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Sample records for rectus muscle surgery

  1. Medial Rectus Muscle Injuries after Functional Endoscopic Sinus Surgery

    PubMed Central

    Demirayak, Bengi; Altıntaş, Özgül; Ağır, Hakan; Alagöz, Şahin

    2015-01-01

    In recent years, functional endoscopic sinus surgery (FESS) has improved the treatment of sinus disorders. However, various orbital complications have been reported, including optic nerve damage, orbital hemorrhage, infection, lacrimal drainage system injury, and strabismus. Complications are rare but may cause severe morbidity. We describe two patients who underwent endoscopic sinus surgery procedures that resulted in trauma to the medial rectus muscle. The first patient had medial rectus paresia due to contusional trauma and showed spontaneous resolution in a month. The other patient had an orbital medial wall defect with medial rectus injury and he underwent orbitotomy. Medial rectus innervation returned at postoperative 8 months. Several extraocular muscles may be traumatized during FESS. Timing and method of treatment are based on the severity and type of injury and the number of muscles involved. Treatment strategies are dependent on accurate interpretation of magnetic resonance imaging scans. PMID:27800227

  2. Minimally invasive strabismus surgery for horizontal rectus muscle reoperations

    PubMed Central

    Mojon, D S

    2008-01-01

    Aims: To study if minimally invasive strabismus surgery (MISS) is suitable for rectus muscle reoperations. Methods: The study presents a series of consecutive patients operated on by the same surgeon at Kantonsspital St Gallen, Switzerland with a novel MISS rectus muscle reoperation technique. Surgery is done by applying two small radial cuts along the muscle insertion. Through the tunnel obtained after muscle separation from surrounding tissue, a recession, advancement or plication is performed. Results: In 62 eyes of 51 patients (age 35.4 (SD 16.3) years) a total of 86 horizontal rectus muscles were reoperated. On the average, the patients had 2.1 strabismus surgeries previously. Preoperative logMAR visual acuity was 0.38 (0.82) compared with 0.37 (0.83) at 6 months (p>0.1). On the first postoperative day, in the primary gaze position conjunctival and lid swelling and redness was hardly visible in 11 eyes, discrete in 15 eyes, moderate in 11 eyes and severe in 15 eyes. One corneal dellen and one corneal erosion occurred, which both quickly resolved. The preoperative deviation at distance for esodeviations (n = 15) of 12.5 (8.5)° decreased to 2.6 (7.8)° at 6 months (p<0.001). For near, a decrease from 12.0 (10.1)° to 2.9 (1.6)° was observed (p<0.001). The preoperative deviation at distance for exodeviations (n = 35) of −16.4 (8.5)° decreased to −7.9 (6.5)° at 6 months (p<0.005). For near, a decrease from −16.5 (11.4)° to −2.9 (1.5)° was observed (p<0.005). Within the first 6 months, only one patient had a reoperation. At month 6, in four patients a reoperation was planned or suggested by us because of unsatisfactory alignment. No patient experienced persistent diplopia or necessitated a reoperation because of double vision. Stereovision improved at month 6 compared with preoperatively (p<0.01). Conclusions: The study demonstrates that a small-cut, minimal dissection technique allows to perform rectus muscle reoperations. The MISS technique

  3. Correction of Excyclotropia by Surgery on the Inferior Rectus Muscle in Patients with Thyroid Eye Disease: A Retrospective, Observational Study

    PubMed Central

    Takahashi, Yasuhiro; Kitaguchi, Yoshiyuki; Nakakura, Shunsuke; Mito, Hidenori; Kimura, Akiko; Kakizaki, Hirohiko

    2016-01-01

    Purpose To examine the characteristics of excyclotropia correction through surgery on the inferior rectus muscle in patients with thyroid eye disease. Methods This was a retrospective, observational study at a single institution. We reviewed 36 patients who had undergone unilateral inferior rectus muscle recession, with or without nasal inferior rectus muscle transposition. The following factors were investigated as possibly influencing excyclotropia correction: inferior rectus muscle thickness, degree of adipose change in the inferior rectus muscle, smoking status, history of orbital radiotherapy, and the amount of inferior rectus muscle recession. Using T1-weighted coronal magnetic resonance imaging, we measured the cross-sectional area of the inferior rectus muscle at its largest point, as well as the bright-signal area of the inferior rectus muscle, which reflects intermuscular adipose change. We then calculated the percentage internal bright-signal area at the point of the largest inferior rectus muscle cross-sectional area. The history of orbital radiotherapy was graded using a binary system. We evaluated correlations among excyclotropia correction, the amount of nasal inferior rectus muscle transposition, and the possible influencing factors listed, using stepwise multiple regression analyses. Results The multiple regression model demonstrated a significant relationship among excyclotropia correction, amount of nasal inferior rectus muscle transposition, and the amount of inferior rectus muscle recession (YCORRECTION = 8.546XTENDON WIDTH + 0.405XRECESSION− 0.908; r = 0.844; adjusted r2 = 0.695; P < 0.001). Conclusions Excyclotropia correction was correlated with the amount of nasal inferior rectus muscle transposition and the amount of inferior rectus muscle recession, but not with the other factors. The regression model presented in this study will enable us to determine more precisely the amount of nasal inferior rectus muscle transposition in patients

  4. Correlation between the Limbus-Insertion Distance of the Lateral Rectus Muscle and Lateral Rectus Recession Surgery in Intermittent Exotropia

    PubMed Central

    Lee, Ju-Yeun; Lee, Eun Jung; Park, Kyung-Ah; Oh, Sei Yeul

    2016-01-01

    The aim of this study was to investigate whether the limbus-insertion distance (LID) of the lateral rectus (LR) muscle can be a useful indicator for predicting the surgical effect of recession surgery in intermittent exotropia (IXT). Patients who underwent unilateral or bilateral LR recession for the basic type of IXT were included. The distance between the corneal limbus and the posterior edge of the insertion of LR muscle (limbus-insertion distance) was measured intraoperatively using surgical calipers (graded with 0.25 mm precision). We calculated the actual dose-response effect as the difference between the angle of preoperative deviation and the angle of postoperative deviation, and then divided the figure by the total amount of recession at postoperative months 1, 3, and 6. The correlation between the limbus-insertion distance (LID) of LR muscle and each dose-response effect was statistically analyzed. A total of 60 subjects were enrolled in this study. The mean LID of LR muscle was 5.8±0.7 mm. The dose-response effect was 3.2±1.0 prism diopters (PD)/mm at postoperative month 1, 3.4±1.0 PD/mm at postoperative month 3, and 3.4±1.1 PD/mm at postoperative month 6. The LID of the LR muscle was significantly correlated with dose-response effects in cases of unilateral and bilateral LR recession at postoperative months 3 and 6 (P = 0.01, <0.01, 0.04 and <0.01 respectively). As the LID of the LR muscle increased by 1 mm, the dose-response effect increased by 0.2PD/mm in unilateral LR recession, and by 0.4 PD/mm in bilateral LR recession at postoperative month 6. In conclusion, the LID of the LR muscle can be used as one predictor of the recession effect to assist in surgical planning for IXT. Moreover, undercorrection at the time of LR recession might be considered in patients with long LID of the LR muscle. PMID:27463100

  5. Rectus abdominis muscle strains in tennis players

    PubMed Central

    Maquirriain, Javier; Ghisi, Juan P; Kokalj, Antonio M

    2007-01-01

    Rectus abdominis muscle strains are common and debilitating injuries among competitive tennis players. Eccentric overload, followed by forced contraction of the non‐dominant rectus abdominis during the cocking phase of the service motion is the accepted injury mechanism. A tennis‐specific rehabilitation program emphasising eccentrics and plyometric strengthening of the abdominal wall muscles, contributes to the complete functional recovery in tennis players, and could help reduce recurrences. PMID:17957025

  6. Iatrogenic Injury to Medial Rectus After Endoscopic Sinus Surgery.

    PubMed

    Mukherjee, Bipasha; Priyadarshini, Omega; Ramasubramanian, Srikanth; Agarkar, Sumita

    2015-12-01

    Endoscopic sinus surgery (ESS) is the mainstay of the treatment in sinus disorders, to re-establish the drainage of the affected sinus. The close proximity of the orbital structures to paranasal sinuses makes them vulnerable to inadvertent injury during the sinus surgery. Medial rectus (MR) muscle is the most commonly injured extraocular muscle during ESS due to its anatomic proximity to the thin medial wall of the orbit. This is a non-comparative, retrospective, interventional case series of six patients presenting with MR injury after ESS. We discuss the management, outcome and review the published literature. A total of six patients met the inclusion criteria. The presenting complaints were diplopia, squinting and limitation of ocular movements. Two patients underwent surgical exploration of the MR muscle and reattachment of the muscle along with injection botulinum to the antagonist lateral rectus muscle. Two patients who had small angle strabismus and who were able to fuse were advised orthoptic exercises and prisms as management. Remaining two patients were advised surgical intervention to correct strabismus but they declined further surgical intervention. Management of MR injury following ESS is complex, often resulting in suboptimal outcomes. Since early intervention is associated with better outcomes, early referral by otolaryngologists to ophthalmologists would result in better outcome. PMID:26693458

  7. Traumatic transection of the lateral rectus muscle with chorioretinitis sclopetaria.

    PubMed

    MacKenzie, Kelly; Verity, David; Ali, Nadeem

    2015-01-01

    A man, aged 67 years, sustained monocular trauma to the left eye while gardening, presenting with light perception, complete absence of abduction, and chorioretinitis sclopetaria. At surgery, the lateral rectus was found to be transected at the equator of the globe, with an area of locally abraded sclera. A few posterior muscle fibers were identified and sutured to the residual anterior fibers. With a partial improvement of the esodeviation, after a further 6 months he proceeded to lateral transposition of the superior and inferior recti to healthy sclera 4 mm from the limbus, with adjunctive medial rectus botulinum toxin. Six months later, the angle of primary deviation remained stable at 4 prism diopters base out with improved abduction. Vision in the eye remained reduced at 20/200 (with eccentric fixation) due to macular changes secondary to the sclopetaria. In conclusion, this case describes a rare example of complete traumatic transection of the lateral rectus with chorioretinitis sclopetaria, due to orbital injury. With appropriate surgery, the angle of deviation can be considerably improved despite complete muscle transection and scleral injury. PMID:25790075

  8. Medial rectus muscle anchoring in complete oculomotor nerve palsy.

    PubMed

    Lee, Si Hyung; Chang, Jee Ho

    2015-10-01

    The management of exotropia resulting from complete oculomotor nerve palsy is challenging. Conventional therapeutic interventions, including supramaximal resection and recession, superior oblique tendon resection and transposition, and several ocular anchoring procedures have yielded less-than-adequate results. Here we describe a novel surgical technique of anchoring the medial rectus muscle to the medial orbital wall in combination with lateral rectus disinsertion and reattachment to the lateral orbital wall. PMID:26486032

  9. Large angle esotropia with high myopia and a lost medial rectus muscle: a case report.

    PubMed

    Akbari, Mohammad Reza; Alhashemi, Leila Hosseini; Jafari, Alireza Keshtcar; Eshraghi, Bahram; Fakhraie, Ghasem

    2013-01-01

    A 67 year old woman presented with her left eye fixed in adduction and infraduction. She had previous complicated strabismus surgery 18 years ago with a report of intraoperative loss of left medial rectus (MR) muscle (not retrieved at the time of surgery). An Orbital MRI of the left eye showed reattachment of the MR muscle to the globe and an axially enlarged globe associated with inferior displacement of the lateral rectus and nasal displacement of the superior rectus muscles. In ultrasonography the axial lengths were 24.1 mm in the right and 29.9 mm in the left eye. She underwent staged surgery: The first stage was a recession of the left MR muscle and union procedure on the SR and LR muscles followed by a second adjustable suture procedure under topical anesthesia, of right MR recession, right LR resection and left IR recession. After 12 months her eyes were still binocularly aligned. Unilateral high myopia must be considered in progressive esotropia. Imaging and ultrasonography can demonstrate anatomical abnormality and muscle paths to confirm the definite diagnosis. Union procedure described by Yokoyama is an effective procedure in correcting this strabismus associated with high myopia. PMID:23822915

  10. Traumatic longitudinal splitting of the inferior rectus muscle

    PubMed Central

    Laursen, Jessica; Demer, Joseph L.

    2011-01-01

    Orbital floor fractures and associated injuries can cause strabismus. We present the case of a 34-year-old man with incomitant strabismus following orbital reconstruction after a high-impact baseball injury. Multipositional, high-resolution magnetic resonance imaging (MRI) revealed extensive longitudinal splitting of the inferior rectus muscle by an orbital floor implant that separated its orbital and global layers. PMID:21463958

  11. Traumatic longitudinal splitting of the inferior rectus muscle.

    PubMed

    Laursen, Jessica; Demer, Joseph L

    2011-04-01

    Orbital floor fractures and associated injuries can cause strabismus. We present the case of a 34-year-old man with incomitant strabismus after orbital reconstruction following a high-impact baseball injury. Multipositional, high-resolution magnetic resonance imaging revealed extensive longitudinal splitting of the inferior rectus muscle by an orbital floor implant that separated its orbital and global layers.

  12. Traumatic longitudinal splitting of the inferior rectus muscle.

    PubMed

    Laursen, Jessica; Demer, Joseph L

    2011-04-01

    Orbital floor fractures and associated injuries can cause strabismus. We present the case of a 34-year-old man with incomitant strabismus after orbital reconstruction following a high-impact baseball injury. Multipositional, high-resolution magnetic resonance imaging revealed extensive longitudinal splitting of the inferior rectus muscle by an orbital floor implant that separated its orbital and global layers. PMID:21463958

  13. Electromyography study of the portions of the abdominal rectus muscle.

    PubMed

    Negrao Filho, R de F; Bérzin, F; Souza, G da C

    1997-01-01

    This study objective was to verify the behavior of three portions of the abdominal rectus muscle through a quantitative analysis of the electromyographic signal in different types of abdominal exercises. Ten young male between 16 and 27 years old were studied and they had no previous history of muscle and joint illness. They were well-trained and did seven abdominal exercises chosen considering the types of contraction (isotonic and isometric) as well as the muscle fixation points. The electric activity of the superior, medium (above umbilicus) and inferior (below umbilicus) portions at the left side of the abdominal rectus muscle was taken using Beckman type surface mini-electrodes. The registers were collected from computerized 8-channel Nicholet electromyography equipment, model Viking II. The signals were quantified using the MVA (Maximum Volunteer Activity) software, being considered for analysis the values of RMS (Root Mean Square). The obtained data were submitted to a parametric analysis using the variance analysis (F test) and also the Tukey test, besides a descriptive graphic analysis starting from the average RMS values of each muscle portion. This study results suggest that for the majority of the subjects, the functional activities of the abdominal rectus muscle are performed with electric activity differences among their portions, showing a tendency of producing more electric activity in the superior portion than in the medium and inferior portions. The experiment also demonstrated an absence of a common behavior pattern in the three portions of the ten tested subjects. PMID:9444489

  14. Aetiology and management of the 'detached' rectus muscle.

    PubMed Central

    MacEwen, C J; Lee, J P; Fells, P

    1992-01-01

    The clinical features and management of 17 cases of detached extraocular muscles are described. They are classified into four groups: (1) the muscle which is cut and lost during squint surgery, (2) the muscle which breaks during squint surgery, (3) the muscle which slips following squint surgery, and (4) the muscle which is damaged during facial or orbital trauma. The prognosis for group 1 is poor whereas groups 2-4 have a good chance of successful muscle relocation. Images PMID:1540554

  15. An anomalous muscle linking superior and inferior rectus muscles in the orbit.

    PubMed

    Kakizaki, Hirohiko; Zako, Masahiro; Nakano, Takashi; Asamoto, Ken; Miyaishi, Osamu; Iwaki, Masayoshi

    2006-09-01

    Dissections of the bilateral orbits in a 45-year-old female cadaver, who had no ocular movement disorders in her lifetime, revealed anomalous muscles linking the superior and inferior rectus muscles. The muscles, situated between the optic nerve and the lateral rectus muscle, originated from the annulus of Zinn and branched off two heads; one inserted into the medial inferior side of the superior rectus muscle and the other inserted into the central superior side of the inferior rectus muscle. Each insertion was located on a distal site of the myoneural junction of each rectus muscle. Histological investigations showed that the muscles had a striated muscle structure. No definite nerve insertion was observed in the muscles. Although this type of anomalous muscle has been reported in a few Caucasian cases, the present study is the first report in an Asian person. Anomalous orbital structures, which are a rare cause of strabismus, are important in the differential diagnosis of intra-orbital space-occupying lesions, rather than the differential diagnosis of strabismus.

  16. Function of transected or avulsed rectus muscles following recovery using an anterior orbitotomy approach

    PubMed Central

    Pineles, Stacy L.; Laursen, Jessica; Goldberg, Robert A.; Demer, Joseph L.; Velez, Federico G.

    2013-01-01

    PURPOSE To assess the function of muscles retrieved from a retrobulbar location using an anterior orbitotomy approach and to identify the prognostic factors favoring a good outcome. METHODS The records of all patients undergoing anterior orbitotomy for the retrieval of a transected or avulsed muscle in a retrobulbar location were reviewed. Ocular motility, before and after retrieval (with ductions scaled from −4 to +4), was evaluated. RESULTS Record review identified 11 patients who had suffered trauma to 12 muscles (5 inferior, 6 medial, and 1 lateral rectus muscle). Ductions improved from −4 ± 0.4 preoperatively to −2.7 ± 0.9 postoperatively (P = 0.002); mean primary position deviation improved from 34Δ ± 14Δ-15Δ ± 9Δ (P < 0.001), and mean deviation in the field of action improved from 47Δ ± 20Δ-20Δ ± 22Δ (P = 0.02). Ductions improved by at least two units in three patients, all of whom had medial rectus trauma. Single binocular vision in primary gaze was achieved in 6 patients. Patients with medial rectus muscle injury and patients injured by sinus surgery had the lowest likelihood of recovering single binocular vision. CONCLUSIONS Our results are similar to historical series in which muscles were not retrieved and transpositions performed; however, muscle retrieval avoids risks associated with transposition surgeries such as anterior segment ischemia. Muscle recovery via the anterior orbitotomy approach may be reasonable to consider in those cases with a reasonable possibility of having active force generation postoperatively. PMID:22835914

  17. Regional neuromuscular regulation within human rectus femoris muscle during gait.

    PubMed

    Watanabe, Kohei; Kouzaki, Motoki; Moritani, Toshio

    2014-11-01

    The spatial distribution pattern of neuromuscular activation within the human rectus femoris (RF) muscle was investigated during gait by multi-channel surface electromyography (surface EMG). Eleven healthy men walked on a treadmill with three gait speeds (4, 5, and 6 km/h) and gradients (0°, 12.5°, and 25°). The spatial distribution of surface EMG was tested by central locus activation (CLA), which is calculated from 2-D multi-channel surface EMG with 46 surface electrodes. For all conditions, CLA was around the middle regions during the swing-to-stance transition and moved in a proximal direction during the stance phase and stance-to-swing transition (p<0.05). CLA during the stance-to-swing transition and early swing phase significantly moved to proximal site with increasing gait speed (p<0.05). During the early stance and swing phases, with increasing grade, CLA significantly moved distally (p<0.05). These results suggest that the RF muscle is regionally activated during a gait cycle and is non-uniformly regulated longitudinally.

  18. Rectus abdominis muscle endometriosis after cesarean section--case report.

    PubMed

    Dordević, Momcilo; Jovanović, Bozidar; Mitrović, Slobodanka; Dordević, Gordana; Radovanović, Dragce; Sazdanović, Predrag

    2009-09-01

    Endometriosis is defined by the presence of functional endometrial tissue outside the uterus, where it is normally located. Endometriosis is one of the most common gynecologic entities affecting 8%-18% of menstrual women. Endometriosis can occur at intra- and extrapelvic localizations. The most common intrapelvic localizations are those involving the ovaries, Douglas' area, pelvic peritoneum, uterus, bladder and rectum. Abdominal endometriosis is the most common localization of extrapelvic endometriosis and usually develops in connective tissue. Extra-pelvic implantation of endometrial tissue may develop in any organ including the skin, lungs, liver, extremities, brain and stomach. Three years after cesarean section, a 35-year-old female was operated on for suspected anterior abdominal hernia at the site of previous section. An egg-sized tumor was removed from the rectus abdominis muscle and referred for histopathologic and immunohistochemical analyses. The results showed endometriosis of the muscle with positive estrogen and progesterone receptors. A year after the procedure, treatment with gonadotropin-releasing hormone analogs was continued due to recurrent pain in the scar area, along with ultrasonography and biochemical marker (carbohydrate antigen 125) follow-up. Clinical diagnosis of scar endometriosis can be made by thorough history and physical, ultrasonography and biochemical examinations. Scar endometriosis should always be considered when the symptoms occur in a cyclic and hormone-dependent pattern, mostly after gynecologic operations, and worsening during menstruation. Definitive diagnosis is based on histopathologic analysis. PMID:20405641

  19. Rectus abdominalis muscle metastasis from uterine leiomyosarcoma: An unusual case and review of the literature

    PubMed Central

    Güngör, Tayfun; Akbay, Serap; Aksüt, Hayri; Yılmaz, Bülent

    2014-01-01

    Uterine leiomyosarcoma is an aggressive malignancy. Spread to the lung, thyroid, liver, brain, pancreas, heart, duodenum, breast, vagina, submandibular gland, and bone has been reported. We describe a case of metastatic uterine leiomyosarcoma to the rectus abdominalis muscle as the first case in the literature. A 39-year-old nulligravid woman presented with a history of pelvic pain. Physical examination discovered about a 6-cm mass in the suprapubic region. She had previously undergone a hysterectomy for uterine leiomyosarcoma. Operative findings had revealed a mass measuring 4×5×6 cm located in the rectus abdominalis muscle. Abnormal mitotic figures and necrosis were evident, and uterine leiomyosarcoma was diagnosed. Uterine leiomyosarcomas are malignancies of the smooth muscle arising from the myometrium. Skeletal muscle is an uncommon site of metastasis by hematogenous spread. In conclusion, we have described a case of skeletal muscle metastasis (first case of rectus abdominalis muscle metastasis) secondary to uterine leiomyosarcoma. PMID:24976779

  20. Giant pseudocyst of the rectus femoris muscle--repetitive strain injury in recreational soccer player.

    PubMed

    Cicvarić, Tedi; Lucin, Ksenija; Roth, Sandor; Ivancić, Aldo; Marinović, Marin; Santić, Veljko

    2010-04-01

    We report a case of a traumatic pseudocyst, in a recreational soccer player, after rupture of rectus femoris muscle. 37-year-old male, with history of repetitive painful accidents, was examined because of a double fist-sized mass in the anterior thigh. Ultrasound examination revealed a cystic mass in the rectus femoris muscle. Surgical removal of the mass and proximal remnant of muscle was done. Primary healing and functional recovery was achieved. Histological analysis revealed pseudocyst filled with degenerating clot and surrounded with thick fibrous capsule. The repetitive strain muscle injury, with prolonged period of healing, can occur like pseudocyst.

  1. Use of the rectus abdominis muscle and fascia flap in reconstruction of epispadias/exstrophy.

    PubMed

    Horton, C E; Sadove, R C; Jordan, G H; Sagher, U

    1988-07-01

    Inferiorly based rectus abdominis muscle flaps and fascial flaps have been used to construct a firm abdominal wall without hernias and to provide coverage of the bladder, bladder neck, and proximal urethra in the secondary reconstruction of patients with epispadias/exstrophy complex. They have also been used to produce an elevation of the mons area, which is lacking in the typical exstrophy patient. Rectus fascial flaps have been the mainstay of abdominal closure when wide diastasis of the rectal muscles is present and when the lower abdomen lacks fascial support. We are pleased with the results of utilizing either the rectus muscle or rectus fascia in this complex condition. We have been using fascial flaps for over 10 years in our epispadias/exstrophy closures and abdominal wall strengthening procedures. We have been using bone grafts and the rectus muscle for the construction of a mons for the past 5 years. Although the rectus muscle procedure to cover the bladder and the bladder neck has been in use for only 2 years, we have seen patients with incontinence restored to a continent state; these patients have not been plagued with fistula problems when a neourethra has to be constructed to elongate the phallus. Previous attempts at urethral repair in this area have been successful in the main, but an occasional fistula at the junction between the penile skin and the abdominopubic skin has resulted. Since using the rectus muscle to cover the bladder and bladder neck area, we have not had this problem. Patients with epispadias/exstrophy remain such difficult problems that every advance in technique should be used to improve results.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3391008

  2. Intraoperative monitoring of torsion to prevent vertical deviations during augmented vertical rectus transposition surgery

    PubMed Central

    Holmes, Jonathan M.; Hatt, Sarah R.; Leske, David A.

    2012-01-01

    Background Total transposition of the superior and inferior rectus muscle laterally, with augmentation sutures, may be complicated by induction of an undesirable vertical deviation. Induced vertical misalignment may be associated with changes in torsion. We have developed a simple method to monitor intraoperative torsion that may reduce the incidence of vertical deviations. Methods We reviewed consecutive cases of total abducens palsy or esotropic Duane syndrome treated with augmented lateral transposition of the superior and inferior rectus muscles, where the 12 o’clock and 6 o’clock intraoperative positions were initially marked with a dot at the limbus using a surgical pen. The location of the marks was monitored during tying of the augmentation sutures; changes in torsion were monitored intraoperatively. Results Records of 9 cases of augmented vertical rectus transposition were reviewed. Based on intraoperative assessment of torsion by observing the position of the preplaced limbal dots, the inferior rectus augmentation suture was tied less tightly than the superior rectus suture, leaving a gap of 1–3 mm between the inferior and lateral rectus muscles in 8 of 9 cases. The augmentation suture was totally removed in 1 case. Following these intraoperative adjustments, there was no induced intraoperative torsion, whereas further tightening of the inferior suture induced extorsion. Six weeks postoperatively, 8 of 9 patients did not experience a symptomatic vertical deviation. Conclusions When performing augmented transposition procedures, intraoperative monitoring of torsion may reduce the incidence of inadvertent vertical deviations and torsion. This technique may also be useful in other cases where correction or avoidance of torsion is needed. PMID:22525168

  3. [Traumatic muscle and tendon ruptures of the lower extremities in sport: adductor muscles, M. rectus femoris and M. biceps femoris].

    PubMed

    Krüger-Franke, M

    2010-12-01

    Ruptures of the adductor muscles, the M. rectus femoris or the M. biceps femoris are sports injuries which need quick and reliable diagnostic management. Treatment of muscle injuries is mostly conservative; complete tendon ruptures or avulsion fractures of the tendons are treated operatively according to the dislocation and the functional loss.

  4. Double insertions of extraocular rectus muscles in humans and the pulley theory.

    PubMed

    Ruskell, Gordon L; Kjellevold Haugen, Inga-Britt; Bruenech, Jan Richard; van der Werf, Frans

    2005-03-01

    Recent studies have promoted the concept that rectus muscles pass through connective tissue pulleys located near the equator of the eye and act, in effect, as the muscle origins. Orbital muscle fibres (facing bone) terminate in pulleys, permitting adjustment of their position independent of the global fibres responsible for rotating the eye. The structure of pulleys (or muscle sleeves) and the passage taken by their muscle fibre insertions are unclear, and a detailed description is presented here together with a review of the active pulley hypothesis. Segments including the full width of single muscles were removed from the full orbital contents of dissection room cadavers and fresh perfusion-fixed rhesus and cynomolgus monkeys and prepared for light microscopy. Thin longitudinal sections were cut as facets from resin-embedded tissue blocks and montages assembled. Interrupted serial sections of selected regions of both species and ultrathin sections of monkey material were prepared for light and electron microscopy, respectively. Slender tendons leave the orbital surface of rectus muscles at intervals, aggregating and entering sleeves in humans and monkey; less frequently, tendons pass from the global surface to sleeves or insert directly in the posterior fascia bulbi. The orbital sides of sleeve rings are continuous with the fascial canopy of the globe and are 5-6 times as thick as the global sides; sleeve structure differs in the four recti. Medial rectus sleeves are the thickest, and contain smooth muscle, whereas little or none is present in the other rectus sleeves. Superior rectus sleeves are variable in structure and relatively insubstantial. A narrow interval separates muscles from the surrounding connective tissue equatorially in some preparations, consistent with a capacity to slide, but the tissues are contiguous in others, especially in monkey material. The structural organization of sleeves and their tendons, together with other presented factors, is

  5. Rectus abdominis muscle injuries in elite handball players: management and rehabilitation

    PubMed Central

    Balius, Ramon; Pedret, Carles; Pacheco, Laura; Gutierrez, Josep Antoni; Vives, Joan; Escoda, Jaume

    2011-01-01

    Muscle injuries generally occur in two-joint muscles with a high percentage of type II fibers during the performance of eccentric activity. Some muscle injuries, such as those located in the adductor longus, a monoarticular muscle, as well as rectus abdominis do not fully comply with these requirements. This study examines five cases of elite handball players with ruptured rectus abdominals. Sonographically, lesions in rectus abdominis are shown as a disruption of the fibrillar pattern with a hematic suffusion that invades the entire lesion. In some of the cases, the ultrasound study was complemented with a MRI. A unified rehabilitation protocol was applied and the return to play time of each handball player ranged between 16 and 22 days, with an average of 18.2 days. Follow-up at 15 months showed no evidence of re-injury or residual discomfort and all of them are playing at their highest level. The aim of this study was to illustrate a feature of handball injury that, as in tennis and volleyball, is uncommon and so far has not been specifically reported. The phenomenon of contralateral abdominal hypertrophy in handball appears in the dominant arm as in tennis and volleyball. PMID:24198573

  6. Patterns of attachment of the myodural bridge by the rectus capitis posterior minor muscle.

    PubMed

    Yuan, Xiao-Ying; Yu, Sheng-Bo; Li, Yun-Fei; Chi, Yan-Yan; Zheng, Nan; Gao, Hai-Bin; Luan, Bing-Yi; Zhang, Zhao-Xi; Sui, Hong-Jin

    2016-03-01

    The myodural bridge was first described by Hack in 1995 and was thought to be related to chronic cervicogenic headaches. For a long time, few studies revealed the patterns of the myodural bridge considering the rectus capitis posterior minor muscle. In this study, P45 plastination technology and anatomical dissection were performed on head specimens, and four different terminal region types of the rectus capitis posterior minor muscle were observed, including the posterior atlanto-occipital interspace, posterior arch of the atlas and posterior atlanto-axial interspace. We propose that the myodural complex structures in the posterior atlanto-occipital and posterior atlanto-axial interspace have cooperative effects on cerebrospinal fluid and work together. This force might be an important source for the circulation of cerebrospinal fluid. PMID:25859757

  7. Patterns of attachment of the myodural bridge by the rectus capitis posterior minor muscle.

    PubMed

    Yuan, Xiao-Ying; Yu, Sheng-Bo; Li, Yun-Fei; Chi, Yan-Yan; Zheng, Nan; Gao, Hai-Bin; Luan, Bing-Yi; Zhang, Zhao-Xi; Sui, Hong-Jin

    2016-03-01

    The myodural bridge was first described by Hack in 1995 and was thought to be related to chronic cervicogenic headaches. For a long time, few studies revealed the patterns of the myodural bridge considering the rectus capitis posterior minor muscle. In this study, P45 plastination technology and anatomical dissection were performed on head specimens, and four different terminal region types of the rectus capitis posterior minor muscle were observed, including the posterior atlanto-occipital interspace, posterior arch of the atlas and posterior atlanto-axial interspace. We propose that the myodural complex structures in the posterior atlanto-occipital and posterior atlanto-axial interspace have cooperative effects on cerebrospinal fluid and work together. This force might be an important source for the circulation of cerebrospinal fluid.

  8. Contractile properties and temperature sensitivity of the extraocular muscles, the levator and superior rectus, of the rabbit.

    PubMed Central

    Frueh, B R; Hayes, A; Lynch, G S; Williams, D A

    1994-01-01

    1. Contractile and fatigue-resistance characteristics, temperature sensitivity (10-37 degrees C) of contraction, and histochemical fibre types were determined for two of the extraocular muscles, the superior rectus and levator palpebrae superioris (levator), of the rabbit. 2. The levator displayed similar contractile characteristics (time to peak, half-relaxation time of twitch response, and twitch-tetanus force ratio) to mammalian fast-twitch limb muscle at room temperature (20 degrees C). However, normalized twitch and tetanic force levels were significantly less than those found in limb muscle. The superior rectus displayed the characteristics of even faster contraction than the levator at 20 degrees C, but generated lower maximum force levels than the levator. 3. The twitch response of the superior rectus showed a biphasic relaxation phase. This response was not due to non-twitch (tonic) fibres present in the superior rectus as it was unaffected by propranolol application during muscle stimulation. 4. The superior rectus and levator displayed significantly less fatigue in the tetanic force response than fast-twitch limb muscles did in response to a fatiguing electrical stimulation protocol. The levator was significantly more fatigue resistant than the superior rectus. 5. The force responses of both extraocular muscles displayed a similar dependence on temperature (10-37 degrees C) to limb skeletal muscles. 6. The superior rectus and levator exhibited a high proportion of fast-twitch muscle fibres (type II) as shown by myosin ATPase staining. Succinate dehydrogenase activity indicated that these muscles showed a high oxidative capacity, with a staining intensity typical of type I or type II A fibres of limb muscles. 7. The results emphasize the morphological and functional complexity of mammalian extraocular muscles. The combination of very fast contractile properties with high oxidative capacity make these muscles well suited to their role in eye

  9. Transneuronal tracing of neural pathways controlling an abdominal muscle, rectus abdominis, in the ferret.

    PubMed

    Billig, I; Foris, J M; Card, J P; Yates, B J

    1999-02-27

    Abdominal muscles participate in generating a large number of behaviors and reflex responses, including expiration, coughing, sneezing, vomiting, postural control, production of speech, straining, facilitation of venous return to the heart, and reaction to vestibular stimulation. However, the only premotor neurons that have been conclusively shown to influence abdominal motoneurons are located in nucleus retroambiguus, the expiratory region of the caudal ventral respiratory group. In the present study, the neural circuitry controlling the activity of one abdominal muscle, rectus abdominis, was mapped using the transneuronal tracer pseudorabies virus (PRV) in the ferret. Injections of PRV into rectus abdominis labeled large presumed motoneurons in the ventral horn of T12-L4, and smaller presumed interneurons that were scattered in laminae VII, VIII, IX, and X of T4-L4. In addition, neurons in several areas of the medulla and caudal pons, including the retroambigual nucleus, medial and ventromedial reticular formation, nucleus prepositus hypoglossi, vestibular nuclei, and raphe nuclei, were infected by transynaptic passage of PRV from rectus abdominis motoneurons. Thus, the multifunctional roles of abdominal muscles appear to be coordinated by premotor neurons located in both the spinal cord and several regions of the brainstem. PMID:10023028

  10. Specific fibre composition and metabolism of the rectus abdominis muscle of bovine Charolais cattle

    PubMed Central

    2010-01-01

    Background An important variability of contractile and metabolic properties between muscles has been highlighted. In the literature, the majority of studies on beef sensorial quality concerns M. longissimus thoracis. M. rectus abdominis (RA) is easy to sample without huge carcass depreciation and may appear as an alternative to M. longissimus thoracis for fast and routine physicochemical analysis. It was considered interesting to assess the muscle fibres of M. rectus abdominis in comparison with M. longissimus thoracis (LT) and M. triceps brachii (TB) on the basis of metabolic and contractile properties, area and myosin heavy chain isoforms (MyHC) proportions. Immuno-histochemical, histochemical, histological and enzymological techniques were used. This research concerned two populations of Charolais cattle: RA was compared to TB in a population of 19 steers while RA was compared to LT in a population of 153 heifers. Results RA muscle had higher mean fibre areas (3350 μm2 vs 2142 to 2639 μm2) than the two other muscles. In RA muscle, the slow-oxidative fibres were the largest (3957 μm2) and the fast-glycolytic the smallest (2868 μm2). The reverse was observed in TB muscle (1725 and 2436 μm2 respectively). In RA muscle, the distinction between fast-oxidative-glycolytic and fast-glycolytic fibres appeared difficult or impossible to establish, unlike in the other muscles. Consequently the classification based on ATPase and SDH activities seemed inappropriate, since the FOG fibres presented rather low SDH activity in this muscle in comparison to the other muscles of the carcass. RA muscle had a higher proportion of I fibres than TB and LT muscles, balanced by a lower proportion either of IIX fibres (in comparison to TB muscle) or of IIA fibres (in comparison to LT muscle). However, both oxidative and glycolytic enzyme activities were lower in RA than in TB muscle, although the LDH/ICDH ratio was higher in RA muscle (522 vs 340). Oxidative enzyme activities were

  11. A new technique of closing a gastroatmospheric fistula with a rectus abdominis muscle flap.

    PubMed

    Gupta, Rahul; Singh, Harjeet; Talukder, Shibojit; Verma, Ganga Ram

    2015-03-27

    Proximal enteroatmospheric fistulae are difficult to manage and carry high mortality from sepsis and electrolyte imbalances. Conservative management with total parenteral nutrition, exclusion of fistula, resection and anastomosis are conventional methods of treatment with low success rate. Providing muscle cover to manage an enteroatmospheric fistula is a noble concept. A postoperative high-output gastroatmospheric fistula (GAF) was repaired by superior epigastric artery-based rectus abdominis muscle flap (RAMF). Postoperative recovery was uneventful. This technique may be useful for closure of proximal enteroatmospheric fistulae that fail to heal through medical and conventional surgical management.

