus, but not in the soleus muscle, of the old calorie-restricted rats was equal to that of the young 12-mo-old animals. Moreover, the age-associated increase in extracellular space was reduced in the fast-twitch extensor digitorum longus muscle (P < 0.05) but not in the soleus muscle with calorie restriction. We also found a significant correlation between the extracellular space and the muscle-specific force in the extensor digitorum longus (r = -0.58; P < 0.05) but not in the soleus muscle (r = -0.38; P > 0.05). Hence, this study shows a loss of muscle function with age and suggests that long-term calorie restriction is an effective intervention against the loss of muscle function with age.

Back Strength Predicts Walking Improvement in Obese, Older Adults With Chronic Low Back Pain

PubMed Central

Vincent, Heather K.; Vincent, Kevin R.; Seay, Amanda N.; Conrad, Bryan P.; Hurley, Robert W.; George, Steven Z.

2014-01-01

Objective To compare the effects of 4 months of isolated lumbar resistance exercise and total body resistance exercise on walking performance in obese, older adults with chronic low back pain. A secondary analysis examined whether responsiveness to training modulated walking improvement. Design Randomized, controlled trial. Setting Research laboratory affiliated with tertiary care facility. Methods and Intervention Participants (N = 49; 60–85 years) were randomized into a 4-month resistance exercise intervention (TOTRX), lumbar extensor exercise intervention (LEXT), or a control group (CON). Main Outcome Measurements Walking performance, maximal low back strength and leg strength, and average resting and low back pain severity score (from an 11-point numerical pain rating scale; NRSpain) were collected at baseline and month 4. Results The TOTRX and LEXT improved lumbar extensor strength relative to CON and the TOTRX (P < .05). NRSpain scores at month 4 were lowest in the TOTRX group compared with the LEXT and CON groups, respectively (2.0 ± 1.7 points vs 3.7 ± 2.6 points and 4.6 ± 2.4 points; P < .006). A total of 53% and 67% of participants in the TOTRX and LEXT groups were responders who made lumbar extensor strength gains that achieved ≥20% greater than baseline values. Although the TOTRX demonstrated the greatest improvement in walking endurance among the intervention groups, this did not reach significance (10.1 ± 12.2% improvement in TOTRX vs 7.4 ± 30.0% LEXT and −1.7 ± 17.4% CON; P = .11). Gait speed increased most in the TOTRX (9.0 ± 13.5%) compared with the LEXT and CON groups (P < .05). The change in lumbar extensor strength explained 10.6% of the variance of the regression model for the change in walking endurance (P = .024). Conclusions The use of LEXT and TOTRX produced similar modest improvements in patients’ walking endurance. Lumbar extensor strength gain compared with leg strength gain is a moderate but important contributor to walking endurance in obese older adults with chronic low back pain. Responders to resistance exercise programs (event those with only lumbar extension exercise) who make at least a 20% improvement in strength can expect better improvement in walking endurance than those who do not achieve this strength improvement. PMID:24211698

Correlation between muscle structure and filter characteristics of the muscle-joint system in three orthopteran insect species

PubMed

BÄSsler; BÜSchges; Meditz; BÄSsler

1996-01-01

In orthopteran insects, neural networks for joint control exhibit different characteristics due to behavioural specializations. We investigated whether these differences are generated purely by the neuronal networks, or whether characteristics of the muscles or joint architecture (muscle­joint system) are also involved in these behavioural specializations. We compared the properties of the muscle system moving the femur­tibia joint of the middle and hindleg of three species, Carausius morosus, Cuniculina impigra and Locusta migratoria. Four aspects were analysed for the tibial extensor muscle: (i) the frequency-dependence of motoneuronal activity in response to sinusoidal stimulation of the femoral chordotonal organ (fCO), (ii) the muscle structure, (iii) the innervation pattern of the muscle and (iv) the histochemical properties of the muscle fibres. These aspects were compared with the filter characteristics of the open-loop femur­tibia control system and of the muscle­joint system involved. Whereas in both phasmid species (Carausius morosus and Cuniculina impigra) the motoneuronal activity steadily increases with sinusoidal stimulation of the fCO in the frequency range 0.01­5 Hz, in Locusta migratoria there is a decrease in motoneuronal activity between 0.01 and 0.3 Hz. The muscle structure is basically similar in all three species, as the number of singly innervated muscle fibres (supplied by the fast extensor tibiae motor neurone, FETi) decreases from proximal to distal. The number of triply innervated fibres supplied by the FETi, the slow extensor tibiae (SETi) and the common inhibitor 1 (CI1) is maximal in the middle of the muscle, and the number of dually innervated fibres (supplied by SETi, CI1) increases from proximal to distal. Differences between the locust and the two phasmid species exist in the distal portion of the muscle. The phasmid extensor tibiae muscle contains a morphologically distinct bundle of muscle fibres, not present in the locust, which is mostly dually innervated and which is larger in Cuniculina impigra. Similar results were obtained for the histochemical characterisation of the muscle fibres as revealed from their staining for myofibrillar ATPase activity. The number of histochemically identified fast fibres decreased from proximal to distal, while the number of slow fibres increased. In Carausius morosus and Locusta migratoria, the percentage of slow fibres increased by up to 60­70 % at the distal end, while this increase was to almost 100 % in Cuniculina impigra. Apparently, the larger this distal region and the higher the percentage of slow, dually innervated fibres in it, the lower is the upper corner frequency (the stimulus frequency at which the joint control system produces a movement with 70 % of its maximal response amplitude) of the muscle­joint system. In summary, it appears that the upper corner frequency of the open-loop system in Locusta migratoria (<0.05 Hz) results at least in part from properties of the neuronal joint control network, but in Carausius morosus (0.5­1.0 Hz) and Cuniculina impigra (0.1­0.2 Hz) it results from the upper corner frequency of the muscle­joint system.

The extensor digitorum brevis: histological and histochemical aspects

PubMed Central

Jennekens, F. G. I.; Tomlinson, B. E.; Walton, J. N.

1972-01-01

Samples of the extensor digitorum brevis muscle (EDB) obtained at necropsy from 26 subjects without known neuromuscular disease were examined histologically and histochemically. In the two youngest subjects, aged 2 months and 8 years, a mosaic distribution of type I and type II fibres was present. From the second decade onwards, increasing with age, the mosaic pattern was gradually replaced by groups of type I and type II fibres and areas of grouped fibre atrophy appeared. It is suggested that these findings may be explained by a slow process of denervation and reinnervation. This process does not seem to occur to the same extent in three other distal limb muscles from which specimens were also examined. Images PMID:4260286

Role of glucocorticoids in increased muscle glutamine production in starvation

NASA Technical Reports Server (NTRS)

Tischler, Marc E.; Henriksen, Erik J.; Cook, Paul H.

1988-01-01

The role of glucocorticoids in the synthesis of muscle glutamine during starvation was investigated in adrenalectomized fasted rats injected with cortisol (1 mg/100 g body weight). It was found that administration of cortisol in vivo increased (compared to nontreated starved adrenalectomized controls) the glutamine/glutamate ratio and the activity of glutamine synthetase in the diaphragm and the extensor digitorum muscles, and that these effects were abolished by prior treatment with actinomycin D or proflavine. The results obtained in in vitro experiments, using fresh-frozen soleus, extensor digitorum longus, and diaphragm muscle preparations, supported the in vivo indications of the cortisol-enhanced glutamine synthesis and protein turnover in starved adrenalectomized animals.

FUNCTIONAL PERFORMANCE AND KNEE LAXITY IN NORMAL INDIVIDUALS AND IN INDIVIDUALS SUBMITTED TO ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

PubMed Central

de Vasconcelos, Rodrigo Antunes; Bevilaqua-Grossi, Débora; Shimano, Antonio Carlos; Jansen Paccola, Cleber Antonio; Salvini, Tânia Fátima; Prado, Christiane Lanatovits; Mello Junior, Wilson A.

2015-01-01

The aim of this study was to analyze the correlation between deficits in the isokinetic peak torque of the knee extensors and flexors with hop tests, postoperative knee laxity and functional scores in normal and ACL- reconstructed subjects with patellar tendon and hamstring tendon autografts. Methods: Sixty male subjects were enrolled and subdivided into three groups: Twenty subjects without knee injuries (GC group) and two groups of 20 subjects submitted to ACL reconstruction with patellar tendon (GTP group) and hamstrings autograft (GTF group). Results: The results showed significant correlation between knee extensors peak torque and performance in the hop tests for GTF and GC groups. There are no significantly correlations between post op knee laxity and Lysholm score compared with the hop tests and peak torque deficits. Concerning the differences between groups, the GTP group showed greater peak torque deficits in knee extensors, worst Lysholm scores and higher percentage of individuals with lower limb symmetry index (ISM) < 90% in both hop tests when compared to the other two groups. Conclusion: It is not recommendable to use only one measurement instrument for the functional evaluation of ACL-reconstructed patients, because significant correlation between peak torque, subject's functional score, knee laxity and hop tests were not observed in all groups. PMID:26998464

Estimation method of finger tapping dynamics using simple magnetic detection system

NASA Astrophysics Data System (ADS)

Kandori, Akihiko; Sano, Yuko; Miyashita, Tsuyoshi; Okada, Yoshihisa; Irokawa, Masataka; Shima, Keisuke; Tsuji, Toshio; Yokoe, Masaru; Sakoda, Saburo

2010-05-01

We have developed the simple estimation method of a finger tapping dynamics model for investigating muscle resistance and stiffness during tapping movement in normal subjects. We measured finger tapping movements of 207 normal subjects using a magnetic finger tapping detection system. Each subject tapped two fingers in time with a metronome at 1, 2, 3, 4, and 5 Hz. The velocity and acceleration values for both the closing and opening tapping data were used to estimate a finger tapping dynamics model. Using the frequency response of the ratio of acceleration to velocity of the mechanical impedance parameters, we estimated the resistance (friction coefficient) and compliance (stiffness). We found two dynamics models for the maximum open position and tap position. In the maximum open position, the extensor muscle resistance was twice as high as the flexor muscle resistance and males had a higher spring constant. In the tap position, the flexor muscle resistance was much higher than the extensor muscle resistance. This indicates that the tapping dynamics in the maximum open position are controlled by the balance of extensor and flexor muscle friction resistances and the flexor stiffness, and the flexor friction resistance is the main component in the tap position. It can be concluded that our estimation method makes it possible to understand the tapping dynamics.

Sprint Acceleration Mechanics: The Major Role of Hamstrings in Horizontal Force Production

PubMed Central

Morin, Jean-Benoît; Gimenez, Philippe; Edouard, Pascal; Arnal, Pierrick; Jiménez-Reyes, Pedro; Samozino, Pierre; Brughelli, Matt; Mendiguchia, Jurdan

2015-01-01

Recent literature supports the importance of horizontal ground reaction force (GRF) production for sprint acceleration performance. Modeling and clinical studies have shown that the hip extensors are very likely contributors to sprint acceleration performance. We experimentally tested the role of the hip extensors in horizontal GRF production during short, maximal, treadmill sprint accelerations. Torque capabilities of the knee and hip extensors and flexors were assessed using an isokinetic dynamometer in 14 males familiar with sprint running. Then, during 6-s sprints on an instrumented motorized treadmill, horizontal and vertical GRF were synchronized with electromyographic (EMG) activity of the vastus lateralis, rectus femoris, biceps femoris, and gluteus maximus averaged over the first half of support, entire support, entire swing and end-of-swing phases. No significant correlations were found between isokinetic or EMG variables and horizontal GRF. Multiple linear regression analysis showed a significant relationship (P = 0.024) between horizontal GRF and the combination of biceps femoris EMG activity during the end of the swing and the knee flexors eccentric peak torque. In conclusion, subjects who produced the greatest amount of horizontal force were both able to highly activate their hamstring muscles just before ground contact and present high eccentric hamstring peak torque capability. PMID:26733889

Assessing the therapeutic effect of 625-nm light-emitting diodes

NASA Astrophysics Data System (ADS)

Mao, Zongzhen; Xu, Guodong; Yang, Yi

2014-09-01

To evaluate the effects of red Light-Emitting Diodes on elbow extensor and flexor strength and the recovery of exercise induced fatigue, the torque values from the isokinetic dynamometer as well as biochemistry parameters were used as outcome measures. A randomized double-blind placebo-controlled crossover trial was performed with twenty male young tennis athletes. Active LED therapy (LEDT, with wavelength 625nm, 10 minutes total irradiation time, irradiated area amount to 30cm2, and 900J of total energy irradiated) or an identical placebo was delivered under double-blinded conditions to the left elbow just before exercise. The isokinetic muscle strength was measured immediately after irradiation. The blood lactate levels were sampled pre-exercise and post-exercise. The peak torque values of elbow extensor strength were significantly different between two groups. As in elbow flexor strength, the difference of peak torque was not significant. The blood lactate concentration of LEDT group post-exercise was significantly lower than those of placebo group. The results indicate that 625nm LED therapy is effective in preventing muscle fatigue as it can significantly reduce peak torque value of elbow extensors and blood lactate concentration. It has no effect on the strength of left elbow flexor or backhand performance in tennis.

A robotic exoskeleton to treat crouch gait from cerebral palsy: Initial kinematic and neuromuscular evaluation.

PubMed

Lerner, Zachary F; Damiano, Diane L; Bulea, Thomas C

2016-08-01

A robotic exoskeleton was designed for individuals with crouch gait caused by cerebral palsy with the intent to supplement existing muscle function during walking. The aim of this study was to evaluate how powered knee extension assistance provided during stance and swing phases of the gait cycle affect knee kinematics, and knee flexor and extensor muscle activity. Muscle activity and kinematic data were collected from four individuals with crouch gait from cerebral palsy during their normal walking condition and while walking with the exoskeleton under stance, swing, and stance & swing assistance. The exoskeleton was effective in reducing crouch by an average of 13.8° in three of the four participants when assistance was provided during the stance phase; assistance during the swing phase alone was ineffective. Peak knee extensor activity was maintained for all of the conditions during the stance and swing phases. Integrated (i.e. area under the curve) knee extensor activity decreased in two of the subjects indicating a more well-modulated activation pattern. Modest increases in peak and integrated antagonist knee flexor activity were exhibited in all participants; the subject without kinematic improvement had the greatest increase. While the exoskeleton was well tolerated, additional training with a focus on reducing knee flexor activity may lead to further improvements in crouch gait reduction.

Effect of thumb anaesthesia on weight perception, muscle activity and the stretch reflex in man.

PubMed Central

Marsden, C D; Rothwell, J C; Traub, M M

1979-01-01

1. We have confirmed the results of Gandevia & McCloskey (1977) on the effect of thumb anaesthesia on perception of weights lifted by the thumb. Weights lifted by flexion feel heavier and weights lifted by extension feel lighter. 2. The change in size of the long-latency stretch reflex in flexor pollicis longus or extensor pollicis longus after thumb anaesthesia cannot explain the effect on weight perception by removal or augmentation of the background servo assistance to muscular contraction. 3. During smooth thumb flexion, thumb anaesthesia increases e.m.g. activity in flexor pollicis longus and extensor pollicis longus for any given opposing torque. 4. During smooth thumb extension the opposite occurs: e.m.g. activity in both extensor and flexor pollicis longus decreases. 5. Clamping the thumb at the proximal phalanx to limit movement solely to the interphalangeal joint reduces or abolishes the effect of anaesthesia on both weight perception and e.m.g. activity during both flexion or extension tasks. 6. Gandevia & McCloskey's findings on the distorting effects of thumb anaesthesia on weight perception cannot be used to support the hypothesis of an efferent monitoring system of the sense of effort. Our results emphasize the close functional relationship between cutaneous and joint afferent information and motor control. PMID:512948

Isokinetic Assessment and Musculoskeletal Complaints in Paralympic Athletes: A Longitudinal Study.

PubMed

Silva, Andressa; Zanca, Gisele; Alves, Eduardo Silva; Lemos, Valdir de Aquino; Gávea, Sebastião Augusto; Winckler, Ciro; Mattiello, Stela Márcia; Peterson, Ronnie; Vital, Roberto; Tufik, Sergio; De Mello, Marco Túlio

2015-10-01

The aim of this study was to assess and monitor the peak torque of the knee extensor and flexor muscles in flexion and extension and the reports of musculoskeletal complaints in members of the main Brazilian Paralympic athletics team through 1 yr. Fourteen healthy athletes from both sexes were assessed three times in 1 yr. The volunteers were assessed for the presence of musculoskeletal complaints and muscle strength at three time points: (1) at the onset of the preparatory phase on December 2009, (2) at a follow-up assessment on June 2010, and (3) before actual competition on December 2010. The athletes' self-reported musculoskeletal complaints were assessed in structured interviews, and the muscle strength was assessed by means of isokinetic dynamometry. The knee flexor and extensor muscle strength exhibited significant increase in both the right and left lower limbs at the second and third assessments compared with the first one (P < 0.05). Muscle imbalance was associated with knee and thigh complaints at all three assessments (P < 0.05). The knee flexor and extensor muscle strength exhibited a gradual increase in both lower limbs during the course of the three assessments. In parallel, muscle imbalance was associated with the occurrence of knee and thigh complaints.

Activity of thoracic and lumbar epaxial extensors during postural responses in the cat

NASA Technical Reports Server (NTRS)

Macpherson, J. M.; Fung, J.; Peterson, B. W. (Principal Investigator)

1998-01-01

This study examined the role of trunk extensor muscles in the thoracic and lumbar regions during postural adjustments in the freely standing cat. The epaxial extensor muscles participate in the rapid postural responses evoked by horizontal translation of the support surface. The muscles segregate into two regional groups separated by a short transition zone, according to the spatial pattern of the electromyographic (EMG) responses. The upper thoracic muscles (T5-9) respond best to posteriorly directed translations, whereas the lumbar muscles (T13 to L7) respond best to anterior translations. The transition group muscles (T10-12) respond to almost all translations. Muscles group according to vertebral level rather than muscle species. The upper thoracic muscles change little in their response with changes in stance distance (fore-hindpaw separation) and may act to stabilize the intervertebral angles of the thoracic curvature. Activity in the lumbar muscles increases along with upward rotation of the pelvis (iliac crest) as stance distance decreases. Lumbar muscles appear to stabilize the pelvis with respect to the lumbar vertebrae (L7-sacral joint). The transition zone muscles display a change in spatial tuning with stance distance, responding to many directions of translation at short distances and focusing to respond best to contralateral translations at the long stance distance.

Estimation method of finger tapping dynamics using simple magnetic detection system.

PubMed

Kandori, Akihiko; Sano, Yuko; Miyashita, Tsuyoshi; Okada, Yoshihisa; Irokawa, Masataka; Shima, Keisuke; Tsuji, Toshio; Yokoe, Masaru; Sakoda, Saburo

2010-05-01

We have developed the simple estimation method of a finger tapping dynamics model for investigating muscle resistance and stiffness during tapping movement in normal subjects. We measured finger tapping movements of 207 normal subjects using a magnetic finger tapping detection system. Each subject tapped two fingers in time with a metronome at 1, 2, 3, 4, and 5 Hz. The velocity and acceleration values for both the closing and opening tapping data were used to estimate a finger tapping dynamics model. Using the frequency response of the ratio of acceleration to velocity of the mechanical impedance parameters, we estimated the resistance (friction coefficient) and compliance (stiffness). We found two dynamics models for the maximum open position and tap position. In the maximum open position, the extensor muscle resistance was twice as high as the flexor muscle resistance and males had a higher spring constant. In the tap position, the flexor muscle resistance was much higher than the extensor muscle resistance. This indicates that the tapping dynamics in the maximum open position are controlled by the balance of extensor and flexor muscle friction resistances and the flexor stiffness, and the flexor friction resistance is the main component in the tap position. It can be concluded that our estimation method makes it possible to understand the tapping dynamics.

Elbow joint adductor moment arm as an indicator of forelimb posture in extinct quadrupedal tetrapods

PubMed Central

Fujiwara, Shin-ichi; Hutchinson, John R.

2012-01-01

Forelimb posture has been a controversial aspect of reconstructing locomotor behaviour in extinct quadrupedal tetrapods. This is partly owing to the qualitative and subjective nature of typical methods, which focus on bony articulations that are often ambiguous and unvalidated postural indicators. Here we outline a new, quantitatively based forelimb posture index that is applicable to a majority of extant tetrapods. By determining the degree of elbow joint adduction/abduction mobility in several tetrapods, the carpal flexor muscles were determined to also play a role as elbow adductors. Such adduction may play a major role during the stance phase in sprawling postures. This role is different from those of upright/sagittal and sloth-like creeping postures, which, respectively, depend more on elbow extensors and flexors. Our measurements of elbow muscle moment arms in 318 extant tetrapod skeletons (Lissamphibia, Synapsida and Reptilia: 33 major clades and 263 genera) revealed that sprawling, sagittal and creeping tetrapods, respectively, emphasize elbow adductor, extensor and flexor muscles. Furthermore, scansorial and non-scansorial taxa, respectively, emphasize flexors and extensors. Thus, forelimb postures of extinct tetrapods can be qualitatively classified based on our quantitative index. Using this method, we find that Triceratops (Ceratopsidae), Anhanguera (Pterosauria) and desmostylian mammals are categorized as upright/sagittally locomoting taxa. PMID:22357261

Pressure Sore at an Unusual Site- the Bilateral Popliteal Fossa: A Case report

PubMed Central

Kataria, Kamal; Sagar, Sushma; Singhal, Manish; Yadav, Rajni

2012-01-01

Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature. PMID:29181131

Hand rest and wrist support are effective in preventing fatigue during prolonged typing.

PubMed

Callegari, Bianca; de Resende, Marília Maniglia; da Silva Filho, Manoel

Case series (longitudinal). Only few reports concerning the efficacy of commonly used strategies for preventing upper limb occupational disorders associated with prolonged typing exist. We aimed to investigate whether the duration of typing and the use of 2 strategies (hand rest and wrist support) changes muscle physiological response and therefore the electromyography records. We enrolled 25 volunteers, who were unfamiliar with the task and did not have musculoskeletal disorders. The subjects underwent 3 prolonged typing protocols to investigate the efficacy of the 2 adopted strategies in reducing the trapezius, biceps brachii, and extensor digitorum communis fatigue. Typing for 1 hour induced muscular fatigue (60%-67% of the subjects). The extensor digitorum communis muscle exhibited the highest percentage of fatigue (72%-84%) after 1 and 4 hours of typing (1 hour, P = .04; 4 hours, P = .02). Fatigue levels in this muscle were significantly reduced (24%) with the use of pause typing (4 hours, P = .045), whereas biceps brachii muscle fatigue was reduced (32%) only with the use of wrist supports (P = .02, after 4 hours). Trapezius muscle fatigue was unaffected by the tested occupational strategies (1 hour, P = .62; 4 hours, P = .85). Despite presenting an overall tendency for fatigue detected during the application of the protocols, the assessed muscles exhibited different behavior patterns, depending on both the preventive strategy applied and the muscle mechanical role during the task. Hand rest and wrist support can successfully reduce muscle fatigue in specific upper limb muscles during prolonged typing, leading to a muscle-selective reduction in the occurrence of fatigue and thus provide direct evidence that they may prevent work-related musculoskeletal disorders. N/A. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Gene Expression Profiling in Slow-Type Calf Soleus Muscle of 30 Days Space-Flown Mice.

PubMed

Gambara, Guido; Salanova, Michele; Ciciliot, Stefano; Furlan, Sandra; Gutsmann, Martina; Schiffl, Gudrun; Ungethuem, Ute; Volpe, Pompeo; Gunga, Hanns-Christian; Blottner, Dieter

2017-01-01

Microgravity exposure as well as chronic disuse are two main causes of skeletal muscle atrophy in animals and humans. The antigravity calf soleus is a reference postural muscle to investigate the mechanism of disuse-induced maladaptation and plasticity of human and rodent (rats or mice) skeletal musculature. Here, we report microgravity-induced global gene expression changes in space-flown mouse skeletal muscle and the identification of yet unknown disuse susceptible transcripts found in soleus (a mainly slow phenotype) but not in extensor digitorum longus (a mainly fast phenotype dorsiflexor as functional counterpart to soleus). Adult C57Bl/N6 male mice (n = 5) flew aboard a biosatellite for 30 days on orbit (BION-M1 mission, 2013), a sex and age-matched cohort were housed in standard vivarium cages (n = 5), or in a replicate flight habitat as ground control (n = 5). Next to disuse atrophy signs (reduced size and myofiber phenotype I to II type shift) as much as 680 differentially expressed genes were found in the space-flown soleus, and only 72 in extensor digitorum longus (only 24 genes in common) compared to ground controls. Altered expression of gene transcripts matched key biological processes (contractile machinery, calcium homeostasis, muscle development, cell metabolism, inflammatory and oxidative stress response). Some transcripts (Fzd9, Casq2, Kcnma1, Ppara, Myf6) were further validated by quantitative real-time PCR (qRT-PCR). Besides previous reports on other leg muscle types we put forth for the first time a complete set of microgravity susceptible gene transcripts in soleus of mice as promising new biomarkers or targets for optimization of physical countermeasures and rehabilitation protocols to overcome disuse atrophy conditions in different clinical settings, rehabilitation and spaceflight.