  12. Retrospective study of recession of four horizontal rectus muscle in periodic alternating nystagmus

    PubMed Central

    Mimura, Osamu; Ishikawa, Hiroto; Kimura, Naoki; Kimura, Akiko; Borlongan, Cesar V

    2014-01-01

    Purpose Periodic alternating nystagmus (PAN) is a spontaneous horizontal nystagmus observed in disorders of the central nervous system. Patients with congenital PAN complain of oscillating vision at high rates. Medication is the first-choice treatment for PAN; however, clinicians still seek better therapy. The aim of this study was to evaluate outcomes of recession of four horizontal rectus muscle (R-FHR) in patients with congenital PAN. Patients and methods This study reports a retrospective case series of ten patients (seven males and three females; mean age 24.4±10.9) with congenital PAN who underwent R-FHR between 2007 and 2012, which was performed by the same surgeon at the Hyogo College of Medicine. Patients were evaluated for complications, recession amount, deviation angle, eye movements including a nystagmus amplitude, and visual acuity during pre- and post-operative periods. Results Pre-operatively, patients complained of oscillating vision, abnormal head posture, esotropia, and congenital superior oblique palsy. Post-operatively, changes from the previous observations of nystagmus amplitudes and abnormal head posture demonstrated a complete reversal in all patients. In addition, visual acuity determined with a Snellen chart improved in two patients. However, esotropia occurred in three patients who underwent additional strabismus surgery 2 days after R-FHR. R-FHR was particularly effective in eight patients who pre-operatively had periodic oscillating vision with a regular pattern of periodic nystagmus. Conclusion We demonstrated that ten patients with congenital PAN had improved vision following R-FHR, indicating that R-FHR was an effective procedure, especially in patients suffering PAN with periodic oscillating vision. PMID:25525330

  13. Large Asymmetric Hypertrophy of Rectus Abdominis Muscle in Professional Tennis Players

    PubMed Central

    Sanchis-Moysi, Joaquin; Idoate, Fernando; Dorado, Cecilia; Alayón, Santiago; Calbet, Jose A. L.

    2010-01-01

    Purpose To determine the volume and degree of asymmetry of the musculus rectus abdominis (RA) in professional tennis players. Methods The volume of the RA was determined using magnetic resonance imaging (MRI) in 8 professional male tennis players and 6 non-active male control subjects. Results Tennis players had 58% greater RA volume than controls (P = 0.01), due to hypertrophy of both the dominant (34% greater volume, P = 0.02) and non-dominant (82% greater volume, P = 0.01) sides, after accounting for age, the length of the RA muscle and body mass index (BMI) as covariates. In tennis players, there was a marked asymmetry in the development of the RA, which volume was 35% greater in the non-dominant compared to the dominant side (P<0.001). In contrast, no side-to-side difference in RA volume was observed in the controls (P = 0.75). The degree of side-to-side asymmetry increased linearly from the first lumbar disc to the pubic symphysis (r = 0.97, P<0.001). Conclusions Professional tennis is associated with marked hypertrophy of the musculus rectus abdominis, which achieves a volume that is 58% greater than in non-active controls. Rectus abdominis hypertrophy is more marked in the non-dominant than in the dominant side, particularly in the more distal regions. Our study supports the concept that humans can differentially recruit both rectus abdominis but also the upper and lower regions of each muscle. It remains to be determined if this disequilibrium raises the risk of injury. PMID:21209832

  14. Spread patterns and effectiveness for surgery after ultrasound-guided rectus sheath block in adult day-case patients scheduled for umbilical hernia repair

    PubMed Central

    Manassero, Alberto; Bossolasco, Matteo; Meineri, Maurizio; Ugues, Susanna; Liarou, Chrysoula; Bertolaccini, Luca

    2015-01-01

    Background and Aims: We conducted a prospective study to examine the local anesthetic (LA) spread and the effectiveness for surgical anesthesia of ultrasound (US)-guided rectus sheath block (RSB) in adult patients undergoing umbilical hernia repair. Material and Methods: Thirty patients received at T-10 level a bilateral US-guided injection of 20 mL levobupivacaine 0.375% + epinephrine 5 μg/mL behind the rectus muscle to detach it from its sheath. Anesthetic spread into the rectus sheath was evaluated ultrasonographically at T-9 and T-11 levels and scored from 0 to 4. The RSB was defined effective for surgical anesthesia if it was able to guarantee an anesthetic level sufficient for surgery without any mepivacaine supplementation. Results: Overall, the block was effective for surgical anesthesia in 53.3% of patients (95% confidence interval, ±17.8). In the remaining patients, anesthesia supplementation was needed at cutaneous incision, whereas manipulation of the muscle and fascial planes was painless. No patients required general anesthesia. LA spreads as advocated (to T-9 and to T-11 bilaterally = spread score 4) in 8/30 patients (26.6%); in these cases, the block was 75% effective for surgery. The anesthetic spread was most negatively influenced by increased body mass index. Postoperative analgesia was excellent in 97% of patients. Conclusion: Use of RSB as an anesthetic management of umbilical herniorrhaphy is recommended only with anesthetic supplementation at the incision site. PMID:26330714

  15. Quantitative end qualitative analysis of the electrical activity of rectus abdominis muscle portions.

    PubMed

    Negrão Filho, R de Faria; Bérzin, F; Souza, G da Cunha

    2003-01-01

    The purpose of this study was to investigate the electrical behavior pattern of the Rectus abdominis muscle by qualitative and quantitative analysis of the electromyographic signal obtained from its superior, medium and inferior portions during dynamic and static activities. Ten voluntaries (aged X = 17.8 years, SD = 1.6) athletic males were studied without history of muscle skeletal disfunction. For the quantitative analysis the RMS (Root Mean Square) values obtained in the electromyographic signal during the isometric exercises were normalized and expressed in maximum voluntary isometric contraction percentages. For the qualitative analysis of the dynamic activity the electromyographic signal was processed by full-wave rectification, linear envelope and normalization (amplitude and time), so that the resulting curve of the processed signal was submitted to descriptive graphic analysis. The results of the quantitative study show that there is not a statistically significant difference among the portions of the muscle. Qualitative analysis demonstrated two aspects: the presence of a common activation electric pattern in the portions of Rectus abdominis muscle and the absence of significant difference in the inclination angles in the electrical activity curve during the isotonic exercises. PMID:12964259

  16. INTERNAL ORGANIZATION OF MEDIAL RECTUS AND INFERIOR RECTUS MUSCLE NEURONS IN THE C-GROUP OF THE OCULOMOTOR NUCLEUS IN MONKEY

    PubMed Central

    Tang, Xiaofang; Büttner-Ennever, Jean A.; Mustari, Michael J.; Horn, Anja K. E.

    2015-01-01

    Summary Mammalian extraocular muscles contain singly-innervated twitch muscle fibers (SIF) and multiply-innervated non-twitch muscle fibers (MIF). In monkey, MIF motoneurons lie around the periphery of oculomotor nuclei and have different premotor inputs from the motoneurons inside the nuclei. The most prominent MIF motoneuron group is the C-group, which innervates the medial rectus (MR) and inferior rectus (IR) muscle. To explore the organization of both cell groups within the C-group we performed small injections of choleratoxin subunit B into the myotendinous junction of MR or IR in monkeys. In three animals the IR and MR myotendinous junction of one eye was injected simultaneously with different tracers (choleratoxin subunit B and wheatgerm agglutinin). It revealed that both muscles were supplied by two different non-overlapping populations in the C-group. The IR neurons lie adjacent to the dorsomedial border of the oculomotor nucleus, whereas MR neurons are located further medially. A striking feature was the differing pattern of dendrite distribution of both cell groups. Whereas the dendrites of IR neurons spread into the supraoculomotor area bilaterally, those of the MR neurons were restricted to the ipsilateral side and sent a focussed bundle dorsally to the preganglionic neurons of the Edinger-Westphal nucleus, which are involved in the ‘near response’. In conclusion, MR and IR are innervated by independent neuron populations from the C-group. Their dendritic branching pattern within the supraoculomotor area indicates a participation in the near response providing vergence, but also reflects their differing functional roles. PMID:25684641

  17. Surface electromyography activity of the rectus abdominis, internal oblique, and external oblique muscles during forced expiration in healthy adults.

    PubMed

    Ito, Kenichi; Nonaka, Koji; Ogaya, Shinya; Ogi, Atsushi; Matsunaka, Chiaki; Horie, Jun

    2016-06-01

    We aimed to characterize rectus abdominis, internal oblique, and external oblique muscle activity in healthy adults under expiratory resistance using surface electromyography. We randomly assigned 42 healthy adult subjects to 3 groups: 30%, 20%, and 10% maximal expiratory intraoral pressure (PEmax). After measuring 100% PEmax and muscle activity during 100% PEmax, the activity and maximum voluntary contraction of each muscle during the assigned experimental condition were measured. At 100% PEmax, the external oblique (p<0.01) and internal oblique (p<0.01) showed significantly elevated activity compared with the rectus abdominis muscle. Furthermore, at 20% and 30% PEmax, the external oblique (p<0.05 and<0.01, respectively) and the internal oblique (p<0.05 and<0.01, respectively) showed significantly elevated activity compared with the rectus abdominis muscle. At 10% PEmax, no significant differences were observed in muscle activity. Although we observed no significant difference between 10% and 20% PEmax, activity during 30% PEmax was significantly greater than during 20% PEmax (external oblique: p<0.05; internal oblique: p<0.01). The abdominal oblique muscles are the most active during forced expiration. Moreover, 30% PEmax is the minimum intensity required to achieve significant, albeit very slight, muscle activity during expiratory resistance.

  18. A study of the effect of pregnancy on muscle fibers of the rectus abdominis muscle of the rat.

    PubMed

    Martin, W D

    1979-11-01

    Samples of the rectus abdominis muscle were taken from Sprague-Dawley rats at 0, 3, 6, 6, 12, 15, 18, and 21 days of pregnancy, and at 1, 3, 6, 9, 12, and 15 days of postpartum. Sections were incubated for actomyosin adenosine triphosphatase activity following preincubation at a basic pH. Muscle fibers within a unit area of each sample were identified as to fiber type according to their enzyme activity, and the population of each type counted. The proportion of each fiber type was calculated and the diameter of 24 fibers of each type measured. No changes were noted in the muscle fiber proportions through the course of the experiment. Differential changes in muscle fiber diameters were noted in each of the three muscle fiber types. Slow oxidative fibers underwent an increase in diameter through the last half of pregnancy. The diameter was further increased as stretch of the muscle was released after birth, and did not decrease in the postpartum period. Fast glycolytic fibers decreased in diameter during the last half of pregnancy, but returned to the prepregnancy diameter in the first postpartum day. The diameter of the fast oxidative glycolytic fibers remained unchanged through the course of pregnacy and in the postpartum period.

  19. Verbal and visual stimulation effects on rectus femoris and biceps femoris muscles during isometric and concentric

    PubMed Central

    2013-01-01

    Background Coactivation may be both desirable (injury prevention) or undesirable (strength measurement). In this context, different styles of muscle strength stimulus have being investigated. In this study we evaluated the effects of verbal and visual stimulation on rectus femoris and biceps femoris muscles contraction during isometric and concentric. Methods We investigated 13 men (age =23.1 ± 3.8 years old; body mass =75.6 ± 9.1 kg; height =1.8 ± 0.07 m). We used the isokinetic dynamometer BIODEX device and an electromyographic (EMG) system. We evaluated the maximum isometric and isokinetic knee extension and flexion at 60°/s. The following conditions were evaluated: without visual nor verbal command (control); verbal command; visual command and; verbal and visual command. In relation to the concentric contraction, the volunteers performed five reciprocal and continuous contractions at 60°/s. With respect to isometric contractions it was made three contractions of five seconds for flexion and extension in a period of one minute. Results We found that the peak torque during isometric flexion was higher in the subjects in the VVC condition (p > 0.05). In relation to muscle coactivation, the subjects presented higher values at the control condition (p > 0.05). Conclusion We suggest that this type of stimulus is effective for the lower limbs. PMID:24099489

  20. Regional neuromuscular regulation within human rectus femoris muscle during gait in young and elderly men.

    PubMed

    Watanabe, Kohei; Kouzaki, Motoki; Moritani, Toshio

    2016-01-01

    Recently, we demonstrated region-specific electromyography (EMG) responses along the rectus femoris (RF) muscle during gait in healthy young men (Watanabe et al., 2014b). For the RF muscle, regional EMG response should be tested to characterize neuromuscular control and/or to assess its dysfunction and/or pathology during gait. We aimed to identify spatial distribution of EMG pattern within the RF muscle in elderly during gait. Seven young men (age: 20.4±1.0 years) and 8 elderly men (age: 73.8±5.9 years) walked on treadmill with three different speed: slow (preferred -1km/h), preferred, and fast (preferred +1km/h). The spatial distribution of surface EMG was tested by central locus activation (CLA), which is calculated from 18 surface electrodes along the longitudinal line of the muscle. CLA were not different between the groups for slow and preferred gait speed (p>0.05) during a gait cycle. In fast gait speed, CLA at 80% of a gait cycle (swing phase) for the elderly were significantly located at more distal site than the young group (p<0.05) (13.0±2.1cm and 10.2±2.2cm from most proximal electrodes for the elderly and young). This difference in CLA reflected a significantly lower EMG activity at the proximal regions in the elderly group (p<0.05). These results suggest the elderly manifest characteristic regional EMG responses within the RF muscle for leg swing movement of fast speed gait.

  1. Vertical rectus abdominis myocutaneous flap for vaginal reconstruction after radical pelvic surgery for Stage II vaginal carcinoma.

    PubMed

    Tapisiz, O L; Gungor, T; Demiralp, C O; Demirseren, M E; Yalcin, H; Mollamahmutoglu, L

    2011-01-01

    Primary carcinomas of the vagina are uncommon, occurring only 2-3% of all gynecological malignancies. In women with early stage of disease, primary surgery, consisting of radical vaginectomy (plus hysterectomy in patients with tumors involving the upper vagina) and systematic dissection of lymphatic drainage of tumor, is a valid option. In these patients, a rectus abdominis myocutaneous (RAM) flap may be favorably used for vaginal reconstruction during radical pelvic surgery. Here we describe a case of Stage II vaginal carcinoma treated with radical pelvic surgery and vertical-RAM (V-RAM) flap reconstruction.

  2. Real-time measurement of rectus femoris muscle kinematics during drop jump using ultrasound imaging: a preliminary study.

    PubMed

    Eranki, Avinash; Cortes, Nelson; Ferencek Gregurić, Zrinka; Kim, John J; Sikdar, Siddhartha

    2012-01-01

    We have developed an office based vector tissue Doppler imaging (vTDI) that can be used to quantitatively measure muscle kinematics using ultrasound. The goal of this preliminary study was to investigate if vTDI measures are repeatable and can be used robustly to measure and understand the kinematics of the rectus femoris muscle during a drop jump task. Data were collected from 8 healthy volunteers. Vector TDI along with a high speed camera video was used to better understand the dynamics of the drop jump. Our results indicate that the peak resultant vector velocity of the rectus femoris immediately following landing was repeatable across trials (intraclass correlation coefficient=0.9).The peak velocity had a relatively narrow range in 6 out of 8 subjects (48-62 cm/s), while in the remaining two subjects it exceeded 70 cm/s. The entire drop jump lasted for 1.45 0.27 seconds. The waveform of muscle velocity could be used to identify different phases of the jump. Also, the movement of the ultrasound transducer holder was minimal with peak deflection of 0.91 0.54 degrees over all trials. Vector TDI can be implemented in a clinical setting using an ultrasound system with a research interface to better understand the muscle kinematics in patients with ACL injuries.

  3. Enthesitis of the direct tendon of the rectus femoris muscle in a professional volleyball player: A case report.

    PubMed

    Bortolotto, C; Coscia, D R; Ferrozzi, G

    2011-06-01

    Enthesitis of the direct tendon of the rectus femoris muscle is a rare pathology which mainly affects professional athletes, and it is caused by overuse and repetitive microtrauma. Athletic jumping and kicking exert a great stress on the direct tendon of the rectus femoris muscle, and volleyball and football players are therefore most frequently affected. Enthesitis may occur suddenly causing pain and functional impairment possibly associated with partial or complete tendon injuries, or it may be a chronic condition causing non-specific clinical symptoms.We present the case of a professional volleyball player who felt a sudden pain in the left side of the groin area during a training session although she had suffered no accidental injury. The pain was associated with impaired ipsilateral limb function. Tendon rupture was suspected, and magnetic resonance imaging (MRI) was performed. MRI showed a lesion at the myotendinous junction associated with marked inhomogeneity of the direct tendon. Ultrasound (US) examination confirmed the presence of both lesions and allowed a more detailed study of the pathology.This is a typical case of enthesitis which confirms that MRI should be considered the examination of choice in hip pain, particularly when the patient is a professional athlete, thanks to its panoramic visualization. However, also US is an ideal imaging technique for evaluating tendon injuries thanks to its high spatial resolution, and it can therefore be used effectively as a second line of investigation.

  4. Predictability of horizontal versus vertical muscle surgery outcomes in thyroid eye disease.

    PubMed

    Iordanous, Yiannis; Sharan, Sapna; Robitaille, Johanne; Walsh, Leah; LaRoche, G Robert

    2016-08-01

    Surgical repair of vertical muscles in thyroid eye disease (TED) is believed to yield more unpredictable results than horizontal muscle surgery. The purpose of this study is to determine if the short-term outcomes for strabismus surgery in TED are equally predictable for horizontal and vertical muscle surgery. We retrospectively reviewed the charts of 27 consecutive patients who underwent strabismus surgery for TED from a single surgeon's practice. Eligibility for inclusion in the study included biochemically stable thyroid disease for at least a year and stable orthoptic measurements for at least 6 months prior to surgery. Nine patients had surgery only on vertical rectus muscles, three only on horizontal, and fifteen on both vertical and horizontal rectus muscles. Mean follow-up was 2.4 ± 5.2 months. In primary gaze at 6 m, a mean horizontal deviation of 16.6 ± 22.3 PD, and a mean vertical deviation of 19.7 ± 14.1 PD were measured pre-operatively. Post-operatively, this measured 2.3 ± 8.4 PD horizontally and 2.1 ± 7.8 PD vertically (p = 0.933). There was no statistically significant difference between post-operative horizontal and vertical deviations in elevation, depression, adduction, and abduction. Nine patients required reoperation to attain satisfactory ocular alignment; seven of these cases involved repeat surgery on vertical muscles, while two cases required operation on both horizontal and vertical muscles. Results suggest that surgical outcomes of both horizontal and vertical muscle surgery are equally predictable in stable TED; however, reoperation rates were higher for vertical muscles compared to horizontal muscles. PMID:26559967

  5. [Recession of the inferior rectus muscle in superficial anesthesia in the treatment of thyroid orbitopathy].

    PubMed

    Koniszewski, G; Zagórski, Z

    1989-06-01

    Recession of the inferior rectus in surface anaesthesia by 5% cocaine drops was performed in 8 patients with signs of hypotropia in the course of thyroid orbitopathia and with diplopia persisting after conservatory treatment and not corrected by prisms. This method enables us an accurate intraoperative settlement of the distance of recession and it may be recommended in cases metabolically normalized, with not too much advanced exophthalmos, with a stability of the motor disturbances for at least 6 months and without any signs of inflammation.

  6. Electromyography analysis of the rectus abdominis and external oblique muscles of children 8 to 10 years old.

    PubMed

    Moraes, A C; Bankoff, A D; Pellegrinotti, L L; Moreira, Z W; Galdi, E H

    1995-11-01

    The objective of this work was to study through in the electromyography the upper and lower umbilical rectus abdominis and the anterior and posterior parts of the external oblique muscles of children 8 to 10 years old. The children studied practice artistic and rhythmical gymnastic sports at the training and learning level and the study was made during abdominal exercise in the dorsal decubitus position on the ground and on a board. The children were divided into 2 groups: Group I - ten already trained children; Group II - nineteen learners. The participants in Group I practiced an average of 5 times a week and those in Group II practiced 2 times a week. The exercises analyzed were: on the ground, lifting the legs 30, 20 and 10 cm high with the knees flexed 90 degrees; flexing the trunk while maintaining the legs elevated and the knees flexed; flexing the trunk with homo and heterolateral rotation of the trunk while maintaining the legs elevated and the knees flexed. On the board, flexing the trunk with the knees flexed 90 degrees on top of the board inclined 30, 20 and 10 cm; flexing the trunk with rotation of the trunk homo and heterolateral with the knees flexed on the board inclined 30, 20 and 10 cm. The results showed that the superior umbilical part of the rectus abdominis muscle presented more intense action potential than the inferior-umbilical part; the more intense action potential occurred at the flexing of the trunk and at the flexing of the trunk with homo and heterolateral rotation. The anterior part of the external oblique muscle presented more intense action potential than the posterior part; the more intense action potential occurred at the flexing of the trunk and at the flexing of the trunk with heterolateral rotation. In both of the muscles the more intense action potential occurred between 45 and 60 degrees of flexing the trunk; the children in Group I presented more intense action potential than those in Group II; the exercise of lifting the

  7. Three horizontal muscle surgery for large-angle infantile esotropia: validation of a table of amounts of surgery

    PubMed Central

    Camuglia, J E; Walsh, M J; Gole, G A

    2011-01-01

    Purpose To validate a table of amounts of three horizontal muscle surgery in patients with large-angle infantile esotropia (≥60 prism dioptres, PD). Methods A prospective interventional case series reporting the postoperative alignment of 51 patients (27 male, 24 female) over a 15-year period was conducted. Surgery amounts were according to a published table developed on a previous patient cohort (n=49), using bilateral medial rectus recession with graded unilateral lateral rectus resection. Kaplan–Meier life-table survival curves were formulated for success to orthotropia (±10 PD) after one and subsequent horizontal muscle surgeries for up to 8 years follow-up. Results The median preoperative deviation was 65 PD (range 60–80 PD) and median age at surgery was 11.8 months (range 5.1 months–3.6 years). Surgical success to orthotropia (±10 PD) after one surgery was 100% at 2 months, 95.7% at 6 months, 91.3% at 12 months, 77.8% at 4 years, and 73.6% at 8 years. Postoperative failure requiring further horizontal surgery occurred in 17.6% (residual esotropia 4, consecutive exotropia 5). Conclusions Our second cohort has reproduced the success rate of the previous cohort (77.8% vs 77.1% at 4 years). If the published table of surgical amounts is used, three horizontal muscle surgery in large-angle infantile esotropia (≥60 PD) appears to have a good long-term success rate, and does not lead to the high rates of either residual esotropia or consecutive exotropia reported by others in the literature. PMID:21818127

  8. The affinity and activity of compounds related to nicotine on the rectus abdominis muscle of the frog (Rana pipiens)

    PubMed Central

    Barlow, R. B.; Thompson, G. M.

    1969-01-01

    1. Series of pyridylalkyl- and substituted phenylalkyl-trimethylammonium salts, triethylammonium salts, diethylamines and di-n-propylamines have been made. The substituents in the benzene ring were nitro, chloro, bromo, methoxy, hydroxy and amino groups and the alkyl residues had one, two, or three methylene groups separating the aromatic nucleus from the cationic head. 2. Most of the trimethylammonium compounds caused a contracture of the frog rectus muscle, but some were partial agonists and a few were antagonists. The di-n-propylamines were all antagonists, as were most of the diethylamines and triethylammonium compounds, though some of these were partial agonists and a few triethylammonium compounds were agonists. The affinities of the antagonists and partial agonists for the receptors stimulated by β-pyridylmethyltrimethylammonium (and by nicotine) were measured. The equipotent molar ratios of all the agonists were measured relative to β-pyridylmethyltrimethylammonium. 3. The dissociation constants of the pyridylmethyldiethylamines and substituted benzyldiethylamines were measured. The effects of substituents on the pKa of benzyldiethylamine were similar to their effects on the pKa of aniline, though there were differences with some of the o-substituted compounds, which could be attributed to internal hydrogen-bond formation. 4. There is no obvious correlation between the effects of a substituent on the pKa of benzyldiethylamine and its effects on affinity. Although increasing the size of the cationic group usually increased affinity, it did not always do so. The compounds with the highest affinity, p-hydroxybenzyldiethylamine (log K, 5·90) had about half the affinity of (+)-tubocurarine (log K, 6·11), but the triethylammonium analogue (log K, 4·17) had only about one-fiftieth of the affinity of the tertiary base. The binding of the drug to the receptor appears to involve many factors which include the size of the groups as well as their electron

  9. Transcatheter Arterial Embolization of Concurrent Spontaneous Hematomas of the Rectus Sheath and Psoas Muscle in Patients Undergoing Anticoagulation

    SciTech Connect

    Basile, Antonio; Medina, Jose Garcia; Mundo, Elena; Medina, Vicente Garcia; Leal, Rafael

    2004-11-15

    We report a case of concurrent rectus sheath and psoas hematomas in a patient undergoing anticoagulant therapy, treated by transcatheter arterial embolization (TAE) of inferior epigastric and lumbar arteries. Computed tomography (CT) demonstrated signs of active bleeding in two hematomas of the anterior and posterior abdominal walls. Transfemoral arteriogram confirmed the extravasation of contrast from the right inferior epigastric artery (RIEA). Indirect signs of bleeding were also found in a right lumbar artery (RLA). We successfully performed TAE of the feeding arteries. There have been few reports in the literature of such spontaneous hemorrhages in patients undergoing anticoagulation, successfully treated by TAE.

  10. Histotopographical study of human periocular elastic fibers using aldehyde-fuchsin staining with special reference to the sleeve and pulley system for extraocular rectus muscles.

    PubMed

    Osanai, Hajime; Murakami, Gen; Ohtsuka, Aiji; Suzuki, Daisuke; Nakagawa, Takashi; Tatsumi, Haruyuki

    2009-09-01

    The aim of this study was to investigate the detailed configuration of periocular elastic fibers. Semiserial paraffin sections were made using 40 whole orbital contents from 27 elderly cadavers and stained by the aldehyde-fuchsin method. Periocular tissues were classified into three types according to directions of the elastic fibers, i.e., tissues containing anteroposteriorly running elastic fibers, those with mediolateral fibers, and those with meshwork of fibers. Anteroposterior elastic fiber-dominant tissue was seen in the upper eyelid and newly defined pulley plate for the medial and lateral recti (MR, LR). Mediolateral fibers were predominant in the central part of the inferior rectus pulley. In the pulley plates for the MR and LR, anteroposteriorly running fibers encased the striated muscle. Tenon's capsule and the epimysium of the recti were mediolateral fiber-dominant. However, at the entrance of the muscle terminal where Tenon's capsule reflects and continues to the epimysium, composite elastic fibers provided a meshwork-like skeleton. The elastic mesh was also seen around the lacrimal canaliculi. The pulley for the recti seemed to be composed of two parts--a connective tissue plate encasing the recti and specialized Tenon's capsule at an entrance or porta of the muscle. For both parts, elastic fibers were major functional components. The anteroposterior elastic fibers in the MR and LR pulley plates, especially, seemed to receive anteroposteriorly directed stress and tension from these striated muscles. The elastic interfaces seemed to prevent any concentration of stress that would interfere with periocular striated muscle functions, including hypothetical active pulleys.

  11. Immunohistochemical analysis of bFGF, TGF-beta1 and catalase in rectus abdominis muscle from cattle foetuses at 180 and 260 days post-conception.

    PubMed

    Orzechowski, A; Gajkowska, B; Wojewódzka, U; Cassar-Malek, I; Picard, B; Hocquette, J F

    2002-12-01

    The potential for muscle growth depends on myoblast proliferation, which occurs essentially during the first two thirds of the foetal period in cattle. Thereafter, myofibres acquire their contractile and metabolic properties. Proliferation is regulated by molecular growth factors and by the tissue oxidative activity. The aim of this study was the quantification by immunochemistry of basic fibroblast growth factor (bFGF) and transforming growth factor beta 1 (TGF-beta1) and also of enzyme catalase (CAT) activity in rectus abdominis muscle. Samples were collected from cattle foetuses of different growth potential at 180 and 260 days post-conception (dpc). One major conclusion from this work is that protein contents of the muscle tissue bFGF and, to a lower extent, CAT activity decreased with increasing age during the foetal life. No differences were found between the different genotypes of cattle. However, the CAT to bFGF ratio tended to be lower in fast-growing cattle and increased with foetal age. TGF-beta1 did not change with age and was localised mostly at the vascular bed. CAT was detected in smooth and rough reticulum in striated muscles at 180dpc, and additionally in mitochondria at 260dpc. In conclusion, the balance between intracellular growth factors (bFGF and TGF-beta1) and the activity of antioxidant enzyme CAT may participate in the regulation of the transition from myoblast proliferation to differentiation. Thus, increased ratio of CAT to bFGF might be a good index indicating initiation of muscle maturation in cattle foetus prior to birth.

  12. Stretchability of the rectus femoris muscle: investigation of validity and intratester reliability of two methods including X-ray analysis of pelvic tilt.

    PubMed

    Hamberg, J; Björklund, M; Nordgren, B; Sahlstedt, B

    1993-03-01

    Validity and intratester reliability of two test methods designed to identify stretchability of the rectus femoris muscle (RFM) was investigated, combined with x-ray analysis of pelvic tilt in the sagittal plane. The first method is commonly used in clinical practice. The second is a new technique supposed to tilt the pelvis posteriorly and thus further separate the origin and insertion of the muscle. Investigation of validity and intratester reliability of the two methods was made by testing and retesting a random sample of 71 persons. The tests were performed with an equipment that automatically recorded the angle of knee flexion from a previously determined applied torque, indicating the end point of motion for that particular subject. Angle of knee flexion and subjective estimation of pain sensation due to stretch were recorded at each measurement. The pelvic tilt-analysis consisted of test-retest reliability of x-ray measurements, comparison between the methods in both starting and final position, and x-ray and electronic goniometer measurements. All applied torques were measured with a strain gauge. Two out of three criteria of validity favored the new method and the third pointed out the two methods as equal. The two methods as well as the x-ray measurements showed high reliability, and the hypothesis of a more posterior tilted pelvis in the new method was confirmed. The electronic goniometer was less sensitive than x-ray, but proposed to analyse pelvic tilt clinically. Methodology procedures for joint angle measurements are discussed.

  13. The Role of Thyroid Eye Disease and Other Factors in the Overcorrection of Hypotropia Following Unilateral Adjustable Suture Recession of the Inferior Rectus (An American Ophthalmological Society Thesis)

    PubMed Central

    Kerr, Natalie C.

    2011-01-01

    Purpose Overcorrection of hypotropia subsequent to adjustable suture surgery following inferior rectus recession is undesirable, often resulting in persistent diplopia and reoperation. I hypothesized that overcorrection shift after suture adjustment may be unique to thyroid eye disease, and the use of a nonabsorbable suture may reduce the occurrence of overcorrection. Methods A retrospective chart review of adult patients who had undergone eye muscle surgery with an adjustable suture technique was performed. Overcorrection shifts that occurred between the time of suture adjustment and 2 months postoperatively were examined. Descriptive statistics, linear regression, Anderson-Darling tests, generalized Pareto distributions, odds ratios, and Fisher tests were performed for two overcorrection shift thresholds (>2 and >5 prism diopters [PD]). Results Seventy-seven patients were found: 34 had thyroid eye disease and inferior rectus recession, 30 had no thyroid eye disease and inferior rectus recession, and 13 patients had thyroid eye disease and medial rectus recession. Eighteen cases exceeded the 2 PD threshold, and 12 exceeded the 5 PD threshold. Statistical analyses indicated that overcorrection was associated with thyroid eye disease (P=6.7E-06), inferior rectus surgery (P=6.7E-06), and absorbable sutures (>2 PD: OR=3.7, 95% CI=0.4–35.0, P=0.19; and >5 PD: OR=6.0, 95% CI=1.1–33.5, P=0.041). Conclusions After unilateral muscle recession for hypotropia, overcorrection shifts are associated with thyroid eye disease, surgery of the inferior rectus, and use of absorbable sutures. Surgeons performing unilateral inferior rectus recession on adjustable suture in the setting of thyroid eye disease should consider using a nonabsorbable suture to reduce the incidence of postoperative overcorrection. PMID:22253487

  14. Comparative study of linear and curvilinear ultrasound probes to assess quadriceps rectus femoris muscle mass in healthy subjects and in patients with chronic respiratory disease

    PubMed Central

    Mandal, S; Suh, E; Thompson, A; Connolly, B; Ramsay, M; Harding, R; Puthucheary, Z; Moxham, J; Hart, N

    2016-01-01

    Introduction Ultrasound measurements of rectus femoris cross-sectional area (RFCSA) are clinically useful measurements in chronic obstructive pulmonary disease (COPD) and critically ill patients. Technical considerations as to the type of probe used, which affects image resolution, have limited widespread clinical application. We hypothesised that measurement of RFCSA would be similar with linear and curvilinear probes. Methods Four studies were performed to compare the use of the curvilinear probe in measuring RFCSA. Study 1 investigated agreement of RFCSA measurements using linear and curvilinear probes in healthy subjects, and in patients with chronic respiratory disease. Study 2 investigated the intra-rater and inter-rater agreement using the curvilinear probe. Study 3 investigated the agreement of RFCSA measured from whole and spliced images using the linear probe. Study 4 investigated the applicability of ultrasound in measuring RFCSA during the acute and recovery phases of an exacerbation of COPD. Results Study 1 showed demonstrated no difference in the measurement of RFCSA using the curvilinear and linear probes (308±104 mm2 vs 320±117 mm2, p=0.80; intraclass correlation coefficient (ICC)>0.97). Study 2 demonstrated high intra-rater and inter-rater reliability of RFCSA measurement with ICC>0.95 for both. Study 3 showed that the spliced image from the linear probe was similar to the whole image RFCSA (308±103.5 vs 263±147 mm2, p=0.34; ICC>0.98). Study 4 confirmed the clinical acceptability of using the curvilinear probe during an exacerbation of COPD. There were relationships observed between admission RFCSA and body mass index (r=+0.65, p=0.018), and between RFCSA at admission and physical activity levels at 4 weeks post-hospital discharge (r=+0.75, p=0.006). Conclusions These studies have demonstrated that clinicians can employ whole and spliced images from the linear probe or use images from the curvilinear probe, to measure RFCSA. This will extend

  15. SPLIT rectus abdominis myocutaneous double free flap for extremity reconstruction.

    PubMed

    Nyame, Theodore T; Holzer, Paul W; Helm, Douglas L; Maman, Daniel Y; Winograd, Jonathan M; Cetrulo, Curtis L

    2014-01-01

    A Mathes and Nahai type III muscle, such as the rectus abdominis muscle, can be utilized to cover two separate wounds simultaneously utilizing its dual blood supply thereby minimizing donor site morbidity and operative time. We report a case for treatment of bilateral Gustillo type IIIB lower extremity injuries treated with a single rectus abdominis muscle split into two free flaps, with one based on the deep inferior epigastric vessels and one on the superior epigastric vessels to cover the contralateral wound. In our patient, both lower extremity wounds were covered with muscle flaps from the same donor site in a single operation, salvaging both limbs with progression to unassisted ambulatory status. We show in this case report that the utilization of the vascular anatomy of the rectus muscle allows for division of the flap into two flaps, permitting preservation of the contralateral abdominal wall integrity and coverage of two wounds with a single muscle.

  16. Changes in the Range of Motion of the Hip Joint and the Muscle Activity of the Rectus Femoris and Biceps Femoris of Stroke Patients during Obstacles Crossing on the Ground and Underwater.

    PubMed

    Kim, Myung-Chul; Han, Seul-Ki; Kim, Seung-Kyun

    2014-08-01

    [Purpose] The purpose of this study was to examine range of motion (ROM) and the muscle activity of stroke patients during obstacle task on the ground and underwater. [Subjects] The subjects of this study were seven stroke patients in a hospital located in Daejeon, South Korea. [Methods] The measurements in this study were conducted in an exercise therapy room and a pool dedicated to underwater exercise (water temperature 33.5 °C, air temperature 27 °C) in the hospital building. The pool's water depth was determined by considering the levels of the xiphoid process of the study subjects. Ten-centimeter-high obstacles were used. An electrogoniometer was used to examine the ROM of flexion and extension of the hip joints on the affected side. An MP150 system a BioNomadix 2-channel wireless EMG transmitter was used to examine the muscle activity of the rectus femoris and biceps femoris of the affected side. [Conclusion] The results suggest that the unaffected side was supported, that the affected side moved, and that the hip joint was bent more underwater than on the ground. The rectus femoris and bicpes femoris were activated significantly less underwater than on the ground in all sections.

  17. Reducing Postoperative Opioid Consumption by Adding an Ultrasound-Guided Rectus Sheath Block to Multimodal Analgesia for Abdominal Cancer Surgery With Midline Incision

    PubMed Central

    Bashandy, Ghada Mohammad Nabih; Elkholy, Abeer Hassan Hamed

    2014-01-01

    Background: Many multimodal analgesia techniques have been tried to provide adequate analgesia for midline incisions extending above and below the umbilicus aiming at limiting the perioperative use of morphine thus limiting side effects. Ultrasound (US) guidance made the anesthesiologist reconsider old techniques for wider clinical use. The rectus sheath block (RSB) is a useful technique under-utilized in the adult population. Objectives: Our study examined the efficacy of a preemptive single-injection rectus sheath block in providing better early postoperative pain scores compared to general anesthesia alone. Patients and Methods: Sixty patients were recruited in this randomized controlled trial. These patients were divided into two groups: RSB group had an RSB after induction of anesthesia and before surgical incision, and GA (general anesthesia) group had general anesthesia alone. Both groups were compared for verbal analogue scale (VAS) score, opioid consumption and hemodynamic variables in the post-anesthesia care unit (PACU). Analgesic requirements in surgical wards were recorded in postoperative days (POD) 0, 1 and 2. Results: The median VAS score was significantly lower in RSB group compared with GA group in all 5 time points in the PACU (P ˂ 0.05). Also PACU morphine consumption was lower in RSB group than GA group patients (95% confidence interval [CI] of the difference in means between groups, −4.59 to −2.23 mg). Morphine consumption was also less in the first 2 postoperative days (POD0 and POD1). Conclusions: Ultrasound-guided rectus sheath block is an easy technique to learn. This technique, when it is used with general anesthesia, will be more effective in reducing pain scores and opioid consumption compared with general anesthesia alone. PMID:25289373

  18. Abdominal wall injuries: rectus abdominis strains, oblique strains, rectus sheath hematoma.

    PubMed

    Johnson, Rob

    2006-04-01

    Abdominal wall injuries are reported to be less common than actually perceived by sports medicine practitioners. National Collegiate Athletic Association injury statistics for 2004-2005 cite a high of 0.71 abdominal muscle injuries per 1000 player-hours in wrestling competition to a low of 0.01 injuries per 1000 player-hours in autumn football practices. British professional soccer clubs reported an incidence of "torso" injuries of up to 7% of all injuries over the course of several seasons. Injury definition is most likely the explanation for this discrepancy. The abdominal wall muscles (rectus abdominis, external and internal obliques, and transverse abdominis) are injured by direct blows to the abdomen or by sudden or repetitive trunk movement, either rotation or flexion/extension. With the exception of the rare rectus sheath hematoma that does not self-tamponade, the treatment for these problems is nonoperative with symptoms guiding rehabilitation and return to play decisions.

  19. Proximal Rectus Femoris Avulsion Repair.

    PubMed

    Dean, Chase S; Arbeloa-Gutierrez, Lucas; Chahla, Jorge; Pascual-Garrido, Cecilia

    2016-06-01

    Proximal rectus femoris tendon avulsions are rare and occur mostly in male athletes. Currently, the standard of care for complete tendinous avulsions of the direct arm of the rectus femoris is nonoperative treatment. However, surgical repair may be considered in high-level athletes who have a high demand for repetitive hip flexion performed in an explosive manner or in patients in whom nonoperative treatment has failed. The purpose of this technical note is to describe the method for surgical repair of the proximal direct arm of the rectus femoris to its origin at the anterior inferior iliac spine using suture anchors. PMID:27656376

  20. Intractable pain due to rectus abdominis intramuscular haemangioma.

    PubMed

    Scozzari, G; Reddavid, R; Conti, L; Trombetta, F; Toppino, M; Sandrucci, S

    2014-08-01

    Haemangiomas are tumours of vascular origin accounting for approximately 7 % of all benign tumours. Three types of haemangioma have been described according to the vessel type involved: capillary, cavernous and mixed. Intramuscular haemangiomas (IMHs) are infrequent, accounting for less than 1 % of all haemangiomas and are mostly located in the extremities and the trunk. Intramuscular haemangiomas of the rectus abdominis muscle are extremely rare, with only one previous case reported in the literature to the best of our knowledge. In this report, we present the case of a patient with intractable pain related to IMHs of the rectus abdominis and we analyse diagnostic assessment and surgical management of the condition.

  1. Repair of rectus femoris rupture with LARS ligament.

    PubMed

    Taylor, Clare; Yarlagadda, Rathan; Keenan, Jonathan

    2012-03-20

    The rectus femoris muscle is the most frequently involved quadriceps muscle in strain pathologies. The majority of quadriceps muscle belly injuries can be successfully treated conservatively and even significant tears in the less active and older population, non-operative management is a reasonable option. The authors report the delayed presentation of a 17-year-old male who sustained an injury to his rectus femoris muscle belly while playing football. This young patient did not recover the functional outcome required to get back to running and participating in sport despite 15 months of physiotherapy and non-operative management. Operative treatment using the ligament augmentation and reconstruction system ligament to augment Kessler repair allowed immediate full passive flexion of the knee and an early graduated physiotherapy programme. Our patient was able to return to running and his previous level of sport without any restrictions.

  2. Medial transposition of split lateral rectus augmented with fixation sutures in cases of complete third nerve palsy.

    PubMed

    Saxena, Rohit; Sharma, Medha; Singh, Digvijay; Dhiman, Rebika; Sharma, Pradeep

    2016-05-01

    Surgical management of complete third nerve paralysis is a challenge. While several techniques have been described over the years, they result in less than satisfactory outcomes with residual deviations in primary gaze or postoperative drifts. One of the described techniques for management of oculomotor palsy has been medial transposition of the lateral rectus muscle which provides a good surgical alternative but often can result in undercorrection. We describe a modification of the existing technique of medial transposition of the split lateral rectus by force augmentation through the use of equatorial fixation sutures resulting in an improved outcome in primary gaze alignment. The modified technique involves splitting of the lateral rectus into two halves followed by transposing the superior half from below the superior oblique and superior rectus and inferior half from below the inferior oblique and inferior rectus to attach them at the superior and inferior edge of the medial rectus insertion, respectively. This is followed by placing non-absorbable sutures to fix each split belly of the transposed muscles to the sclera at the equator adjacent to the medial rectus such that the split muscles lie nearly parallel to the medial rectus till the equator before reflecting away. These sutures augment the force of the transposed muscles by redirecting the force vectors in the direction of action of the medial rectus. Satisfactory postoperative primary gaze alignment was achieved in three cases of complete third nerve paralysis.

  3. Proximal Rectus Femoris Avulsion: Ultrasonic Diagnosis and Nonoperative Management

    PubMed Central

    Esser, Stephan; Jantz, David; Hurdle, Mark F.; Taylor, Walter

    2015-01-01

    Objective To present a case of ultrasonic diagnosis and nonoperative management of a complete proximal rectus femoris avulsion in a National Collegiate Athletic Association Division 1 soccer goalkeeper. Background While delivering a goal kick, a previously uninjured 24-year-old collegiate soccer goalkeeper had the sudden onset of right anterior thigh pain. He underwent rehabilitation with rapid resolution of his presenting pain but frequent intermittent recurrence of anterior thigh pain. After he was provided a definitive diagnosis with musculoskeletal ultrasound, he underwent an extended period of rehabilitation and eventually experienced complete recovery without recurrence. Differential Diagnosis Rectus femoris avulsion, rectus femoris strain or partial tear, inguinal hernia, or acetabular labral tear. Treatment Operative and nonoperative options were discussed. In view of the player's recovery, nonoperative options were pursued with a good result. Uniqueness Complete proximal rectus femoris avulsions are rare. Our case contributes to the debate on whether elite-level kicking and running athletes can return to full on-field performance without surgery. Conclusions Complete proximal rectus femoris avulsions can be treated effectively using nonoperative measures with good preservation of function even in the elite-level athlete. In addition, musculoskeletal ultrasound is an excellent tool for on-site evaluation and may help guide prognosis and management. PMID:25978099

  4. Classification of Chronic Back Muscle Degeneration after Spinal Surgery and Its Relationship with Low Back Pain

    PubMed Central

    Orita, Sumihisa; Yamauchi, Kazuyo; Eguchi, Yawara; Aoki, Yasuchika; Nakamura, Junichi; Ishikawa, Tetsuhiro; Miyagi, Masayuki; Kamoda, Hiroto; Suzuki, Miyako; Kubota, Gou; Inage, Kazuhide; Sainoh, Takeshi; Sato, Jun; Shiga, Yasuhiro; Abe, Koki; Fujimoto, Kazuki; Kanamoto, Hirohito; Inoue, Gen; Takahashi, Kazuhisa

    2016-01-01

    Study Design Retrospective case series. Purpose To classify back muscle degeneration using magnetic resonance imaging (MRI) and investigate its relationship with back pain after surgery. Overview of Literature Back muscle injury and degeneration often occurs after posterior lumbar surgery, and the degeneration may be a cause of back pain. However, the relationship between back muscle degeneration and back pain remains controversial. Methods A total of 84 patients (average age, 65.1 years; 38 men, 46 women) with lumbar spinal stenosis underwent posterior decompression surgery alone. MRI (1.5 tesla) was evaluated before and more than a year after surgery in all patients. Muscle on MRI was classified into three categories: low intensity in T1-weighted imaging, high intensity in T2-weighted imaging (type 1), high intensity in both T1- and T2-weighted images (type 2), and low intensity in both T1- and T2-weighted imaging (type 3). The prevalence of the types and their relationship with back pain (determined on a visual analog scale) were evaluated. Results MRI revealed muscle degeneration in all patients after surgery (type 1, 6%; type 2, 82%; and type 3, 12%). Type 2 was significantly more frequent compared with types 1 and 3 (p<0.01). Low back pain was significantly improved after surgery (p<0.01). Low back pain was not associated with any MRI type of muscle degeneration after surgery (p>0.05). Conclusions Various pathologies of back muscle degeneration after posterior lumbar surgery were revealed. Type 2 (fatty) change was most frequent, and other patients had type 3 (scar) or type 1 (inflammation or water-like) changes. According to the Modic classification of bone marrow changes, Modic type 1 change is associated with inflammation and back pain. However, no particular type of back muscle degeneration was correlated with back pain after surgery. PMID:27340532

  5. Muscle lengthening surgery causes differential acute mechanical effects in both targeted and non-targeted synergistic muscles.

    PubMed

    Ateş, Filiz; Özdeşlik, Rana N; Huijing, Peter A; Yucesoy, Can A

    2013-10-01

    Epimuscular myofascial force transmission (EMFT) is a major determinant of muscle force exerted, as well as length range of force exertion. Therefore, EMFT is of importance in remedial surgery performed, e.g., in spastic paresis. We aimed to test the following hypotheses: (1) muscle lengthening surgery (involving preparatory dissection (PD) and subsequent proximal aponeurotomy (AT)) affects the target muscle force exerted at its distal and proximal tendons differentially, (2) forces of non-operated synergistic muscles are affected as well, (3) PD causes some of these effects. In three conditions (control, post-PD, and post-AT exclusively on m. extensor digitorum longus (EDL)), forces exerted by rat anterior crural muscles were measured simultaneously. Our results confirm hypotheses (1-2), and hypothesis (3) in part: Reduction of EDL maximal force differed by location (i.e. 26.3% when tested distally and 44.5% when tested proximally). EDL length range of active force exertion increased only distally. Force reductions were shown also for non-operated tibialis anterior (by 11.9%), as well as for extensor hallucis longus (by 8.4%) muscles. In tibialis anterior only, part of the force reduction (4.9%) is attributable to PD. Due to EMFT, remedial surgery should be considered to have differential effects for targeted and non-targeted synergistic muscles.

  6. Adaptability of the Immature Ocular Motor Control System: Unilateral IGF-1 Medial Rectus Treatment

    PubMed Central

    Willoughby, Christy L.; Fleuriet, Jérome; Walton, Mark M.; Mustari, Michael J.; McLoon, Linda K.

    2015-01-01

    Purpose. Unilateral treatment with sustained release IGF-1 to one medial rectus muscle in infant monkeys was performed to test the hypothesis that strabismus would develop as a result of changes in extraocular muscles during the critical period of development of binocularity. Methods. Sustained release IGF-1 pellets were implanted unilaterally on one medial rectus muscle in normal infant monkeys during the first 2 weeks of life. Eye position was monitored using standard photographic methods. After 3 months of treatment, myofiber and neuromuscular size, myosin composition, and innervation density were quantified in all rectus muscles and compared to those in age-matched controls. Results. Sustained unilateral IGF-1 treatments resulted in strabismus for all treated subjects; 3 of the 4 subjects had a clinically significant strabismus of more than 10°. Both the treated medial rectus and the untreated ipsilateral antagonist lateral rectus muscles had significantly larger myofibers. No adaptation in myofiber size occurred in the contralateral functionally yoked lateral rectus or in myosin composition, neuromuscular junction size, or nerve density. Conclusions. Sustained unilateral IGF-1 treatment to extraocular muscles during the sensitive period of development of orthotropic eye alignment and binocularity was sufficient to disturb ocular motor development, resulting in strabismus in infant monkeys. This could be due to altering fusion of gaze during the early sensitive period. Serial measurements of eye alignment suggested the IGF-1-treated infants received insufficient coordinated binocular experience, preventing the establishment of normal eye alignment. Our results uniquely suggest that abnormal signaling by the extraocular muscles may be a cause of strabismus. PMID:26030103

  7. Inspiratory Muscle Training and Functional Capacity in Patients Undergoing Cardiac Surgery

    PubMed Central

    Cordeiro, André Luiz Lisboa; de Melo, Thiago Araújo; Neves, Daniela; Luna, Julianne; Esquivel, Mateus Souza; Guimarães, André Raimundo França; Borges, Daniel Lago; Petto, Jefferson

    2016-01-01

    Introduction Cardiac surgery is a highly complex procedure which generates worsening of lung function and decreased inspiratory muscle strength. The inspiratory muscle training becomes effective for muscle strengthening and can improve functional capacity. Objective To investigate the effect of inspiratory muscle training on functional capacity submaximal and inspiratory muscle strength in patients undergoing cardiac surgery. Methods This is a clinical randomized controlled trial with patients undergoing cardiac surgery at Instituto Nobre de Cardiologia. Patients were divided into two groups: control group and training. Preoperatively, were assessed the maximum inspiratory pressure and the distance covered in a 6-minute walk test. From the third postoperative day, the control group was managed according to the routine of the unit while the training group underwent daily protocol of respiratory muscle training until the day of discharge. Results 50 patients, 27 (54%) males were included, with a mean age of 56.7±13.9 years. After the analysis, the training group had significant increase in maximum inspiratory pressure (69.5±14.9 vs. 83.1±19.1 cmH2O, P=0.0073) and 6-minute walk test (422.4±102.8 vs. 502.4±112.8 m, P=0.0031). Conclusion We conclude that inspiratory muscle training was effective in improving functional capacity submaximal and inspiratory muscle strength in this sample of patients undergoing cardiac surgery. PMID:27556313

  8. Medial Rectus Recession Is as Effective as Lateral Rectus Resection in Divergence Paralysis Esotropia

    PubMed Central

    Chaudhuri, Zia; Demer, Joseph L.

    2013-01-01

    Objective To propose medial rectus (MR) recession to be equally as effective as lateral rectus (LR) resection, which has heretofore been the preferred treatment for divergence paralysis esotropia (DPE). Methods We examined a 17-year surgical experience comparing LR resection with MR recession in adults with DPE, defined as symptomatic distance esotropia (ET) at least double the asymptomatic ET of 10 or less prism diopters (Δ) at near. Results Twenty-four patients with DPE underwent surgery. Six patients underwent bilateral LR resection and 2 underwent unilateral LR resection (group L), while 13 underwent bilateral MR recession and 3 underwent unilateral MR recession, with the target angle double the distance ET (group M). One of 8 patients in group L and 15 of 16 patients in group M underwent intraoperative adjustable surgery under topical anesthesia. Mean (SD) preoperative central gaze ET measured 15.0 (7.7) Δ at distance and 4.1 (3.4) Δ at near in group L, but 10.4 (6.8) Δ at distance and 0.6 (1.7) Δ at near in group M (P=.15; distance, 0.003, near). Postoperatively, no patient in either group had symptomatic diplopia or convergence insufficiency in follow-up from 8.5 to 40 months. Twice the usual surgical dose of MR recession per prism diopter was required to achieve correction of the distance deviation in DPE as compared with that recommended for ET generally and also for LR resection in the same condition. Conclusions Recession of the MR provides binocular single vision in DPE without convergence insufficiency at near, and it is convenient for intraoperative adjustment under topical anesthesia. PMID:22688183

  9. Prediction of Muscle Fatigue during Minimally Invasive Surgery Using Recurrence Quantification Analysis

    PubMed Central

    Keshavarz Panahi, Ali; Cho, Sohyung

    2016-01-01

    Due to its inherent complexity such as limited work volume and degree of freedom, minimally invasive surgery (MIS) is ergonomically challenging to surgeons compared to traditional open surgery. Specifically, MIS can expose performing surgeons to excessive ergonomic risks including muscle fatigue that may lead to critical errors in surgical procedures. Therefore, detecting the vulnerable muscles and time-to-fatigue during MIS is of great importance in order to prevent these errors. The main goal of this study is to propose and test a novel measure that can be efficiently used to detect muscle fatigue. In this study, surface electromyography was used to record muscle activations of five subjects while they performed fifteen various laparoscopic operations. The muscle activation data was then reconstructed using recurrence quantification analysis (RQA) to detect possible signs of muscle fatigue on eight muscle groups (bicep, triceps, deltoid, and trapezius). The results showed that RQA detects the fatigue sign on bilateral trapezius at 47.5 minutes (average) and bilateral deltoid at 57.5 minutes after the start of operations. No sign of fatigue was detected for bicep and triceps muscles of any subject. According to the results, the proposed novel measure can be efficiently used to detect muscle fatigue and eventually improve the quality of MIS procedures with reducing errors that may result from overlooked muscle fatigue. PMID:27313884

  10. Decellularized Human Skeletal Muscle as Biologic Scaffold for Reconstructive Surgery

    PubMed Central

    Porzionato, Andrea; Sfriso, Maria Martina; Pontini, Alex; Macchi, Veronica; Petrelli, Lucia; Pavan, Piero G.; Natali, Arturo N.; Bassetto, Franco; Vindigni, Vincenzo; De Caro, Raffaele

    2015-01-01

    Engineered skeletal muscle tissues have been proposed as potential solutions for volumetric muscle losses, and biologic scaffolds have been obtained by decellularization of animal skeletal muscles. The aim of the present work was to analyse the characteristics of a biologic scaffold obtained by decellularization of human skeletal muscles (also through comparison with rats and rabbits) and to evaluate its integration capability in a rabbit model with an abdominal wall defect. Rat, rabbit and human muscle samples were alternatively decellularized with two protocols: n.1, involving sodium deoxycholate and DNase I; n.2, trypsin-EDTA and Triton X-NH4OH. Protocol 2 proved more effective, removing all cellular material and maintaining the three-dimensional networks of collagen and elastic fibers. Ultrastructural analyses with transmission and scanning electron microscopy confirmed the preservation of collagen, elastic fibres, glycosaminoglycans and proteoglycans. Implantation of human scaffolds in rabbits gave good results in terms of integration, although recellularization by muscle cells was not completely achieved. In conclusion, human skeletal muscles may be effectively decellularized to obtain scaffolds preserving the architecture of the extracellular matrix and showing mechanical properties suitable for implantation/integration. Further analyses will be necessary to verify the suitability of these scaffolds for in vitro recolonization by autologous cells before in vivo implantation. PMID:26140375

  11. Simultaneous Prosthetic Mesh Abdominal Wall Reconstruction with Abdominoplasty for Ventral Hernia and Severe Rectus Diastasis Repairs

    PubMed Central

    Cheesborough, Jennifer E.

    2015-01-01

    Background: Standard abdominoplasty rectus plication techniques may not suffice for severe cases of rectus diastasis. In the authors’ experience, prosthetic mesh facilitates the repair of severe rectus diastasis with or without concomitant ventral hernias. Methods: A retrospective review of all abdominal wall surgery patients treated in the past 8 years by the senior author (G.A.D.) was performed. Patients with abdominoplasty and either rectus diastasis repair with mesh or a combined ventral hernia repair were analyzed. Results: Thirty-two patients, 29 women and three men, underwent mesh-reinforced midline repair with horizontal or vertical abdominoplasty. Patient characteristics included the following: mean age, 53 years; mean body mass index, 26 kg/m2; average width of diastasis or hernia, 6.7 cm; and average surgery time, 151 minutes. There were no surgical-site infections and two surgical-site occurrences—two seromas treated with drainage in the office. After an average of 471 days’ follow-up, none of the patients had recurrence of a bulge or a hernia. Conclusions: For patients with significant rectus diastasis, with or without concomitant hernias, the described mesh repair is both safe and durable. Although this operation requires additional dissection and placement of prosthetic mesh in the retrorectus plane, it may be safely combined with standard horizontal or vertical abdominoplasty skin excision techniques to provide an aesthetically pleasing overall result. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV. PMID:25539311

  12. Predictive Factors in the Outcome of Surgical Repair of Abdominal Rectus Diastasis

    PubMed Central

    Clay, Leonard; Stark, Birgit; Gunnarsson, Ulf

    2016-01-01

    Background: The aim of this study was to define the indicators predicting improved abdominal wall function after surgical repair of abdominal rectus diastasis (ARD). Preoperative subjective assessment quantified by the validated Ventral Hernia Pain Questionnaire (VHPQ) was related to relative postoperative functional improvement in abdominal muscle strength. Methods: Fifty-seven patients undergoing surgery for ARD completed the VHPQ before surgery. Preoperative pain assessment results were compared with the relative improvement in muscle strength measured with the BioDex system 4. Results: There was a correlation between the relative improvement in muscle strength measured by the BioDex System 4 for flexion at 30 degrees (P = 0.046) and 60 degrees per second (P = 0.004) and the preoperative question, “Do you find it painful to sit for more than 30 minutes?” There was also a correlation between BioDex improvement for flexion at 30 degrees (P = 0.022) and for isometric work load (P = 0.038) and the preoperative question, “Has abdominal pain limited your ability to perform sports activities?” The VHPQ responses also formed a pattern with a fairly good correlation between other BioDex modalities (with the exception of extension at 60 degrees per second) and the response to the question regarding complaints when performing sports. Postoperative visual analog scale ratings of abdominal wall stability correlated to the questions regarding complaints when sitting (P = 0.040) and standing (P = 0.047). No other correlation was seen. Conclusion: VHPQ ratings concerning pain while being seated for more than 30 minutes and pain limiting the ability to perform sports are promising indicators in the identification of patients likely to benefit from surgical correction of their ARD. PMID:27579227

  13. The temporalis muscle flap in temporo-mandibular joint surgery.

    PubMed

    Brusati, R; Raffaini, M; Sesenna, E; Bozzetti, A

    1990-11-01

    In the treatment of the severely damaged TMJ structural components (ankylosis, arthrosis, tumour, perforation or degeneration of the disc), it is advisable to insert a biological interposition between bony articular surfaces. The temporal muscle, due to its anatomical, topographical, and functional properties, can be successfully employed for this purpose. Based on the experience of Tessier, Delaire and Rowe, a temporalis muscle flap, inferiorly based, is rotated downwards and medially to the zygomatic arch, interposed and then fixed to condyle and capsule. Using this surgical technique, 12 patients and 13 temporo-mandibular joints were treated with good functional results and without any complication.

  14. Bimedial rectus hypermetabolism in convergence spasm as observed on positron emission tomography.

    PubMed

    Jeong, Seong-Hae; Oh, Young-Mi; Kim, Chae-Yong; Kim, Ji Soo

    2008-09-01

    A 52-year-old man developed vertical gaze palsy, convergence spasm, and convergence-retraction nystagmus due to glioblastoma of the right thalamus. 18F-fluorodeoxyglucose positron emission tomography (PET) inadvertently demonstrated markedly increased metabolism in the medial rectus muscles. The hypermetabolism indicates active contraction of these extraocular muscles due to excessive convergence drive attributed to inappropriate activation or disrupted inhibition of convergence neurons by the diencephalic lesion.

  15. Myositis Ossificans of Rectus Femoris: A Rare Case Report

    PubMed Central

    Srikanth, I Muni; Vishal, Amar; Kiran, K Ravi

    2015-01-01

    Introduction: Myositis ossificans (MO), heterotopic ossification, occurs in muscles and soft tissue. This lesion contains actively proliferating fibroblasts and osteoblasts. It commonly affects vigorous young men and more so among athletes. It occurs as a result of trauma, either acute or chronic and can also arise near joints in neurological disorders. By time of presentation, ossification is extensive and the benign nature of the lesion is usually evident on radiological studies. Most common muscles involved in MO are the flexor muscles of the arm, the hamstrings and quadriceps femoris. Case Report: We present a case of MO with isolated involvement of rectus femoris in mid-thigh and sparing of other three muscles of quadriceps femoris, with no improvement following physiotherapy and medical management requiring surgical excision for better prognosis with no recurrence. Conclusion: MO, a benign lesion, is known to affect the flexors of the arm, the hamstrings, and quadriceps femoris; it must be noted that even individual muscle can also be affected as shown in the above case presentation without involving whole group of muscles. Surgical excision is indicated if non-operative measures are not successful. PMID:27299083

  16. Laparoscopic surgery and muscle relaxants: is deep block helpful?

    PubMed

    Kopman, Aaron F; Naguib, Mohamed

    2015-01-01

    It has been hypothesized that providing deep neuromuscular block (a posttetanic count of 1 or more, but a train-of-four [TOF] count of zero) when compared with moderate block (TOF counts of 1-3) for laparoscopic surgery would allow for the use of lower inflation pressures while optimizing surgical space and enhancing patient safety. We conducted a literature search on 6 different medical databases using 3 search strategies in each database in an attempt to find data substantiating this proposition. In addition, we studied the reference lists of the articles retrieved in the search and of other relevant articles known to the authors. There is some evidence that maintaining low inflation pressures during intra-abdominal laparoscopic surgery may reduce postoperative pain. Unfortunately most of the studies that come to these conclusions give few if any details as to the anesthetic protocol or the management of neuromuscular block. Performing laparoscopic surgery under low versus standard pressure pneumoperitoneum is associated with no difference in outcome with respect to surgical morbidity, conversion to open cholecystectomy, hemodynamic effects, length of hospital stay, or patient satisfaction. There is a limit to what deep neuromuscular block can achieve. Attempts to perform laparoscopic cholecystectomy at an inflation pressure of 8 mm Hg are associated with a 40% failure rate even at posttetanic counts of 1 or less. Well-designed studies that ask the question "is deep block superior to moderate block vis-à-vis surgical operating conditions" are essentially nonexistent. Without exception, all the peer-reviewed studies we uncovered which state that they investigated this issue have such serious flaws in their protocols that the authors' conclusions are suspect. However, there is evidence that abdominal compliance was not increased by a significant amount when deep block was established when compared with moderate neuromuscular block. Maintenance of deep block for

  17. Pre-operative inspiratory muscle training preserves postoperative inspiratory muscle strength following major abdominal surgery – a randomised pilot study

    PubMed Central

    Kulkarni, SR; Fletcher, E; McConnell, AK; Poskitt, KR; Whyman, MR

    2010-01-01

    INTRODUCTION The aim of this pilot study was to assess the effect of pre-operative inspiratory muscle training (IMT) on respiratory variables in patients undergoing major abdominal surgery. PATIENTS AND METHODS Respiratory muscle strength (maximum inspiratory [MIP] and expiratory [MEP] mouth pressure) and pulmonary functions were measured at least 2 weeks before surgery in 80 patients awaiting major abdominal surgery. Patients were then allocated randomly to one of four groups (Group A, control; Group B, deep breathing exercises; Group C, incentive spirometry; Group D, specific IMT). Patients in groups B, C and D were asked to train twice daily, each session lasting 15 min, for at least 2 weeks up to the day before surgery. Outcome measurements were made immediately pre-operatively and postop-eratively. RESULTS In groups A, B and C, MIP did not increase from baseline to pre-operative assessments. In group D, MIP increased from 51.5 cmH2O (median) pre-training to 68.5 cmH2O (median) post-training pre-operatively (P < 0.01). Postoperatively, groups A, B and C showed a fall in MIP from baseline (P < 0.01, P < 0.01) and P = 0.06, respectively). No such significant reduction in postoperative MIP was seen in group D (P = 0.36). CONCLUSIONS Pre-operative specific IMT improves MIP pre-operatively and preserves it postoperatively. Further studies are required to establish if this is associated with reduced pulmonary complications. PMID:20663275

  18. The functional effect of a distal rectus femoris tenotomy in adults with cerebral palsy.

    PubMed

    Drefus, Lisa C; Buckland, Melanie A; Backus, Sherry I; Root, Leon

    2014-01-01

    The purpose of this study was to determine the effect of a distal rectus femoris tenotomy on function and gait in adults with cerebral palsy who had diminished knee flexion during swing. A stiff knee gait pattern is commonly seen in individuals with cerebral palsy and frequently leads to tripping and falling. Five subjects, 25-51 years, (34.6±10.3 years) participated in the study; each individual had the surgery after the age of 18. Four of the five subjects underwent bilateral distal rectus femoris tenotomies for a total of nine limbs being studied. Four of the five subjects had a single procedure of a distal rectus femoris tenotomy and one subject also had bilateral adductor tenotomies. All individuals underwent a pre-operative and post-operative, (3.28±1.6 years) three-dimensional gait analysis. Pre-operative gait revealed diminished peak knee flexion and out of phase rectus femoris activity with a quiet vastus lateralis during swing in all subjects. Significant findings after a distal rectus femoris tenotomy included: improved peak swing knee flexion, improved peak stance hip extension, and increased total knee excursion without loss in knee extension strength. During swing, knee flexion angle improved on average 11° which correlated with subjective report of less shoe wear, tripping, and falling due to improved clearance. In conclusion, a distal rectus femoris tenotomy should be considered a surgical option for adults with cerebral palsy and a stiff knee gait pattern to improve mobility, function, and quality of life. PMID:24742707

  19. The functional effect of a distal rectus femoris tenotomy in adults with cerebral palsy.

    PubMed

    Drefus, Lisa C; Buckland, Melanie A; Backus, Sherry I; Root, Leon

    2014-01-01

    The purpose of this study was to determine the effect of a distal rectus femoris tenotomy on function and gait in adults with cerebral palsy who had diminished knee flexion during swing. A stiff knee gait pattern is commonly seen in individuals with cerebral palsy and frequently leads to tripping and falling. Five subjects, 25-51 years, (34.6±10.3 years) participated in the study; each individual had the surgery after the age of 18. Four of the five subjects underwent bilateral distal rectus femoris tenotomies for a total of nine limbs being studied. Four of the five subjects had a single procedure of a distal rectus femoris tenotomy and one subject also had bilateral adductor tenotomies. All individuals underwent a pre-operative and post-operative, (3.28±1.6 years) three-dimensional gait analysis. Pre-operative gait revealed diminished peak knee flexion and out of phase rectus femoris activity with a quiet vastus lateralis during swing in all subjects. Significant findings after a distal rectus femoris tenotomy included: improved peak swing knee flexion, improved peak stance hip extension, and increased total knee excursion without loss in knee extension strength. During swing, knee flexion angle improved on average 11° which correlated with subjective report of less shoe wear, tripping, and falling due to improved clearance. In conclusion, a distal rectus femoris tenotomy should be considered a surgical option for adults with cerebral palsy and a stiff knee gait pattern to improve mobility, function, and quality of life.

  20. Update on enucleation and evisceration surgery.

    PubMed

    Walter, W L

    1985-01-01

    The best operative results with fewest complications after enucleation surgery can be achieved by following basic principles, some of which are those of conservative tissue excision, using spherical implants placed behind Tenon's capsule into the muscle cone and avoiding surgical techniques that overlap the extraocular muscles (especially the superior rectus) over the front of the implant. The presence of an intraocular tumor demands that an enucleation be done. When the possible development of sympathetic ophthalmia is not present, the surgeon should consider doing an evisceration because of the cosmetic and motility advantages. Mention is made of some developments in enucleation surgery, such as the scleral cap reinforcement, the "baseball" implant technique using donor sclera, the use of liquid nitrogen to freeze intraocular tumors before removal of the eye, the dermis-fat orbital graft, and the use of two spherical orbital implants instead of one.

  1. The spinal accessory nerve plexus, the trapezius muscle, and shoulder stabilization after radical neck cancer surgery.

    PubMed Central

    Brown, H; Burns, S; Kaiser, C W

    1988-01-01

    A clinical and anatomic study of the spinal accessory, the eleventh cranial nerve, and trapezius muscle function of patients who had radical neck cancer surgery was conducted. This study was done not only to document the indispensibility of the trapezius muscle to shoulder-girdle stability, but also to clarify the role of the eleventh cranial nerve in the variable motor and sensory changes occurring after the loss of this muscle. Seventeen male patients, 49-69 years of age, (average of 60 years of age) undergoing a total of 23 radical neck dissections were examined for upper extremity function, particularly in regard to the trapezius muscle, and for subjective signs of pain. The eleventh nerve, usually regarded as the sole motor innervation to the trapezius, was cut in 17 instances because of tumor involvement. Dissection of four fresh and 30 preserved adult cadavers helped to reconcile the motor and sensory differences in patients who had undergone loss of the eleventh nerve. The dissections and clinical observations corroborate that the trapezius is a key part of a "muscle continuum" that stabilizes the shoulder. Variations in origins and insertions of the trapezius may influence its function in different individuals. As regards the spinal accessory nerve, it is concluded that varying motor and sensory connections form a plexus with the eleventh nerve, accounting, in part, for the variations in motor innervation and function of the trapezius, as well as for a variable spectrum of sensory changes when the eleventh nerve is cut. For this reason, it is suggested that the term "spinal accessory nerve plexus" be used to refer to the eleventh nerve when it is considered in the context of radical neck cancer surgery. Images Fig. 4. Fig. 6. Fig. 7. Fig. 8. PMID:3056289

  2. Effects of ACL reconstruction surgery on muscle activity of the lower limb during a jump-cut maneuver in males and females.

    PubMed

    Coats-Thomas, Margaret S; Miranda, Daniel L; Badger, Gary J; Fleming, Braden C

    2013-12-01

    We compared muscle activity of the quadriceps, hamstring, and gastrocnemius muscles when ACL-intact (ACL(INT)) and ACL-reconstructed (ACL(REC)) male and female subjects performed a jump-cut task. Surface electromyography sensors were used to evaluate time to peak muscle activity and muscle activity ratios. Rectus femoris (RF) and vastus medialis (VM) peak timing was 71 and 78 ms earlier in ACL(INT) than in ACL(REC) subjects, respectively. Biceps femoris (BF) peak timing was 90 ms earlier in ACL(INT) than in ACL(REC) subjects and 75 ms earlier in females than in males. Medial gastrocnemius (MG) muscle peak timing was 77 ms earlier in ACL(INT) than in ACL(REC) subjects. Lateral gastrocnemius (LG) and MG muscle peak times were 106 ms and 87 ms earlier in females than in males, respectively. The RF, VM, BF, and MG peaked later in ACL(REC) than in ACL(INT) subjects. There was evidence suggesting that the loading phase quadriceps:hamstring (quad:ham) muscle activity ratio was greater in ACL(REC) than in ACL(INT) subjects. Finally, the injury risk phase quad:ham muscle activity ratio was 4.8 times greater in females than in males. In conclusion, differences exist in muscle activity related to ACL status and sex that could potentially help explain graft failure risk and the sex bias.

  3. Substantial effects of epimuscular myofascial force transmission on muscular mechanics have major implications on spastic muscle and remedial surgery.

    PubMed

    Yucesoy, Can A; Huijing, Peter A

    2007-12-01

    The specific aim of this paper is to review the effects of epimuscular myofascial force transmission on muscular mechanics and present some new results on finite element modeling of non-isolated aponeurotomized muscle in order to discuss the dependency of mechanics of spastic muscle, as well as surgery for restoration of function on such force transmission. The etiology of the effects of spasticity on muscular mechanics is not fully understood. Clinically, such effects feature typically a limited joint range of motion, which at the muscle level must originate from altered muscle length-force characteristics, in particular a limited muscle length range of force exertion. In studies performed to understand what is different in spastic muscle and what the effects of remedial surgery are, muscle is considered as being independent of its surroundings. Conceivably, this is because the classical approach in muscle mechanics is built on experimenting with dissected muscles. Certainly, such approach allowed improving our understanding of fundamental muscle physiology yet it yielded implicitly a narrow point of view of considering muscle length-force characteristics as a fixed property of the muscle itself. However, within its context of its intact connective tissue surroundings (the in vivo condition) muscle is not an isolated and independent entity. Instead, collagenous linkages between epimysia of adjacent muscles provide direct intermuscular connections, and structures such as the neurovascular tracts provide indirect intermuscular connections. Moreover, compartmental boundaries (e.g., intermuscular septa, interosseal membranes, periost and compartmental fascia) are continuous with neurovascular tracts and connect muscular and non-muscular tissues at several locations additional to the tendon origins and insertions. Epimuscular myofascial force transmission occurring via this integral system of connections has major effects on muscular mechanics including substantial

  4. Proximal rectus femoris avulsion in an elite, olympic-level sprinter.

    PubMed

    Langer, Phillip R; Selesnick, Harlan

    2010-11-01

    Quadriceps injuries, ranging from simple strains to disabling muscle ruptures, are common athletic injuries. The rectus femoris is the most commonly injure portion of the quadriceps musculature. This article is, to our knowledge, the first report of a proximal rectus femoris avulsion in an elite, Olympic-level 100-meter sprinter, acutely managed with surgical repair. Several key factors must be considered and carefully assessed when determining the appropriate course of management (ie, deciding between operative and nonoperative treatment): amount of distal retraction of the tendon, severity of associated soft-tissue trauma, physical examination, and postoperative goals (eg, return to elite-level competitive sports involving running or kicking vs resuming basic activities of daily living). We believe that these factors in our elite, high-performance athlete dictated an operative course of management.

  5. Retinal vessels caliber changes after strabismus surgery: results of 6mo follow-up

    PubMed Central

    Li, Ji-Peng; Fu, Jing; Zhou, Jin-Qiong; Wang, Xiao-Zhen; Wang, Wen-Ying; Liu, Ning-Pu

    2016-01-01

    AIM To evaluate the effect of strabismus surgery on retinal vessels calibers with digital color fundus photographs. METHODS Two hundred consecutive strabismus patients underwent surgery, and 118 patients (female/male, 55/63) who finished 6-month follow-up were finally included in this study. Optic disc-centered digital color fundus photographs of both eyes of all patients were taken prior to surgery and 6mo post surgery. The retinal vascular caliber of 116 operated eyes were measured using the computer program IVAN. The operated eyes were divided into 3 groups according to the surgical methods, recession of one muscle, one muscle recession and one muscle folding, one muscle resection and one muscle recession. The effect of number of altered muscles on retinal vessels was analyzed using statistic software SPSS 16.0. RESULTS The mean age was 12.4±8.6y. Averaged central retinal artery equivalent (CRAE) of all patients was 120.31±23.02 µm preoperatively, and 122.87±15.93 µm six months after surgery. Averaged central retinal vein equivalent (CRVE) was 171.11±31.73 µm preoperatively and 175.02±21.00 µm postoperatively. There was no significant difference of averaged CRAE (P=0.22) or CRVE (P=0.19) before and after operation. Averaged arteriole to venule ratio (AVR) was 0.71±0.07 before surgery and 0.70±0.07 after surgery. Comparison of preoperative and postoperative retinal vessels calibers among different surgical groups did not show significant differences. Also, there was no advantage of rectus muscle folding to muscle resection. CONCLUSION Up to 6mo after strabismus surgery, the retinal vascular calibers were not altered. No more than two muscles in one surgery are safe for retinal perfusion.