Reconceptualizing Balance: Attributes associated with balance performance

PubMed Central

Thomas, Julia C.; Odonkor, Charles; Griffith, Laura; Holt, Nicole; Percac-Lima, Sanja; Leveille, Suzanne; Ni, Pensheng; Latham, Nancy K.; Jette, Alan M.; Bean, Jonathan F.

2014-01-01

Balance tests are commonly used to screen for impairments that put older adults at risk for falls. The purpose of this study was to determine the attributes that were associated with balance performance as measured by the The Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) balance test. This study was a cross-sectional secondary analysis of baseline data from a longitudinal cohort study, the Boston Rehabilitative Impairment Study of the Elderly (Boston RISE). Boston RISE was performed in an outpatient rehabilitation research center and evaluated Boston area primary care patients aged 65 to 96 (N=364) with self-reported difficulty or task-modification climbing a flight of stairs or walking ½ of a mile. The outcome measure was standing balance as measured by the FICSIT-4 balance assessment. Other measures included: self-efficacy, pain, depression, executive function, vision, sensory loss, reaction time, kyphosis, leg range of motion, trunk extensor muscle endurance, leg strength and leg velocity at peak power. Participants were 67% female, had an average age of 76.5 (± 7.0) years, an average of 4.1 (± 2.0) chronic conditions, and an average FICSIT-4 score of 6.7 (± 2.2) out of 9. After adjusting for age and gender, attributes significantly associated with balance performance were falls self-efficacy, trunk extensor muscle endurance, sensory loss, and leg velocity at peak power. FICSIT-4 balance performance is associated with a number of behavioral and physiologic attributes, many of which are amenable to rehabilitative treatment. Our findings support a consideration of balance as multidimensional activity as proposed by the current International Classification of Functioning, Disability, and Health (ICF) model. PMID:24952097

A Methodologic Approach for Normalizing Angular Work and Velocity During Isotonic and Isokinetic Eccentric Training

PubMed Central

Guilhem, Gaël; Cornu, Christophe; Guével, Arnaud

2012-01-01

Context: Resistance exercise training commonly is performed against a constant external load (isotonic) or at a constant velocity (isokinetic). Researchers comparing the effectiveness of isotonic and isokinetic resistance-training protocols need to equalize the mechanical stimulus (work and velocity) applied. Objective: To examine whether the standardization protocol could be adjusted and applied to an eccentric training program. Design: Controlled laboratory study. Setting: Controlled research laboratory. Patients or Other Participants: Twenty-one sport science male students (age = 20.6 ± 1.5 years, height = 178.0 ± 4.0 cm, mass = 74.5 ± 9.1 kg). Intervention(s): Participants performed 9 weeks of isotonic (n = 11) or isokinetic (n = 10) eccentric training of knee extensors that was designed so they would perform the same amount of angular work at the same mean angular velocity. Main Outcome Measure(s): Angular work and angular velocity. Results: The isotonic and isokinetic groups performed the same total amount of work (−185.2 ± 6.5 kJ and −184.4 ± 8.6 kJ, respectively) at the same angular velocity (21 ± 1°/s and 22°/s, respectively) with the same number of repetitions (8.0 and 8.0, respectively). Bland-Altman analysis showed that work (bias = 2.4%) and angular velocity (bias = 0.2%) were equalized over 9 weeks between the modes of training. Conclusions: The procedure developed allows angular work and velocity to be standardized over 9 weeks of isotonic and isokinetic eccentric training of the knee extensors. This method could be useful in future studies in which researchers compare neuromuscular adaptations induced by each type of training mode with respect to rehabilitating patients after musculoskeletal injury. PMID:22488276

Gene Expression Profiling in Slow-Type Calf Soleus Muscle of 30 Days Space-Flown Mice

PubMed Central

Gambara, Guido; Salanova, Michele; Ciciliot, Stefano; Furlan, Sandra; Gutsmann, Martina; Schiffl, Gudrun; Ungethuem, Ute; Volpe, Pompeo; Gunga, Hanns-Christian; Blottner, Dieter

2017-01-01

Microgravity exposure as well as chronic disuse are two main causes of skeletal muscle atrophy in animals and humans. The antigravity calf soleus is a reference postural muscle to investigate the mechanism of disuse-induced maladaptation and plasticity of human and rodent (rats or mice) skeletal musculature. Here, we report microgravity-induced global gene expression changes in space-flown mouse skeletal muscle and the identification of yet unknown disuse susceptible transcripts found in soleus (a mainly slow phenotype) but not in extensor digitorum longus (a mainly fast phenotype dorsiflexor as functional counterpart to soleus). Adult C57Bl/N6 male mice (n = 5) flew aboard a biosatellite for 30 days on orbit (BION-M1 mission, 2013), a sex and age-matched cohort were housed in standard vivarium cages (n = 5), or in a replicate flight habitat as ground control (n = 5). Next to disuse atrophy signs (reduced size and myofiber phenotype I to II type shift) as much as 680 differentially expressed genes were found in the space-flown soleus, and only 72 in extensor digitorum longus (only 24 genes in common) compared to ground controls. Altered expression of gene transcripts matched key biological processes (contractile machinery, calcium homeostasis, muscle development, cell metabolism, inflammatory and oxidative stress response). Some transcripts (Fzd9, Casq2, Kcnma1, Ppara, Myf6) were further validated by quantitative real-time PCR (qRT-PCR). Besides previous reports on other leg muscle types we put forth for the first time a complete set of microgravity susceptible gene transcripts in soleus of mice as promising new biomarkers or targets for optimization of physical countermeasures and rehabilitation protocols to overcome disuse atrophy conditions in different clinical settings, rehabilitation and spaceflight. PMID:28076365

Healthy older adults have insufficient hip range of motion and plantar flexor strength to walk like healthy young adults.

PubMed

Anderson, Dennis E; Madigan, Michael L

2014-03-21

Limited plantar flexor strength and hip extension range of motion (ROM) in older adults are believed to underlie common age-related differences in gait. However, no studies of age-related differences in gait have quantified the percentage of strength and ROM used during gait. We examined peak hip angles, hip torques and plantar flexor torques, and corresponding estimates of functional capacity utilized (FCU), which we define as the percentage of available strength or joint ROM used, in 10 young and 10 older healthy adults walking under self-selected and controlled (slow and fast) conditions. Older adults walked with about 30% smaller hip extension angle, 28% larger hip flexion angle, 34% more hip extensor torque in the slow condition, and 12% less plantar flexor torque in the fast condition than young adults. Older adults had higher FCU than young adults for hip flexion angle (47% vs. 34%) and hip extensor torque (48% vs. 27%). FCUs for plantar flexor torque (both age groups) and hip extension angle (older adults in all conditions; young adults in self-selected gait) were not significantly <100%, and were higher than for other measures examined. Older adults lacked sufficient hip extension ROM to walk with a hip extension angle as large as that of young adults. Similarly, in the fast gait condition older adults lacked the strength to match the plantar flexor torque produced by young adults. This supports the hypothesis that hip extension ROM and plantar flexor strength are limiting factors in gait and contribute to age-related differences in gait. Copyright © 2014 Elsevier Ltd. All rights reserved.

Angular stable lateral plating is a valid alternative to conventional plate fixation in the proximal phalanx. A biomechanical study.

PubMed

Shanmugam, R; Ernst, M; Stoffel, K; Fischer, M F; Wahl, D; Richards, R G; Gueorguiev, B

2015-06-01

Dorsal plating is commonly used in proximal phalanx fractures but it bears the risk of interfering with the extensor apparatus. In this study, dorsal and lateral plating fixation methods are compared to assess biomechanical differences using conventional 1.5mm non-locking plates and novel 1.3mm lateral locking plates. Twenty-four fresh frozen human cadaveric proximal phalanges were equally divided into four groups. An osteotomy was set at the proximal metaphyseal-diaphyseal junction and fixed with either dorsal (group A) or lateral (group B) plating using a 1.5mm non-locking plate, or lateral plating with a novel 1.3mm locking plate with bicortical (group C) or unicortical (group D) screws. The specimens were loaded in axial, dorsovolar and mediolateral direction to assess fixation stiffness followed by a cyclic destructive test in dorsovolar loading direction. Axial stiffness was highest in group D (mean 321.02, SEM 21.47N/mm) with a significant difference between groups D and B (P=0.033). Locking plates (groups C and D) were stiffer than non-locking plates under mediolateral loading (P=0.007), no significant differences were noted under dorsovolar loading. Furthermore, no significant differences were observed under cyclic loading to failure between any of the study groups. No considerable biomechanical advantage of using a conventional 1.5mm dorsal non-locking plate was identified over the novel 1.3mm lateral locking plate in the treatment of proximal phalanx fractures. Since the novel low-profile plate is less disruptive to the extensor mechanism, it should be considered as a valid alternative. Copyright © 2015 Elsevier Ltd. All rights reserved.

Relationship between electromyographic activity of the vastus lateralis while standing and the extent of bilateral simulated knee-flexion contractures.

PubMed

Potter, P J; Kirby, R L

1991-12-01

The effect of simulated bilateral knee-flexion contractures (KFC) on the electromyographic (EMG) activity of the vastus lateralis was studied by testing 10 normal subjects using surface EMG to test the hypothesis that the activity of the knee extensors would increase as a function of the severity of the contracture. The root mean square of the EMG activity was determined from four 4-s samples taken at 30-s intervals, during 2 min of standing in each of five positions of simulated KFC (0 degree, 10 degrees, 20 degrees, 30 degrees and 40 degrees). A randomly balanced order of conditions was used. KFC were simulated in each subject by means of an adjustable line from the subject's waist to the sole of each foot. An analysis of variance was used to contrast EMG activity, and a significant difference was found between each of the positions (P less than 0.05). The mean (+/- 1 SD) EMG activity, expressed as a percentage of the maximum voluntary contraction, was 0.3% (+/- 0.2) at 0 degree, 7.6% (+/- 5.6) at 10 degrees, 10.9% (+/- 7.6) at 20 degrees, 16.6% (+/- 12.4) at 30 degrees and 24.0% (+/- 14.0) at 40 degrees. A linear relationship was found (r2 = 0.986), expressed by the equation y = 0.62 + 0.56 x, where y represents EMG activity and x represents the extent of simulated KFC (P = 0.0007). The results provide insight into the increased knee extensor activity necessary to stand with KFC and underline the importance of treating this common disorder.

Effects of Quadriceps Muscle Fatigue on Stiff-Knee Gait in Patients with Hemiparesis

PubMed Central

Boudarham, Julien; Roche, Nicolas; Pradon, Didier; Delouf, Eric; Bensmail, Djamel; Zory, Raphael

2014-01-01

The relationship between neuromuscular fatigue and locomotion has never been investigated in hemiparetic patients despite the fact that, in the clinical context, patients report to be more spastic or stiffer after walking a long distance or after a rehabilitation session. The aim of this study was to evaluate the effects of quadriceps muscle fatigue on the biomechanical gait parameters of patients with a stiff-knee gait (SKG). Thirteen patients and eleven healthy controls performed one gait analysis before a protocol of isokinetic quadriceps fatigue and two after (immediately after and after 10 minutes of rest). Spatiotemporal parameters, sagittal knee and hip kinematics, rectus femoris (RF) and vastus lateralis (VL) kinematics and electromyographic (EMG) activity were analyzed. The results showed that quadriceps muscle weakness, produced by repetitive concentric contractions of the knee extensors, induced an improvement of spatiotemporal parameters for patients and healthy subjects. For the patient group, the increase in gait velocity and step length was associated with i) an increase of sagittal hip and knee flexion during the swing phase, ii) an increase of the maximal normalized length of the RF and VL and of the maximal VL lengthening velocity during the pre-swing and swing phases, and iii) a decrease in EMG activity of the RF muscle during the initial pre-swing phase and during the latter 2/3 of the initial swing phase. These results suggest that quadriceps fatigue did not alter the gait of patients with hemiparesis walking with a SKG and that neuromuscular fatigue may play the same functional role as an anti-spastic treatment such as botulinum toxin-A injection. Strength training of knee extensors, although commonly performed in rehabilitation, does not seem to be a priority to improve gait of these patients. PMID:24718087

Ultrasonography of the distal limbs in Nellore and Girolando calves 8 to 12 months of age

PubMed Central

2014-01-01

Background Ultrasonography can be used anywhere and allows rapid, noninvasive differentiation of soft tissue structures of the musculoskeletal system. The objectives of this study were to describe the ultrasonographic appearance of the structures of the metacarpo-/metatarsophalangeal and the interphalangeal joints, the appearance of the growth plates of the distal metacarpus/metatarsus and of the proximal phalanx and to measure the cross-sectional dimensions of the DDFT and SDFT in Nellore and Girolando calves eight to 12 months of age. Results In the longitudinal dorsal view the common digital extensor tendon and the digital extensor tendon were depicted as echogenic parallel fiber bundles located directly under the skin. The joint spaces appeared as anechoic interruptions of the hyperechogenic bone surfaces. The normal amount of synovial fluid could not be depicted. The growth plates were seen as anechoic interruptions of the bone surface proximal and distal to the fetlock joint space. In transverse sonograms of the distal palmar/plantar regions, the flexor tendons and branchs of the suspensory ligament were imaged as echogenic structures. The lumen of the digital flexor tendon sheath could not be imaged in these normal cattle. The thin digital distal annular ligament and the reversal of positions of the DDFT and SDFT could be appreciated. No significant differences were found between the cross-sectional measurements of the DDFT and the SDFT from Nellore and Girolando in any age, thoracic/pelvic limbs, right/left sides and lateral/medial digits. Conclusions The results of this study establish important ultrasonographic reference data of the normal structures of the distal limbs and the normal dimensions of the flexor tendons in Nellore and Girolando calves for use in clinical practice. PMID:24774582

Knee Extensor Rate of Torque Development Before and After Arthroscopic Partial Meniscectomy, With Analysis of Neuromuscular Mechanisms.

PubMed

Cobian, Daniel G; Koch, Cameron M; Amendola, Annunziato; Williams, Glenn N

2017-12-01

Study Design Descriptive, prospective single-cohort longitudinal study. Background Though rapid torque development is essential in activities of daily living and sports, it hasn't been specifically tested by most physical therapists or incorporated into rehabilitation programs until late in the treatment process. Little evidence is available on quadriceps torque development capacity before and after arthroscopic knee surgery. Objectives To study knee extensor rate of torque development, contributing mechanisms, and associations with strength and patient-reported outcomes before and during the first 6 weeks after arthroscopic partial meniscectomy. Methods Twenty subjects (mean ± SD age, 42.3 ± 13.7 years; body mass index, 26.6 ± 3.1 kg/m 2 ) were tested before surgery, and at 2 and 5 weeks after surgery. Quadriceps muscle volume, strength, activation, rate of torque development, and patient-reported outcomes were evaluated across the study period. Results Significant side-to-side differences in quadriceps strength and voluntary rate of torque development were observed at each time point (P<.05). Changes in muscle activity were associated with changes in rapid torque development capacity. Side-to-side rate of torque development deficits after surgery were associated with lower patient-reported outcomes scores. Conclusion Diminished rapid torque development capacity is common in arthroscopic meniscal debridement patients. This reduced capacity is associated with an inability to quickly recruit and drive the quadriceps muscles (neural mechanisms) and not muscle atrophy or other peripheral factors tested. Patient-reported outcomes are associated with quadriceps rate of torque development, but not strength or muscle size. Rapid torque development warrants greater attention in rehabilitation. J Orthop Sports Phys Ther 2017;47(12):945-956. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7310.

Relationships of muscle strength and bone mineral density in ambulatory children with cerebral palsy.

PubMed

Chen, C-L; Lin, K-C; Wu, C-Y; Ke, J-Y; Wang, C-J; Chen, C-Y

2012-02-01

This work explores the relationships of muscle strength and areal bone mineral density (aBMD) in ambulatory children with cerebral palsy (CP). The knee extensor strength, but not motor function, was related to aBMD. Thus, muscle strength, especially antigravity muscle strength, was more associated with aBMD in these children than motor function. Muscle strength is related to bone density in normal children. However, no studies have examined these relationships in ambulatory children with CP. This work explores the relationships of muscle strength and aBMD in ambulatory children with CP. Forty-eight ambulatory children with spastic CP, aged 5-15 years, were classified into two groups based on Gross Motor Function Classification System levels: I (n = 28) and II (n = 20). Another 31 normal development (ND) children were recruited as the comparison group for the aBMD. Children with CP underwent assessments of growth, lumbar and distal femur aBMD, Gross Motor Function Measure-66 (GMFM-66), and muscle strength of knee extensor and flexor by isokinetic dynamometer. The distal femur aBMD, but not lumbar aBMD, was lower in children with CP than in ND children (p < 0.05). Children with level I had greater knee flexor strength and GMFM-66 scores than those with level II (p < 0.001). However, the knee extensor strength and distal femur and lumbar aBMD did not differ between two groups. Regression analysis revealed the weight and knee extensor strength, but not GMFM-66 scores, were related positively to the distal femur and lumbar aBMD (adjusted r (2) = 0.56-0.65, p < 0.001). These results suggest the muscle strength, especially antigravity muscle strength, were more associated with the bone density of ambulatory children with CP than motor function. The data may allow clinicians for early identifying the ambulatory CP children of potential low bone density.

Relationship between isometric thigh muscle strength and minimum clinically important differences in knee function in osteoarthritis: data from the osteoarthritis initiative.

PubMed

Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

2015-04-01

To determine the relationship between thigh muscle strength and clinically relevant differences in self-assessed lower leg function. Isometric knee extensor and flexor strength of 4,553 Osteoarthritis Initiative participants (2,651 women and 1,902 men) was related to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function scores by linear regression. Further, groups of male and female participant strata with minimum clinically important differences (MCIDs) in WOMAC function scores (6 of 68 units) were compared across the full range of observed values and to participants without functional deficits (WOMAC score 0). The effect of WOMAC knee pain and body mass index on the above relationships was explored using stepwise regression. Per regression equations, a 3.7% reduction in extensor strength and a 4.0% reduction in flexor strength were associated with an MCID in WOMAC function in women, and, respectively, a 3.6% and 4.8% reduction in men. For strength divided by body weight, reductions were 5.2% and 6.7%, respectively, in women and 5.8% and 6.7%, respectively, in men. Comparing MCID strata across the full observed range of WOMAC function confirmed the above estimates and did not suggest nonlinear relationships across the spectrum of observed values. WOMAC pain correlated strongly with WOMAC function, but extensor (and flexor) muscle strength contributed significant independent information. Reductions of approximately 4% in isometric muscle strength and of 6% in strength per body weight were related to a clinically relevant difference in WOMAC functional disability. Longitudinal studies will need to confirm these relationships within persons. Muscle extensor (and flexor) strength (per body weight) provided significant independent information in addition to pain in explaining variability in lower leg function. Copyright © 2015 by the American College of Rheumatology.

ARE THERE DIFFERENCES IN STRENGTH TESTS USING ISOKINETIC DYNAMOMETRY BETWEEN FIELD AND INDOOR PROFESSIONAL SOCCER PLAYERS?

PubMed Central

de Aguiar Leonardi, Adriano Barros; Martinelli, Mauro Olivio; Junior, Aires Duarte

2015-01-01

Objective: The objective of this study was to conduct a comparative analysis on isokinetic strength assessments between field and indoor male professional soccer players and correlate the findings with the higher levels of injury risk described in the literature. Methods: We analyzed 16 field soccer players and 15 indoor soccer players. All these professionals were male. Isokinetic muscle strength assessments were made on their knees. Results: The mean weight was 81.81 kg for field soccer and 80.33 kg for indoor soccer. The right and left peak extensor torque left and right for field soccer and indoor soccer were, respectively, 302.50 and 313.31 Nm and 265.20 and 279.80 Nm, and for flexors, 178 and 184.88 Nm and 158.27 and 154 Nm. The peak torque rates according to body weight for the left and right extensors for field soccer and indoor soccer were, respectively, 3.84 and 3.7 Nm/kg and 3.32 and 3.52 Nm/kg, and for flexors, 2.17 and 2.26 Nm/kg and 1.98 and 1.93 Nm/kg. The balance relationships between flexors and extensors on the right and left sides for field soccer and indoor soccer were, respectively, 59.81 and 59.44% and 60.47% and 54.80%. The relationships for extensors between the right and left sides for field soccer and indoor soccer were, respectively, 11.44 and 9.20%, and for the flexors, 7.31 and 8.80%. Conclusions: In accordance with international parameters, comparative analysis on isokinetic strength assessments between field and indoor male professional soccer players before the season showed that there was muscle balance and low probability of injury. There were no statistically significant differences in the parameters analyzed between the players of the two types of soccer. PMID:27042649

Desensitizing the posterior interosseous nerve alters wrist proprioceptive reflexes.

PubMed

Hagert, Elisabet; Persson, Jonas K E

2010-07-01

The presence of wrist proprioceptive reflexes after stimulation of the dorsal scapholunate interosseous ligament has previously been described. Because this ligament is primarily innervated by the posterior interosseous nerve (PIN) we hypothesized altered ligamento-muscular reflex patterns following desensitization of the PIN. Eight volunteers (3 women, 5 men; mean age, 26 y; range 21-28 y) participated in the study. In the first study on wrist proprioceptive reflexes (study 1), the scapholunate interosseous ligament was stimulated through a fine-wire electrode with 4 1-ms bipolar pulses at 200 Hz, 30 times consecutively, while EMG activity was recorded from the extensor carpi radialis brevis, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris, with the wrist in extension, flexion, radial deviation, and ulnar deviation. After completion of study 1, the PIN was anesthetized in the radial aspect of the fourth extensor compartment using 2-mL lidocaine (10 mg/mL) infiltration anesthesia. Ten minutes after desensitization, the experiment was repeated as in study 1. The average EMG results from the 30 consecutive stimulations were rectified and analyzed using Student's t-test. Statistically significant changes in EMG amplitude were plotted along time lines so that the results of study 1 and 2 could be compared. Dramatic alterations in reflex patterns were observed in wrist flexion, radial deviation, and ulnar deviation following desensitization of the PIN, with an average of 72% reduction in excitatory reactions. In ulnar deviation, the inhibitory reactions of the extensor carpi ulnaris were entirely eliminated. In wrist extension, no differences in the reflex patterns were observed. Wrist proprioception through the scapholunate ligament in flexion, radial deviation, and ulnar deviation depends on an intact PIN function. The unchanged reflex patterns in wrist extension suggest an alternate proprioceptive pathway for this position. Routine excision of the PIN during wrist surgical procedures should be avoided, as it alters the proprioceptive function of the wrist. Therapeutic IV. Copyright 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Monosynaptic Ia projections from intrinsic hand muscles to forearm motoneurones in humans.

PubMed

Marchand-Pauvert, V; Nicolas, G; Pierrot-Deseilligny, E

2000-05-15

Heteronymous Ia excitatory projections from intrinsic hand muscles to human forearm motoneurones (MNs) were investigated. Changes in firing probability of single motor units (MUs) in the flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), flexor digitorum superficialis (FDS), extensor carpi radialis (ECR), extensor carpi ulnaris (ECU) and extensor digitorum communis (EDC) were studied after electrical stimuli were applied to the median and ulnar nerve at wrist level and to the corresponding homonymous nerve at elbow level. Homonymous facilitation, occurring at the same latency as the H reflex, and therefore attributed to monosynaptic Ia EPSPs, was found in all the sampled units. In many MUs an early facilitation was also evoked by heteronymous low-threshold afferents from intrinsic hand muscles. The low threshold (between 0.5 and 0.6 times motor threshold (MT)) and the inability of a pure cutaneous stimulation to reproduce this effect indicate that it is due to stimulation of group I muscle afferents. Evidence for a similar central delay (monosynaptic) in heteronymous as in homonymous pathways was accepted when the difference in latencies of the homonymous and heteronymous peaks did not differ from the estimated supplementary afferent conduction time from wrist to elbow level by more than 0.5 ms (conduction velocity in the fastest Ia afferents between wrist and elbow levels being equal to 69 m s-1). A statistically significant heteronymous monosynaptic Ia excitation from intrinsic hand muscles supplied by both median and ulnar nerves was found in MUs belonging to all forearm motor nuclei tested (although not in ECU MUs after ulnar stimulation). It was, however, more often found in flexors than in extensors, in wrist than in finger muscles and in muscles operating in the radial than in the ulnar side. It is argued that the connections of Ia afferents from intrinsic hand muscles to forearm MNs, which are stronger and more widely distributed than in the cat, might be used to provide a support to the hand during manipulatory movements.