  6. Retinal vessels caliber changes after strabismus surgery: results of 6mo follow-up

    PubMed Central

    Li, Ji-Peng; Fu, Jing; Zhou, Jin-Qiong; Wang, Xiao-Zhen; Wang, Wen-Ying; Liu, Ning-Pu

    2016-01-01

    AIM To evaluate the effect of strabismus surgery on retinal vessels calibers with digital color fundus photographs. METHODS Two hundred consecutive strabismus patients underwent surgery, and 118 patients (female/male, 55/63) who finished 6-month follow-up were finally included in this study. Optic disc-centered digital color fundus photographs of both eyes of all patients were taken prior to surgery and 6mo post surgery. The retinal vascular caliber of 116 operated eyes were measured using the computer program IVAN. The operated eyes were divided into 3 groups according to the surgical methods, recession of one muscle, one muscle recession and one muscle folding, one muscle resection and one muscle recession. The effect of number of altered muscles on retinal vessels was analyzed using statistic software SPSS 16.0. RESULTS The mean age was 12.4±8.6y. Averaged central retinal artery equivalent (CRAE) of all patients was 120.31±23.02 µm preoperatively, and 122.87±15.93 µm six months after surgery. Averaged central retinal vein equivalent (CRVE) was 171.11±31.73 µm preoperatively and 175.02±21.00 µm postoperatively. There was no significant difference of averaged CRAE (P=0.22) or CRVE (P=0.19) before and after operation. Averaged arteriole to venule ratio (AVR) was 0.71±0.07 before surgery and 0.70±0.07 after surgery. Comparison of preoperative and postoperative retinal vessels calibers among different surgical groups did not show significant differences. Also, there was no advantage of rectus muscle folding to muscle resection. CONCLUSION Up to 6mo after strabismus surgery, the retinal vascular calibers were not altered. No more than two muscles in one surgery are safe for retinal perfusion. PMID:27672600

  7. Lateral rectus palsy following coronary angiography and percutaneous coronary intervention

    PubMed Central

    Nicholson, Luke; Jones, Ruth; Hughes, David S

    2014-01-01

    We present a rare case of unilateral lateral rectus palsy following an elective coronary angiography and percutaneous coronary intervention in a 78-year-oldwoman. Ophthalmoplegia following coronary angiography is extremely rare and this is the first case of a unilateral lateral rectus palsy following the procedure. PMID:24536054

  8. EMG characteristics and fibre composition: study on rectus femoris of sprinters and long distance runners.

    PubMed

    Goswami, A; Sadhukhan, A K; Gupta, S

    2001-10-01

    The study was conducted on 9 sprinters and 5 long distance runners to investigate the difference in power spectral characteristics of rectus femoris muscle and the feasibility of using electromyographic techniques in categorization of muscle groups in slow dominant and fast dominant types. EMG signal was recorded, after digitization at 4 KHz, from rectus femoris muscle during isometric knee extension (at maximum voluntary contraction level) until fatigue. Digitized signal was processed for Fast Fourier Transform and Root Mean Square (RMS) voltage. Significant difference (P < 0.05) was found in RMS voltage between sprinters and long distance runners. Both groups showed decline in Mean Power Frequency (MPE) and rate of decline in sprinters was rapid. Normalized MPF showed better discrimination between the two groups. It is concluded that the EMG response observed in this study was possibly a result of differences in the muscle fibre composition of the athletes. EMG study using spectral characteristics would be useful in categorizing the sports persons in terms of suitability of the events.

  9. Electromyographic activity of the rectus abdominis during a traditional crunch and the basic jackknife exercise with the Ab Lounge™.

    PubMed

    Nelson, Gail A; Bent-Forsythe, Denise A; Roopchand-Martin, Sharmella C

    2012-06-01

    The use of nontraditional exercise devices such as the Ab Lounge™ has been promoted as being as effective as the traditional abdominal crunch in strengthening the abdominal musculature. Evidence for this is lacking, however. The purpose of this study was to compare the degree of activation of the upper and lower rectus abdominis using electromyography (EMG) during a traditional crunch with the basic jackknife using the Ab Lounge™. Twenty-two subjects (6 men and 16 women) were randomly selected from the student population at the University of the West Indies (Mona Campus). The mean age of the participants was 20.5 ± 1.5 years, height 166.4 ± 6.2 cm, weight 64 ± 10.3 kg, and waist-hip ratio 0.7 ± 0.1. Surface EMG was used to assess the muscle activity from the upper and lower rectus abdominis while each exercise was performed. The EMG data were full-wave rectified and normalized using a mathematical model that was set up in Microsoft Excel for Windows XP. Statistical analysis was performed on the data using a univariate analysis of variance with gender as a covariate. Significance was determined by p < 0.05. The mean EMG data recorded for the upper rectus abdominis was significantly higher with the traditional crunch when compared with the basic jackknife performed on the Ab Lounge™ (F = 4.39, p = 0.04). The traditional crunch produced a higher level of activity in the lower rectus abdominis when compared with the basic jackknife, but this was not statistically significant (F = 0.249, p = 0.62). There was no significant interaction between gender and the effect of the type of exercise on upper and lower rectus abdominis activation. These results suggest that the traditional abdominal crunch is more effective than the basic jackknife is in activating the rectus abdominis musculature.

  10. POSTOPERATIVE EFFECT OF PHYSICAL THERAPY RELATED TO FUNCTIONAL CAPACITY AND RESPIRATORY MUSCLE STRENGTH IN PATIENTS SUBMITTED TO BARIATRIC SURGERY

    PubMed Central

    de OLIVEIRA, Josélia Jucirema Jarschel; de FREITAS, Alexandre Coutinho Teixeira; de ALMEIDA, Andréa Adriana

    2016-01-01

    ABSTRACT Background: Respiratory physiotherapy plays an important role preventing complications in bariatric surgery. Aim: To assess the effects of out-patient physiotherapy during post-operative period through respiratory pressures and functional capacity in individuals submitted to bariatric surgery. Method: A prospective longitudinal and controlled study was done in adults with body mass index (BMI) equal or greater than 40 kg/m², who have been submitted to bariatric surgery. They were divided into two groups: intervention-group, who performed out-patient physiotherapy twice a week, from thirty to sixty days after surgery; and the control-group, who only followed home instructions. Both groups were evaluated before surgery and sixty days after surgery through manovacuometry, six-minute walk test and the Borg Scale of perceived exertion. Results: Twenty participants were included the intervention-group and twenty-three in the control-group. Both groups had significant and similar weight loss after surgery. The manovacuometry presented no differences comparing pre- and post-surgery and in the comparison between the groups. The result of the six-minute walk test for the intervention-group increased by 10.1% in the post-operative period in relation to pre-. The Borg scale of perceived exertion in the intervention-group in pre-surgery decreased by 13.5% in the post-surgery compared to pre-surgery. In the control-group there was no difference comparing pre- and post-operative values, as in the comparison with the intervention-group. Conclusion: The low-intensity exercise program, carried out between the 30th and the 60th day after bariatric surgery provided better functional capacity; did not change respiratory muscle strength; and improved the perceived exertion rate. PMID:27683775

  11. Morphometrics of the Anterior Belly and Intermediate Tendon of the Digastric Muscle: Sexual Dimorphism and Implications for Surgery.

    PubMed

    Zdilla, Matthew J; Pancake, Alex R; Lambert, H Wayne

    2016-07-01

    The anterior belly of the digastric muscle (ABDM) is important in a variety of surgeries including submental lipectomy, rhytidectomy, alteration of the cervicomental angle via muscle resection, the "digastric corset" procedure for submental rejuvenation, the submental artery flap, and reanimation of the mouth after facial nerve palsy. Despite its clinical significance, little information exists regarding the morphometrics of the ABDM or its associated intermediate tendon. This study analyzed a total of 35 intact ABDMs and 43 intact intermediate tendons from 23 cadavers. Measurements were taken of the following parameters: muscle belly area, muscle belly length, intermediate tendon length, and intermediate tendon width at mid-tendon. Normative descriptive statistics are included within the report. Males were found to have significantly longer left-sided muscle bellies than right-sided bellies from males (U = 23.0; P = 0.044), left-sided bellies from females (U = 19.0; P = 0.020), and right-sided bellies from females (U = 12.0; P = 0.035). The morphometry, including sexual dimorphism, presented in this report can aid in the surgical planning and execution of numerous operations performed in head and neck, especially digastric muscle transfer surgery. PMID:27258716

  12. Mechanical characterisation of porcine rectus sheath under uniaxial and biaxial tension.

    PubMed

    Lyons, Mathew; Winter, Des C; Simms, Ciaran K

    2014-06-01

    Incisional hernia development is a significant complication after laparoscopic abdominal surgery. Intra-abdominal pressure (IAP) is known to initiate the extrusion of intestines through the abdominal wall, but there is limited data on the mechanics of IAP generation and the structural properties of rectus sheath. This paper presents an explanation of the mechanics of IAP development, a study of the uniaxial and biaxial tensile properties of porcine rectus sheath, and a simple computational investigation of the tissue. Analysis using Laplace׳s law showed a circumferential stress in the abdominal wall of approx. 1.1MPa due to an IAP of 11kPa, commonly seen during coughing. Uniaxial and biaxial tensile tests were conducted on samples of porcine rectus sheath to characterise the stress-stretch responses of the tissue. Under uniaxial tension, fibre direction samples failed on average at a stress of 4.5MPa at a stretch of 1.07 while cross-fibre samples failed at a stress of 1.6MPa under a stretch of 1.29. Under equi-biaxial tension, failure occurred at 1.6MPa with the fibre direction stretching to only 1.02 while the cross-fibre direction stretched to 1.13. Uniaxial and biaxial stress-stretch plots are presented allowing detailed modelling of the tissue either in silico or in a surrogate material. An FeBio computational model of the tissue is presented using a combination of an Ogden and an exponential power law model to represent the matrix and fibres respectively. The structural properties of porcine rectus sheath have been characterised and add to the small set of human data in the literature with which it may be possible to develop methods to reduce the incidence of incisional hernia development. PMID:24725440

  13. Spontaneous rectus sheath hematoma in a patient treated with apixaban.

    PubMed

    Aktas, Halil; Inci, Sinan; Dogan, Pinar; Izgu, Ibrahim

    2016-02-01

    Apixaban, a non-vitamin K antagonist oral anticoagulants, is a Factor Xa inhibitor that is prescribed for the treatment of non valvular atrial fibrillation. Rectus sheath hematoma is a rare but significant complication of oral anticoagulant treatment. The important causes of rectus sheath hematoma include treatment with anticoagulants, hematologic diseases, trauma, intense physical activity, coughing, sneezing and pregnancy. In this report, we describe case of a 71-year-old woman undergoing apixaban treatment for non valvular atrial fibrillation who presented with spontaneous rectus sheath hematoma. PMID:26989650

  14. Muscle activity in the lower limbs during push-down movement with a new active-exercise apparatus for the leg

    PubMed Central

    Tanaka, Kenta; Kamada, Hiroshi; Shimizu, Yukiyo; Aikawa, Shizu; Irie, Shun; Ochiai, Naoyuki; Sakane, Masataka; Yamazaki, Masashi

    2016-01-01

    [Purpose] Lower-limb deep vein thrombosis is a complication of orthopedic surgery. A leg-exercise apparatus named “LEX” was developed as a novel active-exercise apparatus for deep vein thrombosis prevention. Muscle activity was evaluated to assess the effectiveness of exercise with LEX in the prevention. [Subjects] Eight healthy volunteers participated in this study. [Methods] Muscle activities were determined through electromyography during exercise with LEX [LEX (+)] and during active ankle movements [LEX (−)]. The end points were peak % maximum voluntary contraction and % integrated electromyogram of rectus femoris, vastus lateralis, biceps femoris, tibialis anterior, gastrocnemius, and soleus. [Results] LEX (+) resulted in higher average values in all muscles except the tibialis anterior. Significant differences were noted in the peak of the biceps femoris and gastrocnemius and in the integrated electromyogram of the rectus femoris, vastus lateralis, gastrocnemius, and soleus. The LEX (+)/LEX (−) ratio of the peak was 2.2 for the biceps femoris and 2.0 for the gastrocnemius . The integrated electromyogram was 1.8 for the gastrocnemius, 1.5 for the rectus femoris, 1.4 for the vastus lateralis, and 1.2 for the soleus. [Conclusion] Higher muscle activity was observed with LEX (+). LEX might be a good tool for increasing lower-limb blood flow and deep vein thrombosis prevention. PMID:27134410

  15. A panel data set on harvest and perfusion decellularization of porcine rectus abdominis

    PubMed Central

    Zhang, Jian; Cheng, Wen Yue; Hu, Zhi Qian; Turner, Neill J.; Zhang, Li; Wang, Qiang; Badylak, Stephen F.

    2016-01-01

    In this dataset, we particularly depicted the harvest and perfusion decellularization of porcine rectus abdominis (RA), accompanied with displaying of the retained vascular trees within the perfusion-decellularized skeletal muscle matrix (pM-ECM) using vascular corrosion casting. In addition, several important tips for successful pM-ECM preparation were emphasized, which including using anatomically isolated skeletal muscle as tissue source with all main feeding and draining vessels perfused, preserving the internal microcirculation availability, aseptic technique and pyrogen free in all steps, sequential perfusion via artery or vein, and longtime washing after decellularization. The data are supplemental to our original research article describing detailed associations of pM-ECM as a clinically relevant scale, three-dimensional scaffold with a vascular network template for tissue-specific regeneration, “Perfusion-decellularized skeletal muscle as a three-dimensional scaffold with a vascular network template” Zhang et al. (2016) [1]. PMID:27158653

  16. Septic cavernous sinus thrombosis due to Campylobacter rectus infection.

    PubMed

    Leo, Qi Jie Nicholas; Bolger, Dennis Thomas

    2014-01-01

    We report a case of cavernous sinus thrombosis in a 55-year-old Chinese man who presented with headache, ophthalmoplegia and ptosis. Campylobacter rectus was eventually isolated from the blood cultures. He was treated with broad-spectrum antibiotics, anticoagulation and steroids with improvement in his condition. To our knowledge, this is the first documented case of septic cavernous sinus thrombosis caused by C. rectus. PMID:24842357

  17. Medial rectus re-recession in undercorrected esotropia.

    PubMed

    Biedner, B; Yassur, Y; David, R

    1992-01-01

    Conventional surgical management of surgically undercorrected esotropia includes bilateral lateral rectus resection, marginal myotomy, and Faden operation. During a 3-year period, 10 patients with surgically undercorrected esotropia had medial rectus re-recession 13.5 mm from the limbus. Successful binocular realignment (to 10 prism diopters or less residual binocular misalignment) was achieved in 9 of the 10 cases for both near and distance measurements.

  18. Early American Strabismus Surgery: 1840-1845.

    PubMed

    Currie, Benjamin D; Feibel, Robert M

    2015-01-01

    The discovery of effective surgical therapy for strabismus was one of the outstanding triumphs of the first half of 19th-century ophthalmology, just prior to the invention of the ophthalmoscope in 1850. Although priority for the development of strabismus surgery belongs to Johann Friedrich Dieffenbach of Germany, who first reported his surgical results in 1839, 4 cases of tenotomy of the medial rectus muscle had been performed in the United States by William Gibson in 1818 but never published. By 1840, the reports of surgery in Europe had rapidly spread to America where surgeons immediately began using these procedures. The first American surgeon to perform eye muscle surgery and publish his results was John Dix of Boston, and other surgeons were soon reporting their cases as well. We discuss 8 American pioneers in this field during the time (1840-1845) of the first burst of enthusiasm for this surgery. Although these surgeons were active in performing a large number of cases and carefully reporting their experiences and results, they did not make any major advances in the field. PMID:26669424

  19. Sternalis Muscle: An Unexpected Finding during Mastectomy

    PubMed Central

    Sasmal, Prakash K.; Meher, Susanta; Mishra, Tushar S.; Deep, N.; Tripathy, Prabhas R.; Rath, Satyajit

    2015-01-01

    Sternalis muscle also called rectus sternalis, rectus thoracis, or episternalis is an anomalous muscle of the anterior chest wall with unknown anatomical function. It is regularly observed in lower animal but infrequently in humans. Presence of this muscle can create confusion with tumours of the anterior chest wall during routine mammography. Although less is known about its origin and innervations, knowledge about this muscle can have many clinical implications. A case of unilateral sternalis muscle detected during mastectomy, in a female with carcinoma of the right breast, is being reported with a brief review of the literature and highlighting its clinical significance. PMID:26609461

  20. Medial Wall Fracture and Orbital Emphysema Mimicking Inferior Rectus Entrapment in a Child.

    PubMed

    Collin, John; Afshar, Farid; Thomas, Steven

    2015-12-01

    Orbital emphysema is commonly associated with fractures of the orbital floor or medial wall. The air often dissipates spontaneously, but rarely can cause increased intraocular pressure and even loss of vision. Entrapment of the extraocular muscles can also occur with orbital fractures and may require prompt treatment in the pediatric patient due to the risk muscle ischemia. Both conditions can cause diplopia due to restriction of eye movement and differentiation of the two etiologies is important to prevent unnecessary surgical exploration. Identification and prompt management of raised intraocular pressure is essential in patients with orbital trauma. We present a case of orbital emphysema mimicking inferior rectus entrapment following trauma in an 11-year-old boy.

  1. Isolated Total Rupture of Extraocular Muscles

    PubMed Central

    Chen, Jingchang; Kang, Ying; Deng, Daming; Shen, Tao; Yan, Jianhua

    2015-01-01

    Abstract Total rupture of extraocular muscles is an infrequent clinical finding. Here we conducted this retrospective study to evaluate their causes of injury, clinical features, imaging, surgical management, and final outcomes in cases of isolated extraocular muscle rupture at a tertiary center in China. Thirty-six patients were identified (24 men and 12 women). Mean age was 34 years (range 2–60). The right eye was involved in 21 patients and the left 1 in 15. A sharp object or metal hook was the cause of this lesion in 16 patients, sinus surgery in 14 patients, traffic accident in 3 patients, orbital surgery in 2 patients, and conjunctive tumor surgery in 1 patient. The most commonly involved muscles were medial (18 patients) and inferior rectus muscles (13 patients). The function of the ruptured muscles revealed a scale of −3 to −4 defect of ocular motility and the amount of deviation in primary position varied from 10 to 140 PD (prism diopter). Computerized tomography (CT) confirmed the presence of ruptured muscles. An end-to-end muscle anastomosis was performed and 3 to 5 mm of muscle was resected in 23 patients. When the posterior border of the injured muscle could not be identified (13 patients), a partial tendon transposition was performed, together with recession of the antagonist in most patients, whereas a recession of the antagonist muscle plus a resection of the involved muscle with or without nasal periosteal fixation was performed in the remaining patients. After an average of 16.42 months of follow-up an excellent result was achieved in 23 patients and results of 13 patients were considered as a failure. In most patients, the posterior border of the ruptured muscle can be identified and an early surgery can be performed to restore function. Alternatively, a partial tendon transposition should be performed. When muscular rupture is suspected, an early orbital CT is required to confirm this possibility, which can then verify the necessity for

  2. Exercise and Weight Loss Improve Muscle Mitochondrial Respiration, Lipid Partitioning, and Insulin Sensitivity After Gastric Bypass Surgery.

    PubMed

    Coen, Paul M; Menshikova, Elizabeth V; Distefano, Giovanna; Zheng, Donghai; Tanner, Charles J; Standley, Robert A; Helbling, Nicole L; Dubis, Gabriel S; Ritov, Vladimir B; Xie, Hui; Desimone, Marisa E; Smith, Steven R; Stefanovic-Racic, Maja; Toledo, Frederico G S; Houmard, Joseph A; Goodpaster, Bret H

    2015-11-01

    Both Roux-en-Y gastric bypass (RYGB) surgery and exercise can improve insulin sensitivity in individuals with severe obesity. However, the impact of RYGB with or without exercise on skeletal muscle mitochondria, intramyocellular lipids, and insulin sensitivity index (SI) is unknown. We conducted a randomized exercise trial in patients (n = 101) who underwent RYGB surgery and completed either a 6-month moderate exercise (EX) or a health education control (CON) intervention. SI was determined by intravenous glucose tolerance test. Mitochondrial respiration and intramyocellular triglyceride, sphingolipid, and diacylglycerol content were measured in vastus lateralis biopsy specimens. We found that EX provided additional improvements in SI and that only EX improved cardiorespiratory fitness, mitochondrial respiration and enzyme activities, and cardiolipin profile with no change in mitochondrial content. Muscle triglycerides were reduced in type I fibers in CON, and sphingolipids decreased in both groups, with EX showing a further reduction in a number of ceramide species. In conclusion, exercise superimposed on bariatric surgery-induced weight loss enhances mitochondrial respiration, induces cardiolipin remodeling, reduces specific sphingolipids, and provides additional improvements in insulin sensitivity.

  3. Electromyographic activity of knee stabilizer muscles during six different balance board stimuli after anterior cruciate ligament surgery.

    PubMed

    Pereira, H M; Nowotny, A H; Santos, A B A N; Cardoso, J R

    2009-01-01

    The purpose of this study was to compare the electrical activity of the knee stabilizers, in patients with ACL (anterior cruciate ligament) reconstructed and uninjured individuals during different balance board stimuli. Eleven post-surgery individuals and eleven uninjured controls participated in the study. The muscular activity of the vastus medialis obliquus, vastus lateralis, semitendinosus, biceps femoris and gastrocnemius medial were analyzed by surface electromyography during the execution of six different balance board activities. All electromyographic data were reported as percentage of RMS mean values obtained in maximal voluntary isometric contractions (MVIC) for each muscle. When comparing the individuals with ACL reconstructed and uninjured controls, minor electromyographic activity was observed (MVIC %) for all the muscles in the surgery group (P < 0.05), however, when comparing each exercise between the groups, a statistically significant difference for vastus lateralis was demonstrated in the floor exercise (P = 0.02) and for gastrocnemius on the round board (P = 0.04). Individuals ACL reconstructed presented a decrease in muscular activity during different balance board stimuli, which suggests that compensatory alterations after ACL may still exist even after a surgery to repair an ACL rupture.

  4. Surgery

    MedlinePlus

    ... there can be a risk of complications, including infection, too much bleeding, reaction to anesthesia, or accidental injury. There is almost always some pain with surgery. Agency for Healthcare Research and Quality

  5. Extraocular Muscle Compartments in Superior Oblique Palsy

    PubMed Central

    Suh, Soh Youn; Clark, Robert A.; Le, Alan; Demer, Joseph L.

    2016-01-01

    Purpose To investigate changes in volumes of extraocular muscle (EOM) compartments in unilateral superior oblique (SO) palsy using magnetic resonance imaging (MRI). Methods High-resolution, surface-coil MRI was obtained in 19 patients with unilateral SO palsy and 19 age-matched orthotropic control subjects. Rectus EOMs and the SO were divided into two anatomic compartments for volume analysis in patients with unilateral SO palsy, allowing comparison of total compartmental volumes versus controls. Medial and lateral compartmental volumes of the SO muscle were compared in patients with isotropic (round shape) versus anisotropic (elongated shape) SO atrophy. Results The medial and lateral compartments of the ipsilesional SO muscles were equally atrophic in isotropic SO palsy, whereas the lateral compartment was significantly smaller than the medial in anisotropic SO palsy (P = 0.01). In contrast to the SO, there were no differential compartmental volume changes in rectus EOMs; however, there was significant total muscle hypertrophy in the ipsilesional inferior rectus (IR) and lateral rectus (LR) muscles and contralesional superior rectus (SR) muscles. Medial rectus (MR) volume was normal both ipsi- and contralesionally. Conclusions A subset of patients with SO palsy exhibit selective atrophy of the lateral, predominantly vertically acting SO compartment. Superior oblique atrophy is associated with whole-muscle volume changes in the ipsilesional IR, ipsilesional LR, and contralesional SR; however, SO muscle atrophy is not associated with compartmentally selective volume changes in the rectus EOMs. Selective compartmental SO pathology may provide an anatomic mechanism that explains some of the variability in clinical presentations of SO palsy. PMID:27768791

  6. A cadaver knee simulator to evaluate the biomechanics of rectus femoris transfer.

    PubMed

    Anderson, Michael C; Brown, Nicholas A T; Bachus, Kent N; Macwilliams, Bruce A

    2009-07-01

    A cadaver knee simulator has been developed to model surgical transfer of the rectus femoris. The simulator allows knee specimens six degrees of freedom and is capable of modeling both the swing and stance phases of human gait. Experiments were conducted using a mechanical hinge analog of the knee to verify that time, flexion angle, and knee extension force measurements recorded when using the simulator were not influenced by its design or operation. A ballistic double pendulum model was used to model the swing phase of gait, and the contributions of hip and ankle torques and hamstrings cocontraction were included when modeling the stance phase of gait. When modeling swing, range of motion and time to peak knee flexion in swing for the hinge knee were similar to those of in vivo test subjects. Measurements of hinge knee extension force when modeling stance under various biomechanical conditions matched those predicted using an analytical model. Future studies using cadaver knee specimens will apply techniques described in this paper to further our understanding of changes in knee biomechanics caused by rectus femoris transfer surgery. PMID:19403312

  7. Exercise and Weight Loss Improve Muscle Mitochondrial Respiration, Lipid Partitioning, and Insulin Sensitivity After Gastric Bypass Surgery

    PubMed Central

    Coen, Paul M.; Menshikova, Elizabeth V.; Distefano, Giovanna; Zheng, Donghai; Tanner, Charles J.; Standley, Robert A.; Helbling, Nicole L.; Dubis, Gabriel S.; Ritov, Vladimir B.; Xie, Hui; Desimone, Marisa E.; Smith, Steven R.; Stefanovic-Racic, Maja; Toledo, Frederico G.S.; Houmard, Joseph A.

    2015-01-01

    Both Roux-en-Y gastric bypass (RYGB) surgery and exercise can improve insulin sensitivity in individuals with severe obesity. However, the impact of RYGB with or without exercise on skeletal muscle mitochondria, intramyocellular lipids, and insulin sensitivity index (SI) is unknown. We conducted a randomized exercise trial in patients (n = 101) who underwent RYGB surgery and completed either a 6-month moderate exercise (EX) or a health education control (CON) intervention. SI was determined by intravenous glucose tolerance test. Mitochondrial respiration and intramyocellular triglyceride, sphingolipid, and diacylglycerol content were measured in vastus lateralis biopsy specimens. We found that EX provided additional improvements in SI and that only EX improved cardiorespiratory fitness, mitochondrial respiration and enzyme activities, and cardiolipin profile with no change in mitochondrial content. Muscle triglycerides were reduced in type I fibers in CON, and sphingolipids decreased in both groups, with EX showing a further reduction in a number of ceramide species. In conclusion, exercise superimposed on bariatric surgery–induced weight loss enhances mitochondrial respiration, induces cardiolipin remodeling, reduces specific sphingolipids, and provides additional improvements in insulin sensitivity. PMID:26293505

  8. Insertional tendinopathy of the adductors and rectus abdominis in athletes: a review.

    PubMed

    Valent, Alessandro; Frizziero, Antonio; Bressan, Stefano; Zanella, Elena; Giannotti, Erika; Masiero, Stefano

    2012-04-01

    Insertional tendinopathy of the adductors and rectus abdominis is common in male athletes, especially in soccer players. It may be worsened by physical activity and it usually limits sport performance. The management goal in the acute phase consists of analgesic and anti-inflammatory drugs and physical rehabilitation. In the early stages of rehabilitation, strengthening exercises of adductors and abdominal muscles, such as postural exercises, have been suggested. In the sub-acute phase, muscular strength is targeted by overload training in the gym or aquatherapy; core stability exercises seem to be useful in this phase. Finally, specific sport actions are introduced by increasingly complex exercises along with a preventive program to limit pain recurrences. PMID:23738289

  9. Insertional tendinopathy of the adductors and rectus abdominis in athletes: a review

    PubMed Central

    Valent, Alessandro; Frizziero, Antonio; Bressan, Stefano; Zanella, Elena; Giannotti, Erika; Masiero, Stefano

    2012-01-01

    Summary Insertional tendinopathy of the adductors and rectus abdominis is common in male athletes, especially in soccer players. It may be worsened by physical activity and it usually limits sport performance. The management goal in the acute phase consists of analgesic and anti-inflammatory drugs and physical rehabilitation. In the early stages of rehabilitation, strengthening exercises of adductors and abdominal muscles, such as postural exercises, have been suggested. In the sub-acute phase, muscular strength is targeted by overload training in the gym or aquatherapy; core stability exercises seem to be useful in this phase. Finally, specific sport actions are introduced by increasingly complex exercises along with a preventive program to limit pain recurrences. PMID:23738289

  10. Myocyte Dedifferentiation Drives Extraocular Muscle Regeneration in Adult Zebrafish

    PubMed Central

    Saera-Vila, Alfonso; Kasprick, Daniel S.; Junttila, Tyler L.; Grzegorski, Steven J.; Louie, Ke'ale W.; Chiari, Estelle F.; Kish, Phillip E.; Kahana, Alon

    2015-01-01

    Purpose The purpose of this study was to characterize the injury response of extraocular muscles (EOMs) in adult zebrafish. Methods Adult zebrafish underwent lateral rectus (LR) muscle myectomy surgery to remove 50% of the muscle, followed by molecular and cellular characterization of the tissue response to the injury. Results Following myectomy, the LR muscle regenerated an anatomically correct and functional muscle within 7 to 10 days post injury (DPI). Following injury, the residual muscle stump was replaced by a mesenchymal cell population that lost cell polarity and expressed mesenchymal markers. Next, a robust proliferative burst repopulated the area of the regenerating muscle. Regenerating cells expressed myod, identifying them as myoblasts. However, both immunofluorescence and electron microscopy failed to identify classic Pax7-positive satellite cells in control or injured EOMs. Instead, some proliferating nuclei were noted to express mef2c at the very earliest point in the proliferative burst, suggesting myonuclear reprogramming and dedifferentiation. Bromodeoxyuridine (BrdU) labeling of regenerating cells followed by a second myectomy without repeat labeling resulted in a twice-regenerated muscle broadly populated by BrdU-labeled nuclei with minimal apparent dilution of the BrdU signal. A double-pulse experiment using BrdU and 5-ethynyl-2′-deoxyuridine (EdU) identified double-labeled nuclei, confirming the shared progenitor lineage. Rapid regeneration occurred despite a cell cycle length of 19.1 hours, whereas 72% of the regenerating muscle nuclei entered the cell cycle by 48 hours post injury (HPI). Dextran lineage tracing revealed that residual myocytes were responsible for muscle regeneration. Conclusions EOM regeneration in adult zebrafish occurs by dedifferentiation of residual myocytes involving a muscle-to-mesenchyme transition. A mechanistic understanding of myocyte reprogramming may facilitate novel approaches to the development of molecular

  11. Anatomical study of the opossum (Didelphis albiventris) extraocular muscles.

    PubMed Central

    Matheus, S M; Soares, J C; da Silva, A M; Seullner, G

    1995-01-01

    The anatomy of the extraocular muscles was studied in 10 adult opossums (Didelphis albiventris) of both sexes. Eight extraocular muscles were identified: 4 rectus muscles, 2 oblique muscles, the levator palpebrae superioris and the retractor ocular bulbi. The rectus muscles originate very close one to another between the orbital surfaces of the presphenoid and palatine bones. These muscles diverge on the way to their insertion which occurs at about 2 mm from the limbus. The levator palpebrae superioris originates with the dorsal rectus and is positioned dorsally in relation to it. The retractor ocular bulbi forms a cone which embraces the optic nerve and is located internally in relation to the rectus muscles. The dorsal oblique originates on the presphenoid bone and after a tendinous trajectory through a trochlea on the medial wall of the orbit, inserts into the ocular bulb. The only muscle arising from the anterior orbital floor is the ventral oblique. The main nerve supply for these muscles is the oculomotor, except for the dorsal oblique which is innervated by the trochlear nerve, and the lateral rectus which is innervated by the abducens nerve. The retractor ocular bulbi receives branches from the inferior division of the oculomotor nerve and some branches from the abducens nerve. Images Fig. 1 Fig. 2 Fig. 3 PMID:7649843

  12. Spontaneous intraperitoneal rupture of a postpartum rectus sheath haematoma.

    PubMed

    Elmoghrabi, Adel; Mohamed, Mohamed; McCann, Michael; Sachwani-Daswani, Gul

    2016-01-01

    A 35-year-old woman presented to the emergency department (ED) with acute severe abdominal pain at 4 days postpartum. CT of the abdomen revealed a type II rectus sheath haematoma for which she was initially treated conservatively and discharged. A few hours later, she returned to the ED with a picture suggestive of peritonitis. Exploratory laparoscopy was performed and revealed haemoperitoneum and a ruptured area on the posterior rectus sheath. Approximately 2 L of blood was aspirated. Haemostatic control was achieved and closed suction drains secured in position. The patient was discharged in stable condition on postadmission day 6. She continued to follow-up on an outpatient basis and was doing well 3 months postoperatively. PMID:26961567

  13. DOES RECTUS FEMORIS TRANSFER INCREASE KNEE FLEXION DURING STANCE PHASE IN CEREBRAL PALSY?

    PubMed Central

    de Morais, Mauro César; Blumetti, Francesco Camara; Kawamura, Cátia Miyuki; Lopes, José Augusto Fernandes; Neves, Daniella Lins; Cardoso, Michelle de Oliveira

    2016-01-01

    ABSTRACT Objective: To evaluate whether distal rectus femoris transfer (DRFT) is related to postoperative increase of knee flexion during the stance phase in cerebral palsy (CP). Methods: The inclusion criteria were Gross Motor Function Classification System (GMFCS) levels I-III, kinematic criteria for stiff-knee gait at baseline, and individuals who underwent orthopaedic surgery and had gait analyses performed before and after intervention. The patients included were divided into the following two groups: NO-DRFT (133 patients), which included patients who underwent orthopaedic surgery without DRFT, and DRFT (83 patients), which included patients who underwent orthopaedic surgery that included DRFT. The primary outcome was to evaluate in each group if minimum knee flexion in stance phase (FMJFA) changed after treatment. Results: The mean FMJFA increased from 13.19° to 16.74° (p=0.003) and from 10.60° to 14.80° (p=0.001) in Groups NO-DRFT and DRFT, respectively. The post-operative FMJFA was similar between groups NO-DRFT and DRFT (p=0.534). The increase of FMJFA during the second exam (from 13.01° to 22.51°) was higher among the GMFCS III patients in the DRFT group (p<0.001). Conclusion: In this study, DRFT did not generate additional increase of knee flexion during stance phase when compared to the control group. Level of Evidence III, Retrospective Comparative Study. PMID:26997910

  14. Relative Activity of Abdominal Muscles during Commonly Prescribed Strengthening Exercises.

    ERIC Educational Resources Information Center

    Willett, Gilbert M.; Hyde, Jennifer E.; Uhrlaub, Michael B.; Wendel, Cara L.; Karst, Gregory M.

    2001-01-01

    Examined the relative electromyographic (EMG) activity of upper and lower rectus abdominis (LRA) and external oblique (EOA) muscles during five abdominal strengthening exercises. Isometric and dynamic EMG data indicated that abdominal strengthening exercises activated various abdominal muscle groups. For the LRA and EOA muscle groups, there were…

  15. Localisation of motoneurons supplying the extra-ocular muscles of the rat using horseradish peroxidase and fluorescent double labelling.

    PubMed Central

    Labandeira Garcia, J L; Gomez Segade, L A; Suarez Nuñez, J M

    1983-01-01

    This paper describes a qualitative and quantitative investigation into the location of the motoneurons innervating the extra-ocular muscles of the rat. Injections of horseradish peroxidase, bisbenzimide, propidium iodide and DAPI-primuline were made either in one or simultaneously in two muscles. Unlike those of the cat, rabbit and monkey, the motoneurons which make up the oculomotor nucleus of the rat are not arranged in spatially separate subgroups belonging each to its corresponding extra-ocular muscle, but instead allow a high degree of superposition among the motor pools which they compose. The motoneurons innervating the lateral rectus and inferior oblique muscles are all homolateral; those of the medial and inferior rectus muscles are mainly homolateral with a few contralateral exceptions; and those of the superior rectus, levator palpebrae and superior oblique muscles are mainly contralateral with a small minority of homolateral exceptions. As well as from the main motor pools with which they are associated, the medial rectus, inferior rectus, superior rectus, levator palpebrae, superior oblique and lateral rectus muscles all receive innervation from motoneurons lying among the fibres of the fasciculus longitudinalis medialis. All these observations are supported by quantitative data. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:6195140

  16. Ultrasound Assessment of the Rectus Femoris Cross-Sectional Area: Subject Position Implications.

    PubMed

    Hacker, Eileen Danaher; Peters, Tara; Garkova, Miglena

    2016-09-01

    Ultrasonic measurement of the rectus femoris (RF) is a novel, proxy measure for muscle strength. The impact of hip flexion/head of bed positioning on RF cross-sectional area (CSA) has not been fully explored. This study describes and compares differences in RF CSA across four degrees of hip flexion. This repeated-measures, comparative study enrolled healthy, pre-menopausal women (n = 20). RF CSA of the dominant leg was measured using the SonoSite M-Turbo ultrasound system with the head of bed at 0°, 20°, 30°, and 60°. One-way repeated measures indicated significant differences in RF CSA, F(3, 17) = 14.18, p < .001, with variation in hip flexion/head of bed elevation and significant RF CSA differences between: (a) 0° and 20°, (b) 0° and 30°, (c) 0° and 60°, and (d) 20° and 60°. Standardizing patient positioning when conducting ultrasonic measurement of RF CSA is vital for researchers who assess muscle mass.

  17. Ultrasound Assessment of the Rectus Femoris Cross-Sectional Area: Subject Position Implications.

    PubMed

    Hacker, Eileen Danaher; Peters, Tara; Garkova, Miglena

    2016-09-01

    Ultrasonic measurement of the rectus femoris (RF) is a novel, proxy measure for muscle strength. The impact of hip flexion/head of bed positioning on RF cross-sectional area (CSA) has not been fully explored. This study describes and compares differences in RF CSA across four degrees of hip flexion. This repeated-measures, comparative study enrolled healthy, pre-menopausal women (n = 20). RF CSA of the dominant leg was measured using the SonoSite M-Turbo ultrasound system with the head of bed at 0°, 20°, 30°, and 60°. One-way repeated measures indicated significant differences in RF CSA, F(3, 17) = 14.18, p < .001, with variation in hip flexion/head of bed elevation and significant RF CSA differences between: (a) 0° and 20°, (b) 0° and 30°, (c) 0° and 60°, and (d) 20° and 60°. Standardizing patient positioning when conducting ultrasonic measurement of RF CSA is vital for researchers who assess muscle mass. PMID:27090872

  18. Association Between Rectus Abdominis Denervation and Ventilation Dysfunction in Patients with Amyotrophic Lateral Sclerosis

    PubMed Central

    Zhang, Hua-Gang; Zhang, Shuo; Xu, Ying-Sheng; Zhang, Nan; Fan, Dong-Sheng

    2016-01-01

    Background: Spontaneous potentials in electromyography (EMG) of paraspinal muscles are associated with diaphragm denervation and, therefore, poor respiratory function in amyotrophic lateral sclerosis (ALS) is understandable. EMG changes in the rectus abdominis (RA) display an effect similar to those in paraspinal muscles with respect to the function of lower motor neurons in the thoracic spinal cord. The RA denervation was examined to determine its association with ventilation dysfunction in ALS. Methods: We collected the clinical data of 128 patients with sporadic ALS in Department of Neurology of Peking University Third Hospital from 2009 to 2013. EMG, Revised ALS Functional Rating Scale (ALSFRS-R) and forced vital capacity (FVC) were performed in all patients and the differences in the EMG changes in RA between those with and without FVC ≥ 80% were analysed. Results: The mean FVC value was 83.4% ± 17.1% (range: 45%–131%) of the predicted value. A total of 79 patients displayed FVC ≥80%, and 49 patients displayed FVC <80%. Compared with the patients displaying a normal FVC (60/79, 75.9%), spontaneous activity in RA was significantly different among those patients displaying an FVC <80% (47/49, 95.9%). In addition, spontaneous potentials in RA were more frequently detected in patients exhibiting dyspnea (32/33, 97.0%) than in patients without dyspnea (75/95, 78.9%). Conclusion: Spontaneous potentials in RA are associated with ventilation dysfunction and dyspnea in ALS patients. PMID:27569232

  19. Cortical motor representation of the rectus femoris does not differ between the left and right hemisphere.

    PubMed

    Ward, Sarah; Bryant, Adam L; Pietrosimone, Brian; Bennell, Kim L; Clark, Ross; Pearce, Alan J

    2016-06-01

    Transcranial magnetic stimulation (TMS) involves non-invasive magnetic stimulation of the brain, and can be used to explore the corticomotor excitability and motor representations of skeletal muscles. However there is a lack of motor mapping studies in the lower limb and few conducted in healthy cohorts. The cortical motor representations of muscles can vary between individuals in terms of center position and area despite having a general localized region within the motor cortex. It is important to characterize the normal range for these variables in healthy cohorts to be able to evaluate changes in clinical populations. TMS was used in this cross-sectional study to assess the active motor threshold (AMT) and cortical representation area for rectus femoris in 15 healthy individuals (11M/4F 27.3±5.9years). No differences were found between hemispheres (Left vs. Right P=0.130) for AMT. In terms of y-axis center position no differences were found between hemispheres (Left vs. Right P=0.539), or for the x-axis center position (Left vs. Right P=0.076). Similarly, no differences in calculated area of the motor representation were found (Left vs. Right P=0.699) indicating symmetry between hemispheres.

  20. Functional Improvement Following Diastasis Rectus Abdominus Repair in an Active Duty Navy Female.

    PubMed

    Gallus, Katerina M; Golberg, Kathy F; Field, Robert

    2016-08-01

    Return to physical activity following childbirth can be a difficult process complicated by structural changes during pregnancy. A common problem is the development of a diastasis of the rectus abdominus (DRA), defined as a horizontal separation of the abdominus muscles at the linea alba. Recent data indicate that the greater the distance of separation of the muscle, the worse the functional ability. We describe a 24-year-old active duty U.S. Navy female G1P2 with a diagnosis of DRA. At 2 months postpartum, she was referred to physical therapy because of back pain and inability to meet baseline activities of daily living. After 4 months of physical therapy, she was unable to complete curl ups as required by U.S. Navy physical fitness standards. Abdominoplasty with imbrication of the abdominal wall diastasis was performed followed by additional physical therapy, after which she returned to baseline functioning. The restoration of functional ability postoperatively suggests there is a therapeutic indication for surgical correction of DRA. In high-functioning military patients with DRA who fail to return to baseline level of activity following a trial of physical therapy, surgical intervention should be considered to obtain the optimal functional ability. PMID:27483541

  1. Complications and oncologic outcomes of pedicled transverse rectus abdominis myocutaneous flap in breast cancer patients

    PubMed Central

    Somintara, Ongart; Lertsithichai, Panuwat; Kongdan, Youwanush; Supsamutchai, Chairat; Sukpanich, Rupporn

    2016-01-01

    Background There are several techniques for harvesting the pedicled transverse rectus abdominis myocutaneous (TRAM) flap after mastectomy in breast cancer patients. We examined the whole muscle with partial sheath sparing technique and determined factors associated with its complications and oncological outcomes. Methods We retrospectively reviewed the results of 168 TRAM flaps performed between January 2003 and December 2010, focusing on complications and oncologic outcomes. Results Among the 168 pedicled TRAM flap procedures in 158 patients, flap complications occurred in 34%. Most of the flap complications included some degree of fat necrosis. There was no total flap loss. Flap complications were associated with elderly patients and the presence of major donor site complications. Abdominal bulging and hernia occurred in 12% of patients. The bi-pedicled TRAM flap and higher body mass index (BMI) were significant factors associated with increased donor site complications. Seven patients (4%) developed loco-regional recurrence. Within a median follow-up of 27 months, distant metastasis and death occurred in 6% and 4% of patients, respectively. Conclusions The pedicled TRAM flap using the whole muscle with partial sheath sparing technique in the present study is consistent with the results from previous studies in flap complication rates and oncological outcomes. PMID:27563562

  2. Eye muscle repair - discharge

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000111.htm Eye muscle repair - discharge To use the sharing features on ... enable JavaScript. You or your child had eye muscle repair surgery to correct eye muscle problems that ...

  3. Management of muscle invasive, locally advanced and metastatic urothelial carcinoma of the bladder: a literature review with emphasis on the role of surgery

    PubMed Central

    Abufaraj, Mohammad; Gust, Kilian; Moschini, Marco; Foerster, Beat; Soria, Francesco; Mathieu, Romain

    2016-01-01

    Locally advanced (T3b, T4 and N1−N3) and metastatic urothelial bladder cancer (BCa) is a lethal disease with poor survival outcomes. Combination chemotherapy remains the treatment of choice in patients with metastatic disease and an important part of treatment in addition to radical cystectomy (RC) in patients with locally advanced tumour. Approximately half of patients who underwent RC for muscle invasive BCa relapse after surgery with either local recurrence or distant metastasis. This review focuses on the management of muscle invasive, locally advanced and metastatic BCa with emphasis on the role of surgery; to summarize the current knowledge in order to enhance clinical decision-making and counselling process. PMID:27785430

  4. Muscle strain injuries.

    PubMed

    Garrett, W E

    1996-01-01

    One of the most common injuries seen in the office of the practicing physician is the muscle strain. Until recently, little data were available on the basic science and clinical application of this basic science for the treatment and prevention of muscle strains. Studies in the last 10 years represent action taken on the direction of investigation into muscle strain injuries from the laboratory and clinical fronts. Findings from the laboratory indicate that certain muscles are susceptible to strain injury (muscles that cross multiple joints or have complex architecture). These muscles have a strain threshold for both passive and active injury. Strain injury is not the result of muscle contraction alone, rather, strains are the result of excessive stretch or stretch while the muscle is being activated. When the muscle tears, the damage is localized very near the muscle-tendon junction. After injury, the muscle is weaker and at risk for further injury. The force output of the muscle returns over the following days as the muscle undertakes a predictable progression toward tissue healing. Current imaging studies have been used clinically to document the site of injury to the muscle-tendon junction. The commonly injured muscles have been described and include the hamstring, the rectus femoris, gastrocnemius, and adductor longus muscles. Injuries inconsistent with involvement of a single muscle-tendon junction proved to be at tendinous origins rather than within the muscle belly. Important information has also been provided regarding injuries with poor prognosis, which are potentially repairable surgically, including injuries to the rectus femoris muscle, the hamstring origin, and the abdominal wall. Data important to the management of common muscle injuries have been published. The risks of reinjury have been documented. The early efficacy and potential for long-term risks of nonsteroidal antiinflammatory agents have been shown. New data can also be applied to the field

  5. Biarticular leg muscles and links to running economy.

    PubMed

    Heise, G; Shinohara, M; Binks, L

    2008-08-01

    Relationships between an index of running economy (VO2 per distance) and the temporal electromyographic characteristics of leg muscles were quantified in female runners. Sixteen women performed a 30-min treadmill run at a speed designed to elicit a hard rating of perceived of exertion. Near the end of the run, oxygen uptake, video, and electromyographic data were collected simultaneously. Measures of muscle on-time durations, and on-time coactivation durations were calculated from the following muscles: gastrocnemius, vastus lateralis, rectus femoris, and biceps femoris. Nonparametric correlations between VO2 per distance and temporal electromyographic data were evaluated. Greater on-time duration of rectus femoris during stance, and greater on-time coactivation duration of rectus femoris-gastrocnemius during stance were significantly associated with more economical runners (i.e., lower VO2 per distance). The coactivation of biarticular leg muscles during stance is clearly linked to running economy and this control strategy may elicit greater elastic energy return.

  6. Scar remodeling after strabismus surgery.

    PubMed Central

    Ludwig, I H

    1999-01-01

    PURPOSE: Patients with overcorrected strabismus (and several patients with undercorrection after extraocular muscle resection) underwent exploration of previously operated muscles, with the intention of advancing their tendons to prevent the need for surgery on additional muscles. Unexpectedly, it was found that, in many cases, an elongated scar segment of variable length was interposed between the muscle and its insertion site on the sclera. Laboratory investigations were carried out to elucidate the underlying mechanism(s) and to create an animal model of the disorder. METHODS: Lengthened scars were repaired on 198 muscles during 134 procedures performed on 123 patients. The scars consisted of amorphous connective tissue interposed between the globe and normal tendon. Repair was accomplished by excision of the scar and reattachment of the muscle to sclera, using absorbable sutures in 64 cases and nonabsorbable sutures in 70 cases. Histopathologic examination was performed on 82 clinical specimens, and tissue culture studies were performed on 7 specimens. To develop an animal model, 10 New Zealand white rabbits underwent bilateral superior rectus resection. Half of the eyes received sub-Tenon's injections of collagenase over the operative site during weeks 2, 3, 5, and 6 postoperatively; the other half received saline solution injections on the same schedule. At 10 weeks, half the sites were studied histologically, and the other half underwent collagen creep analysis. In a second study, the use of absorbable versus nonabsorbable sutures was compared in the rabbit model. RESULTS: In the clinical cases, the mean length of the elongated scar segments was 4.2 mm. A total of 105 of the 134 repair procedures were judged successful. Thirty-one procedures resulted in recurrence of the original overcorrection; 7 of these had documented restretches. Factors that distinguished patients with stretched scars from patients with classic slipped muscles included minimal or no

  7. Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post surgery.

    PubMed

    Ageberg, Eva; Roos, Harald P; Silbernagel, Karin Grävare; Thomeé, Roland; Roos, Ewa M

    2009-02-01

    Hamstring muscles play a major role in knee-joint stabilization after anterior cruciate ligament (ACL) injury. Weakness of the knee extensors after ACL reconstruction with patellar tendon (PT) graft, and in the knee flexors after reconstruction with hamstring tendons (HT) graft has been observed up to 2 years post surgery, but not later. In these studies, isokinetic muscle torque was used. However, muscle power has been suggested to be a more sensitive and sport-specific measures of strength. The aim was to study quadriceps and hamstring muscle power in patients with ACL injury treated with surgical reconstruction with PT or HT grafts at a mean of 3 years after surgery. Twenty subjects with PT and 16 subjects with HT grafts (mean age at follow up 30 years, range 20-39, 25% women), who were all included in a prospective study and followed the same goal-based rehabilitation protocol for at least 4 months, were assessed with reliable, valid, and responsive tests of quadriceps and hamstring muscle power at 3 years (SD 0.9, range 2-5) after surgery. The mean difference between legs (injured minus uninjured), the hamstring to quadriceps (H:Q, hamstring divided by quadriceps) ratio, and the limb symmetry index (LSI, injured leg divided by uninjured and multiplied by 100) value, were used for comparisons between the groups (analysis of variance). The mean difference between the injured and uninjured legs was greater in the HT than in the PT group for knee flexion power (-21.3 vs. 7.7 W, p = 0.001). Patients with HT graft had lower H:Q ratio in the injured leg than the patients with PT graft (0.63 vs. 0.77, p = 0.012). They also had lower LSI for knee flexion power than those in the PT group (88 vs. 106%, p < 0.001). No differences were found between the groups for knee extension power. The lower hamstring muscle power, and the lower hamstring to quadriceps ratio in the HT graft group than in the PT graft group 3 years (range 2-5) after ACL reconstruction, reflect imbalance

  8. Inferior oblique muscle paresis as a sign of myasthenia gravis.

    PubMed

    Almog, Yehoshua; Ben-David, Merav; Nemet, Arie Y

    2016-03-01

    Myasthenia gravis may affect any of the six extra-ocular muscles, masquerading as any type of ocular motor pathology. The frequency of involvement of each muscle is not well established in the medical literature. This study was designed to determine whether a specific muscle or combination of muscles tends to be predominantly affected. This retrospective review included 30 patients with a clinical diagnosis of myasthenia gravis who had extra-ocular muscle involvement with diplopia at presentation. The diagnosis was confirmed by at least one of the following tests: Tensilon test, acetylcholine receptor antibodies, thymoma on chest CT scan, or suggestive electromyography. Frequency of involvement of each muscle in this cohort was inferior oblique 19 (63.3%), lateral rectus nine (30%), superior rectus four (13.3%), inferior rectus six (20%), medial rectus four (13.3%), and superior oblique three (10%). The inferior oblique was involved more often than any other muscle (p<0.01). Eighteen (60%) patients had ptosis, six (20%) of whom had bilateral ptosis. Diagnosing myasthenia gravis can be difficult, because the disease may mimic every pupil-sparing pattern of ocular misalignment. In addition diplopia caused by paresis of the inferior oblique muscle is rarely encountered (other than as a part of oculomotor nerve palsy). Hence, when a patient presents with vertical diplopia resulting from an isolated inferior oblique palsy, myasthenic etiology should be highly suspected.

  9. The effect of early physiotherapy on the recovery of mandibular function after orthognathic surgery for class III correction. Part II: electromyographic activity of masticatory muscles.

    PubMed

    Ko, Ellen Wen-Ching; Teng, Terry Te-Yi; Huang, Chiung Shing; Chen, Yu-Ray

    2015-01-01

    The study was conducted to evaluate the effect of early physical rehabilitation by comparing the differences of surface electromyographic (sEMG) activity in the masseter and anterior temporalis muscles after surgical correction of skeletal class III malocclusion. The prospective study included 63 patients; the experimental groups contained 31 patients who received early systematic physical rehabilitation; the control group (32 patients) did not receive physiotherapy. The amplitude of sEMG in the masticatory muscles reached 72.6-121.3% and 37.5-64.6% of pre-surgical values in the experimental and control groups respectively at 6 weeks after orthognathic surgery (OGS). At 6 months after OGS, the sEMG reached 135.1-233.4% and 89.6-122.5% of pre-surgical values in the experimental and control groups respectively. Most variables in the sEMG examination indicated that recovery of the masticatory muscles in the experimental group was better than the control group as estimated in the early phase (T1 to T2) and the total phase (T1 to T3); there were no significant differences between the mean recovery percentages in the later phase (T2 to T3). Early physical rehabilitative therapy is helpful for early recovery of muscle activity in masticatory muscles after OGS. After termination of physical therapy, no significant difference in recovery was indicated in patients with or without early physiotherapy.

  10. Initial experience with the use of porcine acellular dermal matrix (Strattice) for abdominal wall reinforcement after transverse rectus abdominis myocutaneous flap breast reconstruction.

    PubMed

    Cicilioni, Orlando; Araujo, Gerson; Mimbs, Nancy; Cox, Matthew D

    2012-03-01

    Reestablishing anterior rectus fascial integrity remains a clinical challenge after transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. The main concerns include herniation and bulging due to abdominal weakness. Mesh-assisted closure of the fascial defect has improved bulging and herniation rates but infection, extrusion, and encapsulation are serious concerns with mesh use. Biologic tissue matrices may overcome some of these mesh-related complications. The initial experience of using Strattice for fascial closure after TRAM flap procedure is described in this article. Strattice was in-lain and sutured between the anterior and posterior layers of the rectus fascia, at the rectus muscle donor site. The abdominal wall was closed with progressive tension sutures. Postoperative complications at the donor site were assessed. A total of 16 unilateral and 9 bilateral reconstructions were performed in 25 patients. Length of hospital stay was 2 to 3 days which is shorter than with mesh repair (typically 4-5 days). During a mean follow-up period of 14.0 months, complications occurred in 7 patients (28%): seroma formation (2), minor skin separation (2), superficial skin infection (2), and superficial wound dehiscence (1). Complications were not directly related to Strattice and all, except one (superficial skin infection), were resolved without surgical intervention. In all patients, routine abdominal functions were restored 4 months postoperatively. Strattice is a safe, alternative option to synthetic mesh for fascial repair following TRAM flap breast reconstruction. When used in conjunction with progressive tension suture closure of the abdominal wall, dynamic reconstruction of the abdominal wall with resumption of abdominal function is possible with Strattice.

  11. Minimally invasive strabismus surgery versus paralimbal approach: A randomized, parallel design study is minimally invasive strabismus surgery worth the effort?

    PubMed Central

    Sharma, Richa; Amitava, Abadan K; Bani, Sadat AO

    2014-01-01

    Introduction: Minimal access surgery is common in all fields of medicine. We compared a new minimally invasive strabismus surgery (MISS) approach with a standard paralimbal strabismus surgery (SPSS) approach in terms of post-operative course. Materials and Methods: This parallel design study was done on 28 eyes of 14 patients, in which one eye was randomized to MISS and the other to SPSS. MISS was performed by giving two conjunctival incisions parallel to the horizontal rectus muscles; performing recession or resection below the conjunctival strip so obtained. We compared post-operative redness, congestion, chemosis, foreign body sensation (FBS), and drop intolerance (DI) on a graded scale of 0 to 3 on post-operative day 1, at 2-3 weeks, and 6 weeks. In addition, all scores were added to obtain a total inflammatory score (TIS). Statistical Analysis: Inflammatory scores were analyzed using Wilcoxon's signed rank test. Results: On the first post-operative day, only FBS (P =0.01) and TIS (P =0.04) showed significant difference favoring MISS. At 2-3 weeks, redness (P =0.04), congestion (P =0.04), FBS (P =0.02), and TIS (P =0.04) were significantly less in MISS eye. At 6 weeks, only redness (P =0.04) and TIS (P =0.05) were significantly less. Conclusion: MISS is more comfortable in the immediate post-operative period and provides better cosmesis in the intermediate period. PMID:24088635

  12. Effects of barbell deadlift training on submaximal motor unit firing rates for the vastus lateralis and rectus femoris.

    PubMed

    Stock, Matt S; Thompson, Brennan J

    2014-01-01

    Previous investigations that have studied motor unit firing rates following strength training have been limited to small muscles, isometric training, or interventions involving exercise machines. We examined the effects of ten weeks of supervised barbell deadlift training on motor unit firing rates for the vastus lateralis and rectus femoris during a 50% maximum voluntary contraction (MVC) assessment. Twenty-four previously untrained men (mean age  = 24 years) were randomly assigned to training (n = 15) or control (n = 9) groups. Before and following the intervention, the subjects performed isometric testing of the right knee extensors while bipolar surface electromyographic signals were detected from the two muscles. The signals were decomposed into their constituent motor unit action potential trains, and motor units that demonstrated accuracy levels less than 92.0% were not considered for analysis. One thousand eight hundred ninety-two and 2,013 motor units were examined for the vastus lateralis and rectus femoris, respectively. Regression analyses were used to determine the linear slope coefficients (pulses per second [pps]/% MVC) and y-intercepts (pps) of the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. Deadlift training significantly improved knee extensor MVC force (Cohen's d = .70), but did not influence force steadiness. Training had no influence on the slopes and y-intercepts for the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. In agreement with previous cross-sectional comparisons and randomized control trials, our findings do not support the notion that strength training affects the submaximal control of motor units. PMID:25531294

  13. Fixed Foot Balance Training Increases Rectus Femoris Activation During Landing and Jump Height in Recreationally Active Women

    PubMed Central

    Kean, Crystal O.; Behm, David G.; Young, Warren B.

    2006-01-01

    The objective of this study was to determine the effects of fixed foot and functionally directed balance training on static balance time, muscle activation during landing, vertical jump height and sprint time. Twenty-four recreationally active females were tested pre- and post-training (fixed foot balance training, n= 11, functionally directed balance training, n = 7 and control group, n = 6). Experimental subjects completed either fixed foot or functionally directed balance exercises 4 times/week for 6 weeks. Surface electromyography (EMG) was used to assess preparatory and reactive muscle activity of the rectus femoris (RF), biceps femoris (BF), and the soleus during one- and two-foot landings following a jump. Maximum vertical jump height, static balance and 20-meter sprint times were also examined. The fixed foot balance-training group showed a 33% improvement (p < 0.05) in static balance time and 9% improvement in jump height. Neither type of training improved sprint times. Further analysis revealed significant (p < 0.05) overall (data collapsed over groups and legs) increases in reactive RF activity when landing. Independently, the fixed foot balance group showed a 33% increase in reactive RF activity (p < 0.01). Overall, there was also significantly less reactive co-activation following training (p < 0.05). It appears that fixed foot balance training for recreationally active women may provide greater RF activity when landing and increased countermovement jump height. Key points Balance training increased rectus femoris EMG activity upon landing from a stride. Fixed foot balance training improved countermovement jump height. Neither fixed foot nor functionally directed balance training elicited changes in sprint times. PMID:24198691

  14. Effects of Barbell Deadlift Training on Submaximal Motor Unit Firing Rates for the Vastus Lateralis and Rectus Femoris

    PubMed Central

    Stock, Matt S.; Thompson, Brennan J.

    2014-01-01

    Previous investigations that have studied motor unit firing rates following strength training have been limited to small muscles, isometric training, or interventions involving exercise machines. We examined the effects of ten weeks of supervised barbell deadlift training on motor unit firing rates for the vastus lateralis and rectus femoris during a 50% maximum voluntary contraction (MVC) assessment. Twenty-four previously untrained men (mean age  = 24 years) were randomly assigned to training (n = 15) or control (n = 9) groups. Before and following the intervention, the subjects performed isometric testing of the right knee extensors while bipolar surface electromyographic signals were detected from the two muscles. The signals were decomposed into their constituent motor unit action potential trains, and motor units that demonstrated accuracy levels less than 92.0% were not considered for analysis. One thousand eight hundred ninety-two and 2,013 motor units were examined for the vastus lateralis and rectus femoris, respectively. Regression analyses were used to determine the linear slope coefficients (pulses per second [pps]/% MVC) and y-intercepts (pps) of the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. Deadlift training significantly improved knee extensor MVC force (Cohen's d = .70), but did not influence force steadiness. Training had no influence on the slopes and y-intercepts for the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. In agreement with previous cross-sectional comparisons and randomized control trials, our findings do not support the notion that strength training affects the submaximal control of motor units. PMID:25531294

  15. Altered Protein Composition and Gene Expression in Strabismic Human Extraocular Muscles and Tendons

    PubMed Central

    Agarwal, Andrea B.; Feng, Cheng-Yuan; Altick, Amy L.; Quilici, David R.; Wen, Dan; Johnson, L. Alan; von Bartheld, Christopher S.

    2016-01-01

    Purpose To determine whether structural protein composition and expression of key regulatory genes are altered in strabismic human extraocular muscles. Methods Samples from strabismic horizontal extraocular muscles were obtained during strabismus surgery and compared with normal muscles from organ donors. We used proteomics, standard and customized PCR arrays, and microarrays to identify changes in major structural proteins and changes in gene expression. We focused on muscle and connective tissue and its control by enzymes, growth factors, and cytokines. Results Strabismic muscles showed downregulation of myosins, tropomyosins, troponins, and titin. Expression of collagens and regulators of collagen synthesis and degradation, the collagenase matrix metalloproteinase (MMP)2 and its inhibitors, tissue inhibitor of metalloproteinase (TIMP)1 and TIMP2, was upregulated, along with tumor necrosis factor (TNF), TNF receptors, and connective tissue growth factor (CTGF), as well as proteoglycans. Growth factors controlling extracellular matrix (ECM) were also upregulated. Among 410 signaling genes examined by PCR arrays, molecules with downregulation in the strabismic phenotype included GDNF, NRG1, and PAX7; CTGF, CXCR4, NPY1R, TNF, NTRK1, and NTRK2 were upregulated. Signaling molecules known to control extraocular muscle plasticity were predominantly expressed in the tendon rather than the muscle component. The two horizontal muscles, medial and lateral rectus, displayed similar changes in protein and gene expression, and no obvious effect of age. Conclusions Quantification of proteins and gene expression showed significant differences in the composition of extraocular muscles of strabismic patients with respect to important motor proteins, elements of the ECM, and connective tissue. Therefore, our study supports the emerging view that the molecular composition of strabismic muscles is substantially altered. PMID:27768799

  16. Muscle oxygen saturation heterogeneity among leg muscles during ramp exercise.

    PubMed

    Takagi, Shun; Kime, Ryotaro; Niwayama, Masatsugu; Murase, Norio; Katsumura, Toshihito

    2013-01-01

    We examined whether O(2) saturation in several leg muscles changes as exercise intensity increases. Twelve healthy young males performed 20 W/min ramp bicycle exercise until exhaustion. Pulmonary O(2) uptake (VO(2)) was monitored continuously during the experiments to determine peak oxygen uptake. Muscle O(2) saturation (SmO(2)) was also monitored continuously at the belly of the vastus lateralis (VL), rectus femoris, vastus medialis, biceps femoris, gastrocnemius lateralis, gastrocnemius medialis, and tibialis anterior by near-infrared spatial resolved spectroscopy. Although the VL muscle mainly contributes during cycling exercise, deoxygenation was enhanced not only in the VL muscle but also in the other thigh muscles and lower leg muscles with increased exercise intensity. Furthermore, SmO(2) response during ramp cycling exercise differed considerably between leg muscles.

  17. Sellar repair with autologous muscle and composite septal cartilage grafts for treatment of cerebrospinal fluid leakage following trans-sphenoidal pituitary surgery

    PubMed Central

    El Shazly, Ayman A.; El Wardany, Mohammed A.; Abo El Ezz, Tamer A.

    2016-01-01

    Context: Many reconstructive techniques have been proposed to prevent postoperative cerebrospinal fluid (CSF) leakage after trans-sphenoidal pituitary surgery. However, no total agreement has been reached to the best technique. Aim: Assessment of the efficacy of sellar repair with autologous muscle and composite septal cartilage grafts for treatment of intraoperative and delayed postoperative CSF leakage following trans-sphenoidal pituitary surgery without the use of postoperative external lumbar CSF drain. Study Design: This is a retrospective case series study, level IV evidence. Materials and Methods : Twenty three patients were involved in this study. Seventeen patients had intraoperative CSF leakage and were treated immediately by our technique. Six patients had postoperative CSF rhinorrhea and had delayed treatment with our technique after failure of conservative measures and external lumbar CSF drainage for more than three days. The technique involved intradural placement of autologous muscle graft supplemented with extradural composite septal cartilage graft, composed of a piece of the posterior cartilaginous septum with its covering mucoperichondrium on one side only to fit into the sellar defect as a double layer button. Results: CSF leak was of grade 1 in 6 patients (26.1%), grade 2 in 10 patients (43.5%) and grade 3 in 7 patients (30.4%). None of the patients in our study had postoperative CSF leak after the use of our technique during the follow up period (mean 24 ± 10.47 standard deviation months). None of the patients developed treatment-related complications. All the patients had well developed mucosal covering of the sellar defect after two months. Conclusion: Our technique of sellar repair by using autologous muscle and composite septal cartilage grafts is effective in treatment of intraoperative and delayed postoperative CSF leakage following trans-sphenoidal pituitary surgery without the use of postoperative external lumbar CSF drain even in

  18. Sellar repair with autologous muscle and composite septal cartilage grafts for treatment of cerebrospinal fluid leakage following trans-sphenoidal pituitary surgery

    PubMed Central

    El Shazly, Ayman A.; El Wardany, Mohammed A.; Abo El Ezz, Tamer A.

    2016-01-01

    Context: Many reconstructive techniques have been proposed to prevent postoperative cerebrospinal fluid (CSF) leakage after trans-sphenoidal pituitary surgery. However, no total agreement has been reached to the best technique. Aim: Assessment of the efficacy of sellar repair with autologous muscle and composite septal cartilage grafts for treatment of intraoperative and delayed postoperative CSF leakage following trans-sphenoidal pituitary surgery without the use of postoperative external lumbar CSF drain. Study Design: This is a retrospective case series study, level IV evidence. Materials and Methods : Twenty three patients were involved in this study. Seventeen patients had intraoperative CSF leakage and were treated immediately by our technique. Six patients had postoperative CSF rhinorrhea and had delayed treatment with our technique after failure of conservative measures and external lumbar CSF drainage for more than three days. The technique involved intradural placement of autologous muscle graft supplemented with extradural composite septal cartilage graft, composed of a piece of the posterior cartilaginous septum with its covering mucoperichondrium on one side only to fit into the sellar defect as a double layer button. Results: CSF leak was of grade 1 in 6 patients (26.1%), grade 2 in 10 patients (43.5%) and grade 3 in 7 patients (30.4%). None of the patients in our study had postoperative CSF leak after the use of our technique during the follow up period (mean 24 ± 10.47 standard deviation months). None of the patients developed treatment-related complications. All the patients had well developed mucosal covering of the sellar defect after two months. Conclusion: Our technique of sellar repair by using autologous muscle and composite septal cartilage grafts is effective in treatment of intraoperative and delayed postoperative CSF leakage following trans-sphenoidal pituitary surgery without the use of postoperative external lumbar CSF drain even in

  19. [Smile "forced" smile versus "spontaneous": comparison of 3 techniques of reconstructive surgery of the face. Myoplasty temporal muscle, hypoglossal facial anastomosis and gracilis muscle free flap].

    PubMed

    Lheureux-Portmann, A; Lapalus-Curtoud, Q; Robert, M; Tankéré, F; Disant, F; Pasche, P; Lamas, G; Gatignol, P

    2013-01-01

    The facial palsy cause serious consequences for patients. Studies have also shown that in these patients, the inability to produce an appropriate and spontaneous smile would be a key factor of depression. When facial palsy is considered complete and the nerve cannot be repaired, the patient can benefit from palliative surgery to regain a better quality of life in the aesthetic, functional, and psychological aspects. The hypoglossal-facial anastomosis (AHF), temporal myoplasty (MAT) and gracilis transposition (TG) are the major surgeries currently used for this purpose. The aim of our study is to assess quantitatively and qualitatively the effects of each of these surgeries on the lip mobility and production of smile. From this perspective, we proposed a protocol of an evaluation of facial motricity, of quality of life, and more particularly on the quality and the analysis of the smile. The results underline that there is no significant difference in the recovery of the facial motricity according to the surgery. Only the slower, deferred deadline of recovery at the patients AHF and TG who have to wait several months, it is for the same levels as that of the patients' MAT. A premature and intensive rehabilitation such as the patients of our protocol benefited from it what is nevertheless essential to a good recovery whatever is the surgery.

  20. Development of estimation system of knee extension strength using image features in ultrasound images of rectus femoris

    NASA Astrophysics Data System (ADS)

    Murakami, Hiroki; Watanabe, Tsuneo; Fukuoka, Daisuke; Terabayashi, Nobuo; Hara, Takeshi; Muramatsu, Chisako; Fujita, Hiroshi

    2016-04-01

    The word "Locomotive syndrome" has been proposed to describe the state of requiring care by musculoskeletal disorders and its high-risk condition. Reduction of the knee extension strength is cited as one of the risk factors, and the accurate measurement of the strength is needed for the evaluation. The measurement of knee extension strength using a dynamometer is one of the most direct and quantitative methods. This study aims to develop a system for measuring the knee extension strength using the ultrasound images of the rectus femoris muscles obtained with non-invasive ultrasonic diagnostic equipment. First, we extract the muscle area from the ultrasound images and determine the image features, such as the thickness of the muscle. We combine these features and physical features, such as the patient's height, and build a regression model of the knee extension strength from training data. We have developed a system for estimating the knee extension strength by applying the regression model to the features obtained from test data. Using the test data of 168 cases, correlation coefficient value between the measured values and estimated values was 0.82. This result suggests that this system can estimate knee extension strength with high accuracy.

  1. Does the GMFCS level influence the improvement in knee range of motion after rectus femoris transfer in cerebral palsy?

    PubMed

    Blumetti, Francesco C; Morais Filho, Mauro C; Kawamura, Cátia M; Cardoso, Michelle O; Neves, Daniella L; Fujino, Marcelo H; Lopes, José Augusto F

    2015-09-01

    The aim of this study was to evaluate the influence of the Gross Motor Function Classification System (GMFCS) on the outcomes of rectus femoris transfer (RFT) for patients with cerebral palsy and stiff knee gait. We performed a retrospective review of patients seen at our gait laboratory from 1996 to 2013. Inclusion criteria were (i) spastic diplegic cerebral palsy, (ii) GMFCS levels I-III, (iii) reduced peak knee flexion in swing (PKFSw<55°), and (iv) patients who underwent orthopedic surgery with preoperative and postoperative gait analysis. Patients were divided into two groups according to whether they received a concurrent RFT or not at the time of surgery: non-RFT group (185 knees) and RFT group (123 knees). The primary outcome was the overall knee range of motion (KROM) derived from gait kinematics. The secondary outcomes were the PKFSw and the time of peak knee flexion in swing (tPKFSw). We observed a statistically significant improvement in KROM only for patients in the RFT group (P<0.001). However, PKFSw and tPKFSw improved in both groups after surgery (P<0.001 for all analyses). In the RFT group, the improvement in KROM was observed only for patients classified as GMFCS levels I and II. In the non-RFT group, no improvement in KROM was observed in any GMFCS level. In this study, patients at GMFCS levels I and II were more likely to benefit from the RFT procedure.

  2. Major orbital complications of endoscopic sinus surgery

    PubMed Central

    Rene, C; Rose, G; Lenthall, R; Moseley, I

    2001-01-01

    BACKGROUND—The paranasal sinuses are intimately related to the orbit and consequently sinus disease or surgery may cause severe orbital complications. Complications are rare but can result in serious morbidity, the most devastating of which is severe visual loss.
METHODS—A retrospective review was undertaken of four cases of severe orbital trauma during endoscopic sinus surgery.
RESULTS—All the cases suffered medial rectus damage, one had additional injury to the inferior rectus and oblique, and two patients were blinded as a result of direct damage to the optic nerve or its blood supply.
CONCLUSION—Some ophthalmic complications of endoscopic sinus surgery are highlighted, the mechanisms responsible are discussed, and recommendations for prevention, early recognition, and management are proposed. 

 PMID:11316724

  3. Rectus sheath block for postoperative analgesia in patients with mesenteric vascular occlusion undergoing laparotomy: A randomized single-blinded study

    PubMed Central

    Elbahrawy, Khaled; El-Deeb, Alaa

    2016-01-01

    Background: Acute mesenteric ischemia is a life-threatening vascular emergency that requires early diagnosis, immediate anticoagulation, and intervention to restore mesenteric blood flow adequately. Aims: To investigate the effect of rectus sheath block (RSB) for postoperative analgesia in patients with mesenteric vascular occlusion. Settings and Design: Forty patients with mesenteric vascular occlusion, American Society of Anesthesiologists physical status I or II or III, scheduled for laparotomy were enrolled in this study. Subjects and Methods: Patients were randomized into two groups; control group (C Group) and rectus block group (RB Group). In both groups, general anesthesia was induced fentanyl 1 μg/kg with sleeping dose of propofol and 0.15 mg/kg cisatracurium. Then, anesthesia was maintained with sevoflurane in oxygen 100%. In RB Group, under aseptic condition, RSB guided by ultrasound was performed. Surgery is then continued and intravenous fentanyl patient-controlled analgesia pump started. Postoperative pain, sedation, and opioid side effects were assessed. Statistical Analysis Used: Statistical analysis was done using Statistical Package for Social Sciences (SPSS 19.0, Chicago, IL, USA). Results: Patients in the RB Group consumed statistically significant less opioid in comparison to control group either intraoperatively or postoperatively. Mean pain scores were statistically significant less in RB Group than in the control group at 2, 4, and 6 h postoperatively. Sedation score, incidence of nausea and vomiting were statistically significant less in the RB Group in comparison to control group. More patients’ satisfaction was reported in the RB Group. Conclusions: Ultrasound-guided RSB resulted in postoperative reduction of pain scores and opioid consumption compared with general anesthesia alone. Moreover, RSB was associated with better patient satisfaction and less nausea and vomiting. PMID:27746544

  4. Laughing: a demanding exercise for trunk muscles.

    PubMed

    Wagner, Heiko; Rehmes, Ulrich; Kohle, Daniel; Puta, Christian

    2014-01-01

    Social, psychological, and physiological studies have provided evidence indicating that laughter imposes an increased demand on trunk muscles. It was the aim of this study to quantify the activation of trunk muscles during laughter yoga in comparison with crunch and back lifting exercises regarding the mean trunk muscle activity. Muscular activity during laughter yoga exercises was measured by surface electromyography of 5 trunk muscles. The activation level of internal oblique muscle during laughter yoga is higher compared to the traditional exercises. The multifidus, erector spinae, and rectus abdominis muscles were nearly half activated during laughter yoga, while the activation of the external oblique muscle was comparable with the crunch and back lifting exercises. Our results indicate that laughter yoga has a positive effect on trunk muscle activation. Thus, laughter seems to be a good activator of trunk muscles, but further research is required whether laughter yoga is a good exercise to improve neuromuscular recruitment patterns for spine stability.