Sex differences in neuromuscular function after repeated eccentric contractions of the knee extensor muscles.

PubMed

Lee, Andrea; Baxter, Jake; Eischer, Claire; Gage, Matt; Hunter, Sandra; Yoon, Tejin

2017-06-01

This study examined the mechanisms for force and power reduction during and up to 48 h after maximal eccentric contractions of the knee extensor muscles in young men and women. 13 men (22.8 ± 2.6 years) and 13 women (21.6 ± 2.2 years) performed 150 maximal effort eccentric contractions (5 sets of 30) with the knee extensor muscles at 60° s -1 . Maximal voluntary isometric contractions (MVIC) and maximal voluntary concentric contractions (MVCC) were performed before and after the 150 eccentric contractions. The MVCCs involved a set of two isokinetic contractions at 60° s -1 and sets of isotonic contractions performed at seven different resistance loads (1 N m, 10, 20, 30, 40, 50, and 60% MVIC). Electrical stimulation was used during the MVICs and at rest to determine changes in voluntary activation and contractile properties. At baseline, men were stronger than women (MVIC: 276 ± 48 vs. 133 ± 37 N m) and more powerful (MVCC: 649 ± 77 vs. 346 ± 78 W). At termination of the eccentric contractions, voluntary activation, resting twitch amplitude, and peak power during concentric contractions at the seven loads and at 60° s -1 decreased (P < 0.05) similarly in the men and women. At 48 h post-exercise, the MVIC torque, power (for loads ≥20-60% MVIC), and voluntary activation remained depressed (P < 0.05), but the resting twitch had returned to baseline (P > 0.05) with no sex differences. Central mechanisms were primarily responsible for the depressed maximal force production up to 48 h after repeated eccentric contractions of the knee extensors and these mechanisms were similar in men and women.

The effects of low-repetition and light-load power training on bone mineral density in postmenopausal women with sarcopenia: a pilot study.

PubMed

Hamaguchi, Kanako; Kurihara, Toshiyuki; Fujimoto, Masahiro; Iemitsu, Motoyuki; Sato, Koji; Hamaoka, Takafumi; Sanada, Kiyoshi

2017-05-02

Age-related reduction in bone mineral density (BMD) is generally accelerated in women after menopause, and could be even more pronounced in individuals with sarcopenia. Light-load power training with a low number of repetitions would increase BMD, significantly reducing bone loss in individuals at risk of osteoporosis. This study investigated the effects of low-repetition, light-load power training on BMD in Japanese postmenopausal women with sarcopenia. The training group (n = 7) followed a progressive power training protocol that increased the load with a weighted vest, for two sessions per week, over the course of 6 weeks. The training exercise comprised five kinds of exercises (squats, front lunges, side lunges, calf raises, and toe raises), and each exercise contained eight sets of three repetitions with a 15-s rest between each set. The control group (n = 8) did not undergo any training intervention. We measured BMD, muscle strength, and anthropometric data. Within-group changes in pelvis BMD and knee extensor strength were significantly greater in the training group than the control group (p = 0.029 and 0.030 for pelvis BMD and knee extensor strength, respectively). After low-repetition, light-load power training, we noted improvements in pelvis BMD (1.6%) and knee extensor strength (15.5%). No significant within- or between-group differences were observed for anthropometric data or forearm BMD. Six weeks of low-repetition, light-load power training improved pelvis BMD and knee extensor strength in postmenopausal women with sarcopenia. Since this training program does not require high-load exercise and is therefore easily implementable as daily exercise, it could be an effective form of exercise for sedentary adults at risk for osteoporosis who are fearful of heavy loads and/or training that could cause fatigue. This trial was registered with the University Hospital Medical Information Network on 31 October 2016 ( UMIN000024651 ).

Age-Related Differences in Maximal and Rapid Torque Characteristics of the Hip Extensors and Dynamic Postural Balance in Healthy, Young and Old Females.

PubMed

Palmer, Ty B; Thiele, Ryan M; Thompson, Brennan J

2017-02-01

Palmer, TB, Thiele, RM, and Thompson, BJ. Age-related differences in maximal and rapid torque characteristics of the hip extensors and dynamic postural balance in healthy, young and old females. J Strength Cond Res 31(2): 480-488, 2017-The purpose of this study was to examine age-related differences in maximal and rapid torque characteristics of the hip extensor muscles and dynamic postural balance in healthy, young and older females. Eleven younger (age, 26 ± 8 years) and 11 older (age, 67 ± 8 years) females performed 2 isometric maximal voluntary contractions (MVCs) of the hip extensor muscles. Absolute and relative peak torque (PT) and rate of torque development (RTD) at early (0-50 ms) and late (0-200 ms) phases of muscle contraction were examined during each MVC. Dynamic postural balance was assessed using a commercially designed balance testing device, which provides a measurement of dynamic stability based on the overall stability index (OSI). Results indicated that absolute PT and early (RTD50) and late (RTD200) RTD variables were lower (p = 0.009-0.050), and postural OSI was higher (p = 0.011) in the old compared with the younger females; however, no differences were observed for relative PT or RTD variables (p = 0.113-0.895). A significant relationship was also observed in the older (r = -0.601; p = 0.050) but not the younger (r = -0.132; p = 0.698) females between RTD50 and OSI. The lower absolute PT and RTD and higher OSI values for the old females may contribute to the increased functional limitations often observed in older adults. The significant relationship observed in the older females between OSI and RTD50 perhaps suggests that these age-related declines in explosive strength may be an important characteristic relevant to dynamic balance scores, especially in older populations.

Job enlargement and mechanical exposure variability in cyclic assembly work.

PubMed

Möller, Therése; Mathiassen, Svend Erik; Franzon, Helena; Kihlberg, Steve

2004-01-15

Cyclic assembly work is known to imply a high risk for musculoskeletal disorders. To have operators rotate between work tasks is believed to be one way of decreasing this risk, since it is expected to increase variation in mechanical and psychological exposures (physical and mental loads). This assumption was investigated by assessing mechanical exposure variability in three assembly tasks in an electronics assembly plant, each on a separate workstation, as well as in a 'job enlargement' scenario combining all three stations. Five experienced operators worked for 1 h on each station. Data on upper trapezius and forearm extensor muscle activity were obtained by means of electromyography (EMG), and working postures of the head and upper arms were assessed by inclinometry. The cycle-to-cycle variance of parameters representing the three exposure dimensions: level, frequency and duration was estimated using ANOVA algorithms for each workstation separately as well as for a balanced combination of all three. For a particular station, the variability of trapezius EMG activity levels relative to the mean was higher than for extensor EMG: between-cycles coefficients of variation (CV) about 0.15 and 0.10, respectively. A similar relationship between CV applied to the parameter describing frequency of EMG activity. Except for head inclination levels, the between-cycles CV was larger for posture parameters than for EMG. The between-cycles variance increased up to six fold in the job enlargement scenario, as compared to working at only one station. The difference in mean exposure between workstations was larger for trapezius EMG parameters than for forearm extensor EMG and postures, and hence the effect of job enlargement on exposure variability was more pronounced for the trapezius. For some stations, job enlargement even implied less cycle-to-cycle variability in forearm extensor EMG parameters than working at that station only. Whether the changes in exposure variability associated with job enlargement were sufficient to imply a decreased risk for musculoskeletal disorders is not known.

The developmental origin of zygodactyl feet and its possible loss in the evolution of Passeriformes

PubMed Central

Botelho, João Francisco; Smith-Paredes, Daniel; Nuñez-Leon, Daniel; Soto-Acuña, Sergio; Vargas, Alexander O.

2014-01-01

The zygodactyl orientation of toes (digits II and III pointing forwards, digits I and IV pointing backwards) evolved independently in different extant bird taxa. To understand the origin of this trait in modern birds, we investigated the development of the zygodactyl foot of the budgerigar (Psittaciformes). We compared its muscular development with that of the anisodactyl quail (Galliformes) and show that while the musculus abductor digiti IV (ABDIV) becomes strongly developed at HH36 in both species, the musculus extensor brevis digiti IV (EBDIV) degenerates and almost disappears only in the budgerigar. The asymmetric action of those muscles early in the development of the budgerigar foot causes retroversion of digit IV (dIV). Paralysed budgerigar embryos do not revert dIV and are anisodactyl. Both molecular phylogenetic analysis and palaeontological information suggest that the ancestor of passerines could have been zygodactyl. We followed the development of the zebra finch (Passeriformes) foot muscles and found that in this species, both the primordia of the ABDIV and of the EBDIV fail to develop. These data suggest that loss of asymmetric forces of muscular activity exerted on dIV, caused by the absence of the ABDIV, could have resulted in secondary anisodactyly in Passeriformes. PMID:24966313

The developmental origin of zygodactyl feet and its possible loss in the evolution of Passeriformes.

PubMed

Botelho, João Francisco; Smith-Paredes, Daniel; Nuñez-Leon, Daniel; Soto-Acuña, Sergio; Vargas, Alexander O

2014-08-07

The zygodactyl orientation of toes (digits II and III pointing forwards, digits I and IV pointing backwards) evolved independently in different extant bird taxa. To understand the origin of this trait in modern birds, we investigated the development of the zygodactyl foot of the budgerigar (Psittaciformes). We compared its muscular development with that of the anisodactyl quail (Galliformes) and show that while the musculus abductor digiti IV (ABDIV) becomes strongly developed at HH36 in both species, the musculus extensor brevis digiti IV (EBDIV) degenerates and almost disappears only in the budgerigar. The asymmetric action of those muscles early in the development of the budgerigar foot causes retroversion of digit IV (dIV). Paralysed budgerigar embryos do not revert dIV and are anisodactyl. Both molecular phylogenetic analysis and palaeontological information suggest that the ancestor of passerines could have been zygodactyl. We followed the development of the zebra finch (Passeriformes) foot muscles and found that in this species, both the primordia of the ABDIV and of the EBDIV fail to develop. These data suggest that loss of asymmetric forces of muscular activity exerted on dIV, caused by the absence of the ABDIV, could have resulted in secondary anisodactyly in Passeriformes. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Presynaptic control of transmission along the pathway mediating disynaptic reciprocal inhibition in the cat

PubMed Central

Enríquez-Denton, M; Nielsen, J; Perreault, M-C; Morita, H; Petersen, N; Hultborn, H

2000-01-01

In cat lumbar motoneurones, disynaptic inhibitory postsynaptic potentials (IPSPs) evoked by stimulation of antagonist motor nerves were depressed for at least 150 ms following conditioning stimulation of flexor (1.7-2 times threshold (T)) and ankle extensor (5T) nerves. The aim of the present study was to investigate the possibility that this depression is caused by presynaptic inhibitory mechanisms acting at the terminals of group I afferent fibres projecting to the Ia inhibitory interneurones and/or the terminals of these interneurones to the target motoneurones. Conditioning stimulation of flexor, but not ankle extensor, nerves evoked a depression of the monosynaptic Ia excitatory postsynaptic potentials (EPSPs) recorded intracellularly in Ia inhibitory interneurones. This depression lasted between 200 and 700 ms and was not accompanied by a depression of the monosynaptic EPSPs evoked by stimulation of descending pathways. These results suggest that flexor, but not ankle extensor, group I afferent fibres can modulate sensory transmission at the synapse between Ia afferent fibres and Ia inhibitory interneurones. Conditioning stimulation of flexor muscle nerves, extensor muscle nerves and cutaneous nerves produced a long-lasting increase in excitability of the terminals of the Ia inhibitory interneurones. The increase in the excitability of the terminals was not secondary to an electrotonic spread of synaptic excitation at the soma. Indeed, concomitant with the excitability increase of the terminals there were signs of synaptic inhibition in the soma. The unitary IPSPs induced in target motoneurones following the spike activity of single Ia inhibitory interneurones were depressed by conditioning stimulation of muscle and cutaneous nerves. Since the conditioning stimulation also evoked compound IPSPs in those motoneurones, a firm conclusion as to whether unitary IPSP depression involved presynaptic inhibitory mechanism of the terminals of the interneurones could not be reached. The possibility that the changes in excitability of the Ia interneuronal terminals reflect the presence of a presynaptic inhibitory mechanism similar to that operating at the terminals of the afferent fibres (presynaptic inhibition) is discussed.1. In cat lumbar motoneurones, disynaptic inhibitory postsynaptic potentials (IPSPs) evoked by stimulation of antagonist motor nerves were depressed for at least 150 ms following conditioning stimulation of flexor (1.7-2 times threshold (T)) and ankle extensor (5T) nerves. The aim of the present study was to investigate the possibility that this depression is caused by presynaptic inhibitory mechanisms acting at the terminals of group I afferent fibres projecting to the Ia inhibitory interneurones and/or the terminals of these interneurones to the target motoneurones. PMID:10922013

The intra- and inter-rater reliability of five clinical muscle performance tests in patients with and without neck pain

PubMed Central

2013-01-01

Background This study investigates the reliability of muscle performance tests using cost- and time-effective methods similar to those used in clinical practice. When conducting reliability studies, great effort goes into standardising test procedures to facilitate a stable outcome. Therefore, several test trials are often performed. However, when muscle performance tests are applied in the clinical setting, clinicians often only conduct a muscle performance test once as repeated testing may produce fatigue and pain, thus variation in test results. We aimed to investigate whether cervical muscle performance tests, which have shown promising psychometric properties, would remain reliable when examined under conditions similar to those of daily clinical practice. Methods The intra-rater (between-day) and inter-rater (within-day) reliability was assessed for five cervical muscle performance tests in patients with (n = 33) and without neck pain (n = 30). The five tests were joint position error, the cranio-cervical flexion test, the neck flexor muscle endurance test performed in supine and in a 45°-upright position and a new neck extensor test. Results Intra-rater reliability ranged from moderate to almost perfect agreement for joint position error (ICC ≥ 0.48-0.82), the cranio-cervical flexion test (ICC ≥ 0.69), the neck flexor muscle endurance test performed in supine (ICC ≥ 0.68) and in a 45°-upright position (ICC ≥ 0.41) with the exception of a new test (neck extensor test), which ranged from slight to moderate agreement (ICC = 0.14-0.41). Likewise, inter-rater reliability ranged from moderate to almost perfect agreement for joint position error (ICC ≥ 0.51-0.75), the cranio-cervical flexion test (ICC ≥ 0.85), the neck flexor muscle endurance test performed in supine (ICC ≥ 0.70) and in a 45°-upright position (ICC ≥ 0.56). However, only slight to fair agreement was found for the neck extensor test (ICC = 0.19-0.25). Conclusions Intra- and inter-rater reliability ranged from moderate to almost perfect agreement with the exception of a new test (neck extensor test), which ranged from slight to moderate agreement. The significant variability observed suggests that tests like the neck extensor test and the neck flexor muscle endurance test performed in a 45°-upright position are too unstable to be used when evaluating neck muscle performance. PMID:24299621

A new recreational mechanism for the boxer's knuckle: cause for concern?

PubMed

Javed, M; Hemington-Gorse, S; Shokrollahi, K

2011-07-01

Traumatic injuries of the metacarpophalangeal joints are a common occurrence in professional and recreational sports such as boxing and martial arts, especially the fourth and fifth metacarpals. Injury usually results from a forceful impact with a clenched fist. The spectrum of injuries varies from simple skin laceration to extensor mechanism disruption, dorsal capsule rupture, metacarpal fractures and carpometacarpal joint injuries. These injuries are well documented in boxers as well as in patients who had been involved in fights and assaults. We report on two patients sustaining similar injuries to the dorsum of the hand but following punching of a recreational 'punching machine'. We describe the patterns of injury encountered and summarise the treatment. For clinical and safety reasons as well as the potential medicolegal implications, we believe it is important to highlight this mechanism of injury.

A new recreational mechanism for the boxer’s knuckle: cause for concern?

PubMed Central

Hemington-Gorse, S; Shokrollahi, K

2011-01-01

Traumatic injuries of the metacarpophalangeal joints are a common occurrence in professional and recreational sports such as boxing and martial arts, especially the fourth and fifth metacarpals. Injury usually results from a forceful impact with a clenched fist. The spectrum of injuries varies from simple skin laceration to extensor mechanism disruption, dorsal capsule rupture, metacarpal fractures and carpometacarpal joint injuries. These injuries are well documented in boxers as well as in patients who had been involved in fights and assaults. We report on two patients sustaining similar injuries to the dorsum of the hand but following punching of a recreational ’punching machine’. We describe the patterns of injury encountered and summarise the treatment. For clinical and safety reasons as well as the potential medicolegal implications, we believe it is important to highlight this mechanism of injury. PMID:21943451

Neurological disorders in HIV-infected children in India.

PubMed

Gupta, S; Shah, D M; Shah, I

2009-09-01

There are few studies of HIV-related neurological disorders from centres in low-income countries where facilities are available for detailed investigation. Records of all patients attending the paediatric HIV outpatient department at B. J. Wadia Hospital for Children, Mumbai between April 2000 and March 2008 were reviewed. Of 668 HIV-infected patients, 48 (7.2%) had neurological manifestations and are included in this study. Twenty-six (54.2%) children had HIV encephalopathy. Other causes of neurological manifestations include febrile convulsion in five (10.4%), bacterial meningitis in three (6.3%), epilepsy in two (4.2%), tuberculous meningitis and progressive multi-focal encephalopathy in two (4.2%) each and toxoplasmosis, vasculitis, acute demyelinating encephalomyelitis, anti-phospholipid antibody syndrome, Down's syndrome, birth asphyxia, herpes simplex encephalopathy and mitochondrial encephalopathy in one (2.1%) each. Mean (SD) age at presentation was 4.36 (3.38) years with a range of 2 months to 15 years. The common subtle neurological manifestations were abnormal deep tendon reflexes and extensor plantar reflexes. The common symptomatic manifestations were delayed milestones in 21 children (43.8%) and seizures in 19 (39.6%). Seizures were more common in males (54%) than in females (25%) (p=0.038). In children <5 years, delayed milestones was the most common manifestation while focal neurological deficits were more common in older children. Of the 13 children who received HAART, nine (60.23%) improved. Early diagnosis of neurological disorders in HIV-infected children is important for appropriate investigation and management, especially the introduction of HAART.

Anatomy, morphology and evolution of the patella in squamate lizards and tuatara (Sphenodon punctatus).

PubMed

Regnault, Sophie; Jones, Marc E H; Pitsillides, Andrew A; Hutchinson, John R

2016-05-01

The patella (kneecap) is the largest and best-known of the sesamoid bones, postulated to confer biomechanical advantages including increasing joint leverage and reinforcing the tendon against compression. It has evolved several times independently in amniotes, but despite apparently widespread occurrence in lizards, the patella remains poorly characterised in this group and is, as yet, completely undescribed in their nearest extant relative Sphenodon (Rhynchocephalia). Through radiography, osteological and fossil studies we examined patellar presence in diverse lizard and lepidosauromorph taxa, and using computed tomography, dissection and histology we investigated in greater depth the anatomy and morphology of the patella in 16 lizard species and 19 Sphenodon specimens. We have found the first unambiguous evidence of a mineralised patella in Sphenodon, which appears similar to the patella of lizards and shares several gross and microscopic anatomical features. Although there may be a common mature morphology, the squamate patella exhibits a great deal of variability in development (whether from a cartilage anlage or not, and in the number of mineralised centres) and composition (bone, mineralised cartilage or fibrotendinous tissue). Unlike in mammals and birds, the patella in certain lizards and Sphenodon appears to be a polymorphic trait. We have also explored the evolution of the patella through ancestral state reconstruction, finding that the patella is ancestral for lizards and possibly Lepidosauria as a whole. Clear evidence of the patella in rhynchocephalian or stem lepidosaurian fossil taxa would clarify the evolutionary origin(s) of the patella, but due to the small size of this bone and the opportunity for degradation or loss we could not definitively conclude presence or absence in the fossils examined. The pattern of evolution in lepidosaurs is unclear but our data suggest that the emergence of this sesamoid may be related to the evolution of secondary ossification centres and/or changes in knee joint conformation, where enhancement of extensor muscle leverage would be more beneficial. © 2016 The Authors. Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.

Factors predicting dynamic balance and quality of life in home-dwelling elderly women.

PubMed

Karinkanta, S; Heinonen, A; Sievanen, H; Uusi-Rasi, K; Kannus, P

2005-01-01

Proper balance seems to be a critical factor in terms of fall prevention among the elderly. The purpose of this cross-sectional study was to examine factors that are associated with dynamic balance and health-related quality of life in home-dwelling elderly women. One hundred and fifty-three healthy postmenopausal women (mean age: 72 years, height: 159 cm, weight: 72 kg) were examined. General health and physical activity were assessed by a questionnaire. Quality of life was measured using a health-related quality of life questionnaire (Rand 36-Item Health Survey 1.0). Dynamic balance (agility) was tested by a figure-of-eight running test. Static balance (postural sway) was tested on an unstable platform. Maximal isometric strength of the leg extensors was measured with a leg press dynamometer. Dynamic muscle strength of lower limbs was tested by measuring ground reaction forces with a force platform during common daily activities (sit-to-stand and step-on-a-stair tests). Concerning physical activity, 33% of the subjects reported brisk exercise (walking, Nordic walking, cross-country skiing, swimming and aquatic exercises) at least twice a week, and 22% some kind of brisk activity once a week in addition to lighter physical exercise. The remaining 45% did not exercise regularly and were classified as sedentary. The correlations of step-on-a-stair and sit-to-stand ground reaction forces, and leg extensor strength to dynamic balance were from -0.32 to -0.43 (the better the strength, the better the balance). In the regression analysis with backward elimination, step-on-a-stair and sit-to-stand ground reaction forces, and leg extensor strength, age, brisk physical activity, number of diseases and dynamic postural stability explained 42% of the variance in the dynamic balance. Similarly, dynamic balance (figure-of-eight running time), number of diseases and walking more than 3 km per day explained 14% of the variance in the quality of life score. Of these, figure-of-eight running time was the strongest predictor of the quality of life score, explaining 9% of its variance. This study emphasizes the concept that in home-dwelling elderly women good muscle strength in lower limbs is crucial for proper body balance and that dynamic balance is an independent predictor of a standardized quality of life estimate. The results provide important and useful information when planning meaningful contents for studies related to fall prevention and quality of life and interventions in elderly women. Copyright (c) 2005 S. Karger AG, Basel.

Chronic triceps insufficiency managed with extensor carpi radialis longus and palmaris longus tendon grafts.

PubMed

Singh, Dhanpal; Kumar, K Arun; Dinesh, Mc; Raj, Ranju

2012-03-01

Chronic triceps insufficiency, causing prolonged disability, occurs due to a missed diagnosis of an acute rupture. We report a 25 year old male with history of a significant fall sustaining multiple injuries. Since then, he had inability in extending his right elbow for which he sought intervention after a year. Diagnosis of triceps rupture was made clinicoradiologically and surgery was planned. Intraoperative findings revealed a deficient triceps with a fleck of avulsed bone from olecranon. Ipsilateral double tendon graft including extensor carpi radialis longus and palmaris longus were anchored to triceps and secured with the olecranon. Six-months follow revealed a complete active extension of elbow and a full function at the donor site.

Muscular activity during dynamic squats in patients with ACL reconstruction.

PubMed

Ceaglio, Sebastian; Alberto, Federico; Catalfamo, Paola Andrea; Braidot, Ariel Andres

2010-01-01

One of the most frequent injuries in subjects who practice sport is the rupture of the anterior cruciate ligament (ACL). Appropriate reconstruction and rehabilitation are key issues in full recovery of patients and their return to previous activities. This paper presents a new method to estimate muscle strength during a dynamic exercise from kinematic and electromyographic (EMG) data. Recovery of patients with ACL rupture and reconstruction was evaluated 4 and 6 months after surgery by assessing the differences in knee extensor and flexor muscle activity between the unimpaired and injured limbs. The results show that squat EMGs from the extensor muscles of the knee from the injured and unimpaired limb could help assess rehabilitation outputs in patients who had undergone an ACL reconstructive surgery.