  5. Successful repair of injury to the eyelid, lacrimal passage, and extraocular muscle

    PubMed Central

    Shah, Shreya Mehul; Shah, Mehul Ashvin; Shah, Prerna D.; Patel, Kashyap B.

    2016-01-01

    Introduction: Injury is a known cause of monocular blindness. Ocular trauma may affect lacrimal canaliculi and the extraocular muscle. We report this case as it includes injury to lid, lacrimal canaliculi and inferior rectus. Case description: A 25-year-old male presented with an injury caused by a sharp object that resulted in a conjunctival tear, lid tear involving the lacrimal canal, and rupture of the inferior rectus muscle. All of the structures were repaired successfully during a single procedure. Conclusion: An extraocular injury involving the conjunctiva, lid, lacrimal passages, and extraocular muscles can be repaired successfully during a single procedure. PMID:27625963

  6. Successful repair of injury to the eyelid, lacrimal passage, and extraocular muscle

    PubMed Central

    Shah, Shreya Mehul; Shah, Mehul Ashvin; Shah, Prerna D.; Patel, Kashyap B.

    2016-01-01

    Introduction: Injury is a known cause of monocular blindness. Ocular trauma may affect lacrimal canaliculi and the extraocular muscle. We report this case as it includes injury to lid, lacrimal canaliculi and inferior rectus. Case description: A 25-year-old male presented with an injury caused by a sharp object that resulted in a conjunctival tear, lid tear involving the lacrimal canal, and rupture of the inferior rectus muscle. All of the structures were repaired successfully during a single procedure. Conclusion: An extraocular injury involving the conjunctiva, lid, lacrimal passages, and extraocular muscles can be repaired successfully during a single procedure.

  7. Progression of knee joint kinematics in children with cerebral palsy with and without rectus femoris transfers: a long-term follow up.

    PubMed

    Moreau, Noelle; Tinsley, Suzanne; Li, Li

    2005-10-01

    The purpose of this study was to compare long-term outcomes of multi-level surgery with and without rectus femoris transfer (RFT) in a group of children with cerebral palsy. Forty-one subjects with a diagnosis of cerebral palsy were divided into a RFT group (28 subjects with 50 sides) and non-RFT group (13 subjects with 22 sides). The study protocol included pre-operative gait analysis, multi-level orthopedic surgical intervention, one year post-operative gait analysis, and three year or greater post-operative gait analysis. All participants received inpatient physical therapy for 2-12 weeks either following surgery or following a period of immobilization, depending on surgical procedures performed. Results showed improved peak knee flexion during swing phase (PKFS) for the RFT group one year after surgery. The deviation from normal in PKFS in the RFT group improved, on average, from seven to five degrees. The deviation from normal in PKFS in the non-RFT group increased approximately four degrees in the same period of time. The knee flexion swing range (KFSR) of the RFT group increased dramatically by 11 degrees after surgery, where no significant KFSR changes observed in the non-RFT group. Those parameters maintained relatively stable from one to three years post surgery for both groups. These observations support our hypothesis that improvements after RFT surgery persist over time, counteracting the negative effects of growth and time.

  8. Isolated extraocular muscle infiltration with plasmacytoma treated with localized injection of dexamethasone.

    PubMed

    Painter, Sally L; Dickens, Emmy; Elston, John S

    2015-06-01

    Plasmacytoma of the orbit secondary to multiple myeloma is rare and has not previously been reported limited to an extraocular muscle. Conventional treatment is either localized radiotherapy or systemic chemotherapy. We report a case of plasmacytoma within the medial rectus muscle, which regressed completely with localized infiltration of dexamethasone.

  9. Cylinder or mobile cast brace after knee ligament surgery. A clinical analysis and morphologic and enzymatic studies of changes in the quadriceps muscle.

    PubMed

    Häggmark, T; Eriksson, E

    1979-01-01

    Sixteen patients participated in a prospective randomized trial in which a standard cylinder cast was compared with a mobile cast brace. Both were worn for 4 weeks, beginning at 1 week after reconstruction of the anterior cruciate ligament. The athletes that had used a cast brace could return to sports activities in about one-half the time it took for the athletes with a standard cast. The patients with a standard cast showed a significant atrophy of Type I (slow twitch) muscle fibers in the vastus lateralis. The cast brace patients did not show any significant changes in cross-sectional areas of Type I or Type II (fast twitch) muscle fibers. The standard cast patients had a significant reduction of succinate dehydrogenase (SDH) activity in the vastus lateralis whereas the patients with the cast brace did not show any significant changes. No difference in surgical end result was found. A cast brace with a limited range of motion between 20 and 60 degrees of flexion is recommended as the standard postoperative treatment after knee ligament surgery.

  10. A comparison of the effects of epidural and spinal anesthesia with ischemia-reperfusion injury on the rat transverse rectus abdominis musculocutaneous flap.

    PubMed

    Acar, Yusuf; Bozkurt, Mehmet; Firat, Ugur; Selcuk, Caferi Tayyar; Kapi, Emin; Isik, Fatma Birgul; Kuvat, Samet Vasfi; Celik, Feyzi; Bozarslan, Beri Hocaoglu

    2013-11-01

    The purpose of this study is to compare the effects of spinal and epidural anesthesia on a rat transverse rectus abdominus myocutaneous flap ischemia-reperfusion injury model.Forty Sprague-Dawley rats were divided into 4 experimental groups: group I (n = 10), sham group; group II (n = 10), control group; group III (n = 10), epidural group; and group IV (n = 10), spinal group. After the elevation of the transverse rectus abdominus myocutaneous flaps, all groups except for the sham group were subjected to normothermic no-flow ischemia for 4 hours, followed by a reperfusion period of 2 hours. At the end of the reperfusion period, biochemical and histopathological evaluations were performed on tissue samples.Although there was no significant difference concerning the malonyldialdehyde, nitric oxide, and paraoxonase levels in the spinal and epidural groups, the total antioxidant state levels were significantly increased, and the total oxidative stress levels were significantly decreased in the epidural group in comparison to the spinal group. The pathological evaluation showed that findings related to inflammation, nuclear change rates and hyalinization were significantly higher in the spinal group compared with the epidural group.Epidural anesthesia can be considered as a more suitable method that enables a decrease in ischemia-reperfusion injuries in the muscle flaps.

  11. Comparison of 0.25% Ropivacaine for Intraperitoneal Instillation v/s Rectus Sheath Block for Postoperative Pain Relief Following Laparoscopic Cholecystectomy: A Prospective Study

    PubMed Central

    Naithani, Udita; Singariya, Geeta; Gupta, Sunanda

    2016-01-01

    Introduction As Laparoscopic Cholecystectomy (LC) is not a totally pain free procedure, with the pain being most intense on the day of surgery and on the following day. Various techniques are available for postoperative pain relief like intraperitoneal instillation of local anaesthetics and rectus sheath block (RSB)which may provide effective pain relief. Aim To compare the efficacy of preemptive administration (initiated before the surgical procedure) of intraperitoneal instillation and rectus sheath block using ropivacaine for postoperative analgesia after laparoscopic cholecystectomy. Materials and Methods A total of 75 selected patients were randomly assigned to three equal groups as Group R, who received bilateral RSB with 0.25 % ropivacaine 15 ml on either side; Group I, who received intraperitoneal instillation of 0.25% ropivacaine 50 ml and Group C (Control group), who received only rescue analgesic on pain. These were compared regarding postoperative analgesia in terms of Visual Analog Scale (0-10 cm), Prince Henry Hospital Pain Score (0-3), time to first dose of rescue analgesic (tramadol), total rescue analgesic consumption in 48 hours, patient satisfaction scores (1-7) and adverse effects. Results The time to first rescue analgesic was significantly longer in Group R (16.16±4.73h) and Group I (7.84±1.34h) as compared to Group C (1.72±0.67h), p<0.001. Mean tramadol consumption in 48h for each patient was significantly less in Group R (148±54.92mg) and Group I (202±33.78mg) as compared to Group C (298±22.73mg) p<0.001. Postoperative pain scores were also significantly less in Group R and Group I as compared to Group C during first 6 hours, p<0.05. The difference in above parameters was also significant between Group R and Group I, p<0.05. Thus order of postoperative analgesia effect was: Group R > Group I > Group C. Rescue analgesic requirement showed a 32.21% reduction in Group I and 50.33% reduction in Group R as compared to Group C. Patient

  12. Preliminary results using a flexible endoscope for orbital surgery

    NASA Astrophysics Data System (ADS)

    Eaton, Alexander M.; Braunstein, Richard E.; Schubert, Herman D.; Trokel, Stephen L.; Odel, Jeffery G.; Behrens, Myles M.

    1992-08-01

    A technique for visualizing the optic nerve, the short and long posterior ciliary arteries and nerves, the ophthalmic vein, and the rectus muscles using a flexible endoscope was developed in human cadavers. Previous reports of orbital endoscopy were limited to the use of a rigid endoscope. Potential applications for this new flexible endoscopic technique include the biopsy of orbital tumors, fenestration of the optic nerve sheath with mid-infrared lasers, photocoagulation of orbital tumors, and retrieval of foreign bodies or slipped muscles.

  13. Preoperative overnight parenteral nutrition (TPN) improves skeletal muscle protein metabolism indicated by microarray algorithm analyses in a randomized trial.

    PubMed

    Iresjö, Britt-Marie; Engström, Cecilia; Lundholm, Kent

    2016-06-01

    Loss of muscle mass is associated with increased risk of morbidity and mortality in hospitalized patients. Uncertainties of treatment efficiency by short-term artificial nutrition remain, specifically improvement of protein balance in skeletal muscles. In this study, algorithmic microarray analysis was applied to map cellular changes related to muscle protein metabolism in human skeletal muscle tissue during provision of overnight preoperative total parenteral nutrition (TPN). Twenty-two patients (11/group) scheduled for upper GI surgery due to malignant or benign disease received a continuous peripheral all-in-one TPN infusion (30 kcal/kg/day, 0.16 gN/kg/day) or saline infusion for 12 h prior operation. Biopsies from the rectus abdominis muscle were taken at the start of operation for isolation of muscle RNA RNA expression microarray analyses were performed with Agilent Sureprint G3, 8 × 60K arrays using one-color labeling. 447 mRNAs were differently expressed between study and control patients (P < 0.1). mRNAs related to ribosomal biogenesis, mRNA processing, and translation were upregulated during overnight nutrition; particularly anabolic signaling S6K1 (P < 0.01-0.1). Transcripts of genes associated with lysosomal degradation showed consistently lower expression during TPN while mRNAs for ubiquitin-mediated degradation of proteins as well as transcripts related to intracellular signaling pathways, PI3 kinase/MAPkinase, were either increased or decreased. In conclusion, muscle mRNA alterations during overnight standard TPN infusions at constant rate altered mRNAs associated with mTOR signaling; increased initiation of protein translation; and suppressed autophagy/lysosomal degradation of proteins. This indicates that overnight preoperative parenteral nutrition is effective to promote muscle protein metabolism. PMID:27273879

  14. Preoperative overnight parenteral nutrition (TPN) improves skeletal muscle protein metabolism indicated by microarray algorithm analyses in a randomized trial.

    PubMed

    Iresjö, Britt-Marie; Engström, Cecilia; Lundholm, Kent

    2016-06-01

    Loss of muscle mass is associated with increased risk of morbidity and mortality in hospitalized patients. Uncertainties of treatment efficiency by short-term artificial nutrition remain, specifically improvement of protein balance in skeletal muscles. In this study, algorithmic microarray analysis was applied to map cellular changes related to muscle protein metabolism in human skeletal muscle tissue during provision of overnight preoperative total parenteral nutrition (TPN). Twenty-two patients (11/group) scheduled for upper GI surgery due to malignant or benign disease received a continuous peripheral all-in-one TPN infusion (30 kcal/kg/day, 0.16 gN/kg/day) or saline infusion for 12 h prior operation. Biopsies from the rectus abdominis muscle were taken at the start of operation for isolation of muscle RNA RNA expression microarray analyses were performed with Agilent Sureprint G3, 8 × 60K arrays using one-color labeling. 447 mRNAs were differently expressed between study and control patients (P < 0.1). mRNAs related to ribosomal biogenesis, mRNA processing, and translation were upregulated during overnight nutrition; particularly anabolic signaling S6K1 (P < 0.01-0.1). Transcripts of genes associated with lysosomal degradation showed consistently lower expression during TPN while mRNAs for ubiquitin-mediated degradation of proteins as well as transcripts related to intracellular signaling pathways, PI3 kinase/MAPkinase, were either increased or decreased. In conclusion, muscle mRNA alterations during overnight standard TPN infusions at constant rate altered mRNAs associated with mTOR signaling; increased initiation of protein translation; and suppressed autophagy/lysosomal degradation of proteins. This indicates that overnight preoperative parenteral nutrition is effective to promote muscle protein metabolism.

  15. Effect of craniocervical posture on abdominal muscle activities

    PubMed Central

    Su, Jung Gil; Won, Shin Ji; Gak, Hwangbo

    2016-01-01

    [Purpose] The aim of this study was to investigate the influence of the craniocervical posture on abdominal muscle activities in hook-lying position. [Subjects] This study recruited 12 healthy young adults. [Methods] Each subject was asked to adopt a supine position with the hip and knee flexed at 60°. Surface electromyographic signals of transversus abdominis/internal oblique, rectus abdominis, and external oblique in different craniocervical postures (extension, neutral, and flexion) were compared. [Results] The transversus abdominis and rectus abdominis showed increased muscle activities in craniocervical flexion compared to craniocervical extension and neutral position. Greater muscle activities of the external oblique were seen in craniocervical flexion than in craniocervical extension. [Conclusion] Craniocervical flexion was found to be effective to increase the abdominal muscle activities. Consideration of craniocervical posture is recommended when performing trunk stabilization exercises. PMID:27065558

  16. Clinical anatomy and mechanical tensile properties of the rectus femoris tendon

    PubMed Central

    Zhu, Xing-Fei; Zhang, Xin-Chao

    2015-01-01

    Purpose: We aimed to provide anatomical data and mechanical tensile properties for the rectus femoris tendon to determine if it is a feasible substitute for the anterior cruciate ligament during knee joint reconstruction. Methods: The length and width of the quadriceps femoris tendon were measured from ten adult cadavers (20 knees; age =48±2 years). The anatomic features of the patellar insertion on the quadriceps femoris tendon were also documented. The rectus femoris tendon and anterior cruciate ligament were harvested from an additional five fresh specimens (10 knees; age =41±3 years). To minimize dehydration, each specimen was wrapped in saline-moistened paper towels and stored at -10°C. We imposed tensile stresses on a total of twenty samples in a sample-driven machine at 10 mm/min until the specimens failed. Results: The inserted and discrete widths of the rectus femoris tendon were 3.20±0.33 and 1.28±0.25 cm, respectively. The length of the tendon tissue was 6.96±0.80 cm and the length of mixing zone was 3.81±0.53 cm. The average thickness of the upper pole of the patella was 2.22±0.14 cm. In mechanical tensile properties, the unit modulus and unit maximum load of the rectus femoris tendon were both 63% of the anterior cruciate ligament. Conclusions: Based on its anatomical and mechanical tensile properties, the rectus femoris tendon is a feasible donor site to reconstitute the anterior cruciate ligament. PMID:26885205

  17. Successful return to high-level sports following early surgical repair of combined adductor complex and rectus abdominis avulsion.

    PubMed

    Tansey, R J; Benjamin-Laing, H; Jassim, S; Liekens, K; Shankar, A; Haddad, F S

    2015-11-01

    Hip and groin injuries are common in athletes who take part in high level sports. Adductor muscle tendon injuries represent a small but important number of these injuries. Avulsion of the tendons attached to the symphysis pubis has previously been described: these can be managed both operatively and non-operatively. We describe an uncommon variant of this injury, namely complete avulsion of the adductor sleeve complex: this includes adductor longus, pectineus and rectus abdominis. We go on to describe a surgical technique which promotes a full return to the pre-injury level of sporting activity. Over a period of ten years, 15 high-level athletes with an MRI-confirmed acute adductor complex avulsion injury (six to 34 days old) underwent surgical repair. The operative procedure consisted of anatomical re-attachment of the avulsed tissues in each case and mesh reinforcement of the posterior inguinal wall in seven patients. All underwent a standardised rehabilitation programme, which was then individualised to be sport-specific. One patient developed a superficial wound infection, which was successfully treated with antibiotics. Of the 15 patients, four complained of transient local numbness which resolved in all cases. All patients (including seven elite athletes) returned to their previous level of participation in sport.

  18. Influence of hip external rotation on hip adductor and rectus femoris myoelectric activity during a dynamic parallel squat.

    PubMed

    Pereira, Glauber Ribeiro; Leporace, Gustavo; Chagas, Daniel das Virgens; Furtado, Luis F L; Praxedes, Jomilto; Batista, Luiz A

    2010-10-01

    This study sought to compare the myoelectric activity of the hip adductors (HAs) and rectus femoris (RF) when the hip was in a neutral position or externally rotated by 30° or 50° (H0, H30, and H50, respectively) during a parallel squat. Ten healthy subjects performed 10 repetitions of squats in each of the 3 hip positions and the myoelectric activities of the HAs and RF were recorded. The signal was then divided into categories representing concentric (C) and eccentric (E) contractions in the following ranges of motion: 0-30° (C1 and E1), 30-60° (C2 and E2), and 60-90° (C3 and E3) of knee flexion. From those signals, an root mean square (RMS) value for each range of motion in each hip position was obtained. All values were normalized to those obtained during maximum voluntary isometric contraction. We found that HAs showed a significant increase in myoelectric activity during C3 and E3 in the H30 and H50 positions, as compared with H0. Meanwhile, RF activity did not significantly differ between hip positions. Both muscles showed higher activation during 60-90° (C3 and E3) of knee flexion, as compared with 0-30° (C1 and E1) and 30-60° (C2 and E2). The results suggest that if the aim is to increase HA activity despite the low percentage of muscle activation, squats should be performed with 30° of external rotation and at least 90° of knee flexion. PMID:20651607

  19. Interrelationships between meat quality traits, texture measurements and physicochemical characteristics of M. rectus abdominis from Charolais heifers.

    PubMed

    Oury, M P; Picard, B; Briand, M; Blanquet, J P; Dumont, R

    2009-10-01

    Ninety-nine Charolais heifers were used to study the variability of meat quality traits in relation to the physicochemical characteristics of M. rectus abdominis. The heifers of the same trade class were slaughtered at 33months of age (±4months) and 381kg carcass weight (±31kg). Muscle and bone development scores were evaluated before slaughter. Carcass weight, slaughter age and life average daily gain were recorded. Shear force measurements and meat quality traits were evaluated after 14days of aging. Some physicochemical characteristics were measured 24h post-slaughter. Tenderness was correlated with slaughter age (r=-0.31), bone development (r=-0.22) and life average daily gain (r=+0.37). Tenderness was significantly related to total collagen content (r=-0.24), lipid content (r=+0.27) and I myosin heavy chain proportion (r=+0.24). Juiciness was positively correlated with lipid content (r=+0.31) and I myosin heavy chain proportion (r=+0.20). Flavor intensity was correlated with lipid content (r=+0.26) and mean fiber area (r=+0.24). Shear force was correlated with total collagen, lipid and 27K proteasome sub-unit contents. Taking animal characteristics and muscle properties together in a multiple regression analysis increased the explained tenderness variability to 33%. The independent variables listed in order of importance were life average daily gain, total collagen content, bone development, lipid content, I myosin heavy chain isoform proportion, shear force of broiled meat and slaughter age. PMID:20416732

  20. Pelvic floor muscle training exercises

    MedlinePlus

    Kegel exercises ... Pelvic floor muscle training exercises are recommended for: Women with urinary stress incontinence Men with urinary stress incontinence after prostate surgery People who have fecal ...

  1. Interaction of Gender and Body Composition on Rectus Femoris Morphology as Measured With Musculoskeletal Ultrasound Imaging

    PubMed Central

    Martinez, Corina; Davis, Ashley; Myers, Heather; Butler, Robert J.

    2014-01-01

    Background: Quadriceps function is an important measure in patients recovering postoperatively. Traditionally, strength measures that require high levels of resistance are contraindicated during the early postoperative phase. Thus it may be helpful to evaluate the utilization of other tools, such as ultrasound imaging, that allow for assessment during a position of low resistance. Hypothesis: The rectus femoris cross-sectional area (CSA) is affected by sex and body composition in healthy subjects. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: Thirty-two healthy subjects (16 women, 16 men), selected from a previously larger study, were chosen for analysis. All subjects underwent a maximal volitional isometric contraction protocol from 0° to 90° of knee motion controlled by an isokinetic dynamometer. In the contracted and resting positions, the rectus femoris CSA was measured at each angle using ultrasound imaging. The contractile index (contracted − resting CSA) was calculated at each position. Subjects were separated into 1 of 4 groups based on sex and fat percentage (low or high). These data were analyzed using mixed-factor analysis of variance (group × angle) for each variable, with a critical α level of 0.05. Results: A significant interaction was noted for the CSA of the rectus femoris at rest (P < 0.03) and during contraction (P < 0.02). For both variables, all groups performed similarly, with the exception of women with high body fat percentage. No statistically significant interaction existed for the contractile index; however, a main effect for angle (P < 0.01) was observed. Conclusion: Rectus femoris CSA appears to depend on sex as well as the body composition of individuals. Clinical Relevance: Traditional subjective assessment measures of quadriceps strength and function have low reliability and functional validity. With the improved feasibility of ultrasound imaging in the clinical setting, quadriceps size may be more

  2. Use of Oral Mucoperiosteal and Pterygo-Masseteric Muscle Flaps as Interposition Material in Surgery of Temporomandibular Joint Ankylosis: A Comparative Study

    PubMed Central

    Anyanechi, CE; Osunde, OD; Bassey, GO

    2015-01-01

    Background: The most common complication of surgery for the release of temporomandibular joint (TMJ) ankylosis is relapse of the ankylosis. To prevent re-ankylosis, a variety of interpositional materials have been used. Aim: The aim was to compare the surgical outcome of oral mucoperiosteal flap, not hitherto used as interpositional material, with pterygo-masseteric muscles flap after surgical release of TMJ ankylosis. Subjects and Methods: This was a prospective randomized study of all consecutive patients treated for the release of complete TMJ bony ankylosis, from January 2003 to December 2012, at the Oral and Maxillofacial unit of our institution. The patients were randomized into two groups: The pterygo-masseteric group comprises 22 patients while the oral mucoperiosteal group had 23 patients. Information on demographics, clinical characteristics, and postoperative complications over a 5 year follow-up period were obtained, and analyzed using the statistical package for social sciences (Statistical Package for the Social Sciences version 13, Chicago, IL, USA). A P < 0.05 was considered significant. Results: The age of the patients ranged from 15 to 28 mean 20.3 (3.35) years while the duration of ankylosis ranged from 2 to 16 mean 5.1 (3.4) years. The baseline demographic (gender; P = 0.92; side; P = 0.58) and clinical characteristics in terms of etiology (P = 0.60) and age (P = 0.52) were comparable in both treatment groups. All the patients presented with complete bony TMJ ankylosis with a preoperative inter-incisal distance of <0.5 cm. The intraoperative mouth opening achieved ranged from 4 cm to 5 cm, mean 4.6 (0.27) cm and this was not different for either group (P = 0.51). The patients were followed up postoperatively for a period ranging from 3 to 5 years, mean 3.4 (0.62) years. The mouth opening decreased, over the period of postoperative review, from the initial range of 4–5 cm to 2.9–3.6 cm, and this was not different in both groups (P = 0

  3. Impact of decline-board squat exercises and knee joint angles on the muscle activity of the lower limbs

    PubMed Central

    Lee, Daehee; Lee, Sangyong; Park, Jungseo

    2015-01-01

    [Purpose] This study aims to investigate how squat exercises on a decline board and how the knee joint angles affect the muscle activity of the lower limbs. [Subjects] The subjects were 26 normal adults. [Methods] A Tumble Forms wedge device was used as the decline board, and the knee joint angles were measured with a goniometer. To examine the muscle activity of the biceps femoris, rectus femoris, gastrocnemius lateralis, and tibialis anterior of the lower limbs, a comparison analysis with electromyography was conducted. [Results] The muscle activity of the biceps femoris, rectus femoris, gastrocnemius lateralis, and tibialis anterior increased with increased knee joint angles, both for squat exercises on the decline board and on a flat floor. When the knee joint angle was 45°, 60°, and 90°, the muscle activity of the rectus femoris was significantly higher and that of the tibialis anterior was significantly lower during squat exercises on the decline board than on the flat floor. When the knee joint angle was 90°, the muscle activity of the gastrocnemius lateralis was significantly lower. [Conclusion] Squat exercises on a decline board are an effective intervention to increase the muscle activity of the rectus femoris with increased knee joint angles. PMID:26357447

  4. Endolymphatic sac surgery versus tenotomy of the stapedius and tensor tympani muscles in the management of patients with unilateral definite Meniere's disease.

    PubMed

    Albu, Silviu; Babighian, Gregorio; Amadori, Maurizio; Trabalzini, Franco

    2015-12-01

    This study aims to compare the outcomes of patients with Meniere's disease submitted to either endolymphatic mastoid shunt (ES) or tenotomy of the stapedius and tensor tympani muscles (TSTM). This is a retrospective chart review of patients treated with ES or TSTM between 2000 and 2010 and followed up for at least 12 months. The main outcomes were represented by: (1) vertigo class, hearing stage and functional level according to the American Academy of Otolaryngology-Head and Neck Surgery criteria; (2) adjustment of dizziness handicap inventory (DHI) and (3) complete and substantial vertigo control using the Kaplan-Meier survival method. Sixty-three patients met the inclusion criteria: 34 underwent ES and 29 TSTM. The baseline demographic characteristics, the hearing stage, the functional level, the DHI and hearing levels were not different between the two groups. No significant difference in vertigo class was demonstrated: 66 % of TSTM patients attained class A compared to 44 % in the ES group (p = 0.14). Kaplan-Meier survival curves specific to class A showed significant differences, favoring TSTM (log-rank test, p = 0.022). TSTM patients demonstrated significantly improved functional level (p = 0.0004) and improved DHI scores (p = 0.001). Eight ES patients (25 %) demanded a second surgical attempt compared to none in the TSTM. Aural fullness was significantly improved in TSTM group (p = 0.01), while the difference in tinnitus improvement was non-significant. Hearing preservation was significantly better in TSTM group (p = 0.001). TSTM is a safe surgical procedure, with significant vertigo control rates, and important hearing preservation rates. More patients and longer follow-up are needed to support our preliminary findings.

  5. Changes in Extraocular Muscle Volume During Ocular Duction

    PubMed Central

    Clark, Robert A.; Demer, Joseph L.

    2016-01-01

    Purpose It has been tacitly assumed that overall extraocular muscle (EOM) volume is conserved during contraction and relaxation, yet this assumption has been untested up to now. We used high-resolution magnetic resonance imaging (MRI) to determine if total EOM volume changes during relaxation and contraction. Methods Surface coil MRI in quasi-coronal planes was obtained in target-controlled, maximal secondary gaze positions in 30 orbits of 15 normal subjects at 312-μm resolution. Ductions were quantified by changes in globe-optic nerve positions. Cross-sections of EOM were manually outlined in contiguous image planes so that volumes could be calculated by multiplying summed cross sections by the 2-mm slice thickness. Three-dimensional reconstruction allowed measurement of the lengths of terminal, unresolvable EOM segments, providing estimates of terminal EOM volumes to be summed with measured midorbital volumes to obtain total EOM volumes. Results Duction range averaged 44.3 ± 4.8° from relaxation to contraction. There was a significant increase in total volume in each rectus EOM from relaxation to contraction: superior rectus (SR) 92 ± 36 mm3 (+18%, P < 10−11); inferior rectus (IR) 51 ± 18 mm3 (+9%, P < 10−11); medial rectus (MR) 78 ± 36 mm3 (+11%, P < 10−5); and lateral rectus (LR) 47 ± 45 mm3 (+7%, P = 0.005). Because volume changes for SR and MR exceed IR and LR, total rectus EOM volume increases in supraduction 41 ± 42 mm3 (+3.7%) and adduction 32 ± 63 mm3 (+2.3%). Conclusions Total EOM volume is not conserved but instead increases with contraction and decreased with relaxation. Contractile volume increases may be secondary to increased actin-myosin lattice spacing, so that density decreases. This effect is opposite that of possible hemodynamic changes. PMID:26968741

  6. An investigation of the application of laser-assisted indocyanine green fluorescent dye angiography in pedicle transverse rectus abdominus myocutaneous breast reconstruction

    PubMed Central

    Newman, Martin I; Samson, Michel C; Tamburrino, Joseph F; Swartz, Kimberly A; Brunworth, Louis

    2011-01-01

    BACKGROUND: Pedicle transverse rectus abdominus myocutaneous (pTRAM) flaps remain the most common method of autologous tissue breast reconstruction. Using pTRAM flaps, complications often arise postoperatively, secondary to inadequate circulation. Tissues from distant angiosomes are associated with poorer perfusion, but this differs among patients. Many modalities have been used to reduce the risk of complications, but none have achieved widespread application. The authors believe that laser-assisted indocyanine green fluorescent dye angiography (LA-ICGA) can potentially reduce the risk of complications. METHODS: In two routine, single-pedicle, ipsilateral pTRAM flaps, LA-ICGA imaging was performed following the division of the distal rectus muscle and deep inferior epigastric pedicle. The resulting images were used to guide design of the flap and debridement. RESULTS: In case 1, good perfusion was observed in zone 1 and part of zone 2. In case 2, good perfusion was observed in zone 1 and 50% of zone 3, with little perfusion in zone 2. In both cases, tissues with poor perfusion were debrided before transfer and inset. In both patients, there were no issues with wound healing, tissue necrosis or fat necrosis. CONCLUSIONS: The variability of perfusion of the pTRAM flap among individuals is well appreciated. LA-ICGA helped to determine the limits of good perfusion and, therefore, the limits of tissue to be preserved for transfer and inset. This helped to avoid harvesting poorly perfused tissue that would have almost certainly experienced necrosis and, ultimately, would have reduced the risk of postoperative complications. PMID:22379372

  7. Long-Term Outcome of Medial Rectus Recession and Pulley Posterior Fixation in Esotropia With High AC/A Ratio

    PubMed Central

    Wabulembo, Geoffrey; Demer, Joseph L.

    2014-01-01

    Purpose: Medial rectus (MR) recession with pulley posterior fixation (PF) can be used to treatesotropia (ET) with a high accommodative convergence to accommodation (AC/A) ratio as effectively in the short term as MR recession with scleral PF. This study provides a novel examination of the long-term results of MR recession with pulley PF (PPF). Methods: In 21 children we performed bilateral MR recession and pulley PF for ET greater at near than distance (high AC/A). Mean follow-up was 3.5 ± 2.5 (standard deviation [SD]) years. Results: Mean age at presentation was 2.7 ± 1.8 and at surgery 4.3 ± 1.6 years. Fourteen (67%) children had amblyopia. Distance and near pre-operative ET averaged 19.6Δ ± 10.5Δ and 36.9Δ ± 18.9Δ, respectively. Mean near-distance (N-D) disparity was 16.4Δ ± 12.3Δ. The MR recession averaged 4.4 ± 0.9 mm. Early mean postoperative ET was 1.3 ± 3.3Δ at distance and 2.8Δ ± 5.2Δ at near. Mean late postoperative ET was 0.1Δ ± 5.8Δ and 1.0Δ ± 6.2Δ at distance and near, respectively. At the final postoperative examination, mean N-D disparity was reduced to 0.9Δ ± 3.6Δ. Discussion: MR recession with PPF has a high long-term effectiveness, even in patients with amblyopia and autism. Since no posterior scleral suturing is required, it minimizes the perforation risk associated with scleral PF. Conclusion: MR recession with PPF is a safe and highly effective long-term treatment for ET with high AC/A ratio. Long-term results may surpass those of alternate procedures. PMID:22906381

  8. Discomfort and muscle activation during car egress in drivers with hemiplegia following stroke

    PubMed Central

    Jung, Nam-hae; Kim, Hwanhee; Chang, Moonyoung

    2015-01-01

    [Purpose] This study investigated and compared the discomfort experienced during car egress with the car door opened at different angles and muscle activation in drivers with hemiplegia following stroke and non-disabled drivers. [Subjects and Methods] The participants were five drivers with hemiplegia and five non-disabled drivers. The discomfort experienced during car egress was measured using the nine-point Likert scale when the door was opened wide and when it was opened 45°. Muscle activation was measured using the TeleMyo 2400T G2 electromyography system. Electromyograph electrodes were placed on the erector spinae, rectus abdominis, and rectus femoris muscles. [Results] In the non-disabled drivers, there was no significant difference in the discomforts they experienced during car egress when the door was opened wide and when it was opened 45°. However, the discomfort experienced by drivers with hemiplegia when the door was opened 45° was significantly higher than that experienced when it was opened wide. There was a significant difference in the activation of the erector spinae, but no difference in the activation of the rectus abdominis or rectus femoris muscles. [Conclusion] This study will help to understand the difficulties experienced by drivers with hemiplegia following stroke during car ingress and egress. PMID:26834350

  9. Discomfort and muscle activation during car egress in drivers with hemiplegia following stroke.

    PubMed

    Jung, Nam-Hae; Kim, Hwanhee; Chang, Moonyoung

    2015-12-01

    [Purpose] This study investigated and compared the discomfort experienced during car egress with the car door opened at different angles and muscle activation in drivers with hemiplegia following stroke and non-disabled drivers. [Subjects and Methods] The participants were five drivers with hemiplegia and five non-disabled drivers. The discomfort experienced during car egress was measured using the nine-point Likert scale when the door was opened wide and when it was opened 45°. Muscle activation was measured using the TeleMyo 2400T G2 electromyography system. Electromyograph electrodes were placed on the erector spinae, rectus abdominis, and rectus femoris muscles. [Results] In the non-disabled drivers, there was no significant difference in the discomforts they experienced during car egress when the door was opened wide and when it was opened 45°. However, the discomfort experienced by drivers with hemiplegia when the door was opened 45° was significantly higher than that experienced when it was opened wide. There was a significant difference in the activation of the erector spinae, but no difference in the activation of the rectus abdominis or rectus femoris muscles. [Conclusion] This study will help to understand the difficulties experienced by drivers with hemiplegia following stroke during car ingress and egress.

  10. Effects of a multichannel dynamic functional electrical stimulation system on hemiplegic gait and muscle forces.

    PubMed

    Qian, Jing-Guang; Rong, Ke; Qian, Zhenyun; Wen, Chen; Zhang, Songning

    2015-11-01

    [Purpose] The purpose of the study was to design and implement a multichannel dynamic functional electrical stimulation system and investigate acute effects of functional electrical stimulation of the tibialis anterior and rectus femoris on ankle and knee sagittal-plane kinematics and related muscle forces of hemiplegic gait. [Subjects and Methods] A multichannel dynamic electrical stimulation system was developed with 8-channel low frequency current generators. Eight male hemiplegic patients were trained for 4 weeks with electric stimulation of the tibia anterior and rectus femoris muscles during walking, which was coupled with active contraction. Kinematic data were collected, and muscle forces of the tibialis anterior and rectus femoris of the affected limbs were analyzed using a musculoskelatal modeling approach before and after training. A paired sample t-test was used to detect the differences between before and after training. [Results] The step length of the affected limb significantly increased after the stimulation was applied. The maximum dorsiflexion angle and maximum knee flexion angle of the affected limb were both increased significantly during stimulation. The maximum muscle forces of both the tibia anterior and rectus femoris increased significantly during stimulation compared with before functional electrical stimulation was applied. [Conclusion] This study established a functional electrical stimulation strategy based on hemiplegic gait analysis and musculoskeletal modeling. The multichannel functional electrical stimulation system successfully corrected foot drop and altered circumduction hemiplegic gait pattern.

  11. Robotic surgery

    MedlinePlus

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... Robotic surgery is similar to laparoscopic surgery. It can be performed through smaller cuts than open surgery. ...

  12. Effects of bridge exercise on trunk core muscle activity with respect to sling height and hip joint abduction and adduction.

    PubMed

    Lee, Daehee; Park, Jungseo; Lee, Sangyong

    2015-06-01

    [Purpose] This study evaluated the effects of bridge exercise on trunk core muscle activity with respect to sling height and hip joint abduction and adduction. [Subjects] Fifteen healthy adult males participated. [Methods] In the bridge exercise, the height of the sling was set low or high during hip joint abduction and adduction. Electromyography was used to compare the differences between the muscle activities of the transverse abdominis, rectus abdominis, and erector spinae muscles. [Results] The muscle activities of the transverse abdominis, rectus abdominis, and erector spinae were significantly higher in the high sling position. Furthermore, the activities of the transverse abdominis and erector spinae were significantly higher during hip joint adduction than abduction regardless of sling height. [Conclusion] A high sling height is the most effective intervention for increasing the muscle activities of the transverse abdominis and erector spinae muscles during hip joint adduction in a bridge exercise. PMID:26180366

  13. An analysis on muscle tone of lower limb muscles on flexible flat foot.

    PubMed

    Um, Gi-Mai; Wang, Joong-San; Park, Si-Eun

    2015-10-01

    [Purpose] The aim of this study was to examine differences in the muscle tone and stiffness of leg muscles according to types of flexible flat foot. [Subjects and Methods] For 30 subjects 10 in a normal foot group (NFG), 10 in group with both flexible flat feet (BFFG), and 10 in a group with flexible flat feet on one side (OFFG), myotonometry was used to measure the muscle tone and stiffness of the tibialis anterior muscle (TA), the rectus femoris muscle (RF), the medial gastrocnemius (MG), and the long head of the biceps femoris muscle (BF) of both lower extremities. [Results] In the measurement results, only the stiffness of TA and MG of the NFG and the BFFG showed significant differences. The muscle tone and stiffness were highest in the BFFG, followed by the OFFG and NFG, although the difference was insignificant. In the case of the OFFG, there was no significant difference in muscle tone and stiffness compared to that in the NGF and the BFFG. Furthermore, in the NFG, the non-dominant leg showed greater muscle tone and stiffness than the dominant leg, although the difference was insignificant. [Conclusion] During the relax condition, the flexible flat foot generally showed a greater muscle tone and stiffness of both lower extremities compared to the normal foot. The stiffness was particularly higher in the TA and MG muscles. Therefore, the muscle tone and stiffness of the lower extremity muscles must be considered in the treatment of flat foot.

  14. Actions of Two Bi-Articular Muscles of the Lower Extremity: A Review

    PubMed Central

    Landin, Dennis; Thompson, Melissa; Reid, Meghan

    2016-01-01

    The extremities of the human body contain several bi-articular muscles. The actions produced by muscles at the joints they cross are greatly influenced by joint moment arms and muscle length. These factors are dynamic and subject to change as joint angles are altered. Therefore, to more completely understand the actions of such muscles, the angles of both joints must be manipulated. This report reviews investigations, which have explored the actions of two bi-articular muscles of the lower extremities (gastrocnemius and rectus femoris) as the joints they cross are moved into various combinations of angles. The findings have both clinical and physical performance ramifications. PMID:27298656

  15. Localization of motoneurons innervating individual abdominal muscles of the cat

    NASA Technical Reports Server (NTRS)

    Miller, Alan D.

    1987-01-01

    The paper presents the results of a systematic investigation of the innervation of the cat's individual abdominal muscles. The segmental distribution of the different motor pools was determined by using electrical microstimulation of the ventral horn to produce visible localized muscle twitches and by retrograde transport of horseradish peroxidase injected into individual muscles. The segmental distribution of each motor pool was as follows: rectus abdominis, T4-L3; external oblique, T6-L3; transverse abdominis, T9-L3; and internal oblique, T13-L3.

  16. Does the rectus femoris nerve block improve knee recurvatum in adult stroke patients? A kinematic and electromyographic study.

    PubMed

    Gross, R; Delporte, L; Arsenault, L; Revol, P; Lefevre, M; Clevenot, D; Boisson, D; Mertens, P; Rossetti, Y; Luauté, J

    2014-02-01

    Knee recurvatum (KR) during gait is common in hemiplegic patients. Quadriceps spasticity has been postulated as a cause of KR in this population. The aim of this study was to assess the role of rectus femoris spasticity in KR by using selective motor nerve blocks of the rectus femoris nerve in hemiparetic stroke patients. The data from six adult, post-stroke hemiplegic patients who underwent a rectus femoris nerve block for a stiff-knee gait were retrospectively analyzed. An extensive clinical and functional evaluation was performed and gait was assessed by motion analysis (kinematic, kinetic and electromyographic parameters) before and during the block realized using 2% lidocaine injected under a neurostimulation and ultrasonographic targeting procedure. The main outcome measures were the peak knee extension in stance and peak knee extensor moment obtained during gait analysis. No serious adverse effect of the nerve block was observed. The block allowed a reduction of rectus femoris overactivity in all patients. Peak knee extension and extensor moment in stance did not improve in any patient, but peak knee flexion during the swing phase was significantly higher after block (mean: 31.2° post, 26.4 pre, p < 0.05). Our results provide arguments against the hypothesis that the spasticity of the rectus femoris contributes to KR. PMID:24286615

  17. Scrub Typhus Presenting with Bilateral Lateral Rectus Palsy in A Female

    PubMed Central

    Mishra, Jaya; Barman, Bhupen; Mondal, Sumantro; Sivam, Rondeep Kumar Nath

    2016-01-01

    Scrub typhus, a rickettsial disease is endemic in several parts of India usually presenting with acute symptoms. Fever, maculopapular rash, eschar, history of tick exposure and supportive diagnostic tests usually leads to diagnosis. Scrub typhus should be included in the differential diagnosis in occasions when a patient presents with fever with or without eschar and isolated cranial nerve palsy. Here we are reporting a case of Scrub typhus who presented with fever and altered sensorium of short duration, eschar formation and bilateral lateral rectus palsy. Patient was treated with doxycycline with complete reversal of neurodeficit. PMID:27190871

  18. The muscle activation patterns of lower limb during stair climbing at different backpack load.

    PubMed

    Yali, Han; Aiguo, Song; Haitao, Gao; Songqing, Zhu

    2015-01-01

    Stair climbing under backpack load condition is a challenging task. Understanding muscle activation patterns of lower limb during stair climbing with load furthers our understanding of the factors involved in joint pathology and the effects of treatment. At the same time, stair climbing under backpack load requires adjustments of muscle activations and increases joint moment compared to level walking, which with muscle activation patterns are altered as a result of using an assistive technology, such as a wearable exoskeleton leg for human walking power augmentation. Therefore, the aim of this study was to analyze lower limb muscles during stair climbing under different backpack load. Nine healthy volunteers ascended a four-step staircase at different backpack load (0 kg, 10 kg, 20 kg, 30 kg). Electromyographic (EMG) signals were recorded from four lower limb muscles (gastrocnemius, tibialis anterior, hamstring, rectus femoris). The results showed that muscle activation amplitudes of lower limb increase with increasing load during stair climbing, the maximum RMS of gastrocnemius are greater than tibialis anterior, hamstring and rectus femoris whether stair climbing or level walking under the same load condition. However, the maximum RMS of hamstring are smaller than gastrocnemius, tibialis anterior and rectus femoris. The study of muscle activation under different backpack load during stair climbing can be used to design biomechanism and explore intelligent control based on EMG for a wearable exoskeleton leg for human walking power augmentation. PMID:26899302

  19. The comparison of abdominal muscle activation on unstable surface according to the different trunk stability exercises

    PubMed Central

    Lee, Jung-seok; Kim, Da-yeon; Kim, Tae-ho

    2016-01-01

    [Purpose] This study aimed to determine the effect of abdominal muscle activities and the activation ratio related to trunk stabilization to compare the effects between the abdominal drawing-in maneuver and lumbar stabilization exercises on an unstable base of support. [Subjects and Methods] Study subjects were 20 male and 10 female adults in their 20s without lumbar pain, who were equally and randomly assigned to either the abdominal drawing-in maneuver group and the lumbar stabilization exercise group. Abdominal muscle activation and ratio was measured using a wireless TeleMyo DTS during right leg raise exercises while sitting on a Swiss ball. [Results] Differences in rectus abdominis, external oblique abdominis, and internal oblique abdominis muscle activation were observed before and after treatment. Significant differences were observed between the groups in the muscle activation of the external oblique abdominis and internal oblique abdominis, and the muscle activation ratio of external oblique abdominis/rectus abdominis and internal oblique abdominis/rectus abdominis. [Conclusion] Consequently trunk stability exercise enhances internal oblique abdominis activity and increases trunk stabilization. In addition, the abdominal drawing-in maneuver facilitates the deep muscle more than LSE in abdominal muscle. Therefore, abdominal drawing-in maneuver is more effective than lumbar stabilization exercises in facilitating trunk stabilization. PMID:27134401

  20. Optimizing Muscle Parameters in Musculoskeletal Modeling Using Monte Carlo Simulations

    NASA Technical Reports Server (NTRS)

    Hanson, Andrea; Reed, Erik; Cavanagh, Peter

    2011-01-01

    Astronauts assigned to long-duration missions experience bone and muscle atrophy in the lower limbs. The use of musculoskeletal simulation software has become a useful tool for modeling joint and muscle forces during human activity in reduced gravity as access to direct experimentation is limited. Knowledge of muscle and joint loads can better inform the design of exercise protocols and exercise countermeasure equipment. In this study, the LifeModeler(TM) (San Clemente, CA) biomechanics simulation software was used to model a squat exercise. The initial model using default parameters yielded physiologically reasonable hip-joint forces. However, no activation was predicted in some large muscles such as rectus femoris, which have been shown to be active in 1-g performance of the activity. Parametric testing was conducted using Monte Carlo methods and combinatorial reduction to find a muscle parameter set that more closely matched physiologically observed activation patterns during the squat exercise. Peak hip joint force using the default parameters was 2.96 times body weight (BW) and increased to 3.21 BW in an optimized, feature-selected test case. The rectus femoris was predicted to peak at 60.1% activation following muscle recruitment optimization, compared to 19.2% activation with default parameters. These results indicate the critical role that muscle parameters play in joint force estimation and the need for exploration of the solution space to achieve physiologically realistic muscle activation.

  1. The muscles of the infrapubic abdominal wall of a 6-month-old Crocodylus niloticus (Reptilia: Crocodylia).

    PubMed

    Fechner, R; Schwarz-Wings, D

    2013-06-01

    The muscles of the infrapubic abdominal wall of crocodilians play an important role in their ventilatory mechanism. Yet the anatomy and homology of these muscles is poorly understood. To gain new insights into the anatomy of the crocodilian infrapubic abdominal wall, we dissected a specimen of Crocodylus niloticus. Origin and insertion of the muscles, as well as their arrangement relative to each other was examined in great detail. The findings were compared with those of other crocodilian taxa to detect potential variability of the muscles of interest. The homology of the muscles was studied by comparing the muscles of the crocodilian infrapubic abdominal wall with those of other diapsids. In Crocodylus niloticus, the infrapubic abdominal wall consists of four muscles: Musculus truncocaudalis, M. ischiotruncus, and Mm. rectus abdominis externus and internus. The arrangement of the muscles of the infrapubic abdominal wall of Crocodylus niloticus is consistent with that found in most other crocodilian taxa. In some crocodilian taxa, an additional muscle, M. ischiopubis, is found. In the remaining diapsids, only M. rectus abdominis is present. The crocodilian M. truncocaudalis, M. ischiotruncus and, if present, M. ischiopubis appear to be derivates of M. rectus abdominis; the development of those might be related to the evolution of the unique crocodilian ventilatory mechanism.

  2. Comparative analysis of trunk muscle activities in climbing of during upright climbing at different inclination angles

    PubMed Central

    Park, Byung-Joon; Kim, Joong-Hwi; Kim, Jang-Hwan; Choi, Byeong-Ho

    2015-01-01

    [Purpose] This study was performed to provide evidence for the therapeutic exercise approach through a compative analysis of muscle activities according to climbing wall inclination. [Subjects and Methods] Twentyfour healthy adult subjects without climbing experience performed static exercises at a therapeutic climbing at with various inclination angles (0°, 10°, 20°), and the activities of the trunk muscles (rectus abdominis, obliquus externus abdominis, obliquus internus abdominis, erector spinae) were measured using surface electromyography (EMG) for 7 seconds. [Results] Significant differences were found between the inclination angles of 10° and 0°, as well as 20° in the rectus abdominis, obliquus internus abdominis, right obliquus externus abdominis, and right erector spinae. [Conclusion] Based on measurements of trunk muscle activity in a static climbing standing position at different angles, significant changes in muscle activity appear to be induced at 10 degrees. Therefore, the results appear to provide clinically relevant evidence. PMID:26644661

  3. Leg muscle activation and distance setting of the leg cycle ergometer for use by the elderly.

    PubMed

    Kim, Seon-Chill; Lee, Sang-Yeol; Lee, Young-Ik

    2014-10-01

    [Purpose] This study verified the leg muscle activities of elderly subjects performing leg cycle ergometer exercise. [Subjects] Forty-one elderly persons were the subjects of this study. [Methods] For the three distances corresponding to knee flexion angles of 15, 45, and 70, the muscle activities of the rectus femoris, biceps femoris, tibialis anterior and lateral gastrocnemius were measured while the subjects exercised on a cycle ergometer. [Results] The rectus femoris and biceps femoris showed statistically significant increases as the distance between the cycle ergometer and the body increased, and the lateral gastrocnemius muscle activation showed a statistically significant increase as the distance from the body to the cycle ergometer decreased. [Conclusion] When the elderly have limb muscle weakness, leg cycle ergometer distances should be adjusted.

  4. Muscle Activation during Push-Ups with Different Suspension Training Systems

    PubMed Central

    Calatayud, Joaquin; Borreani, Sebastien; Colado, Juan C.; Martín, Fernando F; Rogers, Michael E.; Behm, David G.; Andersen, Lars L.

    2014-01-01

    The purpose of this study was to analyze upper extremity and core muscle activation when performing push-ups with different suspension devices. Young fit male university students (n = 29) performed 3 push-ups each with 4 different suspension systems. Push-up speed was controlled using a metronome and testing order was randomized. Average amplitude of the electromyographic root mean square of Triceps Brachii, Upper Trapezius, Anterior Deltoid, Clavicular Pectoralis, Rectus Abdominis, Rectus Femoris, and Lumbar Erector Spinae was recorded. Electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC). Electromyographic data were analyzed with repeated-measures analysis of variance with a Bonferroni post hoc. Based upon global arithmetic mean of all muscles analyzed, the suspended push-up with a pulley system provided the greatest activity (37.76% of MVIC; p < 0.001). Individually, the suspended push-up with a pulley system also provided the greatest triceps brachii, upper trapezius, rectus femoris and erector lumbar spinae muscle activation. In contrast, more stable conditions seem more appropriate for pectoralis major and anterior deltoid muscles. Independent of the type of design, all suspension systems were especially effective training tools for reaching high levels of rectus abdominis activation. Key Points Compared with standard push-ups on the floor, suspended push-ups increase core muscle activation. A one-anchor system with a pulley is the best option to increase TRICEP, TRAPS, LUMB and FEM muscle activity. More stable conditions such as the standard push-up or a parallel band system provide greater increases in DELT and PEC muscle activation. A suspended push-up is an effective method to achieve high muscle activity levels in the ABS. PMID:25177174

  5. Cosmetic Surgery

    MedlinePlus

    ... Body Looking and feeling your best Cosmetic surgery Cosmetic surgery Teens might have cosmetic surgery for a ... about my body? What are the risks of cosmetic surgery? top People who have cosmetic surgery face ...

  6. Spontaneous rectus sheath haematoma in a deceased donor renal transplant recipient: a rare complication.

    PubMed

    Sreenivas, Jayaram; Karthikeyan, Vilvapathy Senguttuvan; SampathKumar, Nathee; Umesha, Lingaraju

    2016-01-01

    Rectus sheath haematoma (RSH) is rarely thought of as a cause of abdominal pain in renal transplant recipients. A 36-year-old woman, a post-deceased donor renal allograft transplant recipient for chronic interstitial nephritis, on triple drug immunosuppression (tacrolimus, mycophenolate mofetil and prednisolone) with basiliximab induction, developed acute vascular rejection and acute tubular injury with suspected antibody-mediated rejection. While on plasmapheresis and haemodialysis for delayed graft function, she developed acute left lower abdominal pain on the 16th postoperative day with tender swelling in the left paraumbilical region. CT of the abdomen showed a large haematoma in the left rectus sheath with no extension. The patient underwent haematoma evacuation through a left paramedian incision and had an uneventful recovery. Serum creatinine stabilised at 0.8 mg/dL and she is on regular follow-up with excellent graft function at 6 months. Diagnosis requires a high index of suspicion, and prompt treatment prevents morbidity and can expedite patient recovery. PMID:26847807

  7. Reconstruction of full-thickness chest wall defects using rectus abdominis musculocutaneous flap: A report of fifteen cases

    SciTech Connect

    Miyamoto, Y.; Hattori, T.; Niimoto, M.; Toge, T. )

    1986-02-01

    In 15 patients chest walls were excised because of recurrent breast cancer, radiation ulcer, or rib tumor. In most cases the full-thickness defect of the chest wall was about 10 x 10 cm. Reconstruction was performed using only a rectus abdominis musculocutaneous flap. No patient developed circulation problems in the flap or severe flail chest, and we had successful results in all our cases. These results show that the rectus abdominis musculocutaneous flap is quite effective and safe to use in the reconstruction of chest wall defects.

  8. Your Muscles

    MedlinePlus

    ... Homework? Here's Help White House Lunch Recipes Your Muscles KidsHealth > For Kids > Your Muscles Print A A ... and skeletal (say: SKEL-uh-tul) muscle. Smooth Muscles Smooth muscles — sometimes also called involuntary muscles — are ...

  9. 'Serious thigh muscle strains': beware the intramuscular tendon which plays an important role in difficult hamstring and quadriceps muscle strains.

    PubMed

    Brukner, Peter; Connell, David

    2016-02-01

    Why do some hamstring and quadriceps strains take much longer to repair than others? Which injuries are more prone to recurrence? Intramuscular tendon injuries have received little attention as an element in 'muscle strain'. In thigh muscles, such as rectus femoris and biceps femoris, the attached tendon extends for a significant distance within the muscle belly. While the pathology of most muscle injures occurs at a musculotendinous junction, at first glance the athlete appears to report pain within a muscle belly. In addition to the musculotendinous injury being a site of pathology, the intramuscular tendon itself is occasionally injured. These injuries have a variety of appearances on MRIs. There is some evidence that these injuries require a prolonged rehabilitation time and may have higher recurrence rates. Therefore, it is important to recognise the tendon component of a thigh 'muscle strain'.

  10. Endoscopic Extra-articular Surgical Removal of Heterotopic Ossification of the Rectus Femoris Tendon in a Series of Athletes

    PubMed Central

    Comba, Fernando; Piuzzi, Nicolás S.; Oñativia, José Ignacio; Zanotti, Gerardo; Buttaro, Martín; Piccaluga, Francisco

    2016-01-01

    Background: Calcific deposits in tendon, muscles, and periarticular areas are very common. Heterotopic ossification of the rectus femoris (HORF) is a rare condition, and several theories exist regarding the etiopathogenesis, which appears to be multifactorial with traumatic, genetic, and local metabolic factors involved. Although HORF typically responds to nonoperative treatment, when this approach fails, endoscopic treatment is a minimally invasive technique to address the pathology. Purpose: To report the clinical and radiological outcomes of 9 athletes with HORF who underwent endoscopic resection. Study Design: Case series; Level of evidence, 4. Methods: Nine male athletes were treated with endoscopic extra-articular resection of HORF after failure of a 6-month course of nonoperative treatment. All patients were studied with radiographs, computed tomography, and magnetic resonance imaging. Outcomes were assessed clinically using the modified Harris Hip Score (mHHS), a visual analog scale for sport activity–related pain (VAS-SRP), patient satisfaction, and ability and time to return to the preoperative sport level. Radiographic assessment was performed to determine recurrence. Results: The mean age of the patients was 32 years (range, 23-47 years). Mean follow-up was 44 months (range, 14-73 months). All patients had improved mHHS scores from a mean preoperative of 65.6 (SD, 8.2) to 93.9 (SD, 3.6). Pain decreased from a mean 8.2 preoperatively (SD, 0.9) to 0.4 (SD, 0.7) at last follow-up. There were no complications, and all patients were able to return to their previous sports at the same level except for 1 recreational athlete. There was only 1 radiological recurrence at last follow-up in an asymptomatic patient. Conclusion: To our knowledge, this is the largest case series of athletes with HORF treated with endoscopic resection. We found this extra-articular endoscopic technique to be safe and effective, showing clinical outcome improvement and 90% chance of

  11. Endoscopic Extra-articular Surgical Removal of Heterotopic Ossification of the Rectus Femoris Tendon in a Series of Athletes

    PubMed Central

    Comba, Fernando; Piuzzi, Nicolás S.; Oñativia, José Ignacio; Zanotti, Gerardo; Buttaro, Martín; Piccaluga, Francisco

    2016-01-01

    Background: Calcific deposits in tendon, muscles, and periarticular areas are very common. Heterotopic ossification of the rectus femoris (HORF) is a rare condition, and several theories exist regarding the etiopathogenesis, which appears to be multifactorial with traumatic, genetic, and local metabolic factors involved. Although HORF typically responds to nonoperative treatment, when this approach fails, endoscopic treatment is a minimally invasive technique to address the pathology. Purpose: To report the clinical and radiological outcomes of 9 athletes with HORF who underwent endoscopic resection. Study Design: Case series; Level of evidence, 4. Methods: Nine male athletes were treated with endoscopic extra-articular resection of HORF after failure of a 6-month course of nonoperative treatment. All patients were studied with radiographs, computed tomography, and magnetic resonance imaging. Outcomes were assessed clinically using the modified Harris Hip Score (mHHS), a visual analog scale for sport activity–related pain (VAS-SRP), patient satisfaction, and ability and time to return to the preoperative sport level. Radiographic assessment was performed to determine recurrence. Results: The mean age of the patients was 32 years (range, 23-47 years). Mean follow-up was 44 months (range, 14-73 months). All patients had improved mHHS scores from a mean preoperative of 65.6 (SD, 8.2) to 93.9 (SD, 3.6). Pain decreased from a mean 8.2 preoperatively (SD, 0.9) to 0.4 (SD, 0.7) at last follow-up. There were no complications, and all patients were able to return to their previous sports at the same level except for 1 recreational athlete. There was only 1 radiological recurrence at last follow-up in an asymptomatic patient. Conclusion: To our knowledge, this is the largest case series of athletes with HORF treated with endoscopic resection. We found this extra-articular endoscopic technique to be safe and effective, showing clinical outcome improvement and 90% chance of

  12. Ontogenetic changes of trunk muscle structure in the Japanese black salamander (Hynobius nigrescens).

    PubMed

    Omura, Ayano; Anzai, Wataru; Koyabu, Daisuke; Endo, Hideki

    2015-08-01

    We investigated ontogenetic changes in the trunk muscles of the Japanese black salamander (Hynobius nigrescens) before, during and after metamorphosis. Given that amphibians change their locomotive patterns with metamorphosis, we hypothesized that they may also change the structure of their trunk muscles. The trunk muscles were macroscopically observed, and the weight ratios of each trunk muscle group were quantified at six different developmental stages. Immediately after hatching, we found that the lateral hypaxial muscle was composed of one thick M. ventralis, from ventral edge of which M. transversus abdominis arose later, followed by M. obliquus externus and M. rectus abdominis. The weight ratios of the dorsal and abdominal muscles to the trunk muscles increased with growth. We suggest that a single thick and large lateral hypaxial muscle facilitates swimming during early developmental stages. The increase in the weight ratios of the dorsal and abdominal muscles with growth possibly assists with gravity resistance necessary for terrestrial life.

  13. Ontogenetic changes of trunk muscle structure in the Japanese black salamander (Hynobius nigrescens)

    PubMed Central

    OMURA, Ayano; ANZAI, Wataru; KOYABU, Daisuke; ENDO, Hideki

    2015-01-01

    We investigated ontogenetic changes in the trunk muscles of the Japanese black salamander (Hynobius nigrescens) before, during and after metamorphosis. Given that amphibians change their locomotive patterns with metamorphosis, we hypothesized that they may also change the structure of their trunk muscles. The trunk muscles were macroscopically observed, and the weight ratios of each trunk muscle group were quantified at six different developmental stages. Immediately after hatching, we found that the lateral hypaxial muscle was composed of one thick M. ventralis, from ventral edge of which M. transversus abdominis arose later, followed by M. obliquus externus and M. rectus abdominis. The weight ratios of the dorsal and abdominal muscles to the trunk muscles increased with growth. We suggest that a single thick and large lateral hypaxial muscle facilitates swimming during early developmental stages. The increase in the weight ratios of the dorsal and abdominal muscles with growth possibly assists with gravity resistance necessary for terrestrial life. PMID:25816856

  14. The JACS prospective cohort study of newly diagnosed women with breast cancer investigating joint and muscle pain, aches, and stiffness: pain and quality of life after primary surgery and before adjuvant treatment

    PubMed Central

    2014-01-01

    Background Breast cancer affects one in eight UK women during their lifetime: many of these women now receive adjuvant chemotherapy and hormone therapy. Joint and muscle pains, aches, and stiffness are common but the natural history, aetiology and impact of these symptoms are unknown. A cohort study of newly diagnosed women with primary breast cancer was established to explore this. In this paper we present study methods and sample characteristics, describe participants’ experience of musculoskeletal pain at baseline interview, and explore its impact on quality of life. Methods Women with non-metastatic breast cancer were recruited following primary surgery into a multi-centre cohort study. They received questionnaires by post five times (baseline, 3, 6 , 9 and 12 months) to investigate prevalence, severity, location and correlates of musculoskeletal pain, and impact on quality-of-life. Pain was measured by the Nordic musculoskeletal questionnaire, the Brief Pain Inventory, and MSK-specific questions, and quality of life by the SF-36 and FACIT scales. Results 543 women (mean age 57 years, range 28–87, 64% postmenopausal) were recruited following surgery for primary breast cancer from breast cancer clinics in eight hospitals. Fifteen per cent of the eligible cohort was missed; 28% declined to participate. Joint or muscle aches, pains or stiffness were reported by 69% women with 28% specifically reporting joint pain/aches/stiffness. Quality of life, as measured by the FACT-B and adjusted for age, depression, surgery and analgesic use, is significantly worse in all domains in those with musculoskeletal problems than those without. Conclusions Our findings highlights the importance of a better understanding of these symptoms and their impact on the lives of women with primary breast cancer so that healthcare professionals are better equipped to support patients and to provide accurate information to inform treatment decisions. Further papers from this study will

  15. Sensitivity of subject-specific models to Hill muscle-tendon model parameters in simulations of gait.

    PubMed

    Carbone, V; van der Krogt, M M; Koopman, H F J M; Verdonschot, N

    2016-06-14

    Subject-specific musculoskeletal (MS) models of the lower extremity are essential for applications such as predicting the effects of orthopedic surgery. We performed an extensive sensitivity analysis to assess the effects of potential errors in Hill muscle-tendon (MT) model parameters for each of the 56 MT parts contained in a state-of-the-art MS model. We used two metrics, namely a Local Sensitivity Index (LSI) and an Overall Sensitivity Index (OSI), to distinguish the effect of the perturbation on the predicted force produced by the perturbed MT parts and by all the remaining MT parts, respectively, during a simulated gait cycle. Results indicated that sensitivity of the model depended on the specific role of each MT part during gait, and not merely on its size and length. Tendon slack length was the most sensitive parameter, followed by maximal isometric muscle force and optimal muscle fiber length, while nominal pennation angle showed very low sensitivity. The highest sensitivity values were found for the MT parts that act as prime movers of gait (Soleus: average OSI=5.27%, Rectus Femoris: average OSI=4.47%, Gastrocnemius: average OSI=3.77%, Vastus Lateralis: average OSI=1.36%, Biceps Femoris Caput Longum: average OSI=1.06%) and hip stabilizers (Gluteus Medius: average OSI=3.10%, Obturator Internus: average OSI=1.96%, Gluteus Minimus: average OSI=1.40%, Piriformis: average OSI=0.98%), followed by the Peroneal muscles (average OSI=2.20%) and Tibialis Anterior (average OSI=1.78%) some of which were not included in previous sensitivity studies. Finally, the proposed priority list provides quantitative information to indicate which MT parts and which MT parameters should be estimated most accurately to create detailed and reliable subject-specific MS models. PMID:27131851

  16. Reconstruction of concomitant total loss of the upper and lower lips with a free vertical rectus abdominis flap.

    PubMed

    Jallali, Navid; Malata, Charles M

    2005-01-01

    Total loss of both lips is fortunately rare as reconstruction of such defects poses an enormous challenge. We present a case of concomitant loss of both lips as a result of fulminant pneumococcal septicemia, which was reconstructed with a free vertical rectus abdominis myocutaneous flap due to lack of traditional donor sites. PMID:15696515

  17. The effect of trunk stabilization exercises with a swiss ball on core muscle activation in the elderly.

    PubMed

    Kim, Seong Gil; Yong, Min Sik; Na, Sang Su

    2014-09-01

    [Purpose] The purpose of this study was to investigate the effects of trunk stabilization exercise on the muscle EMG activations related to core stability. [Subjects and Methods] Fifteen elderly people in a geriatric hospital performed trunk stabilization exercises with a Swiss ball for 20 minutes five times per week for 8 weeks. Trunk muscle activations were measured using electromyography before and after the intervention. [Results] After the intervention, the muscle activations of the rectus abdominis, erector spinae, lateral low-back (quadratus lumborum and external oblique), and gluteus medius muscles increased significantly. [Conclusion] The trunk stabilization exercise with a Swiss ball significantly increased the muscle activities of the elderly.

  18. Muscular activity of lower limb muscles associated with working on inclined surfaces.

    PubMed

    Lu, Ming-Lun; Kincl, Laurel; Lowe, Brian; Succop, Paul; Bhattacharya, Amit

    2015-01-01

    This study investigated the effects of visual cues, muscular fatigue, task performance and experience of working on inclined surfaces on activity of postural muscles in the lower limbs associated with maintaining balance on three inclined surfaces - 0°, 14° and 26°. Normalised electromyographic (NEMG) data were collected in 44 professional roofers bilaterally from the rectus femoris, biceps femoris, tibialii anterior and gastrocnemii medial muscle groups. The 50th and 95th percentile NEMG amplitudes were used as EMG variables. Results showed that inclination angle and task performance caused a significant increase in the NEMG amplitudes of all postural muscles. Visual cues were significantly associated with a decrease in the 95th percentile EMG amplitude for the right gastrocnemius medial and tibialis anterior. Fatigue was related to a significant decrease in the NEMG amplitude for the rectus femoris. Experience of working on inclined surfaces did not have a significant effect on the NEMG amplitude.

  19. Oculomotor nerve and muscle abnormalities in congenital fibrosis of the extraocular muscles.

    PubMed

    Engle, E C; Goumnerov, B C; McKeown, C A; Schatz, M; Johns, D R; Porter, J D; Beggs, A H

    1997-03-01

    Congenital fibrosis of the extraocular muscles is an autosomal dominant congenital disorder characterized by bilateral ptosis, restrictive external ophthalmoplegia with the eyes partially or completely fixed in an infraducted (downward) and strabismic position, and markedly limited and aberrant residual eye movements. It has been generally thought that these clinical abnormalities result from myopathic fibrosis of the extraocular muscles. We describe the intracranial and orbital pathology of 1 and the muscle pathology of 2 other affected members of a family with chromosome 12-linked congenital fibrosis of the extraocular muscles. There is an absence of the superior division of the oculomotor nerve and its corresponding alpha motor neurons, and abnormalities of the levator palpebrae superioris and rectus superior (the muscles innervated by the superior division of the oculomotor nerve). In addition, increased numbers of internal nuclei and central mitochondrial clumping are found in other extraocular muscles, suggesting that the muscle pathology extends beyond the muscles innervated by the superior division of cranial nerve III. This report presents evidence that congenital fibrosis of the extraocular muscles results from an abnormality in the development of the extraocular muscle lower motor neuron system. PMID:9066352

  20. Cataract Surgery

    MedlinePlus

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ...

  1. Activity of trunk muscles during aquatic and terrestrial locomotion in Ambystoma maculatum.

    PubMed

    Deban, Stephen M; Schilling, Nadja

    2009-09-15

    The activity of seven trunk muscles was recorded at two sites along the trunk in adult spotted salamander, Ambystoma maculatum, during swimming and during trotting in water and on land. Several muscles showed patterns of activation that are consistent with the muscles producing a traveling wave of lateral bending during swimming and a standing wave of bending during aquatic and terrestrial trotting: the dorsalis trunci, subvertebralis lateralis and medialis, rectus lateralis and obliquus internus. The interspinalis showed a divergent pattern and was active out of phase with the other muscles suggesting that it functions in vertebral stabilization rather than lateral bending. The obliquus internus and rectus abdominis showed bilateral activity indicating that they counteract sagittal extension of the trunk that is produced when the large dorsal muscles are active to produce lateral bending. Of the muscles examined, only the obliquus internus showed a clear shift in function from lateral bending during swimming to resistance of long-axis torsion during trotting. During terrestrial trotting, muscle recruitment was greater in several muscles than during aquatic trotting, despite similar temporal patterns of muscle activation, suggesting that the trunk is stiffened during terrestrial locomotion against greater gravitational forces whereas the basic functions of the trunk muscles in trotting are conserved across environments.

  2. Muscle force output and electromyographic activity in squats with various unstable surfaces.

    PubMed

    Saeterbakken, Atle H; Fimland, Marius S

    2013-01-01

    The purpose of the study was to compare force output and muscle activity of leg and trunk muscles in isometric squats executed on stable surface (i.e., floor), power board, BOSU ball, and balance cone. Fifteen healthy men (23.3 ± 2.7 years, mass: 80.5 ± 8.5 kg, height: 1.81 ± 0.09 m) volunteered. The force output and electromyographic (EMG) activities of the rectus femoris, vastus medialis, vastus lateralis, biceps femoris, soleus, rectus abdominis, oblique external, and erector spinae were assessed. The order of the surfaces was randomized. One familiarization session was executed before the experimental test. Compared with stable surface (749 ± 222 N), the force output using power board was similar (-7%, p = 0.320) but lower for BOSU ball (-19%, p = 0.003) and balance cone (-24%, p ≤ 0.001). The force output using BOSU ball and balance cone was approximately 13% (p = 0.037) and approximately 18% (p = 0.001) less than the power board. There were similar EMG activities between the surfaces in all muscles except for rectus femoris, in which stable squat provided greater EMG activity than did the other exercises (p = 0.004-0.030). Lower EMG activity was observed in the rectus femoris using balance cone compared with the BOSU ball (p = 0.030). In conclusion, increasing the instability of the surface during maximum effort isometric squats usually maintains the muscle activity of lower-limb and superficial trunk muscles although the force output is reduced. This suggests that unstable surfaces in the squat may be beneficial in rehabilitation and as a part of periodized training programs, because similar muscle activity can be achieved with reduced loads.

  3. Identification of motoneurons supplying multiply- or singly-innervated extraocular muscle fibers in the rat.

    PubMed

    Eberhorn, A C; Büttner-Ennever, J A; Horn, A K E

    2006-02-01

    In mammals, the extraocular muscle fibers can be categorized in singly-innervated and multiply-innervated muscle fibers. In the monkey oculomotor, trochlear and abducens nucleus the motoneurons of multiply-innervated muscle fibers lie separated from those innervating singly-innervated muscle fibers and show different histochemical properties. In order to discover, if this organization is a general feature of the oculomotor system, we investigated the location of singly-innervated muscle fiber and multiply-innervated muscle fiber motoneurons in the rat using combined tract-tracing and immunohistochemical techniques. The singly-innervated muscle fiber and multiply-innervated muscle fiber motoneurons of the medial and lateral rectus muscle were identified by retrograde tracer injections into the muscle belly or the distal myotendinous junction. The belly injections labeled the medial rectus muscle subgroup of the oculomotor nucleus or the greatest part of abducens nucleus, including some cells outside the medial border of abducens nucleus. In contrast, the distal injections labeled only a subset of the medial rectus muscle motoneurons and exclusively cells outside the medial border of abducens nucleus. The tracer detection was combined with immunolabeling using antibodies for perineuronal nets (chondroitin sulfate proteoglycan) and non-phosphorylated neurofilaments. In monkeys both antibodies permit a distinction between singly-innervated muscle fiber and multiply-innervated muscle fiber motoneurons. The experiments revealed that neurons labeled from a distal injection lack both markers and are assumed to represent multiply-innervated muscle fiber motoneurons, whereas those labeled from a belly injection are chondroitin sulfate proteoglycan- and non-phosphorylated neurofilament-immunopositive and assumed to represent singly-innervated muscle fiber motoneurons. The overall identification of multiply-innervated muscle fiber and singly-innervated muscle fiber motoneurons

  4. Influence of exercise training on the oxidative capacity of rat abdominal muscles

    NASA Technical Reports Server (NTRS)

    Uribe, J. M.; Stump, C. S.; Tipton, C. M.; Fregosi, R. F.

    1992-01-01

    Our purpose was to determine if endurance exercise training would increase the oxidative capacity of the abdominal expiratory muscles of the rat. Accordingly, 9 male rats were subjected to an endurance training protocol (1 h/day, 6 days/week, 9 weeks) and 9 litter-mates served as controls. Citrate synthase (CS) activity was used as an index of oxidative capacity, and was determined in the following muscles: soleus, plantaris, costal diaphragm, crural diaphragm, and in all four abdominal muscles: rectus abdominis, transversus abdominis, external oblique, and internal oblique. Compared to their non-trained litter-mates, the trained rats had higher peak whole body oxygen consumption rates (+ 16%) and CS activities in plantaris (+34%) and soleus (+36%) muscles. Thus, the training program caused substantial systemic and locomotor muscle adaptations. The CS activity of costal diaphragm was 20% greater in the trained animals, but no difference was observed in crural diaphragm. The CS activity in the abdominal muscles was less than one-half of that in locomotor and diaphragm muscles, and there were no significant changes with training except in the rectus abdominis where a 26% increase was observed. The increase in rectus abdominis CS activity may reflect its role in postural support and/or locomotion, as none of the primary expiratory pumping muscles adapted to the training protocol. The relatively low levels of CS activity in the abdominal muscles suggests that they are not recruited frequently at rest, and the lack of an increase with training indicates that these muscles do not contribute significantly to the increased ventilatory activity accompanying exercise in the rat.