Aerobic fitness does not modify the effect of FTO variation on body composition traits.

PubMed

Huuskonen, Antti; Lappalainen, Jani; Oksala, Niku; Santtila, Matti; Häkkinen, Keijo; Kyröläinen, Heikki; Atalay, Mustafa

2012-01-01

Poor physical fitness and obesity are risk factors for all cause morbidity and mortality. We aimed to clarify whether common genetic variants of key energy intake determinants in leptin (LEP), leptin receptor (LEPR), and fat mass and obesity-associated (FTO) are associated with aerobic and neuromuscular performance, and whether aerobic fitness can alter the effect of these genotypes on body composition. 846 healthy Finnish males of Caucasian origin were genotyped for FTO (rs8050136), LEP (rs7799039) and LEPR (rs8179183 and rs1137101) single nucleotide polymorphisms (SNPs), and studied for associations with maximal oxygen consumption, body fat percent, serum leptin levels, waist circumference and maximal force of leg extensor muscles. Genotype AA of the FTO SNP rs8050136 associated with higher BMI and greater waist circumference compared to the genotype CC. In general linear model, no significant interaction for FTO genotype-relative VO(2)max (mL·kg(-1)·min(-1)) or FTO genotype-absolute VO(2)max (L·min(-1)) on BMI or waist circumference was found. Main effects of aerobic performance on body composition traits were significant (p<0.001). Logistic regression modelling found no significant interaction between aerobic fitness and FTO genotype. LEP SNP rs7799039, LEPR SNPs rs8179183 and rs1137101 did not associate with any of the measured variables, and no significant interactions of LEP or LEPR genotype with aerobic fitness were observed. In addition, none of the studied SNPs associated with aerobic or neuromuscular performance. Aerobic fitness may not modify the effect of FTO variation on body composition traits. However, relative aerobic capacity associates with lower BMI and waist circumference regardless of the FTO genotype. FTO, LEP and LEPR genotypes unlikely associate with physical performance.

Border Collie Collapse: Owner Survey Results and Veterinary Description of Videotaped Episodes.

PubMed

Taylor, Susan; Minor, Katie; Shmon, Cindy L; Shelton, G Diane; Patterson, Edward E; Mickelson, James R

Completed surveys were obtained from owners of 165 border collies experiencing repeated episodes of abnormal gait or collapse during strenuous exercise. Unremarkable veterinary evaluation and lack of disease progression over time made common systemic, cardiac, and neurologic causes of exercise intolerance unlikely. Survey questions addressed signalment, age of onset, description of episodes, and owner perception of factors associated with collapse. Most dogs were young adults (median 2 yr) when episodes began, and they had experienced from 2 to more than 100 episodes (median 6) prior to their owners completing the survey. Retrieving was the activity most commonly associated with episodes (112/165 dogs, 68%), followed by herding stock (39/165 dogs, 24%). Owners reported that high environmental temperatures (111/165 dogs, 67%) and excitement (67/165 dogs, 41%) increased the likelihood of their dog having an episode during strenuous activity. Veterinary evaluation of videotapes of presumed border collie collapse (BCC) episodes (40 dogs) were used to provide a description of the typical features of BCC episodes. Altered mentation, symmetrical ataxia affecting all four limbs, increased pelvic limb extensor tone and toe scuffing or knuckling, truncal swaying, and falling to the side were common features, suggesting that BCC may be an episodic diffuse central nervous system disorder.

Directional tuning of human forearm muscle afferents during voluntary wrist movements

PubMed Central

Jones, Kelvin E; Wessberg, Johan; Vallbo, Åke B

2001-01-01

Single unit activity was recorded with the microneurography technique from sixteen spindle afferents and one Golgi tendon organ afferent originating from the forearm extensor muscles. Impulse rates were studied while subjects performed unobstructed aiming movements at the wrist in eight different directions 45 deg apart. In addition, similar imposed movements were performed while the subject was instructed to remain relaxed. Movement amplitudes were about 5 deg and the speed 10–30 deg s−1. Joint movements were translated to movements of a cursor on a monitor to provide visual feedback. Individual spindle afferents modulated their activity over a number of targets, i.e. were broadly tuned, during these aiming movements. The preferred direction for a spindle afferent was the same during both passive and active movements, indicating that the fusimotor effects associated with active contractions had little or no effect on the direction of tuning. The direction of tuning of individual spindle afferents could be predicted from the biomechanically inferred length changes of the parent muscle. Thus spindle afferents responded as stretch receptors, i.e. impulse rates increased with lengthening and decreased with shortening, in active as well as passive movements. Spindles from muscles, which continuously counteracted gravity exhibited a stretch response and directional tuning during the phase of movement alone whereas their position sensitivity was poor. In contrast, spindle afferents from the muscles that had no or minimal antigravity role were directionally tuned during both the dynamic and the static phase of the aiming task and their position sensitivity was substantially higher. In spite of the limited data base from three extensor muscles it could be demonstrated that wrist joint position was remarkably well encoded in the ensemble muscle spindle data. In some cases the ensemble muscle spindle data encoded the instantaneous trajectory of movement as well. PMID:11600696

Motion-plane dependency of the range of dart throw motion and the effects of tendon action due to finger extrinsic muscles during the motion.

PubMed

Mitsukane, Masahiro; Sekiya, Noboru; Kamono, Arinori; Nakabo, Tohru

2018-03-01

[Purpose] To clarify the motion-plane dependency of the range of dart throw motion and the effects of tendon action due to long finger flexors and extensors during the motion. [Subjects and Methods] Forty healthy subjects attended the experiment, and the active range of wrist motion in seven motion planes was measured with an originally designed apparatus. [Results] The reliability of the measurement was acceptable. The range of dart throw motion depended on the motion planes, with a maximum at around the motion plane of 45° from the sagittal plane (45° of pronation). The tendon action of long finger muscles was shown in dart throw motion except in 45° of pronation. [Conclusion] Motion-plane dependency of the range of dart throw motion exists in healthy subjects. The absence of tendon action due to finger extrinsic muscles in dart throw motion at 45° might be one of the causes of the advantage of dart throw motion.

The Feasibility of Functional Electrical Stimulation to Improve Upper Extremity Function in a Two-year-old Child with Perinatal Stroke: A Case Report.

PubMed

Musselman, Kristin E; Manns, Patricia; Dawe, Jaclyn; Delgado, Rhina; Yang, Jaynie F

2018-02-01

To evaluate the effectiveness and feasibility (i.e. tolerability, adherence) of functional electrical stimulation (FES) for the upper extremity (UE) in a two-year-old child with perinatal stroke. Forty hours of FES over eight weeks was prescribed. FES to the hemiplegic triceps, extensor carpi radialis longus and brevis, extensor carpi ulnaris and extensor digitorum was timed with reaching during play. Assessments were performed before, during, and two months post-intervention. UE function (Melbourne Assessment 2 (MA2), Assisting Hand Assessment (AHA)) and spasticity (Modified Tardieu with electrogoniometry and electromyography) were measured. The mother completed a semi-structured interview post-intervention. Descriptive statistics were used for adherence and UE measures. A repeated-measures ANOVA compared Modified Tardieu parameters (e.g. catch angle) over time. Conventional content analysis was used for the interview data. The child completed 39.2/40 hours. Immediately post-intervention, improvements were observed on MA2's Range of Motion subscale and catch angle (Modified Tardieu, p < 0.001). Two months post-intervention, improvements were observed on MA2's Accuracy and Fluency subscales. No change in AHA score occurred. Three themes emerged from the interview: (1) Ingredients for program success; (2) Information about the FES device; and (3) The child's response. UE FES was feasible in a two-year-old child with hemiplegia.

Flexor and extensor muscle tone evaluated using the quantitative pendulum test in stroke and parkinsonian patients.

PubMed

Huang, Han-Wei; Ju, Ming-Shaung; Lin, Chou-Ching K

2016-05-01

The aim of this study was to evaluate the flexor and extensor muscle tone of the upper limbs in patients with spasticity or rigidity and to investigate the difference in hypertonia between spasticity and rigidity. The two experimental groups consisted of stroke patients and parkinsonian patients. The control group consisted of age and sex-matched normal subjects. Quantitative upper limb pendulum tests starting from both flexed and extended joint positions were conducted. System identification with a simple linear model was performed and model parameters were derived. The differences between the three groups and two starting positions were investigated by these model parameters and tested by two-way analysis of variance. In total, 57 subjects were recruited, including 22 controls, 14 stroke patients and 21 parkinsonian patients. While stiffness coefficient showed no difference among groups, the number of swings, relaxation index and damping coefficient showed changes suggesting significant hypertonia in the two patient groups. There was no difference between these two patient groups. The test starting from the extended position constantly manifested higher muscle tone in all three groups. In conclusion, the hypertonia of parkinsonian and stroke patients could not be differentiated by the modified pendulum test; the elbow extensors showed a higher muscle tone in both control and patient groups; and hypertonia of both parkinsonian and stroke patients is velocity dependent. Copyright © 2015 Elsevier Ltd. All rights reserved.

Short-Term High Intensity Plyometric Training Program Improves Strength, Power and Agility in Male Soccer Players

PubMed Central

Váczi, Márk; Tollár, József; Meszler, Balázs; Juhász, Ivett; Karsai, István

2013-01-01

The aim of the present study was to investigate the effects of a short-term in-season plyometric training program on power, agility and knee extensor strength. Male soccer players from a third league team were assigned into an experimental and a control group. The experimental group, beside its regular soccer training sessions, performed a periodized plyometric training program for six weeks. The program included two training sessions per week, and maximal intensity unilateral and bilateral plyometric exercises (total of 40 – 100 foot contacts/session) were executed. Controls participated only in the same soccer training routine, and did not perform plyometrics. Depth vertical jump height, agility (Illinois Agility Test, T Agility Test) and maximal voluntary isometric torque in knee extensors using Multicont II dynamometer were evaluated before and after the experiment. In the experimental group small but significant improvements were found in both agility tests, while depth jump height and isometric torque increments were greater. The control group did not improve in any of the measures. Results of the study indicate that plyometric training consisting of high impact unilateral and bilateral exercises induced remarkable improvements in lower extremity power and maximal knee extensor strength, and smaller improvements in soccer-specific agility. Therefore, it is concluded that short-term plyometric training should be incorporated in the in-season preparation of lower level players to improve specific performance in soccer. PMID:23717351

Effects of equal-volume resistance training with different training frequencies in muscle size and strength in trained men

PubMed Central

Fisher, James; Steele, James; Campos, Mario H.; Silva, Marcelo H.; Paoli, Antonio; Giessing, Jurgen; Bottaro, Martim

2018-01-01

Background The objective of the present study was to compare the effects of equal-volume resistance training (RT) performed with different training frequencies on muscle size and strength in trained young men. Methods Sixteen men with at least one year of RT experience were divided into two groups, G1 and G2, that trained each muscle group once and twice a week, respectively, for 10 weeks. Elbow flexor muscle thickness (MT) was measured using a B-Mode ultrasound and concentric peak torque of elbow extensors and flexors were assessed by an isokinetic dynamometer. Results ANOVA did not reveal group by time interactions for any variable, indicating no difference between groups for the changes in MT or PT of elbow flexors and extensors. Notwithstanding, MT of elbow flexors increased significantly (3.1%, P < 0.05) only in G1. PT of elbow flexors and extensors did not increase significantly for any group. Discussion The present study suggest that there were no differences in the results promoted by equal-volume resistance training performed once or twice a week on upper body muscle strength in trained men. Only the group performing one session per week significantly increased the MT of their elbow flexors. However, with either once or twice a week training, adaptations appear largely minimal in previously trained males.

Effects of equal-volume resistance training with different training frequencies in muscle size and strength in trained men.

PubMed

Gentil, Paulo; Fisher, James; Steele, James; Campos, Mario H; Silva, Marcelo H; Paoli, Antonio; Giessing, Jurgen; Bottaro, Martim

2018-01-01

The objective of the present study was to compare the effects of equal-volume resistance training (RT) performed with different training frequencies on muscle size and strength in trained young men. Sixteen men with at least one year of RT experience were divided into two groups, G1 and G2, that trained each muscle group once and twice a week, respectively, for 10 weeks. Elbow flexor muscle thickness (MT) was measured using a B-Mode ultrasound and concentric peak torque of elbow extensors and flexors were assessed by an isokinetic dynamometer. ANOVA did not reveal group by time interactions for any variable, indicating no difference between groups for the changes in MT or PT of elbow flexors and extensors. Notwithstanding, MT of elbow flexors increased significantly (3.1%, P  < 0.05) only in G1. PT of elbow flexors and extensors did not increase significantly for any group. The present study suggest that there were no differences in the results promoted by equal-volume resistance training performed once or twice a week on upper body muscle strength in trained men. Only the group performing one session per week significantly increased the MT of their elbow flexors. However, with either once or twice a week training, adaptations appear largely minimal in previously trained males.

A lower extremity strength-based profile of NCAA Division I women's basketball and gymnastics athletes: implications for knee joint injury risk assessment.

PubMed

Thompson, Brennan J; Cazier, Curtis S; Bressel, Eadric; Dolny, Dennis G

2018-08-01

This study aimed to provide a comprehensive strength-based physiological profile of women's NCAA Division I basketball and gymnastic athletes; and to make sport-specific comparisons for various strength characteristics of the knee flexor and extensor muscles. A focus on antagonist muscle balance (hamstrings-to-quadriceps ratios, H:Q) was used to elucidate vulnerabilities in these at-risk female athletes. Fourteen NCAA Division I women's basketball and 13 gymnastics athletes performed strength testing of the knee extensors and flexors. Outcome measures included absolute and relative (body mass normalised) peak torque (PT), rate of torque development at 50, 100, 200 ms (RTD50 etc.) and H:Q ratios of all variables. The basketball athletes had greater absolute strength for all variables except for isokinetic PT at 240°s -1 and isometric RTD50 for the knee extensors. Gymnasts showed ~20% weaker body mass relative concentric PT for the knee flexors at 60 and 120°·s -1 , and decreased conventional H:Q ratios at 60 and 240°·s -1 (~15%). These findings suggest that collegiate level gymnastics athletes may be prone to increased ACL injury risk due to deficient knee flexor strength and H:Q strength imbalance. Coaches may use these findings when implementing injury prevention screening and/or for individualised strength training programming centered around an athletes strength-related deficits.

Low back pain characterized by muscle resistance and occupational factors associated with nursing1

PubMed Central

Petersen, Rafael de Souza; Marziale, Maria Helena Palucci

2014-01-01

Objective to identify the occupational factors associated with low back pain using a surveillance tool and to characterize the low back pain by the resistance of the extensor muscles of the vertebral column among nursing professionals at an Intensive Care Unit. Methods Cross-sectional study. The workers answered a questionnaire about occupational factors and participated in a resistance test of the extensor muscles of the vertebral column. Associations were established through Student's T-test or Mann-Whitney's U-test and correlations using Pearson's test. Results Out of 48 participants, 32 (67%) suffered from low pain. For the resistance test, the subjects suffering from low back pain endured less time in comparison with asymptomatic subjects, but without significant differences (p=0.147). The duration of the pain episode showed a significant negative correlation (p=0.016) with the results of the resistance test though. The main factors identified as causes of low back pain were biomechanical and postural elements, conditions of the muscle structure and physical and organizational conditions. Conclusions the main occupational factors associated with the low back pain were the posture and the characteristics of the physical and organizational conditions. In addition, the extensor muscles of the column showed a trend towards lesser resistance for workers in pain. This evidence is important when considering prevention and treatment strategies. PMID:25029048

Alpha-actinin-3 (ACTN3) R577X polymorphism influences knee extensor peak power response to strength training in older men and women.

PubMed

Delmonico, Matthew J; Kostek, Matthew C; Doldo, Neil A; Hand, Brian D; Walsh, Sean; Conway, Joan M; Carignan, Craig R; Roth, Stephen M; Hurley, Ben F

2007-02-01

The alpha-actinin-3 (ACTN3) R577X polymorphism has been associated with muscle power performance in cross-sectional studies. We examined baseline knee extensor concentric peak power (PP) and PP change with approximately 10 weeks of unilateral knee extensor strength training (ST) using air-powered resistance machines in 71 older men (65 [standard deviation = 8] years) and 86 older women (64 [standard deviation = 9] years). At baseline in women, the XX genotype group had an absolute (same resistance) PP that was higher than the RR (p =.005) and RX genotype groups (p =.02). The women XX group also had a relative (70% of one-repetition maximum [1-RM]) PP that was higher than that in the RR (p =.002) and RX groups (p =.008). No differences in baseline absolute or relative PP were observed between ACTN3 genotype groups in men. In men, absolute PP change with ST in the RR (n = 16) group approached a significantly higher value than in the XX group (n = 9; p =.07). In women, relative PP change with ST in the RR group (n = 16) was higher than in the XX group (n = 17; p =.02). The results indicate that the ACTN3 R577X polymorphism influences the response of quadriceps muscle power to ST in older adults.

Short-term high intensity plyometric training program improves strength, power and agility in male soccer players.

PubMed

Váczi, Márk; Tollár, József; Meszler, Balázs; Juhász, Ivett; Karsai, István

2013-03-01

The aim of the present study was to investigate the effects of a short-term in-season plyometric training program on power, agility and knee extensor strength. Male soccer players from a third league team were assigned into an experimental and a control group. The experimental group, beside its regular soccer training sessions, performed a periodized plyometric training program for six weeks. The program included two training sessions per week, and maximal intensity unilateral and bilateral plyometric exercises (total of 40 - 100 foot contacts/session) were executed. Controls participated only in the same soccer training routine, and did not perform plyometrics. Depth vertical jump height, agility (Illinois Agility Test, T Agility Test) and maximal voluntary isometric torque in knee extensors using Multicont II dynamometer were evaluated before and after the experiment. In the experimental group small but significant improvements were found in both agility tests, while depth jump height and isometric torque increments were greater. The control group did not improve in any of the measures. Results of the study indicate that plyometric training consisting of high impact unilateral and bilateral exercises induced remarkable improvements in lower extremity power and maximal knee extensor strength, and smaller improvements in soccer-specific agility. Therefore, it is concluded that short-term plyometric training should be incorporated in the in-season preparation of lower level players to improve specific performance in soccer.

The prevalence of the extensor digiti minimi tendon of the hand and its variants in humans: a systematic review and meta-analysis.

PubMed

Yammine, Kaissar

2015-01-01

The extensor digiti minimi (EDM) is frequently used in the case of an abduction deformity of the little finger. It is also considered as a main resource for tendon transfer. However, it shows many variations in the human hand, which include splitting into two or more slips and sending a slip to the fourth finger, named the extensor digiti minimi et quarti (EDMQ). The aim of this systematic review is to perform an evidence synthesis on the prevalence of the EDM and its variants. Twenty-six cadaveric studies met the inclusion criteria with a total of 2247 hands. Meta-analysis results yielded an overall pooled prevalence estimate (PPE) of the EDM of 99.7% and PPEs of 11.5, 77.6, 7 and 0.6% for the single-, double-, triple- and quadruple-slip EDM, respectively. For the single-slip EDM, the frequencies were such that Indians > Middle Eastern > Europeans > Japanese > North Americans. For the double-slip EDM, the frequencies were such that Japanese > North Americans = Europeans > Middle Eastern > Indians. No significance was found with regard to hand side. The true EDMQ prevalence was found to be at 7.3%, whereas its crude prevalence was 8%. This artilce offers reference values on the prevalence of the EDM and its variants, which are thought to be highly relevant to both anatomists and clinicians.

Comparison of isokinetic muscle strength and muscle power by types of warm-up.

PubMed

Sim, Young-Je; Byun, Yong-Hyun; Yoo, Jaehyun

2015-05-01

[Purpose] The purpose of this study was to clarify the influence of static stretching at warm-up on the isokinetic muscle torque (at 60°/sec) and muscle power (at 180°/sec) of the flexor muscle and extensor muscle of the knee joint. [Subjects and Methods] The subjects of this study were 10 healthy students with no medically specific findings. The warm-up group and warm-up with stretching group performed their respective warm-up prior to the isokinetic muscle torque evaluation of the knee joint. One-way ANOVA was performed by randomized block design for each variable. [Results] The results were as follows: First, the flexor peak torque and extensor peak torque of the knee joint tended to decrease at 60°/sec in the warm-up with stretching group compared with the control group and warm-up group, but without statistical significance. Second, extensor power at 180°/sec was also not statistically significant. However, it was found that flexor power increased significantly in the warm-up with stretching group at 180°/sec compared with the control group and warm-up group in which stretching was not performed. [Conclusion] Therefore, it is considered that in healthy adults, warm-up including two sets of stretching for 20 seconds per muscle group does not decrease muscle strength and muscle power.

Ipsilateral hip abductor weakness after inversion ankle sprain.

PubMed

Friel, Karen; McLean, Nancy; Myers, Christine; Caceres, Maria

2006-01-01

Hip stability and strength are important for proper gait mechanics and foot position during heel strike. To determine the relationships between hip muscle strength and chronic ankle sprains and hip muscle strength and ankle range of motion. Ex post facto design with the uninvolved limb serving as the control. Laboratory. A total of 23 subjects with unilateral chronic ankle sprain were recruited. Subjects had at least 2 ipsilateral ankle sprains and were bearing full weight, with the most recent injury occurring at least 3 months earlier. They were not undergoing formal or informal rehabilitation at the time of the study. We obtained goniometric measurements for all planes of motion at the ankle. Handheld dynamometry was used to assess the strength of the hip abductor and hip extensor muscles in both limbs. Hip abductor muscle strength and plantar flexion were significantly less on the involved side than the uninvolved side (P < .001 in each case). Strength of the involved hip abductor and hip extensor muscles was significantly correlated (r = 0.539, P < .01). No significant difference was noted in hip extensor muscle strength between sides (P = .19). Our subjects with unilateral chronic ankle sprains had weaker hip abduction strength and less plantar-flexion range of motion on the involved sides. Clinicians should consider exercises to increase hip abduction strength when developing rehabilitation programs for patients with ankle sprains.

Validity of trunk extensor and flexor torque measurements using isokinetic dynamometry.

PubMed

Guilhem, Gaël; Giroux, Caroline; Couturier, Antoine; Maffiuletti, Nicola A

2014-12-01

This study aimed to evaluate the validity and test-retest reliability of trunk muscle strength testing performed with a latest-generation isokinetic dynamometer. Eccentric, isometric, and concentric peak torque of the trunk flexor and extensor muscles was measured in 15 healthy subjects. Muscle cross sectional area (CSA) and surface electromyographic (EMG) activity were respectively correlated to peak torque and submaximal isometric torque for erector spinae and rectus abdominis muscles. Reliability of peak torque measurements was determined during test and retest sessions. Significant correlations were consistently observed between muscle CSA and peak torque for all contraction types (r=0.74-0.85; P<0.001) and between EMG activity and submaximal isometric torque (r ⩾ 0.99; P<0.05), for both extensor and flexor muscles. Intraclass correlation coefficients were comprised between 0.87 and 0.95, and standard errors of measurement were lower than 9% for all contraction modes. The mean difference in peak torque between test and retest ranged from -3.7% to 3.7% with no significant mean directional bias. Overall, our findings establish the validity of torque measurements using the tested trunk module. Also considering the excellent test-retest reliability of peak torque measurements, we conclude that this latest-generation isokinetic dynamometer could be used with confidence to evaluate trunk muscle function for clinical or athletic purposes. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Secondary tendon reconstruction on the thumb].

PubMed

Bickert, B; Kremer, T; Kneser, U

2016-12-01

Closed tendon ruptures of the thumb that require secondary reconstruction can affect the extensor pollicis longus (EPL), extensor pollicis brevis (EPB) and flexor pollicis longus (FPL) tendons. Treatment of rupture of the EPB tendon consists of refixation to the bone and temporary transfixation of the joint. In the case of preexisting or posttraumatic arthrosis, definitive arthrodesis of the thumb is the best procedure. Closed ruptures of the EPL and FPL tendons at the wrist joint cannot be treated by direct tendon suture. Rupture of the EPL tendon occurs after distal radius fractures either due to protruding screws or following conservative treatment especially in undisplaced fractures. Transfer of the extensor indicis tendon to the distal EPL stump is a good option and free interposition of the palmaris longus tendon is a possible alternative. The tension should be adjusted to slight overcorrection, which can be checked intraoperatively by performing the tenodesis test. Closed FPL ruptures at the wrist typically occur 3-6 months after osteosynthesis of distal radius fractures with palmar plates and are mostly characterized by crepitation and pain lasting for several weeks. They can be prevented by premature plate removal, synovectomy and carpal tunnel release. For treatment of a ruptured FPL tendon in adult patients the options for tendon reconstruction should be weighed up against the less complicated tenodesis or arthrodesis of the thumb interphalangeal joint.

Changes in the activity of trunk and hip extensor muscles during bridge exercises with variations in unilateral knee joint angle.

PubMed

Kim, Juseung; Park, Minchul

2016-09-01

[Purpose] This study compared abdominal and hip extensor muscle activity during a bridge exercise with various knee joint angles. [Subjects and Methods] Twenty-two healthy male subjects performed a bridge exercise in which the knee joint angle was altered. While subjects performed the bridge exercise, external oblique, internal oblique, gluteus maximus, and semitendinosus muscle activity was measured using electromyography. [Results] The bilateral external and internal oblique muscle activity was significantly higher at 0° knee flexion compared to 120°, 90°, and 60°. The bilateral gluteus maximus muscle activity was significantly different at 0° of knee flexion compared to 120°, 90°, and 60°. The ipsilateral semitendinosus muscle activity was significantly increased at 90° and 60° of knee flexion compared to 120°, and significantly decreased at 0° knee flexion compared with 120°, 90°, and 60°. The contralateral semitendinosus muscle activity was significantly higher at 60° of knee flexion than at 120°, and significantly higher at 0° of knee flexion than at 120°, 90°, and 60°. [Conclusion] Bridge exercises performed with knee flexion less than 90° may be used to train the ipsilateral semitendinosus. Furthermore, bridge exercise performed with one leg may be used to train abdominal and hip extensor muscles.

Electrophysiological appraisal of relative segmental motoneurone pool excitability in flexor and extensor.

PubMed Central

Fisher, M A

1978-01-01

F responses recorded from flexor and extensor muscles were analysed in 18 normal subjects and in 16 patients with motor system abnormalities. The prominence of the F responses was evaluated quantitatively by determining the persistence--that is, the fraction of measurable F responses which actually occur after a series of supramaximal stimuli--and average amplitude of the F responses. In the normal resting state, the data are consistent with the hypothesis that the "central excitatory states" of motoneurones is greater in the antigravity muscles than in those muscles not stretched by gravity. This pattern was disrupted in eight of the 16 patients with motor system abnormalities caused by central nervous system lesions. These changes reflect a clinically testable aspect of the pathophysiology of certain motor system disorders. PMID:690640

Limb salvage after infected knee arthroplasty with bone loss and extensor mechanism deficiency using a modular segmental replacement system.

PubMed

Namdari, Surena; Milby, Andrew H; Garino, Jonathan P

2011-09-01

Multiple total knee arthroplasty revisions pose significant surgical challenges, such as bone loss and soft tissue compromise. For patients with bone loss and extensor mechanism insufficiency after total knee arthroplasty, arthrodesis is a treatment option for the avoidance of amputation. However, arthrodesis is both difficult to achieve in situations with massive bone loss and potentially undesirable due to the dramatic shortening that follows. Although intramedullary nailing for knee arthrodesis has been widely reported, this technique has traditionally relied on the achievement of bony union. We report a case of a patient with massive segmental bone loss in which a modular intercalary prosthesis was used for arthrodesis to preserve limb length without bony union. Copyright © 2011 Elsevier Inc. All rights reserved.

Anatomy of the inferior extensor retinaculum and its role in lateral ankle ligament reconstruction: a pictorial essay.

PubMed

Dalmau-Pastor, M; Yasui, Y; Calder, J D; Karlsson, J; Kerkhoffs, G M M J; Kennedy, J G

2016-04-01

The inferior extensor retinaculum (IER) is an aponeurotic structure, which is in continuation with the anterior part of the sural fascia. The IER has often been used to augment the reconstruction of the lateral ankle ligaments, for instance in the Broström-Gould procedure, with good outcomes reported. However, its anatomy has not been described in detail and only a few studies are available on this structure. The presence of a non-constant oblique supero-lateral band appears to be important. This structure defines whether the augmentation of the lateral ankle ligaments reconstruction is performed using true IER or only the anterior part of the sural fascia. It is concluded that the use of this structure will have an impact on the resulting ankle stability.

Catalase-positive microperoxisomes in rat soleus and extensor digitorum longus muscle fiber types

NASA Technical Reports Server (NTRS)

Riley, Danny A.; Bain, James L. W.; Ellis, Stanley

1988-01-01

The size, distribution, and content of catalase-reactive microperoxisomes were investigated cytochemically in three types of muscle fibers from the soleus and the extensor digitorum longus (EDL) of male rats. Muscle fibers were classified on the basis of the mitochondrial content and distribution, the Z-band widths, and the size and shape of myofibrils as the slow-twitch oxidative (SO), the fast-twitch oxidative glycolytic (FOG), and the fast-twitch glycolytic (FG) fibers. It was found that both the EDL and soleus SO fibers possessed the largest microperoxisomes. A comparison of microperoxisome number per muscle fiber area or the microperoxisome area per fiber area revealed following ranking, starting from the largest number and the area-ratio values: soleus SO, EDL SO, EDL FOG, and EDL FG.

Deep and shallow forms of the sulcus for extensor carpi ulnaris.

PubMed

Nakashima, T; Hojo, T; Furukawa, H

1993-12-01

Anatomical variations in the sulcus for the tendon of extensor carpi ulnaris were studied in 240 upper limbs. The sulcus lies between the head and the styloid process on the dorsal surface of the distal end of the ulna. This groove has deep and shallow forms and, rarely, a flat form. The sulcus was classified into 4 grades according to its depth. Grade I, a deep sulcus, was found in 51.3%. Grades II and III are shallow, but the styloid process in grade II is more prominent than in grade III. The former was found in 28.8%, the latter in 14.2%. Grade IV is a flat form. This was rare and found only in 1.3%. This variation was not age-related, but was a congenital feature.

Elicitation and abrupt termination of behaviorally significant catchlike tension in a primitive insect.

PubMed

Hoyle, G; Field, L H

1983-07-01

Sustained steady contractural or catchlike tension (CT) occurs in the metathoracic extensor tibiae muscle of the primitive insect the weta (Orthoptera: Stenopelmatidae) during its characteristic leg-extension defense behavior or following leg-position conditioning. Similar action occurs occasionally in semi-intact preparations and is abruptly turned off by a single peripheral inhibitory impulse. These phenomena were reproduced routinely by first infusing saline containing 10(-8) M (or stronger) octopamine into the muscle for 12 min, and then stimulating the slow excitatory motor neuron SETi with a brief burst. Direct stimulation of the dorsal unpaired median neuron, innervating the extensor tibiae (DUMETi) prior to SETi stimulation, also led to CT. Both octopamine and DUMETi markedly enhanced the tension developed in response to a burst of impulses in SETi.

Comparative proteomic profiling of soleus, extensor digitorum longus, flexor digitorum brevis and interosseus muscles from the mdx mouse model of Duchenne muscular dystrophy.

PubMed

Carberry, Steven; Brinkmeier, Heinrich; Zhang, Yaxin; Winkler, Claudia K; Ohlendieck, Kay

2013-09-01

Duchenne muscular dystrophy is due to genetic abnormalities in the dystrophin gene and represents one of the most frequent genetic childhood diseases. In the X-linked muscular dystrophy (mdx) mouse model of dystrophinopathy, different subtypes of skeletal muscles are affected to a varying degree albeit the same single base substitution within exon 23 of the dystrophin gene. Thus, to determine potential muscle subtype-specific differences in secondary alterations due to a deficiency in dystrophin, in this study, we carried out a comparative histological and proteomic survey of mdx muscles. We intentionally included the skeletal muscles that are often used for studying the pathomechanism of muscular dystrophy. Histological examinations revealed a significantly higher degree of central nucleation in the soleus and extensor digitorum longus muscles compared with the flexor digitorum brevis and interosseus muscles. Muscular hypertrophy of 20-25% was likewise only observed in the soleus and extensor digitorum longus muscles from mdx mice, but not in the flexor digitorum brevis and interosseus muscles. For proteomic analysis, muscle protein extracts were separated by fluorescence two-dimensional (2D) gel electrophoresis. Proteins with a significant change in their expression were identified by mass spectrometry. Proteomic profiling established an altered abundance of 24, 17, 19 and 5 protein species in the dystrophin-deficient soleus, extensor digitorum longus, flexor digitorum brevis and interosseus muscle, respectively. The key proteomic findings were verified by immunoblot analysis. The identified proteins are involved in the contraction-relaxation cycle, metabolite transport, muscle metabolism and the cellular stress response. Thus, histological and proteomic profiling of muscle subtypes from mdx mice indicated that distinct skeletal muscles are differentially affected by the loss of the membrane cytoskeletal protein, dystrophin. Varying degrees of perturbed protein expression patterns in the muscle subtypes from mdx mice may be due to dissimilar downstream events, including differences in muscle structure or compensatory mechanisms that counteract pathophysiological processes. The interosseus muscle from mdx mice possibly represents a naturally protected phenotype.

The Fate of the Iliopsoas Muscle in Long-term Follow-up After Open Reduction With a Medial Approach in Developmental Dysplasia of the Hip. Part 2: Isokinetic Muscle Strength Evaluation.

PubMed

Yilmaz, Serdar; Aksahin, Ertugrul; Ersoz, Murat; Bicimoglu, Ali

2017-09-01

The impact on long-term weakness of hip flexion of complete iliopsoas tenotomy during open reduction of developmental hip dysplasia with a medial approach has not yet been fully clarified. The purpose of this study was to investigate the isokinetic muscle strength (IMS) of hip flexor and extensor muscles in these patients and also to analyze the effect of spontaneous reattachment of the iliopsoas muscle on IMS measurements. The study included 20 patients. Earlier magnetic resonance imaging examination of all the patients revealed spontaneous reattachment of the iliopsoas in 18 (90%) patients. IMS measurements were performed at 60 and 150 degrees/s. The peak torque, total work (TW), average power (AP), work fatigue, and agonist to antagonist muscle ratio of the operated and nonoperated hips were recorded separately for flexors and extensors. The effect of iliopsoas reattachment on IMS was also evaluated. The mean follow-up period was 16.65±2.16 (13 to 20) years. Total work (P=0.013) and average power (P=0.009) of the flexor muscles and work fatigue of the extensor muscles (P=0.030) of the operated hip were significantly decreased when compared with the nonoperated hips at 150 degrees/s. There was no significant difference between the flexor muscles of the operated and nonoperated hips (P<0.05) at 60 degrees/s and extensor muscles (P<0.05) at 150 degrees/s. In addition, patients without reattachment had lower IMS in the operated hips. Flexor muscle strength was decreased in the operated hip against low resistance in long-term follow-up after iliopsoas tenotomy. This may reflect that hip muscle strength was decreased after prolonged activities such as sports. However, in forceful activities flexor muscle strength was retained due to iliopsoas reattachment. On the basis of this study we thought that spontaneous reattachment of the iliopsoas tendon substantially preserves muscle strength. Nonetheless possible efforts should be made to surgically reattach the psoas tendon to preserve strength of the muscle. Therapeutic level IV.

Comparative proteomic profiling of soleus, extensor digitorum longus, flexor digitorum brevis and interosseus muscles from the mdx mouse model of Duchenne muscular dystrophy

PubMed Central

CARBERRY, STEVEN; BRINKMEIER, HEINRICH; ZHANG, YAXIN; WINKLER, CLAUDIA K.; OHLENDIECK, KAY

2013-01-01

Duchenne muscular dystrophy is due to genetic abnormalities in the dystrophin gene and represents one of the most frequent genetic childhood diseases. In the X-linked muscular dystrophy (mdx) mouse model of dystrophinopathy, different subtypes of skeletal muscles are affected to a varying degree albeit the same single base substitution within exon 23 of the dystrophin gene. Thus, to determine potential muscle subtype-specific differences in secondary alterations due to a deficiency in dystrophin, in this study, we carried out a comparative histological and proteomic survey of mdx muscles. We intentionally included the skeletal muscles that are often used for studying the pathomechanism of muscular dystrophy. Histological examinations revealed a significantly higher degree of central nucleation in the soleus and extensor digitorum longus muscles compared with the flexor digitorum brevis and interosseus muscles. Muscular hypertrophy of 20–25% was likewise only observed in the soleus and extensor digitorum longus muscles from mdx mice, but not in the flexor digitorum brevis and interosseus muscles. For proteomic analysis, muscle protein extracts were separated by fluorescence two-dimensional (2D) gel electrophoresis. Proteins with a significant change in their expression were identified by mass spectrometry. Proteomic profiling established an altered abundance of 24, 17, 19 and 5 protein species in the dystrophin-deficient soleus, extensor digitorum longus, flexor digitorum brevis and interosseus muscle, respectively. The key proteomic findings were verified by immunoblot analysis. The identified proteins are involved in the contraction-relaxation cycle, metabolite transport, muscle metabolism and the cellular stress response. Thus, histological and proteomic profiling of muscle subtypes from mdx mice indicated that distinct skeletal muscles are differentially affected by the loss of the membrane cytoskeletal protein, dystrophin. Varying degrees of perturbed protein expression patterns in the muscle subtypes from mdx mice may be due to dissimilar downstream events, including differences in muscle structure or compensatory mechanisms that counteract pathophysiological processes. The interosseus muscle from mdx mice possibly represents a naturally protected phenotype. PMID:23828267

Is the relationship between increased knee muscle strength and improved physical function following exercise dependent on baseline physical function status?

PubMed

Hall, Michelle; Hinman, Rana S; van der Esch, Martin; van der Leeden, Marike; Kasza, Jessica; Wrigley, Tim V; Metcalf, Ben R; Dobson, Fiona; Bennell, Kim L

2017-12-08

Clinical guidelines recommend knee muscle strengthening exercises to improve physical function. However, the amount of knee muscle strength increase needed for clinically relevant improvements in physical function is unclear. Understanding how much increase in knee muscle strength is associated with improved physical function could assist clinicians in providing appropriate strength gain targets for their patients in order to optimise outcomes from exercise. The aim of this study was to investigate whether an increase in knee muscle strength is associated with improved self-reported physical function following exercise; and whether the relationship differs according to physical function status at baseline. Data from 100 participants with medial knee osteoarthritis enrolled in a 12-week randomised controlled trial comparing neuromuscular exercise to quadriceps strengthening exercise were pooled. Participants were categorised as having mild, moderate or severe physical dysfunction at baseline using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Associations between 12-week changes in physical function (dependent variable) and peak isometric knee extensor and flexor strength (independent variables) were evaluated with and without accounting for baseline physical function status and covariates using linear regression models. In covariate-adjusted models without accounting for baseline physical function, every 1-unit (Nm/kg) increase in knee extensor strength was associated with physical function improvement of 17 WOMAC units (95% confidence interval (CI) -29 to -5). When accounting for baseline severity of physical function, every 1-unit increase in knee extensor strength was associated with physical function improvement of 24 WOMAC units (95% CI -42 to -7) in participants with severe physical dysfunction. There were no associations between change in strength and change in physical function in participants with mild or moderate physical dysfunction at baseline. The association between change in knee flexor strength and change in physical function was not significant, irrespective of baseline function status. In patients with severe physical dysfunction, an increase in knee extensor strength and improved physical function were associated. ANZCTR 12610000660088 . Registered 12 August 2010.

Isokinetic trunk muscle performance in pre-teens and teens with and without back pain.

PubMed

Bernard, J-C; Boudokhane, S; Pujol, A; Chaléat-Valayer, E; Le Blay, G; Deceuninck, J

2014-02-01

To assess with an isokinetic dynamometer the force and endurance of the spinal flexor and extensor muscles in pre-teens or teens aged 11 to 13 and 14 to 16 years with and without low back pain (LBP). The control group and the LBP group were homogeneous in terms of age, weight, height and Body Mass Index (BMI). Assessment was carried out with the isokinetic dynamometer Cybex Norm®. The spinal flexors and extensors were explored concentrically at speeds of 60°, 90° and 120°/sec. The parameters chosen were: maximal moment of force (MMF), mean power (MP), total work (TW), F/E ratios (between the flexors and the extensors for the aforesaid parameters). In the LBP groups, clinical information (pain, extensibility of the spinal and sub-pelvic muscles, sports practice) and sagittal radiological data were all measured. While no significant difference in isokinetic performance was found between asymptomatic and LBP children in the 11-to-13-year-old group, the isokinetic performances of the LBP children were influenced positively by BMI value, number of hours of physical activity and radiologic value of the lumbar lordosis. As regards these pre-teens, assessment with an isokinetic dynamometer does not highlight muscle characteristics that might explain LBP occurrence. As regards the 14-to-16-year-old group, muscle strength has been found to be correlated with age. LBP teens were showed to have weaker extensors and stronger flexors than the healthy teens. It is with regard to this age group that assessment with an isokinetic dynamometer clearly yields interesting results. Since we have yet to standardize our evaluation criteria (working speed, number of trials…), it is difficult to compare our results with those reported in the literature. This is a preliminary study involving a relatively low number of patients. That said, given the fact that numerous parameters are connected with the age and height of the subjects, assessment with an isokinetic dynamometer can be constructively carried out from the age of 14. In order to further enhance understanding of this phenomenon, a longitudinal and comparative study of a larger group is needed. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Hypogravity-induced atrophy of rat soleus and extensor digitorum longus muscles

NASA Technical Reports Server (NTRS)

Riley, D. A.; Ellis, S.; Slocum, G. R.; Satyanarayana, T.; Bain, J. L.; Sedlak, F. R.

1987-01-01

Prolonged exposure of humans to hypogravity causes weakening of their skeletal muscles. This problem was studied in rats exposed to hypogravity for 7 days aboard Spacelab 3. Hindlimb muscles were harvested 12-16 hours postflight for histochemical, biochemical, and ultrastructural analyses. The majority of the soleus and extensor digitorum longus fibers exhibited simple cell shrinkage. However, approximately 1% of the fibers in flight soleus muscles appeared necrotic. Flight muscle fibers showed increased glycogen, lower subsarcolemmal staining for mitochondrial enzymes, and fewer subsarcolemmal mitochondria. During atrophy, myofibrils were eroded by multiple focal losses of myofilaments; lysosomal autophagy was not evident. Tripeptidylaminopeptidase and calcium-activated protease activities of flight soleus fibers were significantly increased, implying a role in myofibril breakdown. Simple fiber atrophy appears to account for muscle weakening during spaceflight, but fiber necrosis is also a contributing factor.

Secreted Wnt Signaling Inhibitors in Disuse-Induced Bone Loss

DTIC Science & Technology

2014-07-01

goal, we proposed to in‐ duce disuse (using Botox‐induced paralysis of the quadriceps,  hamstrings , and soleus) in one hindlimb of a se‐ ries of mice...muscle paralysis of the lower limb via botulinum toxin (Botox; 20 U/kg) injec on into the  quadriceps,  hamstrings , triceps surae, and leg extensor...kg) injec on into the quadriceps,  hamstrings , tri‐ ceps surae, and leg extensor compartment of the right lower limb.   The le  lower limb was

Effect of hindlimb suspension and clenbuterol treatment on polyamine levels in skeletal muscle

NASA Technical Reports Server (NTRS)

Abukhalaf, Imad K.; von Deutsch, Daniel A.; Wineski, Lawrence E.; Silvestrov, Natalia A.; Abera, Saare A.; Sahlu, Sinafikish W.; Potter, David E.; Thierry-Palmer, M. (Principal Investigator)

2002-01-01

Polyamines are unbiquitous, naturally occurring small aliphatic, polycationic, endogenous compounds. They are involved in many cellular processes and may serve as secondary or tertiary messengers to hormonal regulation. The relationship of polyamines and skeletal muscle mass of adductor longus, extensor digitorum longus, and gastrocnemius under unloading (hindlimb suspension) conditions was investigated. Unloading significantly affected skeletal muscle polyamine levels in a fiber-type-specific fashion. Under loading conditions, clenbuterol treatment increased all polyamine levels, whereas under unloading conditions, only the spermidine levels were consistently increased. Unloading attenuated the anabolic effects of clenbuterol in predominately slow-twitch muscles (adductor longus), but had little impact on clenbuterol's action as a countermeasure in fast- twitch muscles such as the extensor digitorum longus. Spermidine appeared to be the primary polyamine involved in skeletal muscle atrophy/hypertrophy. Copyright 2002 S. Karger AG, Basel.

The Hindlimb Myology of Tyto alba (Tytonidae, Strigiformes, Aves).

PubMed

Mosto, M C

2017-02-01

This work is the first myological dissection performed in detail on the hindlimb of Tyto alba. Six specimens were dissected and their muscle masses were obtained. T. alba has the classical myological pattern present in other species of Strigiformes, such as a well-developed m. flexor digitorum longus and the absence of the m. plantaris, flexor cruris lateralis and ambiens. Also, T. alba lacks the m. extensor propius digiti III, m. extensor propius digiti IV and m. lumbricalis, present in the Strigidae. Hindlimb muscle mass accounts for 14.13% of total body mass, which is within the range of values of both nocturnal (Strigiformes) and diurnal (Falconidae and Accipitridae) raptors. This study provides important information for future studies related to functional morphology and ecomorphology. © 2016 Blackwell Verlag GmbH.

Biomechanical Analysis of All-Inside, Arthroscopic Suture Repair Versus Extensor Retinaculum Capsulorrhaphy for Triangular Fibrocartilage Complex Tears With Instability.

PubMed

Patel, Amar A; Alhandi, Ali A; Milne, Edward; Dy, Christopher J; Latta, Loren L; Ouellette, E Anne

2016-03-01

To assess ulnocarpal joint stability after treatment of a peripheral triangular fibrocartilage complex (TFCC) injury with all-inside arthroscopic suture repair (SR), extensor retinaculum capsulorrhaphy with the Herbert sling (HS), and a combination of both (SR+HS). Twelve fresh-frozen, age-matched, upper-extremity specimens intact from the distal humerus were prepared. Nondestructive mechanical testing was performed to assess native ulnocarpal joint stability and load-displacement curves were recorded. A peripheral, ulnar-sided TFCC injury was created with arthroscopic assistance, and mechanical testing was performed. Each specimen was treated with SR or HS and testing was repeated. The 6 specimens treated with SR were then treated with HS (SR+HS), and testing was repeated. We used paired Student t tests for statistical analysis within cohorts. For all cohorts, there was an average increase in ulnar translation after the creation of a peripheral TFCC injury and an average decrease after repair. Herbert sling decreased translation by 21%, SR decreased translation by 12%, and SR+HS decreased translation by 26%. Suture repair plus HS and HS reduce ulnar translation the most after a peripheral TFCC injury, followed by SR alone. Ulnocarpal joint stability should be assessed clinically in patients with peripheral TFCC injury, and consideration should be made for using extensor capsulorrhaphy in isolation or as an adjunct to SR as a treatment option. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Ipsilateral Hip Abductor Weakness After Inversion Ankle Sprain

PubMed Central

Friel, Karen; McLean, Nancy; Myers, Christine; Caceres, Maria

2006-01-01

Context: Hip stability and strength are important for proper gait mechanics and foot position during heel strike. Objective: To determine the relationships between hip muscle strength and chronic ankle sprains and hip muscle strength and ankle range of motion. Design: Ex post facto design with the uninvolved limb serving as the control. Setting: Laboratory. Patients or Other Participants: A total of 23 subjects with unilateral chronic ankle sprain were recruited. Subjects had at least 2 ipsilateral ankle sprains and were bearing full weight, with the most recent injury occurring at least 3 months earlier. They were not undergoing formal or informal rehabilitation at the time of the study. Main Outcome Measure(s): We obtained goniometric measurements for all planes of motion at the ankle. Handheld dynamometry was used to assess the strength of the hip abductor and hip extensor muscles in both limbs. Results: Hip abductor muscle strength and plantar flexion were significantly less on the involved side than the uninvolved side (P < .001 in each case). Strength of the involved hip abductor and hip extensor muscles was significantly correlated (r = 0.539, P < .01). No significant difference was noted in hip extensor muscle strength between sides (P = .19). Conclusions: Our subjects with unilateral chronic ankle sprains had weaker hip abduction strength and less plantar-flexion range of motion on the involved sides. Clinicians should consider exercises to increase hip abduction strength when developing rehabilitation programs for patients with ankle sprains. PMID:16619098

Reconstruction of long digital extensor tendon by cranial tibial muscle fascia graft in a dog.

PubMed

Sabiza, Soroush; Khajeh, Ahmad; Naddaf, Hadi

2016-01-01

Tendon rupture in dogs is generally the result of a direct trauma. This report described the use of adjacent muscle autogenic fascial graft for reconstruction of distal rupture of long digital extensor tendon in a dog. A two-year-old male mix breed dog, was presented with a non-weight bearing lameness of the right hind limb and a deep rupture of lateral side of right tarsus. History taking revealed that this rupture appeared without any apparent cause, when walking around the farm, three days before. Radiography was done and no fracture was observed. Hyperextension of right tarsal joint compared to left limb was observed. Under general anesthesia, after dissections of the ruptured area, complete rupture of long digital extensor tendon was revealed. Then, we attempted to locate the edge of the tendon, however, the tendon length was shortened approximately 1 cm. Hence, a strip of 1 cm length from fascia of cranial tibial muscle was harvested to fill the defect. The graft was sutured to the two ends of tendon using locking loop pattern. Subcutaneous layers and the skin were sutured routinely. Ehmer sling bandage was applied to prevent weight bearing on the surgical region. Re-examination and phone contact with the owner eight weeks and six months postoperatively revealed a poor lameness and excellent function of the dog, respectively. It could be concluded that the fascia of adjacent muscles can be used as an autogenic graft for reconstruction of some tendon ruptures.

Reconstruction of long digital extensor tendon by cranial tibial muscle fascia graft in a dog

PubMed Central

Sabiza, Soroush; Khajeh, Ahmad; Naddaf, Hadi

2016-01-01

Tendon rupture in dogs is generally the result of a direct trauma. This report described the use of adjacent muscle autogenic fascial graft for reconstruction of distal rupture of long digital extensor tendon in a dog. A two-year-old male mix breed dog, was presented with a non-weight bearing lameness of the right hind limb and a deep rupture of lateral side of right tarsus. History taking revealed that this rupture appeared without any apparent cause, when walking around the farm, three days before. Radiography was done and no fracture was observed. Hyperextension of right tarsal joint compared to left limb was observed. Under general anesthesia, after dissections of the ruptured area, complete rupture of long digital extensor tendon was revealed. Then, we attempted to locate the edge of the tendon, however, the tendon length was shortened approximately 1 cm. Hence, a strip of 1 cm length from fascia of cranial tibial muscle was harvested to fill the defect. The graft was sutured to the two ends of tendon using locking loop pattern. Subcutaneous layers and the skin were sutured routinely. Ehmer sling bandage was applied to prevent weight bearing on the surgical region. Re-examination and phone contact with the owner eight weeks and six months postoperatively revealed a poor lameness and excellent function of the dog, respectively. It could be concluded that the fascia of adjacent muscles can be used as an autogenic graft for reconstruction of some tendon ruptures. PMID:27872726

Topsy-turvy locomotion: biomechanical specializations of the elbow in suspended quadrupeds reflect inverted gravitational constraints

PubMed Central

Fujiwara, Shin-ichi; Endo, Hideki; Hutchinson, John R

2011-01-01

Some tetrapods hang upside down from tree branches when moving horizontally. The ability to walk in quadrupedal suspension has been acquired independently in at least 14 mammalian lineages. During the stance (supportive) phase of quadrupedal suspension, the elbow joint flexor muscles (not the extensors as in upright vertebrates moving overground) are expected to contract to maintain the flexed limb posture. Therefore muscular control in inverted, suspended quadrupeds may require changes of muscle control, and even morphologies, to conditions opposite to those in upright animals. However, the relationships between musculoskeletal morphologies and elbow joint postures during the stance phase in suspended quadrupeds have not been investigated. Our analysis comparing postures and skeletal morphologies in Choloepus (Pilosa), Pteropus (Chiroptera), Nycticebus (Primates) and Cynocephalus (Dermoptera) revealed that the elbow joints of these animals were kept at flexed angles of 70–100 ° during the stance phase of quadrupedal suspension. At these joint angles the moment arms of the elbow joint flexors were roughly maximized, optimizing that component of antigravity support. Our additional measurements from various mammalian species show that suspended quadrupeds have relatively small extensor/flexor ratios in both muscle masses and maximum moment arms. Thus, in contrast to the pattern in normal terrestrial quadrupeds, suspended quadrupeds emphasize flexor over extensor muscles for body support. This condition has evolved independently multiple times, attendant with a loss or reduction of the ability to move in normal upright postures. PMID:21477151

Effect of immobilization and retraining on torque-velocity relationship of human knee flexor and extensor muscles.

PubMed

Labarque, V L; Eijnde, B Op 't; Van Leemputte, M

2002-01-01

The effect of 2 weeks immobilization of the uninjured right knee and 10 weeks of retraining on muscle torque-velocity characteristics was investigated in nine young subjects. Left and right knee extension and flexion maximal voluntary isometric torque (Tmax) and dynamic torque at 60 degrees s(-1) (T60) and 180 degrees x s(-1) (T180) were measured before (PRE) and after immobilization (POST) and after 3 (R3) and 10 (R10) weeks of dynamic retraining. The torque-velocity relationship was quantified by expressing T60 and T180 relative to Tmax (NT60 and NT180, respectively). For the right extensor muscles, percutaneous biopsy samples were obtained from the vastus lateralis muscle and fibre type distribution was measured. POST extension and flexion torque (mean of Tmax, T60 and T180) decreased by 27% and 11%, respectively. During the course of the experiment, the changes in NT60 and NT180 were similar. POST extensor muscle NTV (mean of NT60 and NT180) was decreased significantly (12%, P<0.05), but no significant change was found for flexor muscle NTV (+ 3%). At R3 Tmax, dynamic torque and NTV were restored to normal. Unlike isometric torque, NTV did not change from R3 to R10. No changes in fibre type distribution were found. The adaptation of muscle length is suggested as the mechanism to explain the change in NTV.

Control of trunk motion following sudden stop perturbations during cart pushing.

PubMed

Lee, Yun-Ju; Hoozemans, Marco J M; van Dieën, Jaap H

2011-01-04

External perturbations during pushing tasks have been suggested to be a risk factor for low-back symptoms. An experiment was designed to investigate whether self-induced and externally induced sudden stops while pushing a high inertia cart influence trunk motions, and how flexor and extensor muscles counteract these perturbations. Twelve healthy male participants pushed a 200 kg cart at shoulder height and hip height. Pushing while walking was compared to situations in which participants had to stop the cart suddenly (self-induced stop) or in which the wheels of the cart were unexpectedly blocked (externally induced stop). For the perturbed conditions, the peak values and the maximum changes from the reference condition (pushing while walking) of the external moment at L5/S1, trunk inclination and electromyographic amplitudes of trunk muscles were determined. In the self-induced stop, a voluntary trunk extension occurred. Initial responses in both stops consisted of flexor and extensor muscle cocontraction. In self-induced stops this was followed by sustained extensor activity. In the externally induced stops, an external extension moment caused a decrease in trunk inclination. The opposite directions of the internal moment and trunk motion in the externally induced stop while pushing at shoulder height may indicate insufficient active control of trunk posture. Consequently, sudden blocking of the wheels in pushing at shoulder height may put the low back at risk of mechanical injury. Copyright © 2010 Elsevier Ltd. All rights reserved.

Squatting Exercises in Older Adults: Kinematic and Kinetic Comparisons

PubMed Central

FLANAGAN, SEAN; SALEM, GEORGE J.; WANG, MAN-YING; SANKER, SERENA E.; GREENDALE, GAIL A.

2012-01-01

Purpose Squatting activities may be used, within exercise programs, to preserve physical function in older adults. This study characterized the lower-extremity peak joint angles, peak moments, powers, work, impulse, and muscle recruitment patterns (electromyographic; EMG) associated with two types of squatting activities in elders. Methods Twenty-two healthy, older adults (ages 70–85) performed three trials each of: 1) a squat to a self-selected depth (normal squat; SQ) and 2) a squat onto a chair with a standardized height of 43.8 cm (chair squat; CSQ). Descending and ascending phase joint kinematics and kinetics were obtained using a motion analysis system and inverse dynamics techniques. Results were averaged across the three trials. A 2 × 2 (activity × phase) ANOVA with repeated measures was used to examine the biomechanical differences among the two activities and phases. EMG temporal characteristics were qualitatively examined. Results CSQ generated greater hip flexion angles, peak moments, power, and work, whereas SQ generated greater knee and ankle flexion angles, peak moments, power, and work. SQ generated a greater knee extensor impulse, a greater plantar flexor impulse and a greater total support impulse. The EMG temporal patterns were consistent with the kinetic data. Conclusions The results suggest that, with older adults, CSQ places greater demand on the hip extensors, whereas SQ places greater demand on the knee extensors and ankle plantar flexors. Clinicians may use these discriminate findings to more effectively target specific lower-extremity muscle groups when prescribing exercise for older adults. PMID:12673148

Influence of patellofemoral bracing on pain, knee extensor torque, and gait function in females with patellofemoral pain.

PubMed

Powers, Christopher M; Doubleday, Kathryn L; Escudero, Carina

2008-01-01

Our purpose was to evaluate the effects of a patellofemoral brace on pain response, knee extensor torque production, and gait function in females with patellofemoral pain (PFP). Sixteen females between the ages of 14 and 46 with diagnosis of PFP participated. Knee extensor torque was measured by using a LIDO isokinetic dynamometer. Pain levels were documented by using the Visual Analog Pain Scale. Stride characteristics during the conditions of free walk, fast walk, ascend stairs, descend stairs, ascend ramp, and descend ramp were obtained with a stride analyzer unit. EMG activity of the vasti musculature was recorded by using indwelling, bipolar, wire electrodes. Knee joint motion was assessed by using a VICON motion analysis system. All testing was performed with and without the Bauerfeind Genutrain P3 patellofemoral brace. There were no significant differences in torque production, pain levels, and stride characteristics between braced and non-braced trials. In addition, there were no significant differences in mean vasti EMG between braced and non-braced trials. When averaged across all conditions, a small but statistically significant increase in knee flexion was found during the braced trials. Although the current study did not find significant improvements in the clinical measures evaluated, 8 of the 16 subjects did experience a decrease in knee pain. This finding suggests that certain patients with PFP may respond favorably to bracing, and criteria must be established to determine which patients would best benefit from such an intervention.

Influence of muscle groups' activation on proximal femoral growth tendency.

PubMed

Yadav, Priti; Shefelbine, Sandra J; Pontén, Eva; Gutierrez-Farewik, Elena M

2017-12-01

Muscle and joint contact force influence stresses at the proximal growth plate of the femur and thus bone growth, affecting the neck shaft angle (NSA) and femoral anteversion (FA). This study aims to illustrate how different muscle groups' activation during gait affects NSA and FA development in able-bodied children. Subject-specific femur models were developed for three able-bodied children (ages 6, 7, and 11 years) using magnetic resonance images. Contributions of different muscle groups-hip flexors, hip extensors, hip adductors, hip abductors, and knee extensors-to overall hip contact force were computed. Specific growth rate for the growth plate was computed, and the growth was simulated in the principal stress direction at each element in the growth front. The predicted growth indicated decreased NSA and FA (of about [Formula: see text] over a four-month period) for able-bodied children. Hip abductors contributed the most, and hip adductors, the least, to growth rate. All muscles groups contributed to a decrease in predicted NSA ([Formula: see text]0.01[Formula: see text]-0.04[Formula: see text] and FA ([Formula: see text]0.004[Formula: see text]-[Formula: see text]), except hip extensors and hip adductors, which showed a tendency to increase the FA ([Formula: see text]0.004[Formula: see text]-[Formula: see text]). Understanding influences of different muscle groups on long bone growth tendency can help in treatment planning for growing children with affected gait.

Extensor indicis proprius tendon transfer using shear wave elastography.

PubMed

Lamouille, J; Müller, C; Aubry, S; Bensamoun, S; Raffoul, W; Durand, S

2017-06-01

The means for judging optimal tension during tendon transfers are approximate and not very quantifiable. The purpose of this study was to demonstrate the feasibility of quantitatively assessing muscular mechanical properties intraoperatively using ultrasound elastography (shear wave elastography [SWE]) during extensor indicis proprius (EIP) transfer. We report two cases of EIP transfer for post-traumatic rupture of the extensor pollicis longus muscle. Ultrasound acquisitions measured the elasticity modulus of the EIP muscle at different stages: rest, active extension, active extension against resistance, EIP section, distal passive traction of the tendon, after tendon transfer at rest and then during active extension. A preliminary analysis was conducted of the distribution of values for this modulus at the various transfer steps. Different shear wave velocity and elasticity modulus values were observed at the various transfer steps. The tension applied during the transfer seemed close to the resting tension if a traditional protocol were followed. The elasticity modulus varied by a factor of 37 between the active extension against resistance step (565.1 kPa) and after the tendon section (15.3 kPa). The elasticity modulus values were distributed in the same way for each patient. The therapeutic benefit of SWE elastography was studied for the first time in tendon transfers. Quantitative data on the elasticity modulus during this test may make it an effective means of improving intraoperative adjustments. Copyright © 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Changes in trunk posture and muscle responses in standing during pregnancy and postpartum

PubMed Central

Biviá-Roig, Gemma; Lisón, Juan Francisco

2018-01-01

The aim of this study was to analyze the position of the lumbopelvic region and the muscle activation of erector spinae and biceps femoris muscles in a group of pregnant women in the third trimester. The hypothesis was that pregnancy-related biomechanical and morphological changes modify the position of the lumbopelvic region and the activation of extensor muscles. The position of the lumbar spine and pelvis in the sagittal plane, and the EMG activity of the erector spinae and biceps femoris muscles, were recorded during standing in 34 nulliparous and 34 pregnant women in the third trimester, and also two months after birth in the group of pregnant women. No significant differences in the position of the lumbar spine or pelvis between the group of pregnant women and nulliparous or postpartum were observed. A significant increase was observed in the EMG activity of the erector spinae (4.6% vs 2.4% and 2.1% in the nulliparous group and postpartum respectively) and the biceps femoris (3.4% vs 1.2% and 1.4%) in pregnant women compared to the other two groups (p <0.01). We conclude that pregnant women in the third trimester show no alterations in lumbopelvic position compared to nulliparous and postpartum women. However, there is an increase of the EMG activity of the trunk extensors. These results indicate that the extensor muscles of the trunk show, in static positions, adaptive responses to the increase of anterior loads during pregnancy. PMID:29584774

[Obtaining a fermented chickpea extract (Cicer arietinum L.) and its use as a milk extensor].

PubMed

Morales de León, J; Cassís Nosthas, M L; Cecin Salomón, P

2000-06-01

Chickpea (Cicer arietinum L) is cultivated in the North part of México and it is considered a good source of vegetal protein of low cost (20% average), nevertheless, the 80% used for the exportation and only the 20% less was used for animal feeding. The main objective in this study is to obtain a fermented chickpea extract for using in dairy extensor. Chickpea water absorbtion kinetics were carried out in e temperature conditions:while the conditions were established, chickpea was grounded and fermented in different amounts with its natural flora, L. casei, L. plantarum and a mixture culture of both microorganism in logarithmic phase. The results showed that the presence of microorganism of chickpea natural flora interferes during the fermentation, so before the inoculation it was necessary treat the chickpea extract (CE) terminally in a dilution 1:4 during 20 min at 7.7 kg/cm2 of pressure. The use of a mixture culture of 5% of L. casei and 5% L. plantarum inoculated in MRS broth was used to decrease fermentation time. Its addition in logarithmic phase to the sterile chickpea extract increased the lactic acid production and decreased the pH value in 6 h which was less time that one obtained with each of lactobacillus. The fermented extract obtained finally, presented similar sensory characteristics to the ones of dairy products. Therefore, chickpea is a good alternative as a extensor for this kind of products.

Effects of Wearing a Compression Garment During Night Sleep on Recovery From High-Intensity Eccentric-Concentric Quadriceps Muscle Fatigue.

PubMed

Shimokochi, Yohei; Kuwano, Satoshi; Yamaguchi, Taichi; Abutani, Hiroyuki; Shima, Norihiro

2017-10-01

This study aimed to investigate the effects of wearing a compression garment (CG) during night sleep on muscle fatigue recovery after high-intensity eccentric and concentric knee extensor exercises. Seventeen male college students participated in 2 experimental sessions under CG and non-CG (NCG) wearing conditions. Before night sleep under CG or NCG wearing conditions, the subjects performed a fatiguing protocol consisting of 10 sets of 10 repetitions of maximal isokinetic eccentric and concentric knee extensor contractions, with 30-second rest intervals between the sets. Immediately before and after and 24 hours after the fatiguing protocol, maximum voluntary isometric contraction (MVIC) force for knee extensor muscles was measured; surface electromyographic data from the vastus medialis and rectus femoris were also measured. A 2-way repeated-measure analysis of variance followed by Bonferroni pairwise comparisons were used to analyze the differences in each variable. Paired-sample t-tests were used to analyze the mean differences between the conditions at the same time points for each variable. The MVIC 24 hours after the fatiguing protocol was approximately 10% greater in the CG than in the NCG condition (p = 0.033). Changes in the electromyographic variables over time did not significantly differ between the conditions. Thus, it was concluded that wearing a CG during night sleep may promote localized muscle fatigue recovery but does not influence neurological factors after the fatiguing exercise.

BIOMECHANICAL DIFFERENCES IN BRAZILIAN JIU-JITSU ATHLETES: THE ROLE OF COMBAT STYLE.

PubMed

Lima, Pedro Olavo de Paula; Lima, Alane Almeida; Coelho, Anita Camila Sampaio; Lima, Yuri Lopes; Almeida, Gabriel Peixoto Leão; Bezerra, Márcio Almeida; de Oliveira, Rodrigo Ribeiro

2017-02-01

Brazilian Jiu-Jitsu (BJJ) athletes can be divided into two combat styles: pass fighters (PFs) and guard fighters (GFs). Flexibility of the posterior chain muscles is highly necessary in these athletes, especially in GFs. On the other hand, isometric strength of the trunk extensors is required in PFs. Handgrip strength is important in holding the kimono of the opponent, and symmetrical lower-limb strength is important for the prevention of injuries due to the overload caused by training. The aim of this study was to compare the biomechanical profiles of BJJ athletes with different combat styles using the following outcome measures: flexibility, trunk extensor isometric endurance, postural balance, handgrip isometric endurance and lower-limb muscle strength. A cross-sectional study was conducted using 19 GFs and 19 PFs. The sit-and-reach test was used to evaluate the flexibility of the posterior chain muscles. The Biodex Balance System® was used to evaluate balance. A handgrip dynamometer and a dorsal dynamometer were used to evaluate handgrip and trunk extensor endurance, respectively. Quadriceps and hamstring strength were evaluated with an isokinetic dynamometer at 60 °/s. No differences were observed between groups in terms of flexibility, balance, handgrip isometric endurance or quadriceps and hamstring strength; however, PFs (81.33) showed more isometric trunk extension endurance than GFs (68.85) ( p = 0.02). Both groups had low values for hamstring/quadriceps ratio. No significant biomechanical differences were observed between PFs and GFs. 2b.

Gait perturbation response in chronic anterior cruciate ligament deficiency and repair.

PubMed

Ferber, Reed; Osternig, Louis R; Woollacott, Marjorie H; Wasielewski, Noah J; Lee, Ji Hang

2003-02-01

To determine how chronic anterior cruciate ligament deficient and surgically repaired subjects react to unexpected forward perturbations during gait as compared to healthy controls. Gait testing of 10 chronic anterior cruciate ligament deficient subjects prior to and three months following reconstructive surgery, and 10 uninjured controls. The ability of an anterior cruciate ligament injured individual to react and maintain equilibrium during gait perturbations is critical for the prevention of reinjury. No studies have investigated how these individuals respond to unexpected perturbations during normal gait. An unexpected forward perturbation was induced upon heel strike using a force plate capable of translational movement. Prior to surgery, the anterior cruciate ligament subjects exhibited a greater knee extensor moment in response to the perturbation compared to healthy controls. Following surgery, the anterior cruciate ligament injured subjects exhibited a static knee position and a sustained knee extensor moment throughout stance in response to the perturbation as compared to controls. These data suggest that chronic anterior cruciate ligament deficient subjects rely heavily on knee extensor musculature to prevent collapse in response to an unexpected perturbation. This same reactive response was more pronounced 3 months following surgery. The results suggest that, prior to and following surgery, chronic anterior cruciate ligament injured subjects respond differently than healthy controls to an unexpected perturbation during gait. Anterior cruciate ligament injured or repaired subjects do not reduce or avoid vigorous contraction of the quadriceps muscles when responding to gait perturbations.

Gains in flexibility related to measures of muscular performance: impact of flexibility on muscular performance.

PubMed

Ferreira, Gustavo Nunes Tasca; Teixeira-Salmela, Luci Fuscaldi; Guimarães, Cristiano Queiroz

2007-07-01

Studies that investigated possible correlations between flexibility and muscular performance are scarce in the literature. Therefore, the purpose of this study was to investigate the impact of a program of static stretching on the flexibility of the hamstrings and on muscular performance of the knee flexors and extensors. Pre-post experimental design. University laboratory. Thirty subjects aged 22.8 +/- 4.9 years with bilaterally shortened hamstrings. Using a protocol that has been previously described, the intervention consisted of 30 sessions of static stretching, performed bilaterally five times a week for 6 weeks. Measures of knee range of motion and isokinetic muscular performance (peak torque, angle of peak torque, and work) of knee flexors and extensors at speeds of 60 and 300 degrees/s. After intervention, significant gains in measures of flexibility (P < 0.0001) were observed, with an average gain of the knee-extension angle of 12.6 degrees, ranging from -1.2 to 30.7 degrees. In addition, we found significant increases in the following parameters of muscular performance: angle of peak torque of hamstrings at 60 and 300 degrees/s (P < 0.0001 and 0.018) and for work at 60 and 300 degrees/s for knee flexors (P = 0.012 and 0.005) and for knee extensors (P < 0.0001). The intervention resulted in gains in measures of flexibility, and these gains had a positive impact on some parameters of muscular performance.

Physical performance measures that predict faller status in community-dwelling older adults.

PubMed

Macrae, P G; Lacourse, M; Moldavon, R

1992-01-01

Falls are a leading cause of fatal and nonfatal injuries among the elderly. Accurate determination of risk factors associated with falls in older adults is necessary, not only for individual patient management, but also for the development of fall prevention programs. The purpose of this study was to evaluate the effectiveness of clinical measures, such as the one-legged stance test (OLST), sit-to-stand test (STST), manual muscle tests (MMT), and response speed in predicting faller status in community-dwelling older adults (N = 94, age 60-89 years). The variables assessed were single-leg standing (as measured by OLST), STST, and MMT of 12 different muscle groups (hip flexors, hip abductors, hip adductors, knee flexors, knee extensors, ankle dorsiflexors, ankle plantarflexors, shoulder flexors, shoulder abductors, elbow flexors, elbow extensors, and finger flexors), and speed of response (as measured by a visual hand reaction and movement time task). Of the 94 older adults assessed, 28 (29.7%) reported at least one fall within the previous year. The discriminant analysis revealed that there were six variables that significantly discriminated between fallers and nonfallers. These variables included MMT of the ankle dorsiflexors, knee flexors, hip abductors, and knee extensors, as well as time on the OLST and the STST. The results indicate that simple clinical measures of musculoskeletal function can discriminate fallers from nonfallers in community-dwelling older adults. J Orthop Sports Phys Ther 1992;16(3):123-128.

Ultrasound-guided injection of triamcinolone and bupivacaine in the management of De Quervain's disease.

PubMed

Jeyapalan, Kanagaratnam; Choudhary, Surabhi

2009-11-01

The aim of this study was to describe the technique and usefulness of ultrasound-guided intrasynovial injection of triamcinolone and bupivacaine in treatment of de Quervain's disease. A total of 17 patients with symptomatic De Quervain's disease were included in this study. The procedure involved confirmation of diagnosis with ultrasound followed by guided injection of a mixture of 20 mg of triamcinolone (40 mg/ml) and 1 ml of 0.5% bupivacaine. Ultrasound guidance with a high resolution 15-Mhz footprint probe was used for injection into the first dorsal extensor compartment tendon sheath (E1). The response to ultrasound-guided injection was ascertained at the post procedure outpatient clinic appointment according to the follow-up clinic notes. There were 14 female and 3 male patients aged 29 to 74 years. Mean duration of symptoms was 8.9 months. One patient had an atypical septum in the first extensor compartment and the extensor pollicis brevis alone was involved. The mean post-injection follow-up was at 6.75 weeks. One patient was lost to follow-up. Fifteen out of 16 patients had significant symptomatic relief (93.75%). There were no immediate or delayed complications. Recurrence of symptoms was seen in 3 (20%) patients. Ultrasound-guided injection of triamcinolone and bupivacaine is safe and useful in controlling symptoms of De Quervain's disease. Correct needle placement with ultrasound guidance avoids intratendinous injection as well as local complications like fat atrophy and depigmentation.

The structure and function of serially homologous leg motor neurons in the locust. I. Anatomy.

PubMed

Wilson, J A

1979-01-01

Twenty-one prothoracic and 17 mesothoracic motor neurons innervating leg muscles have been identified physiologically and subsequently injected with dye from a microelectrode. A tract containing the primary neurites of motor neurons innervating the retractor unquis, levator and depressor tarsus, flexor tibiae, and reductor femora is described. All motor neurons studied have regions in which their dendritic branches overlap with those of other leg motor neurons. Identified, serially homologous motor neurons in the three thoracic ganglia were found to have: (1) cell bodies at similar locations and morphologically similar primary neurites (e.g., flexor tibiae motor neurons), (2) cell bodies at different locations in each ganglion and morphologically different primary neurites in each ganglion (e.g., fast retractor unguis motor neurons), or (3) cell bodies at similar locations and morphologically similar primary neurites but with a functional switch in one ganglion relative to the function of the neurons in the other two ganglia. As an example of the latter, the morphology of the metathoracic slow extensor tibiae (SETi) motor neurons was similar to that of pro- and mesothoracic fast extensor tibiae (FETi) motor neurons. Similarly the metathoracic FETi bears a striking resemblance to the pro- and the mesothoracic SETi. It is proposed that in the metathoracic ganglion the two extensor tibiae motor neurons have switched functions while retaining similar morphologies relative to the structure and function of their pro- and mesothoracic serial homologues.

Long-term results after vascularised bone graft as treatment of Kienböck disease.

PubMed

Kirkeby, Lone; von Varfalva Palffy, Lena; Hansen, Torben Bæk

2014-02-01

The aim of this study was to present the long-term results in a small series of patients with Kienböck disease treated with a pedicled vascularised bone graft from the 4/5 extensor compartment of the distal radius as the only surgical treatment. In the period 2002-2006, five patients, three men and two women, mean age 41 years (22-54) were operated on using a pedicled vascularised bone graft from the 4/5 extensor compartment of the distal radius as described by Sheetz et al. Four patients were staged as Lichtman stage 2 and one as Lichtman stage 3. At the follow-up examination with radiographs and clinical examination at a mean of 7.4 years (5-9) after the operation, they all stated that they were satisfied with the operation. None of the patients had any further surgery in the observation period. Four patients were fully employed, and only one had changed employment due to his hand. The last patient was on a medical pension due to other medical causes. In all patients, no sign of progression was found of the radiological changes in the lunate and in all patients the arches of Gilula were unchanged without signs of carpal collapse. So, in this small series, a pedicled vascularised bone graft from the 4/5 extensor compartment of the distal radius as the only surgical treatment provided good long-term results in patients with stage 2 and 3 Kienböck disease.

Changes in muscle strength in individuals with statin-induced myopathy: A summary of 3 investigations.

PubMed

Panza, Gregory A; Taylor, Beth A; Dada, Marcin R; Thompson, Paul D

2015-01-01

There are inconsistent findings regarding muscular weakness in individuals with statin-induced myalgia. We used rigorous muscle testing to compare findings from 3 investigations in 3 different study populations to determine if statin myalgia is associated with measurable weakness. In all 3 studies, we measured maximal isometric handgrip strength, resting respiratory exchange ratio (RER), and knee extensor isometric and isokinetic force. In 2 of the 3 studies, elbow flexor isometric and isokinetic force and knee endurance fatigue index were also assessed. Knee extensor and elbow flexor measurements were obtained using an isokinetic dynamometer. Resting RER was measured using a metabolic breath-by-breath collection method. Measurement outcomes were compared on vs off drug. In study 1, 18 participants fit the criteria for statin myalgia. Participants taking atorvastatin 80 mg daily had significantly lower muscle strength in 5 (P < .05) of 14 measured variables. Participants on placebo (N = 10) with myalgia had significantly lower muscle strength in 4 (P < .05) of 14 measured variables. In study 2, 18 participants tested positive for statin-induced myalgia when receiving simvastatin 20 mg daily and displayed no significant muscle strength changes (all P > .05). In study 3, 11 patients with statin-induced myalgia completed the study and had a significant decrease in 2 (P < .05) of 10 leg muscle strength variables. In all 3 studies, no significant changes were shown for handgrip strength or RER (all P > .05). Our results indicate that after a short-term treatment with statin therapy, a rigorous muscle strength protocol does not show decrements of muscle strength in subjects with statin myalgia. Short-term treatment with statin therapy is not common in clinical practice. Thus, future studies should examine the effects of prolonged statin therapy on muscle strength. Published by Elsevier Inc.

Reciprocal inhibition between motor neurons of the tibialis anterior and triceps surae in humans.

PubMed

Yavuz, Utku Ş; Negro, Francesco; Diedrichs, Robin; Farina, Dario

2018-05-01

Motor neurons innervating antagonist muscles receive reciprocal inhibitory afferent inputs to facilitate the joint movement in the two directions. The present study investigates the mutual transmission of reciprocal inhibitory afferent inputs between the tibialis anterior (TA) and triceps surae (soleus and medial gastrocnemius) motor units. We assessed this mutual mechanism in large populations of motor units for building a statistical distribution of the inhibition amplitudes during standardized input to the motor neuron pools to minimize the effect of modulatory pathways. Single motor unit activities were identified using high-density surface electromyography (HDsEMG) recorded from the TA, soleus (Sol), and medial gastrocnemius (GM) muscles during isometric dorsi- and plantarflexion. Reciprocal inhibition on the antagonist muscle was elicited by electrical stimulation of the tibial (TN) or common peroneal nerves (CPN). The probability density distributions of reflex strength for each muscle were estimated to examine the strength of mutual transmission of reciprocal inhibitory input. The results showed that the strength of reciprocal inhibition in the TA motor units was fourfold greater than for the GM and the Sol motor units. This suggests an asymmetric transmission of reciprocal inhibition between ankle extensor and flexor muscles. This asymmetry cannot be explained by differences in motor unit type composition between the investigated muscles since we sampled low-threshold motor units in all cases. Therefore, the differences observed for the strength of inhibition are presumably due to a differential reciprocal spindle afferent input and the relative contribution of nonreciprocal inhibitory pathways. NEW & NOTEWORTHY We investigated the mutual transmission of reciprocal inhibition in large samples of motor units using a standardized input (electrical stimulation) to the motor neurons. The results demonstrated that the disynaptic reciprocal inhibition exerted between ankle flexor and extensor muscles is asymmetric. The functional implication of asymmetric transmission may be associated with the neural strategies of postural control.

Quadriceps tendon injuries in national football league players.

PubMed

Boublik, Martin; Schlegel, Theodore F; Koonce, Ryan C; Genuario, James W; Kinkartz, Jason D

2013-08-01

Distal quadriceps tendon tears are uncommon injuries that typically occur in patients older than 40 years of age, and they have a guarded prognosis. Predisposing factors, prodromal findings, mechanisms of injury, treatment guidelines, and recovery expectations are not well described in high-level athletes. Professional American football players with an isolated tear of the quadriceps tendon treated with timely surgical repair will return to their sport. Case series; Level of evidence, 4. Fourteen unilateral distal quadriceps tendon tears were identified in National Football League (NFL) players from 1994 to 2004. Team physicians retrospectively reviewed training room and clinic records, operative notes, and imaging studies for each of these players. Data on each player were analyzed to identify variables predicting return to play. A successful outcome was defined as returning to play in regular-season NFL games. Eccentric contraction of the quadriceps was the most common mechanism of injury, occurring in 10 players. Only 1 player had antecedent ipsilateral extensor mechanism symptoms. Eleven players had a complete rupture of the quadriceps tendon, and 3 had partial tears. There were no associated knee injuries. All ruptures were treated with surgical repair, 1 of which was delayed after failure of nonoperative treatment. Fifty percent of players returned to play in regular-season NFL games. There was a trend toward earlier draft status for those who returned to play compared with those who did not (draft round, 3.1 ± 2.5 vs. 6.0 ± 2.9, respectively; P = .073). For those who returned to play, the average number of games after injury was 40.9 (range, 12-92). Quadriceps tendon tears are rare in professional American football players, and they usually occur from eccentric load on the extensor mechanism. Prodromal symptoms and predisposing factors are usually absent. Even with timely surgical repair, there is a low rate of return to play in regular-season games. There is a trend toward early draft rounds for those who successfully return to play.

Comparison of spinal alignment, muscular strength, and quality of life between women with postmenopausal osteoporosis and healthy volunteers.

PubMed

Miyakoshi, N; Kudo, D; Hongo, M; Kasukawa, Y; Ishikawa, Y; Shimada, Y

2017-11-01

This study compared spinal alignment, muscular strength, and quality of life (QOL) between women with postmenopausal osteoporosis and healthy volunteers. The results indicated that lower QOL in osteoporosis patients may be associated with increased thoracic kyphosis, reduced lean muscle mass, and generalized muscle weakness. Increased spinal kyphosis is common in patients with osteoporosis and negatively impacts quality of life (QOL). Muscular strength is also important for QOL in patients with osteoporosis. However, spinal kyphosis and muscle weakness also occur in healthy individuals with advancing age. The purposes of this study were thus to compare spinal alignment, muscular strength, and QOL between women with postmenopausal osteoporosis and healthy volunteers. Participants comprised 236 female patients with postmenopausal osteoporosis (mean age, 68.7 years) and 93 healthy volunteer women (mean age, 71.0 years). Body mass index (BMI), angles of spinal kyphosis, back extensor strength, grip strength, and QOL were compared between groups. BMI, back extensor strength, and grip strength were significantly higher in the volunteer group than in the osteoporosis group (p < 0.01). Both thoracic kyphosis and lumbar lordosis were significantly greater in the osteoporosis group than in the volunteer group (p < 0.01). With regard to QOL, the 36-Item Short-Form Health Survey (SF-36) subscale scores of role physical, bodily pain, general health, and role emotional were all significantly lower in the osteoporosis group than in the volunteer group (p < 0.05 each). SF-36 physical component summary (PCS) score was significantly lower in the osteoporosis group than in the volunteer group (p < 0.001). SF-36 PCS score correlated positively with thoracic kyphosis and negatively with BMI only in the osteoporosis group (p < 0.05 each). These results indicated that lower QOL in osteoporosis patients may be associated with increased thoracic kyphosis, reduced lean muscle mass, and generalized muscle weakness.

Characteristics and preliminary observations of the influence of electromyostimulation on the size and function of human skeletal muscle during 30 days of simulated microgravity

NASA Technical Reports Server (NTRS)

Duvoisin, Marc R.; Convertino, Victor A.; Buchanan, Paul; Gollnick, Philip A.; Dudley, Gary A.

1989-01-01

The effect of transcutaneous electromyostimulation (EMS) on the development of atrophy and the loss of strength in lower limb musculature in humans exposed to microgravity was determined in three subjects who received EMS twice daily in a 3-d on/1-d off cycle on their dominant leg during 30 days of bedrest. The output waveform from the stimulator was sequenced to the knee extensors, knee flexors, ankle extensors, and ankle flexors, and caused three isometric contractions of each muscle group per minute. It was found that, in the dominant leg, EMS acted to attenuate the changes caused by bedrest, such as reductions in the leg volume, muscle compartment size, cross-sectional area of slow- and fast-twitch fibers, strength, and aerobic enzyme activities, and an increase in leg compliance.

Two families with MYH7 distal myopathy associated with cardiomyopathy and core formations.

PubMed

Naddaf, Elie; Waclawik, Andrew J

2015-03-01

Laing distal myopathy is caused by MYH7 gene mutations. Multiple families have been reported with varying patterns of skeletal and cardiac involvement as well as histopathological findings. We report 2 families with p.Glu1508del mutation with detailed electrophysiological and muscle pathology findings. All patients displayed the classic phenotype with weakness starting in the anterior compartment of the legs with a "hanging great toe." It was followed by finger extensors involvement, relatively sparing the extensor indicis proprius, giving the appearance of a "pointing index" finger. All the affected individuals had a dilated cardiomyopathy and core formations on muscle biopsy. Unexpectedly, neurogenic changes were also observed in some individuals. Both families were initially misdiagnosed with either central core disease or hereditary neuropathy. Recognizing the classic phenotype, screening for cardiac involvement that may be clinically silent, and determining the mode of inheritance help with selecting the appropriate genetic test.

Vascularised knee joint transplantation in man: the first two years experience.

PubMed

Kirschner, M H; Brauns, L; Gonschorek, O; Bühren, V; Hofmann, G O

2000-04-01

To describe our early experience with a new technique for restoring destroyed knee joints to give reasonable functional results. Observational clinical trial. Level-1-Trauma centre, Germany. 5 patients with large bone defects of the knee and loss of the extensor apparatus caused either by serious injury alone, or infection after serious injury. Transplantation of fresh and perfused knee joints with a vascular pedicle from multiorgan donors under immunosuppression. Ability to walk, need to remove one transplanted joint. Four patients are able to walk, the range of movement being from 50 degrees-120 degrees. The first patient additionally had to be provided with a total knee joint arthroplasty. In the third patient the graft became infected and had to be removed. She finally had an arthrodesis and bone lengthening by the Ilizarov technique. Transplantation of the knee joint may be an alternative to bone lengthening or amputation for patients with total loss of the extensor apparatus.

Muscle strength at the trunk*.

PubMed

Smidt, G L; Amundsen, L R; Dostal, W F

1980-01-01

The purpose of this study was to determine the strength of trunk flexors and extensors in normal male subjects during isometric, concentric, and eccentric contractions. Subjects were tested in the sidelying position to minimize the effects of gravity. The pelvis and lower extremities were measured on a custom built force table (lowa Force Table). Muscle strength was expressed as a moment of force (external force times the moment arm) in Newton-meter (Nm) units. Greater Nm were registered in the muscle-lengthened position than in the muscle-shortened position for all isometric contractions. The Nm registered for eccentric contractions always exceeded the Nm registered for concentric contractions of the same muscle group. The Nm registered during contractions of trunk extensors always exceeded the values obtained during corresponding modes of contractions (isometric, eccentric, and concentric) of trunk flexors.J Orthop Sports Phys Ther 1980;1(3):165-170.

Surgical Approaches to the Proximal Interphalangeal Joint.

PubMed

Cheah, Andre Eu-Jin; Yao, Jeffrey

2016-02-01

The proximal interphalangeal (PIP) joint may be affected by many conditions such as arthropathy, fractures, dislocations, and malunions. Whereas some of these conditions may be treated nonsurgically, many require open surgical intervention. Open interventions include implant arthroplasty or arthrodesis for arthropathy, open reduction internal fixation, or hemi-hamate arthroplasty for dorsal fracture-dislocations. Volar plate arthroplasty and corrective osteotomy for malunion about the PIP joint are also surgeries that may be required. The traditional approach to the PIP joint has been dorsal, which damages the delicate extensor apparatus with subsequent development of an extensor lag. This has led surgeons to explore volar and lateral approaches to the PIP joint. In this article, we describe each of these surgical approaches, discuss their advantages and disadvantages, and provide some guidance on which approach to choose based on the surgery that is to be performed. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Vibration-induced muscle injury. An experimental model and preliminary findings.

PubMed

Necking, L E; Dahlin, L B; Fridén, J; Lundborg, G; Lundström, R; Thornell, L E

1992-06-01

The hind paws of rats were subjected to vibration at a frequency of 80 Hz., an acceleration of 32 m./s.2 rms (i.e. ah.w approximately 6.3 m./s.2 rms) for five hours daily during five consecutive days. Morphological, histochemical and immunohistochemical analyses of the soleus, extensor digitorum longus and the plantar muscles in the vibrated limb and the contralateral control limb were performed. No changes were seen in the soleus or extensor digitorum longus muscles but different degrees of degeneration of the muscle fibres were seen in the plantar muscle sections as well as signs of regeneration. No changes were observed in the contralateral unexposed limb. It is concluded that it is not only nervous tissue but also muscle tissue that can be affected by vibration. The changes seem to be confined to muscles close to the vibration exciter.

Cross-education of wrist extensor strength is not influenced by non-dominant training in right-handers.

PubMed

Coombs, Timothy A; Frazer, Ashlyn K; Horvath, Deanna M; Pearce, Alan J; Howatson, Glyn; Kidgell, Dawson J

2016-09-01

Cross-education of strength has been proposed to be greater when completed by the dominant limb in right handed humans. We investigated whether the direction of cross-education of strength and corticospinal plasticity are different following right or left limb strength training in right-handed participants. Changes in strength, muscle thickness and indices of corticospinal plasticity were analyzed in 23 adults who were exposed to 3-weeks of either right-hand strength training (RHT) or left-hand strength training (LHT). Maximum voluntary wrist extensor strength in both the trained and untrained limb increased, irrespective of which limb was trained, with TMS revealing reduced corticospinal inhibition. Cross-education of strength was not limited by which limb was trained and reduced corticospinal inhibition was not just confined to the trained limb. Critically, from a behavioral perspective, the magnitude of cross-education was not limited by which limb was trained.

A dental stool with chest support reduces lower back muscle activation.

PubMed

Tran, Viet; Turner, Reid; MacFadden, Andrew; Cornish, Stephen M; Esliger, Dale; Komiyama, Kunio; Chilibeck, Philip D

2016-09-01

Activation of back musculature during work tasks leads to fatigue and potential injury. This is especially prevalent in dentists who perform much of their work from a seated position. We examined the use of an ergonomic dental stool with mid-sternum chest support for reducing lower back muscle activation. Electromyography of lower back extensors was assessed from 30 dental students for 20 s during three conditions in random order: (a) sitting upright at 90° of hip flexion on a standard stool, (b) leaning forward at 80° of hip flexion on a standard stool, and (c) leaning forward at 80° of hip flexion while sitting on an ergonomic stool. Muscular activity of the back extensors was reduced when using the ergonomic stool compared to the standard stool, by 33-50% (p < 0.01). This suggests a potential musculoskeletal benefit with use of a dental stool with mid-sternum chest support.

Effects of fatigue on motor unit firing rate versus recruitment threshold relationships.

PubMed

Stock, Matt S; Beck, Travis W; Defreitas, Jason M

2012-01-01

The purpose of this study was to examine the influence of fatigue on the average firing rate versus recruitment threshold relationships for the vastus lateralis (VL) and vastus medialis. Nineteen subjects performed ten maximum voluntary contractions of the dominant leg extensors. Before and after this fatiguing protocol, the subjects performed a trapezoid isometric muscle action of the leg extensors, and bipolar surface electromyographic signals were detected from both muscles. These signals were then decomposed into individual motor unit action potential trains. For each subject and muscle, the relationship between average firing rate and recruitment threshold was examined using linear regression analyses. For the VL, the linear slope coefficients and y-intercepts for these relationships increased and decreased, respectively, after fatigue. For both muscles, many of the motor units decreased their firing rates. With fatigue, recruitment of higher threshold motor units resulted in an increase in slope for the VL. Copyright © 2011 Wiley Periodicals, Inc.

Morphological and biochemical changes in soleus and extensor digitorum longus muscles of rats orbited in Spacelab 3

NASA Technical Reports Server (NTRS)

Riley, D. A.; Slocum, T.; Bain, J. L. W.; Sedlak, F. R.; Elis, S.; Satyanarayana, T.

1985-01-01

Muscle atrophy in rats exposed to hypogravity for seven days aboard Spacelab 3 is examined. Hindlimb muscles were harvested 12-16 days postflight, and prepared for enzyme studies and electron microscopy. Simple cell shrinkage was found, with a mean fiber area decrease of 35.8 percent for soleus and 24.9 percent for extensor digitorum longus (EDL) flight muscle fibers, as compared with control muscle fibers. EDL and soleus muscles showed increases in alkaline myofibrillar ATPase, alpha glycerophosphate dehydrogenase, and glycogen, and a decrease in NADH dehydrogenase staining. The 26 percent increase in calcium activated protease suggests that the focal degradation of myofibrils is the key process of myofibril breakdown. The presence in the flight soleus muscles of one percent necrotic fibers is unexplained. The observed shift towards histochemical fast-muscle type properties is consistent with previous findings.

Outcome of Boyd-McLeod procedure for recalcitrant lateral epicondylitis of elbow.

PubMed

Reddy, V R M; Satheesan, K S; Bayliss, N

2011-08-01

Various surgical procedures including percutaneous and open release and arthroscopic procedures have been described to treat recalcitrant tennis elbow. We present the outcome of Boyd-McLeod surgical procedure for tennis elbow resistant to non-operative treatment in twenty-seven patients (twenty-nine limbs). Boyd McLeod procedure involves excision of the proximal portion of the annular ligament, release of the origin of the extensor muscles, excision of the bursa if present, and excision of the synovial fringe. The average time interval from the onset of symptoms of tennis elbow until surgery was 28 months (range 8-72 months). Of those patients, 91% reported complete relief of symptoms with return to full normal activities including sports. Average post-operative time for return to professional/recreational activity was 5 weeks. One case developed pain secondary to ectopic bone formation after surgery, which settled after excision, and in another there was no pain relief with Boyd McLeod procedure. Two patients had scar tenderness that did not affect the final outcome. We conclude that Boyd-McLeod procedure is an effective treatment option in patients with resistant lateral epicondylitis.

Does metabosensitive afferent fibers activity differ from slow- and fast-twitch muscles?

PubMed

Caron, Guillaume; Decherchi, Patrick; Marqueste, Tanguy

2015-09-01

This study was designed to investigate the metabosensitive afferent response evoked by electrically induced fatigue (EIF), lactic acid (LA) and potassium chloride (KCl) in three muscle types. We recorded the activity of groups III-IV afferents originating from soleus, gastrocnemius and tibialis anterior muscles. Our data showed a same pattern of response in the three muscles after chemical injections, i.e., a bell curve with maximal discharge rate at 1 mM for LA injections and a linear relationship between KCl concentrations and the afferent discharge rate. Furthermore, a stronger response was recorded after EIF in the gastrocnemius muscle compared to the two other muscles. The change in afferent discharge after 1 mM LA injection was higher for the gastrocnemius muscle compared to the response obtained with the corresponding concentration applied in the two other muscles, whereas changes to KCl injections did not dramatically differ between the three muscles. We conclude that anatomical (mass, phenotype, vascularization, receptor and afferent density…) and functional (flexor vs. extensor) differences between muscles could explain the amplitude of these responses.

The effects of lumbar extensor strength on disability and mobility in patients with persistent low back pain.

PubMed

Helmhout, Pieter H; Witjes, Marloes; Nijhuis-VAN DER Sanden, Ria W; Bron, Carel; van Aalst, Michiel; Staal, J Bart

2017-04-01

It is assumed that low back pain patients who use pain-avoiding immobilizing strategies may benefit from specific back flexion and extension exercises aimed at reducing sagittal lumbar hypomobility. The aim of this study was to test this potential working mechanism in chronic low back pain patients undergoing lumbar extensor strengthening training. A single-group prospective cohort design was used in this study. Patients with persistent low back complaints for at least 2 years were recruited at a specialized physical therapy clinics center. They participated in a progressive 11-week lumbar extensor strength training program, once a week. At baseline, sagittal lumbar mobility in flexion and extension was measured with a computer-assisted inclinometer. Self-rated pain intensity was measured using a visual analogue scale, back-specific functional status was assessed with the Quebec Back Pain Disability Scale and the Patient Specific Complains questionnaire. Statistically significant improvements were found in pain (28% decrease) and functional disability (23% to 36% decrease). Most progress was seen in the first 5 treatment weeks. Lumbar mobility in flexion showed non-significant increases over time (+12%). Pre-post treatment changes in flexion and extension mobility did not contribute significantly to the models. The retained factors together explained 15% to 48% of the variation in outcome. Specific lumbar strengthening showed clinically relevant improvements in pain and disability in patients with persistent chronic low back pain. These improvements did not necessarily relate to improvements in lumbar mobility. Parameters representing other domains of adaptations to exercise may be needed to evaluate the effects of back pain management.

Greater glucose uptake heterogeneity in knee muscles of old compared to young men during isometric contractions detected by [18F]-FDG PET/CT

PubMed Central

Rudroff, Thorsten; Kindred, John H.; Benson, John-Michael; Tracy, Brian L.; Kalliokoski, Kari K.

2014-01-01

We used positron emission tomography/computed tomography (PET/CT) and [18F]-FDG to test the hypothesis that glucose uptake (GU) heterogeneity in skeletal muscles as a measure of heterogeneity in muscle activity is greater in old than young men when they perform isometric contractions. Six young (26 ± 6 years) and six old (77 ± 6 years) men performed two types of submaximal isometric contractions that required either force or position control. [18F]-FDG was injected during the task and PET/CT scans were performed immediately after the task. Within-muscle heterogeneity of knee muscles was determined by calculating the coefficient of variation (CV) of GU in PET image voxels within the muscles of interest. The average GU heterogeneity (mean ± SD) for knee extensors and flexors was greater for the old (35.3 ± 3.3%) than the young (28.6 ± 2.4%) (P = 0.006). Muscle volume of the knee extensors were greater for the young compared to the old men (1016 ± 163 vs. 598 ± 70 cm3, P = 0.004). In a multiple regression model, knee extensor muscle volume was a predictor (partial r = −0.87; P = 0.001) of GU heterogeneity for old men (R2 = 0.78; P < 0.001), and MVC force predicted GU heterogeneity for young men (partial r = −0.95, P < 0.001). The findings demonstrate that GU is more spatially variable for old than young men and especially so for old men who exhibit greater muscle atrophy. PMID:24904432

Reliability of the hand held dynamometer in measuring muscle strength in people with interstitial lung disease.

PubMed

Dowman, Leona; McDonald, Christine F; Hill, Catherine J; Lee, Annemarie; Barker, Kathryn; Boote, Claire; Glaspole, Ian; Goh, Nicole; Southcott, Annemarie; Burge, Angela; Ndongo, Rebecca; Martin, Alicia; Holland, Anne E

2016-09-01

To evaluate the inter-rater and intra-rater reliability of the hand held dynamometer in measuring muscle strength in people with interstitial lung disease (ILD). Test retest reliability of hand-held dynamometry for elbow flexor and knee extensor strength between two independent raters and two testing sessions. Physiotherapy department within a tertiary hospital. Thirty participants with ILD of varying aetiology were included. Twenty participants completed the inter-rater reliability protocol (10 idiopathic pulmonary fibrosis, mean (SD) age 73 (10) years, 11 male) and 21 participants completed the intra-rater reliability protocol (10 idiopathic pulmonary fibrosis, mean age 71 (10) years, 11 male). Mean muscle strength (kg). Agreement between the two raters and testing sessions was analyzed using Bland-Altman plots and reliability was estimated using intraclass correlation coefficients (ICC). For elbow flexor strength there was a mean difference between raters of -0.6kg (limits of agreement (LOA) -5.6 to 4.4kg) and within raters of -0.3kg (LOA -2.8 to 2.3kg). The ICCs were 0.95 and 0.98, respectively. For knee extensor strength there was a mean difference between raters of -1.5kg (LOA -6.9 to 3.9kg) and within raters of -0.7kg (LOA -3.9 to 2.4kg). The ICCs were 0.95 and 0.97, respectively. Hand-held dynamometry is reliable in measuring elbow flexor and knee extensor strength in people with ILD. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Changes in diffusion tensor imaging (DTI) eigenvalues of skeletal muscle due to hybrid exercise training.

PubMed

Okamoto, Yoshikazu; Kemp, Graham J; Isobe, Tomonori; Sato, Eisuke; Hirano, Yuji; Shoda, Junichi; Minami, Manabu

2014-12-01

Several studies have proposed the cell membrane as the main water diffusion restricting factor in the skeletal muscle cell. We sought to establish whether a particular form of exercise training (which is likely to affect only intracellular components) could affect water diffusion. The purpose of this study is to characterise prospectively the changes in diffusion tensor imaging (DTI) eigenvalues of thigh muscle resulting from hybrid training (HYBT) in patients with non-alcoholic fatty liver disease (NAFLD). Twenty-one NAFLD patients underwent HYBT for 30 minutes per day, twice a week for 6 months. Patients were scanned using DTI of the thigh pre- and post-HYBT. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), the three eigenvalues lambda 1 (λ1), λ2, λ3, and the maximal cross sectional area (CSA) were measured in bilateral thigh muscles: knee flexors (biceps femoris (BF), semitendinosus (ST), semimembranous (SM)) and knee extensors (medial vastus (MV), intermediate vastus (IV), lateral vastus (LV), and rectus femoris (RF)), and compared pre- and post-HYBT by paired t-test. Muscle strength of extensors (P<0.01), but not flexors, increased significantly post-HYBT. For FA, ADC and eigenvalues, the overall picture was of increase. Some (P<0.05 in λ2 and P<0.01 in λ1) eigenvalues of flexors and all (λ1-λ3) eigenvalues of extensors increased significantly (P<0.01) post-HYBT. HYBT increased all 3 eigenvalues. We suggest this might be caused by enlargement of muscle intracellular space. Copyright © 2014 Elsevier Inc. All rights reserved.

THE FUNCTIONAL ROLES OF MUSCLES DURING SLOPED WALKING

PubMed Central

Pickle, Nathaniel T.; Grabowski, Alena M.; Auyang, Arick G.; Silverman, Anne K.

2016-01-01

Sloped walking is biomechanically different from level-ground walking, as evidenced by changes in joint kinematics and kinetics. However, the changes in muscle functional roles underlying these altered movement patterns have not been established. In this study, we developed a total of 273 muscle-actuated simulations to assess muscle functional roles, quantified by induced body center-of-mass accelerations and trunk and leg power, during walking on slopes of 0°, ±3°, ±6°, and ±9° at 1.25 m/s. The soleus and gastrocnemius both provided greater forward acceleration of the body parallel to the slope at +9° compared to level ground (+126% and +66%, respectively). However, while the power delivered to the trunk by the soleus varied with slope, the magnitude of net power delivered to the trunk and ipsilateral leg by the biarticular gastrocnemius was similar across all slopes. At +9°, the hip extensors absorbed more power from the trunk (230% hamstrings, 140% gluteus maximus) and generated more power to both legs (200% hamstrings, 160% gluteus maximus) compared to level ground. At −9°, the knee extensors (rectus femoris and vasti) accelerated the body upward perpendicular to the slope at least 50% more and backward parallel to the slope twice as much as on level ground. In addition, the knee extensors absorbed greater amounts of power from the ipsilateral leg on greater declines to control descent. Future studies can use these results to develop targeted rehabilitation programs and assistive devices aimed at restoring sloped walking ability in impaired populations. PMID:27553849

Functional specialization and ontogenetic scaling of limb anatomy in Alligator mississippiensis

PubMed Central

Allen, Vivian; Elsey, Ruth M; Jones, Nicola; Wright, Jordon; Hutchinson, John R

2010-01-01

Crocodylians exhibit a fascinating diversity of terrestrial gaits and limb motions that remain poorly described and are of great importance to understanding their natural history and evolution. Their musculoskeletal anatomy is pivotal to this diversity and yet only qualitative studies of muscle-tendon unit anatomy exist. The relative masses and internal architecture (fascicle lengths and physiological cross-sectional areas) of muscles of the pectoral and pelvic limbs of American alligators (Alligator mississippiensis Daudin 1801) were recorded for an ontogenetic series of wild specimens (n = 15, body masses from 0.5 to 60 kg). The data were analysed by reduced major axis regression to determine scaling relationships with body mass. Physiological cross-sectional areas and therefore muscle force-generating capacity were found to be greater in the extensor (anti-gravity) muscles of the pelvic limb than in the pectoral limb, reflecting how crocodylians differ from mammals in having greater loading of the hindlimbs than the forelimbs. Muscle masses and architecture were generally found to scale isometrically with body mass, suggesting an ontogenetic decrease in terrestrial athleticism. This concurs with the findings of previous studies showing ontogenetic decreases in limb bone length and the general scaling principle of a decline of strength : weight ratios with increasing size in animals. Exceptions to isometric scaling found included positive allometry in fascicle length for extensor musculature of both limbs, suggesting an ontogenetic increase in working range interpreted as increasing postural variability – in particular the major hip extensors – the interpretation of which is complicated by previous described ontogenetic increase of moment arms for these muscles. PMID:20148991

Evaluation of Interhandle Distance During Pushing and Pulling of a Four-Caster Cart for Upper Limb Exertion.

PubMed

Ohnishi, Akihiro; Takanokura, Masato; Sugama, Atsushi

2016-09-01

This study examined the relationship between interhandle distances and upper limb exertion during simply pushing and pulling of a cart with four swivel wheels, defined by a roll box pallet (RBP) in a Japanese industrial standard. Six healthy young male participants were asked to push and pull an RBP at a distance of 5.2 m under six conditions corresponding to different interhandle distances (40 cm, 60 cm, and 80 cm) and weights (130 kg and 250 kg). The upper limb exertion was studied by shoulder abduction and flexion, and elbow flexion, as well as surface electromyogram (EMG) in shoulder extensor, and elbow flexor and extensor. Participants were required to provide subjective evaluations on operability after each trial. Subjective operability indicated that a narrower interhandle distance had a better operability for pushing. Interhandle distance was also related to upper limb exertion especially for pushing. A narrow interhandle distance caused smaller shoulder adduction but larger elbow flexion. The normalized EMG data revealed that muscular activity became smaller with a narrow interhandle distance in shoulder extensor. During the pulling task, elbow flexion was smaller at a narrow interhandle distance, although subjective operability and normalized EMG were not significantly varied. A wider interhandle distance, such as 80 cm, was not suitable in the forwardbackward movement of the RBP. Therefore, this study concluded that an interhandle distance of 40 cm would be suitable for pushing and pulling an RBP to protect the workers' hands against the risk of injury by installing inner handles.

Tenosynovitis US scoring systems follow synovitis and clinical scoring systems in RA and are responsive to change after biologic therapy.

PubMed

Vlad, Violeta; Berghea, Florian; Micu, Mihaela; Varzaru, Luminita; Bojinca, Mihai; Milicescu, Mihaela; Ionescu, Ruxandra; Naredo, Esperanza

2015-09-01

To investigate by ultrasonography (US) in a cohort of active RA patients starting biologic therapy the responsiveness of tenosynovitis of wrist and hands compared to the responsiveness of synovitis in a 6 month period follow-up, to compare the responsiveness of finger flexor tenosynovitis with the responsiveness of wrist extensor tenosynovitis and to describe the subclinical synovitis and tenosynovitis in RA patients in clinical remission. Fifty seven patients with active RA starting biologic therapy were included. Clinical, laboratory, and US evaluations were performed at baseline, 1, and 6 months. US evaluation included wrist and MCPs 2-5 joints, bilaterally for synovitis and extensor tendons compartments 2, 4, and 6 and finger flexors 2-5 for tenosynovitis. Eighteen US scores based on semiquantitative or binary grades were calculated at each visit. Responsiveness of synovitis and tenosynovitis scores was calculated using the standardized response mean (SRM). The responsiveness of US tenosynovitis was lower comparing with the responsiveness of US synovitis but both showed large effect of therapy. Furthermore, tenosynovitis responsiveness was similar to CRP responsiveness (SRM -0.90). Finger flexors tenosynovitis showed a higher responsiveness than extensor tenosynovitis on GS (-0.94 compared to -0.63) and a lower SRM on PD (-0.56 compared to -0.85). Tenosynovitis scores remission was overlapping clinical remission according to CDAI and SDAI in 100% of cases. Overall there was less subclinical tenosynovitis than subclinical synovitis at final visit according to clinical activity indices. Tenosynovitis US scoring in RA may be as good as synovitis scoring for characterization of disease activity and responsiveness.

Influence of obstructive sleep apnea syndrome in the fluctuation of the submaximal isometric torque of knee extensors in patients with early-grade osteoarthritis

PubMed Central

Silva, Andressa; Mello, Marco T.; Serrão, Paula R.; Luz, Roberta P.; Bittencourt, Lia R.; Mattiello, Stela M.

2015-01-01

OBJECTIVE: The aim of this study was to investigate whether obstructive sleep apnea (OSA) alters the fluctuation of submaximal isometric torque of the knee extensors in patients with early-grade osteoarthritis (OA). METHOD: The study included 60 male volunteers, aged 40 to 70 years, divided into four groups: Group 1 (G1) - Control (n=15): without OA and without OSA; Group 2 (G2) (n=15): with OA and without OSA; Group 3 (G3) (n=15): without OA and with OSA; and Group 4 (G4) (n=15) with OA and with OSA. Five patients underwent maximal isometric contractions of 10 seconds duration each, with the knee at 60° of flexion to determine peak torque at 60°. To evaluate the fluctuation of torque, 5 submaximal isometric contractions (50% of maximum peak torque) of 10 seconds each, which were calculated from the standard deviation of torque and coefficient of variation, were performed. RESULTS: Significant differences were observed between groups for maximum peak torque, while G4 showed a lower value compared with G1 (p=0.005). Additionally, for the average torque exerted, G4 showed a lower value compared to the G1 (p=0.036). However, no differences were found between the groups for the standard deviation (p=0.844) and the coefficient of variation (p=0.143). CONCLUSION: The authors concluded that OSA did not change the parameters of the fluctuation of isometric submaximal torque of knee extensors in patients with early-grade OA. PMID:26443974

Outcomes of percutaneous trigger finger release with concurrent steroid injection.

PubMed

Liu, Wen-Chih; Lu, Chun-Kuan; Lin, Yu-Chuan; Huang, Peng-Ju; Lin, Gau-Tyan; Fu, Yin-Chih

2016-12-01

Percutaneous release (PR) of the A1 pulley is a quick, safe, and minimally invasive procedure for treating trigger fingers. The purpose of this study is to identify if PR with additional steroid injections can shorten the recovery to reach unlimited range of motion. Between January 2013 and December 2013, we included 432 trigger fingers with actively correctable triggering or severer symptoms without previous surgical release or steroid injections from two hand clinic offices (A and B). The same experienced surgeon performed PR at the office. Patients from Clinic A received PR with steroid injections and those from Clinic B received PR without steroid injections. Patients returned for follow-up 1 week, 6 weeks, and 12 weeks after the procedure. Between the steroid group and the nonsteroid group, there is no significant difference in the mean time for patients to return to normal work and the rate of residual extensor lag. Middle fingers showed a 5.09-fold chance of having a residual extensor lag over that of the other fingers. High grade trigger fingers recovered more slowly than low grade ones. The success rate of a 12-week follow-up was 98.4%. There was no significant difference between the steroid group (97.5%) and the nonsteroid group (99.1%). PR can treat trigger fingers effectively, but additional steroid injection does not provide more benefit. Some fingers showed temporary extensor lag, especially in middle fingers and high grade trigger fingers, but 85% of those will eventually reach full recovery after self-rehabilitation without another surgical release. Copyright © 2016. Published by Elsevier Taiwan.

Feed-forward motor control of ultrafast, ballistic movements.

PubMed

Kagaya, K; Patek, S N

2016-02-01

To circumvent the limits of muscle, ultrafast movements achieve high power through the use of springs and latches. The time scale of these movements is too short for control through typical neuromuscular mechanisms, thus ultrafast movements are either invariant or controlled prior to movement. We tested whether mantis shrimp (Stomatopoda: Neogonodactylus bredini) vary their ultrafast smashing strikes and, if so, how this control is achieved prior to movement. We collected high-speed images of strike mechanics and electromyograms of the extensor and flexor muscles that control spring compression and latch release. During spring compression, lateral extensor and flexor units were co-activated. The strike initiated several milliseconds after the flexor units ceased, suggesting that flexor activity prevents spring release and determines the timing of strike initiation. We used linear mixed models and Akaike's information criterion to serially evaluate multiple hypotheses for control mechanisms. We found that variation in spring compression and strike angular velocity were statistically explained by spike activity of the extensor muscle. The results show that mantis shrimp can generate kinematically variable strikes and that their kinematics can be changed through adjustments to motor activity prior to the movement, thus supporting an upstream, central-nervous-system-based control of ultrafast movement. Based on these and other findings, we present a shishiodoshi model that illustrates alternative models of control in biological ballistic systems. The discovery of feed-forward control in mantis shrimp sets the stage for the assessment of targets, strategic variation in kinematics and the role of learning in ultrafast animals. © 2016. Published by The Company of Biologists Ltd.

The reliability and validity of a designed setup for the assessment of static back extensor force and endurance in older women with and without hyperkyphosis.

PubMed

Roghani, Taybeh; Khalkhali Zavieh, Minoo; Rahimi, Abbas; Talebian, Saeed; Manshadi, Farideh Dehghan; Akbarzadeh Baghban, Alireza; King, Nicole; Katzman, Wendy

2018-01-25

The purpose of this study was to investigate the intra-rater reliability and validity of a designed load cell setup for the measurement of back extensor muscle force and endurance. The study sample included 19 older women with hyperkyphosis, mean age 67.0 ± 5.0 years, and 14 older women without hyperkyphosis, mean age 63.0 ± 6.0 years. Maximum back extensor force and endurance were measured in a sitting position with a designed load cell setup. Tests were performed by the same examiner on two separate days within a 72-hour interval. The intra-rater reliability of the measurements was analyzed using intraclass correlation coefficient (ICC), standard errors of measurement (SEM), and minimal detectable change (MDC). The validity of the setup was determined using Pearson correlation analysis and independent t-test. Using our designed load cell, the values of ICC indicated very high reliability of force measurement (hyperkyphosis group: 0.96, normal group: 0.97) and high reliability of endurance measurement (hyperkyphosis group: 0.82, normal group: 0.89). For all tests, the values of SEM and MDC were low in both groups. A significant correlation between two documented forces (load cell force and target force) and significant differences in the muscle force and endurance among the two groups were found. The measurements of static back muscle force and endurance are reliable and valid with our designed setup in older women with and without hyperkyphosis.

Lumbar kinematic variability during gait in chronic low back pain and associations with pain, disability and isolated lumbar extension strength.

PubMed

Steele, James; Bruce-Low, Stewart; Smith, Dave; Jessop, David; Osborne, Neil

2014-12-01

Chronic low back pain is a multifactorial condition with many dysfunctions including gait variability. The lumbar spine and its musculature are involved during gait and in chronic low back pain the lumbar extensors are often deconditioned. It was therefore of interest to examine relationships between lumbar kinematic variability during gait, with pain, disability and isolated lumbar extension strength in participants with chronic low back pain. Twenty four participants with chronic low back pain were assessed for lumbar kinematics during gait, isolated lumbar extension strength, pain, and disability. Angular displacement and kinematic waveform pattern and offset variability were examined. Angular displacement and kinematic waveform pattern and offset variability differed across movement planes; displacement was highest and similar in frontal and transverse planes, and pattern variability and offset variability higher in the sagittal plane compared to frontal and transverse planes which were similar. Spearman's correlations showed significant correlations between transverse plane pattern variability and isolated lumbar extension strength (r=-.411) and disability (r=.401). However, pain was not correlated with pattern variability in any plane. The r(2) values suggested 80.5% to 86.3% of variance was accounted for by other variables. Considering the lumbar extensors role in gait, the relationship between both isolated lumbar extension strength and disability with transverse plane pattern variability suggests that gait variability may result in consequence of lumbar extensor deconditioning or disability accompanying chronic low back pain. However, further study should examine the temporality of these relationships and other variables might account for the unexplained variance. Copyright © 2014 Elsevier Ltd. All rights reserved.

Periodization effects during short-term resistance training with equated exercise variables in females.

PubMed

Pelzer, Thiemo; Ullrich, Boris; Pfeiffer, Mark

2017-03-01

During resistance training, volume and load can be altered either gradually (traditional periodization: TP) or with frequent changes between subsequent sessions (daily undulating periodization: DUP). We hypothesized that the periodization model employed would not impact upon training-induced adaptations when exercise variables are equated. Nineteen females (22.0 years, moderate resistance training experience of 27.9 months) performed 6 weeks of knee extensor training with 3 weekly sessions exercising one leg using TP and the contralateral leg using DUP. Training load varied between 40, 60, and 80% of one repetition maximum (1RM). Volume, range of motion, and time under tension were equated for each leg with a biofeedback software. Dynamometry, surface EMG and ultrasonography were used to determine temporal changes of knee extensor maximum voluntary strength (MVC), neural drive of the M. quadriceps femoris (QF) and vastus lateralis (VL) and rectus femoris (RF) muscle architecture. Significant (P < 0.05) gains for isometric (TP 15%, DUP 13%) and isokinetic-concentric (TP 8%, DUP 10%) MVC and knee extensor 1RM (TP 18%, DUP 24%) occurred post training. VL and RF-muscle thickness showed significant (P < 0.05) increases ranging from 12 to 20% for TP and from 13 to 19% for DUP. Furthermore, significant (P < 0.05) increases in VL-pennation angle and VL-fascicle length occurred in both legs while QF EMG remained unchanged. No significant temporal differences were found between both models, displaying similar small to large effect sizes. Periodization is no adaptation trigger during short-term resistance training with equated exercise variables.

The comparison of muscle strength and short-term endurance in the different periods of type 2 diabetes

PubMed Central

2014-01-01

Background Patients with type 2 diabetes (T2DM) are subjected to reduction in the quality and oxidative capacity of muscles. The effect of duration of diabetes on the muscle endurance response is not clear and strength as well. Objective The aim of this study was the assessment of strength and endurance of knee extensor and flexor in the patients with T2DM < 10 and T2DM > 10 years in comparison with age, sex, BMI, ABI and PAI-matched health control subjects. Methods Isometric maximal peak torque (MPT) of knee extensor and flexor before and after 40 isokinetic repetitions with velocity of 150 degree/s were recorded in 18 patients with T2DM < 10 Y , 12 patients with T2DM > 10 Y and 20 matched health control (HC) groups. Results Both diabetic patient groups had significant lower isometric and isotonic knee extensor and flexor strength than HC. The endurance indices indicated that whereas the isometric MPT of flexor movement was reduced after isokinetic protocol in the both patient groups in comparison with HC, the less decline was seen in the isotonic torque and work during isokinetic protocol in the T2DM > 10 Y group in comparison with two other groups. The HbA1c and FPG were significantly correlated with strength not with endurance indices. Conclusions It seems the progression of diabetes accompanied with vascular, neural and muscular deficits activate, some adaptive and compensatory processes which can maintain muscle performance. PMID:24476108

Low-frequency electric muscle stimulation combined with physical therapy after total hip arthroplasty for hip osteoarthritis in elderly patients: a randomized controlled trial.

PubMed

Gremeaux, Vincent; Renault, Julien; Pardon, Laurent; Deley, Gaelle; Lepers, Romuald; Casillas, Jean-Marie

2008-12-01

To assess the effects of low-frequency electric muscle stimulation associated with usual physiotherapy on functional outcome after total hip arthroplasty (THA) for hip osteoarthritis (OA) in elderly subjects. Randomized controlled trial; pre- and posttreatment measurements. Hospital rehabilitation department. Subjects (N=29) referred to the rehabilitation department after THA for hip OA. The intervention group (n=16; 78+/-8 y) received simultaneous low-frequency electric muscle stimulation of bilateral quadriceps and calf muscles (highest tolerated intensity, 1h session, 5 d/wk, for 5 weeks) associated with conventional physical therapy including resistance training. The control group (n=13; 76+/-10 y) received conventional physical therapy alone (25 sessions). Maximal isometric strength of knee extensors, FIM instrument, before and after; a six-minute walk test and a 200 m fast walk test, after; length of stay (LOS). Low-frequency electric muscle stimulation was well tolerated. It resulted in a greater improvement in strength of knee extensors on the operated side (77% vs 23%; P<.01), leading to a better balance of muscle strength between the operated and nonoperated limb. The low-frequency electric muscle stimulation group also showed a greater improvement in FIM scores, though improvements in the walk tests were similar for the 2 groups, as was LOS. Low-frequency electric muscle stimulation is a safe, well-tolerated therapy after THA for hip OA. It improves knee extensor strength, which is one of the factors leading to greater functional independence after THA.