  5. Surgical Results of Symmetric and Asymmetric Surgeries and Dose-Response in Patients with Infantile Esotropia

    PubMed Central

    Yurdakul, Nazife Sefi; Bodur, Seda; Koç, Feray

    2015-01-01

    Objectives: To evaluate the results of symmetric and asymmetric surgery and responses to surgical amounts in patients with infantile esotropia. Materials and Methods: The records of patients with infantile esotropia who underwent bilateral medial rectus recession (symmetric surgery) and unilateral medial rectus recession with lateral rectus resection (asymmetric surgery) were analyzed. The results of the cases with symmetric (group 1) and asymmetric (group 2), successful (group 3) and failed (group 4) surgeries were compared, and responses to the amount of surgery were investigated. Results: There were no significant differences between group 1 (n=71) and group 2 (n=13) cases in terms of gender, refraction, preoperative distance deviation, anisometropia and postoperative deviation angles, binocular vision, surgical success or follow-up period (p>0.05). The rate of amblyopia, near deviation and amount of surgery were higher in group 2 cases (p<0.05). Between group 3 (n=64) and group 4 subjects (n=20), no significant differences were detected in terms of gender, surgical age, refraction, amblyopia, anisometropia, preoperative deviation angles, the number of symmetric and asymmetric surgeries, the amount of surgery, or postoperative binocular vision (p>0.05). The average postoperative follow-up period was 15.41±19.93 months (range, 6-98 months) in group 3 cases and 40.45±40.06 months (range, 6-143 months) in group 4 cases (p=0.000). No significant difference was detected in the amount of deviation corrected per 1 mm of surgical procedure between the successful cases in the symmetric and asymmetric groups (p>0.05). Conclusion: Symmetric or asymmetric surgery may be preferable in patients with infantile esotropia according to the clinical features. It is necessary for every clinic to review its own dose-response results. PMID:27800232

  6. Knee extensor muscle oxygen consumption in relation to muscle activation.

    PubMed

    Kooistra, R D; Blaauboer, M E; Born, J R; de Ruiter, C J; de Haan, A

    2006-12-01

    Recently, fatigability and muscle oxygen consumption (mVO(2)) during sustained isometric contractions were found to be less at shorter (30 degrees knee angle; 0 degrees = full extension) compared to longer knee extensor muscle lengths (90 degrees ) and, at low torques, less in the rectus femoris (RF) muscle than in the vastus lateralis and medialis. In the present study we hypothesized that these findings could be accounted for by a knee angle- and a muscle-dependent activation respectively. On two experimental days rectified surface EMG (rsEMG) was obtained as a measure of muscle activation in nine healthy young males. In addition, on day 1 maximal torque capacity (MTC) was carefully determined using superimposed nerve stimulation on brief high intensity contractions (> 70%MVC) at 30, 60 and 90 degrees knee angles. On day 2, subjects performed longer lasting isometric contractions (10-70%MTC) while mVO(2) was measured using near-infrared spectroscopy (NIRS). At 30 degrees , maximal mVO(2) was reached significantly later (11.0 s +/- 6.5 s) and was 57.9 +/- 8.3% less (average +/- SD, across intensities and muscles) than mVO(2) at 60 and 90 degrees (p < 0.05). However, rsEMG was on average only 18.0 +/- 11.8% (p = 0.062) less at the start of the contraction at 30 degrees . At 10%MTC at all knee angles, maximal mVO(2) of the RF occurred significantly later (28.8 +/- 36.0 s) and showed a significantly smaller increase in rsEMG compared to both vasti. In conclusion, it is unlikely that the tendency for less intense muscle activation could fully account for the approximately 60% lower oxygen consumption at 30 degrees , but the later increase in RFmVO(2) seemed to be caused by a less strong activation of the RF.

  7. Lower extremity muscles activity in standing and sitting position with use of sEMG in patients suffering from Charcot-Marie-Tooth syndrome.

    PubMed

    Kuciel, Natalia Maria; Konieczny, Grzegorz Krzysztof; Oleksy, Łukasz; Wrzosek, Zdzisława

    2016-01-01

    There is very limited, evidenced data about movement possibilities in patients with high level of lower limb muscles atrophy and fatigue in patients suffering from Charcot-Marie-Tooth syndrome. Patient (age 46) suffering from Charcot-Marie-Tooth disease for 30 years with multiple movement restrictions and muscles atrophy above knees took part into the study. Tests were performed for 8 muscles of the lower limb and pelvis. Muscles electrical activity was tested in sitting and standing position (for knees extended and hyperextended). In the right leg rectus femoris, vastus lateralis obliquus, gluteus medius and semitendinosus muscles activated at first and were working the longest time. The highest activity was observed in standing position with knees extended. In the left leg rectus femoris and biceps femoris muscles activated at first and biceps femoris was working the longest time. Activity level in left lower limb is much lower than in the right one. Muscles weakness is asymmetric. Left leg is much weaker and engages antagonists and synergists muscles to compensate weaker rectus femoris, vastus medialis obliquus and vastus lateralis obliquus.

  8. Effects of Three Bridging Exercises on Local and Global Muscles of Middle Aged Women

    PubMed Central

    Jeon, Ji Kyeng; Lim, Hee Sung; Shin, Sung Rae; Kim, Bo Hyun; Lee, Suk Min

    2013-01-01

    [Purpose] This study investigated the muscle activity differences of three different lumbar stabilization exercises in a comparison of middle-aged and young women. [Subjects] Seventeen middle-aged women and fifteen young women were enrolled in this study. Patients with a history of any neurologic disorders, orthopedic disorders, or cardiopulmonary problems that would have affected their lumbar stabilization exercise performance were excluded. [Methods] All subjects performed 3 exercises while the surface electromographic activity was recorded of the rectus abdominis, internal oblique, multifidus, and iliocostalis lumbolum. The mean electromyographic amplitudes obtained during the exercise were normalized to the amplitude of maximal voluntary isometric contraction (%MVIC) to produce an inter-individually comparable muscle activity index. [Results] The highest muscle activity of middle-aged women was observed in the ring bridging exercise. The middle-aged women had higher levels of all muscle activaties than the young women, particularly in the multifidus muscle and iliocostalis lumborum. No significant difference in muscle activity ratio was observed between the local muscles and global muscles in the three different exercises, though the muscle activity ratio was the highest in the ring bridging exercise. The young women group showed a higher ratio of the internal oblique/rectus abdominus than the middle aged women in the bridging exercise. [Conclusion] The ring bridging exercise should be used for stabilizing the lumbar area because the young women showed a higher ratio than the middle aged women. PMID:24259869

  9. Influence of exercise intensity on atrophied quadriceps muscle in the rat

    PubMed Central

    Tanaka, Shoji; Obatake, Taishi; Hoshino, Koichi; Nakagawa, Takao

    2015-01-01

    [Purpose] The aim of this study was to determine the effect of resistance training on atrophied skeletal muscle in rats based on evidence derived from physical therapy. [Subjects and Methods] Rats were forced to undergo squats as resistance training for 3 weeks after atrophying the rectus femoris muscle by hindlimb suspension for 2 weeks. The intensity of resistance training was adjusted to 50% and 70% of the maximum lifted weight, i.e., 50% of the one-repetition maximum and 70% of the one-repetition maximum, respectively. [Results] Three weeks of training did not alter the one-repetition maximum, and muscle fibers were injured while measuring the one-repetition maximum and reloading. The decrease in cross-sectional area in the rectus femoris muscle induced by unloading for 2 weeks was significantly recovered after training at 70% of the one-repetition maximum. The levels of muscle RING-finger protein-1 mRNA expression were significantly lower in muscles trained at 70% of the one-repetition maximum than in untrained muscles. [Conclusion] These results suggest that high-intensity resistance training can promote atrophic muscle recovery, which provides a scientific basis for therapeutic exercise methods for treatment of atrophic muscle in physical therapy. PMID:26696716

  10. Orbital complications in functional endoscopic sinus surgery.

    PubMed

    Corey, J P; Bumsted, R; Panje, W; Namon, A

    1993-11-01

    Endoscopic sinus surgery can result in both minor and major complications. Among these, orbital complications--including retroorbital hematoma--are among the most feared. Injuries can be direct or indirect from pulling on diseased structures. A retrospective chart review of 616 endoscopic sinus procedures revealed eight orbital complications in seven patients. These included two medial rectus injuries, five orbital hemorrhages, and one nasolacrimal duct injury. Predisposing factors may include hypertension, lamina papyracia dehiscences, extensive polypoid disease, previous surgery, inability to visualize the maxillary ostia, violent coughing or sneezing, and chronic steroid use. Suggested management in the literature includes lateral canthotomy, steroids, and mannitol with ophthalmologic consultation. Opening of the wound by means of an external ethmoidectomy incision has also been suggested. We suggest that adding orbital decompression by means of multiple incisions into the periorbita should be added for fully effective relief. A "management" tree of decision parameters relevant to orbital complications is presented.

  11. Relationships between muscle growth potential, intramuscular fat content and different indicators of muscle fibre types in young Charolais bulls.

    PubMed

    Hocquette, Jean-François; Cassar-Malek, Isabelle; Jurie, Catherine; Bauchart, Dominique; Picard, Brigitte; Renand, Gilles

    2012-11-01

    Genetic selection in favor of muscle growth at the expense of fat should affect characteristics of muscles, and therefore beef quality. This study was conducted with two extreme groups of six animals selected among 64 Charolais young bulls ranked according to their genetic potential for muscle growth. Muscle characteristics were assessed in Rectus abdominis (RA, slow oxidative) and Semitendinosus (ST, fast glycolytic) muscles. Intramuscular fat content and proportions of myosin heavy chains I (slow) and IIA (fast oxido-glycolytic) and certain indicators of oxidative metabolism (activities of citrate synthase (CS), isocitrate dehydrogenase and cytochrome-c oxidase (COX); expression of H-fatty acid binding protein (FABP)) were higher in RA than in ST muscle. Genetic selection for muscle growth reduced intramuscular fat content and the activities of some oxidative metabolism indicators (namely CS, COX only). The positive correlation between muscle triacylglycerol content and A-FABP messenger RNA level (a marker of adipocyte differentiation) (r = 0.53, P < 0.05) suggests that A-FABP may be a good marker of the ability of bovines to deposit intramuscular fat. In conclusion, the metabolic muscle characteristics which respond to the selection process in favor of muscle growth clearly differ from the muscle characteristics which allow muscle types to be differentiated.

  12. Arthroscopic Labrum Reconstruction in the Hip Using the Indirect Head of Rectus Femoris as a Local Graft: Surgical Technique.

    PubMed

    Sharfman, Zachary T; Amar, Eyal; Sampson, Thomas; Rath, Ehud

    2016-04-01

    The importance of the acetabular labrum has been well documented for the health and function of the hip joint. Labral reconstruction has proven effective but often requires the use of a cadaveric allograft or auto graft from the fascia lata or gracilis. The indirect head of the rectus femoris is in close proximity with the anterior superior acetabulum, which is the most common site of labral tears. Using the indirect head of the rectus femoris as a local graft minimizes surgical invasiveness by mitigating the need to harvest the graft from a different location, in case of an autograft, and by minimizing donor site morbidity and damage to local tissues. The graft is harvested and fixed to the acetabular rim through the same arthroscopic portals. Hip labral reconstruction using the reflected head of the rectus femoris tendon is a minimally invasive surgical procedure that restores stability to the hip joint, is applicable in all patients undergoing hip labral reconstruction, and offers decreased tissue morbidity compared with other grafting techniques. PMID:27462534

  13. Real-time noninvasive optical imaging of exercising muscle and brain upon cognitive stimuli

    NASA Astrophysics Data System (ADS)

    Quaresima, Valentina; van der Sluijs, Marco C.; Menssen, Jan; Grillotti, Lucia; Ferrari, Marco; Colier, Willy N.

    2001-06-01

    The monitoring of a single muscle location does not reflect the heterogeneity of the muscle groups activation during exercise. In the past, measurements of oxygen consumption (VO2) at single muscle locations could be carried out non-invasively by near-infrared continuous wave spectroscopy (NIRCWS) at rest or during isometric contractions. In the present study, human regional quadriceps (vastus lateralis and rectus femoris) VO2 was investigated at rest and during maximal voluntary contractions using a 12- channel NIRCWS system with an acquisition time of 0.1 s.

  14. Muscle Cramps

    MedlinePlus

    Muscle cramps are sudden, involuntary contractions or spasms in one or more of your muscles. They often occur after exercise or at night, ... to several minutes. It is a very common muscle problem. Muscle cramps can be caused by nerves ...

  15. Muscle Disorders

    MedlinePlus

    Your muscles help you move and help your body work. Different types of muscles have different jobs. There are many problems that can affect muscles. Muscle disorders can cause weakness, pain or even ...

  16. Muscle atrophy

    MedlinePlus

    Muscle wasting; Wasting; Atrophy of the muscles ... There are two types of muscle atrophy: disuse and neurogenic. Disuse atrophy is caused by not using the muscles enough . This type of atrophy can often be ...

  17. Muscle biopsy

    MedlinePlus

    ... the removal of a small piece of muscle tissue for examination. ... dystrophy Myopathic changes (destruction of the muscle) Necrosis (tissue death) of muscle Necrotizing vasculitis Traumatic muscle damage Polymyositis Additional conditions ...

  18. Extraocular Muscle Motor Units Characterized By Spike-Triggered Averaging In Alert Monkey

    PubMed Central

    Gamlin, Paul D.; Miller, Joel M.

    2011-01-01

    Single-unit recording in macaque monkeys has been widely used to study extraocular motoneuron behavior during eye movements. However, primate extraocular motor units have only been studied using electrical stimulation in anesthetized animals. To study motor units in alert, behaving macaques, we combined chronic muscle force transducer (MFT) and single-unit extracellular motoneuron recordings. During steady fixation with low motoneuron firing rates, we used motoneuron spike-triggered averaging of MFT signals (STA-MFT) to extract individual motor unit twitches, thereby characterizing each motor unit in terms of twitch force and dynamics. It is then possible, as in conventional studies, to determine motoneuron activity during eye movements, but now with knowledge of underlying motor unit characteristics. We demonstrate the STA-MFT technique for medial rectus motor units. Recordings from 33 medial rectus motoneurons in three animals identified 20 motor units, which had peak twitch tensions of 0.5 – 5.25 mg, initial twitch delays averaging 2.4ms, and time to peak contraction averaging 9.3ms. These twitch tensions are consistent with those reported in unanesthetized rabbits, and with estimates of the total number of medial rectus motoneurons and twitch tension generated by whole-nerve stimulation in monkey, but are substantially lower than those reported for lateral rectus motor units in anesthetized squirrel monkey. Motor units were recruited in order of twitch tension magnitude with stronger motor units reaching threshold further in the muscle’s ON-direction, showing that, as in other skeletal muscles, medial rectus motor units are recruited according to the “size principle”. PMID:22108141

  19. Plastic Surgery

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A ... her forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word " ...

  20. Lung surgery

    MedlinePlus

    ... Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Video-assisted thoracoscopic surgery; VATS ... You will have general anesthesia before surgery. You will be asleep and unable to feel pain. Two common ways to do surgery on your lungs are thoracotomy and video- ...

  1. Foot Surgery

    MedlinePlus

    ... About Feet » Foot Health Information Surgery When is Foot Surgery Necessary? Many foot problems do not respond ... restore the function of your foot. Types of Foot Surgery Fusions: Fusions are usually performed to treat ...

  2. MUSCLE INJURIES IN ATHLETES

    PubMed Central

    Barroso, Guilherme Campos; Thiele, Edilson Schwansee

    2015-01-01

    This article had the aim of demonstrating the physiology, diagnosis and treatment of muscle injuries, focusing on athletes and their demands and expectations. Muscle injuries are among the most common complaints in orthopedic practice, occurring both among athletes and among non-athletes. These injuries present a challenge for specialists, due to the slow recovery, during which time athletes are unable to take part in training and competitions, and due to frequent sequelae and recurrences of the injuries. Most muscle injuries (between 10% and 55% of all injuries) occur during sports activities. The muscles most commonly affected are the ischiotibial, quadriceps and gastrocnemius. These muscles go across two joints and are more subject to acceleration and deceleration forces. The treatment for muscle injuries varies from conservative treatment to surgery. New procedures are being used, like the hyperbaric chamber and the use of growth factors. However, there is still a high rate of injury recurrence. Muscle injury continues to be a topic of much controversy. New treatments are being researched and developed, but prevention through muscle strengthening, stretching exercises and muscle balance continues to be the best “treatment”. PMID:27027021

  3. Immediate effects of kinematic taping on lower extremity muscle tone and stiffness in flexible flat feet

    PubMed Central

    Wang, Joong-San; Um, Gi-Mai; Choi, Jung-Hyun

    2016-01-01

    [Purpose] This study aimed to examine the immediate effects of kinematic taping on the tone and stiffness in the leg muscles of subjects with flexible flat feet. [Subjects and Methods] A total of 30 subjects, 15 in the kinematic taping and 15 in the sham taping group, were administered respective taping interventions. Subsequently, the foot pressure and the tone and stiffness in the tibialis anterior, rectus femoris, medial gastrocnemius, and the long head of the biceps femoris muscles of both the lower extremities were measured. [Results] The foot pressure of the dominant leg significantly decreased in the kinematic taping group. The muscle tone and stiffness in the rectus femoris muscle of the dominant and non-dominant leg, tibialis anterior muscle of the dominant leg, medial gastrocnemius muscle of the non-dominant leg, and the stiffness in the dominant leg significantly decreased. The muscle tone and stiffness generally increased in the sham taping group. However, no significant difference was observed between the 2 groups. [Conclusion] This study demonstrated that kinematic taping on flexible flat feet had positive effects of immediately reducing the abnormally increased foot pressure and the tone and stiffness in the lower extremity muscles. PMID:27190479

  4. Mechanics of the muscles crossing the hip joint during sprint running.

    PubMed

    Nagano, Yasuharu; Higashihara, Ayako; Takahashi, Kazumasa; Fukubayashi, Toru

    2014-01-01

    We aimed to demonstrate the changes over time in the lengths and forces of the muscles crossing the hip joint during overground sprinting and investigate the relationships between muscle lengths and muscle-tendon unit forces - particularly peak biceps femoris force. We obtained three-dimensional kinematics during 1 running cycle from 8 healthy sprinters sprinting at maximum speed. Muscle lengths and muscle-tendon unit forces were calculated for the iliacus, rectus femoris, gluteus maximus, and biceps femoris muscles of the target leg as well as the contralateral iliacus and rectus femoris. Our results showed that during sprinting, the muscles crossing the hip joint demonstrate a stretch-shortening cycle and 1 or 2 peak forces. The timing of peak biceps femoris force, expressed as a percentage of the running cycle (mean [SD], 80.5 [2.9]%), was synchronous with those of the maximum biceps femoris length (82.8 [1.9]%) and peak forces of the gluteus maximus (83.8 [9.1]%), iliacus (81.1 [5.2]%), and contralateral iliacus (78.5 [5.8]%) and also that of the peak pelvic anterior tilt. The force of the biceps femoris appeared to be influenced by the actions of the muscles crossing the hip joint as well as by the pelvic anterior tilt.

  5. A microcalorimetric study of the sodium-potassium-pump and thermogenesis in human skeletal muscle.

    PubMed

    Fagher, B; Sjögren, A; Monti, M

    1987-11-01

    Thermogenesis in human skeletal muscle was monitored by measurement of heat production using perfusion microcalorimetry. Heat production significantly correlated with relative body weight. The energy expenditure of the Na-K-pump (delta P), assessed after inhibition by ouabain in Krebs-Ringer phosphate buffer containing glucose and insulin, amounted to 6% of the total heat production in vastus lateralis muscle. Muscle potassium positively correlated with delta P (r = 0.84, P less than 0.005). For rectus abdominis muscle delta P was 8-15%; 95% confidence interval for the difference was 3-5% when comparison was made with vastus lateralis. The finding of a positive relationship between delta P and muscle magnesium (r = 0.68, P less than 0.04) is possibly explained by the dependence of ATP hydrolysis on internal magnesium. Our data on resting thermogenesis in small muscle samples agree to previous estimates of O2 consumption in human skeletal muscle in vivo.

  6. Treatment of gummy smile: Gingival recontouring with the containment of the elevator muscle of the upper lip and wing of nose. A surgery innovation technique

    PubMed Central

    Storrer, Carmen Lucia Mueller; Valverde, Fabiane Kristine Bochenek; Santos, Felipe Rychuv; Deliberador, Tatiana Miranda

    2014-01-01

    The containment of the elevator muscle of the upper lip and wing of nose was used for the treatment of patients with gummy smile. This technique had corrected esthetic alterations of smile, reducing the upper lip elevation, which results in a smaller gingival display. An upper lip lengthening as well as a reduction in the upper lip shortening when the patient smiled could be observed. The high smile line was corrected without compromising the labial harmony. This study presents an innovative and effective therapeutic option to obtain a natural and harmonious smile. The patient expressed a high degree of satisfaction. PMID:25425832

  7. ‘Serious thigh muscle strains’: beware the intramuscular tendon which plays an important role in difficult hamstring and quadriceps muscle strains

    PubMed Central

    Brukner, Peter; Connell, David

    2016-01-01

    Why do some hamstring and quadriceps strains take much longer to repair than others? Which injuries are more prone to recurrence? Intramuscular tendon injuries have received little attention as an element in ‘muscle strain’. In thigh muscles, such as rectus femoris and biceps femoris, the attached tendon extends for a significant distance within the muscle belly. While the pathology of most muscle injures occurs at a musculotendinous junction, at first glance the athlete appears to report pain within a muscle belly. In addition to the musculotendinous injury being a site of pathology, the intramuscular tendon itself is occasionally injured. These injuries have a variety of appearances on MRIs. There is some evidence that these injuries require a prolonged rehabilitation time and may have higher recurrence rates. Therefore, it is important to recognise the tendon component of a thigh ‘muscle strain’. PMID:26519522

  8. Functional and morphological variety in trunk muscles of Urodela.

    PubMed

    Omura, Ayano; Anzai, Wataru; Endo, Hideki

    2014-03-01

    Trunk musculature in Urodela species varies by habitat. In this study, trunk musculature was examined in five species of adult salamanders representing three different habitats: aquatic species, Amphiuma tridactylum and Necturus maculosus; semi-aquatic species, Cynops pyrrhogaster; terrestrial species, Hynobius nigrescens and Ambystoma tigrinum. More terrestrial species have heavier dorsal and ventral trunk muscles than more aquatic forms. By contrast, the lateral hypaxial musculature was stronger in more aquatic species. The number of layers of lateral hypaxial musculature varied among Urodela species and did not clearly correlate with their habitats. The M. rectus abdominis was separated from the lateral hypaxial musculature in both terrestrial and semi-aquatic species. In aquatic species, M. rectus abdominis was not separated from lateral hypaxial musculature. Lateral hypaxial musculature differed in thickness among species and was relatively thinner in terrestrial species. In more terrestrial species, dorsal muscles may be used for stabilization and ventral flexing against gravity. Ventral muscle may be used in preventing dorsally concave curvature of the trunk by dorsal muscles and by weight. The lengthy trunk supported by limbs needs muscular forces along the ventral contour line in more terrestrial species. And, the locomotion on well-developed limbs seems to lead to a decrease of the lateral hypaxial musculature.

  9. Transcriptome analysis of two bovine muscles during ontogenesis.

    PubMed

    Sudre, Karine; Leroux, Christine; Piétu, Geneviève; Cassar-Malek, Isabelle; Petit, Elisabeth; Listrat, Anne; Auffray, Charles; Picard, Brigitte; Martin, Patrice; Hocquette, Jean-François

    2003-06-01

    Macro-arrays, on which 1339 human skeletal muscle cDNA clone inserts had been spotted as PCR products, were used to make large-scale measurement of gene expression in bovine muscles during ontogenesis. Ten complex cDNA targets derived from two mixed muscle samples, Rectus abdominis (rather red oxidative muscle, RA) and Semitendinosus (rather white glycolytic muscle, ST), were taken from foetuses at 4 different stages (110, 180, 210, and 260 days post-conception) and from 15-month-old young bulls to generate differential expression patterns. Each sample analysed was prepared from a pool of RNA extracted from muscle tissues sampled from at least 6 different animals. Approximately 200 expression signals were validated and taken into account to provide a first "bovine" muscle gene repertoire. Despite the relatively small number of probes and the heterologous approach, this made it possible to identify up to 7 genes differentially expressed between RA and ST, depending on age. From 110 days post-conception to 15 months of age, differences in the expression levels of 110 genes were detected in the four comparisons between two consecutive ages. By comparing 260 days post-conception foetal muscles and adult muscles, up to 87 genes were overexpressed, whereas only 7 genes were shown to be down-regulated. Among these genes, 33% have unknown biological functions. Taken together, the results reported here underline the importance of the last three months of gestation in muscle myogenesis, and highlight new genes involved in this process.

  10. Skeletal muscle

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There are approximately 650-850 muscles in the human body these include skeletal (striated), smooth and cardiac muscle. The approximation is based on what some anatomists consider separate muscle or muscle systems. Muscles are classified based on their anatomy (striated vs. smooth) and if they are v...

  11. Age-Related Differences in Muscle Shear Moduli in the Lower Extremity.

    PubMed

    Akagi, Ryota; Yamashita, Yota; Ueyasu, Yuta

    2015-11-01

    This study investigated the age-related differences in shear moduli of the rectus femoris muscle (RF), the lateral head of the gastrocnemius muscle (LG) and the soleus muscle (SOL) using shear wave ultrasound elastography. Thirty-one young individuals and 49 elderly individuals volunteered for this study. The shear modulus of RF was determined at 50% of the thigh length, and those of LG and SOL were determined at 30% of the lower leg length. RF and LG shear moduli were significantly higher in young individuals than in elderly individuals, but there was no age-related difference in SOL shear modulus. From the standpoint of an index reflecting muscle mechanical properties, it is suggested that the lower muscle shear moduli of RF and LG are the reason for the decreased explosive muscle strength in the lower extremity and the increased risk of falls for elderly individuals.

  12. Assessment of the sensory quality and shelf stability of selected Horro beef muscles in Ethiopia.

    PubMed

    Yadata, Melese Abdisa; Werner, Carsten; Tibbo, Markos; Wollny, Clemens B A; Wicke, Michael

    2009-09-01

    The objective of this work was to assess sensory quality and retail life of Horro beef muscles in Ethiopia. Six muscles: M. rhomboideus (RM), M. infraspinatus (IS), M. longissimus lumborum (LL), M. semimembranosus (SM), M. biceps femoris (BF) and M. rectus femoris (RF) were considered. Sensory quality of the muscles was rated by a 9-member trained panel for palatability, tenderness, juiciness, amount of connective tissue (ACT), lean color and surface discoloration and measured by Warner-Bratzler Shear Force (WBSF). Retail life of the six muscles were evaluated for CIE 1976 L(∗)a(∗)b(∗) color values across 6 days. Significant differences (p<0.05) between muscles for all sensory attributes and WBSF were found. Significant L(∗)a(∗)b(∗) color values of muscles and USDA quality grades by retail life were found (p<0.05). Significant correlations (p<0.05 or p<0.01) of key parameters were also identified.

  13. Analysis of skeletal muscle has potential value in the assessment of cocaine-related deaths.

    PubMed

    Rees, Kelly A; Seulin, Saskia; Yonamine, Mauricio; Leyton, Vilma; Munoz, Daniel R; Gianvecchio, Victor A P; Pounder, Derrick J; Osselton, M David

    2013-03-10

    This study assesses the interpretive value of cocaine, benzoylecgonine (BZE) and cocaethylene (COET) in skeletal muscle (rectus femoris) in cocaine-using decedents. The distribution of these analytes in cardiac muscle (CM), vitreous humour (VH), femoral blood (FB) and cardiac blood (CB) is also reported. In rectus femoris muscle, the spatial distribution of the analytes was examined across the whole rectus femoris muscle collected from seven fatalities in which cocaine was detected. In six of these cases, death was attributed to trauma and in one case the cause of death was undetermined but suspected to be drug related. In two additional cases analytes were detected in the blood and/or VH but not in the muscle. The muscle was sectioned into 12-15 approximately equal segments, each of which was analysed after homogenisation. Tissue and bio-fluid samples were extracted by solid phase extraction with confirmation and quantification by GC-ion trap-MS/MS. No significant variation was observed in the concentration of any analyte throughout the muscle in the 7 cases analysed. The results reported here are in contrast to a previous study in which great variation in the concentration of some basic drugs (mainly tricyclic antidepressants and benzodiazepines) was observed throughout the thigh muscle bulk (Williams and Pounder, 1997). Analyte concentrations in skeletal muscle (SM) correlated well with those in FB (p<0.01). In general, the concentration of cocaine and COET followed the order VH > CM > SM > FB ≥ CB. Cocaine concentrations measured in VH were significantly higher than in blood and muscle. Inter-matrix variations in the concentrations of BZE and COET were less marked. The concentration of BZE exceeded that of cocaine in all matrices and in all cases except one where the time between death and drug intake was suspected to be short. In this case, the cocaine to BZE ratio measured in SM (2.66), CM (2.91) and VH (2.19) was higher than that measured in FB (0

  14. Influence of different control strategies on muscle activation patterns in trunk muscles

    PubMed Central

    Hansen, Laura; Anders, Christoph

    2014-01-01

    Abstract Adequate training of the trunk muscles is essential to prevent low back pain. Although sit‐ups are simple to perform, the perceived high effort is the reason why training the abdominal muscles is seldom continued over a longer period of time. It is well known that the abdominal muscles are inferior to the back muscles in terms of force, but this cannot explain the extreme difference in perceived effort between trunk flexion and extension tasks. Therefore, this study was aimed at the identification of control strategy influences on the muscular stress level. Thirty‐nine subjects were investigated. The performed tasks were restricted to the sagittal plane and were implemented with simulated and realized tilt angles. Subjects were investigated in an upright position with their lower bodies fixed and their upper bodies free. Posture‐controlled tasks involved graded forward and backward tilting, while force‐controlled tasks involved the application of force based on a virtual tilt angle. The Surface EMG (SEMG) was taken from five trunk muscles on both sides. Control strategies seemed to have no systematic influence on the SEMG amplitudes of the back muscles. In contrast, the abdominal muscles exhibited significantly higher stress levels under posture‐controlled conditions without relevantly increasing antagonistic co‐activation of back muscles. The abdominal muscles' relative differences ranged from an average of 20% for the external oblique abdominal muscle to approximately 40% for the rectus abdominal muscle. The perceived high effort expended during sit‐ups can now be explained by the posture‐controlled contractions that are required. PMID:25501425

  15. Ultrasound-guided rectus sheath block or wound infiltration in children: A randomized blinded study of analgesia and bupivacaine absorption

    PubMed Central

    Flack, Sean H.; Martin, Lizabeth D.; Walker, Benjamin J.; Bosenberg, Adrian T.; Helmers, Laurilyn D.; Goldin, Adam B.; Haberkern, Charles M.

    2014-01-01

    Background Rectus sheath block can provide analgesia following umbilical hernia repair. However, conflicting reports on its analgesic effectiveness exist. No study has investigated plasma local anesthetic concentration following ultrasound-guided rectus sheath block (USGRSB) in children. Objectives Compare the effectiveness and bupivacaine absorption following USGRSB or wound infiltration (WI) for umbilical hernia repair in children. Methods A randomized blinded study comparing WI to USGRSB in 40 children undergoing umbilical hernia repair was performed. Group WI (n=20) received wound infiltration 1mg/kg 0.25% bupivacaine. Group RS (n=20) received USGRSB 0.5mg/kg 0.25% bupivacaine per side in the posterior rectus sheath compartment. Pain scores and rescue analgesia were recorded. Blood samples were drawn at 0, 10, 20, 30, 45 and 60 minutes. Results Patients in the WI group had a 2-fold increased risk of requiring morphine (Hazard ratio 2.06, 95% CI 1.01, 4.20, p=0.05). When required, median time to first morphine dose was longer in the USGRSB group (65.5 min vs 47.5 min, p=0.049). Peak plasma bupivacaine concentration was higher following USGRSB than WI (median: 631.9 ng/ml IQR: 553.9 – 784.1 vs 389.7 ng/ml IQR: 250.5-502.7, p= 0.002). Tmax was longer in the USGRSB group (median 45 min IQR: 30 - 60 vs 20 min IQR: 20 – 45, p= 0.006). Conclusions USGRSB provides more effective analgesia than WI for umbilical hernia repair. USGRSB with 1mg/kg 0.25% bupivacaine is associated with safe plasma bupivacaine concentration that peaks higher and later than WI. Caution against using larger volumes of higher concentration local anesthetic for USGRSB is advised. PMID:24853314

  16. Corticospinal Excitability of Trunk Muscles during Different Postural Tasks

    PubMed Central

    Chiou, Shin-Yi; Gottardi, Sam E. A.; Hodges, Paul W.; Strutton, Paul H.

    2016-01-01

    Evidence suggests that the primary motor cortex (M1) is involved in both voluntary, goal-directed movements and in postural control. Trunk muscles are involved in both tasks, however, the extent to which M1 controls these muscles in trunk flexion/extension (voluntary movement) and in rapid shoulder flexion (postural control) remains unclear. The purpose of this study was to investigate this question by examining excitability of corticospinal inputs to trunk muscles during voluntary and postural tasks. Twenty healthy adults participated. Transcranial magnetic stimulation was delivered to the M1 to examine motor evoked potentials (MEPs) in the trunk muscles (erector spinae (ES) and rectus abdominis (RA)) during dynamic shoulder flexion (DSF), static shoulder flexion (SSF), and static trunk extension (STE). The level of background muscle activity in the ES muscles was matched across tasks. MEP amplitudes in ES were significantly larger in DSF than in SSF or in STE; however, this was not observed for RA. Further, there were no differences in levels of muscle activity in RA between tasks. Our findings reveal that corticospinal excitability of the ES muscles appears greater during dynamic anticipatory posture-related adjustments than during static tasks requiring postural (SSF) and goal-directed voluntary (STE) activity. These results suggest that task-oriented rehabilitation of trunk muscles should be considered for optimal transfer of therapeutic effect to function. PMID:26807583

  17. Corticospinal Excitability of Trunk Muscles during Different Postural Tasks.

    PubMed

    Chiou, Shin-Yi; Gottardi, Sam E A; Hodges, Paul W; Strutton, Paul H

    2016-01-01

    Evidence suggests that the primary motor cortex (M1) is involved in both voluntary, goal-directed movements and in postural control. Trunk muscles are involved in both tasks, however, the extent to which M1 controls these muscles in trunk flexion/extension (voluntary movement) and in rapid shoulder flexion (postural control) remains unclear. The purpose of this study was to investigate this question by examining excitability of corticospinal inputs to trunk muscles during voluntary and postural tasks. Twenty healthy adults participated. Transcranial magnetic stimulation was delivered to the M1 to examine motor evoked potentials (MEPs) in the trunk muscles (erector spinae (ES) and rectus abdominis (RA)) during dynamic shoulder flexion (DSF), static shoulder flexion (SSF), and static trunk extension (STE). The level of background muscle activity in the ES muscles was matched across tasks. MEP amplitudes in ES were significantly larger in DSF than in SSF or in STE; however, this was not observed for RA. Further, there were no differences in levels of muscle activity in RA between tasks. Our findings reveal that corticospinal excitability of the ES muscles appears greater during dynamic anticipatory posture-related adjustments than during static tasks requiring postural (SSF) and goal-directed voluntary (STE) activity. These results suggest that task-oriented rehabilitation of trunk muscles should be considered for optimal transfer of therapeutic effect to function.

  18. Muscle Deoxygenation Causes Muscle Fatigue

    NASA Technical Reports Server (NTRS)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D.

    1999-01-01

    Muscle fatigue is a common musculoskeletal disorder in the work place, and may be a harbinger for more disabling cumulative trauma disorders. Although the cause of fatigue is multifactorial, reduced blood flow and muscle oxygenation may be the primary factor in causing muscle fatigue during low intensity muscle exertion. Muscle fatigue is defined as a reduction in muscle force production, and also occurs among astronauts who are subjected to postural constraints while performing lengthy, repetitive tasks. The objectives of this research are to: 1) develop an objective tool to study the role of decreased muscle oxygenation on muscle force production, and 2) to evaluate muscle fatigue during prolonged glovebox work.

  19. Muscle disorder

    MedlinePlus

    Myopathic changes; Myopathy; Muscle problem ... Blood tests sometimes show abnormally high muscle enzymes. If a muscle disorder might also affect other family members, genetic testing may be done. When someone has symptoms and signs ...

  20. Effects of a Bridging Exercise with Hip Adduction on the EMG Activities of the Abdominal and Hip Extensor Muscles in Females

    PubMed Central

    Jang, Eun-Mi; Kim, Mi-Hyun; Oh, Jae-Seop

    2013-01-01

    [Purpose] This study compared the activities of the abdominal and hip extensor muscles between the bridging exercise (BE) and bridging exercise with hip adduction (BEHA) positions in women using electromyography (EMG). [Subjects] We recruited 14 healthy adult females with no history of low back pain. [Methods] The subjects performed bridging exercises with and without hip adduction. The EMG activities of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and gluteus maximus (GM) muscles were recorded. [Result] The EMG activities of all muscles were significantly increased during the BEHA compared to the BE. [Conclusion] The bridging exercise with hip adduction produced greater activation of the abdominal and hip extensor muscles. PMID:24259933

  1. 3D False Color Computed Tomography for Diagnosis and Follow-Up of Permanent Denervated Human Muscles Submitted to Home-Based Functional Electrical Stimulation.

    PubMed

    Carraro, Ugo; Edmunds, Kyle J; Gargiulo, Paolo

    2015-03-11

    This report outlines the use of a customized false-color 3D computed tomography (CT) protocol for the imaging of the rectus femoris of spinal cord injury (SCI) patients suffering from complete and permanent denervation, as characterized by complete Conus and Cauda Equina syndrome. This muscle imaging method elicits the progression of the syndrome from initial atrophy to eventual degeneration, as well as the extent to which patients' quadriceps could be recovered during four years of home-based functional electrical stimulation (h-b FES). Patients were pre-selected from several European hospitals and functionally tested by, and enrolled in the EU Commission Shared Cost Project RISE (Contract n. QLG5-CT-2001-02191) at the Department of Physical Medicine, Wilhelminenspital, Vienna, Austria. Denervated muscles were electrically stimulated using a custom-designed stimulator, large surface electrodes, and customized progressive stimulation settings. Spiral CT images and specialized computational tools were used to isolate the rectus femoris muscle and produce 3D and 2D reconstructions of the denervated muscles. The cross sections of the muscles were determined by 2D Color CT, while muscle volumes were reconstructed by 3D Color CT. Shape, volume, and density changes were measured over the entirety of each rectus femoris muscle. Changes in tissue composition within the muscle were visualized by associating different colors to specified Hounsfield unit (HU) values for fat, (yellow: [-200; -10]), loose connective tissue or atrophic muscle, (cyan: [-9; 40]), and normal muscle, fascia and tendons included, (red: [41; 200]). The results from this analysis are presented as the average HU values within the rectus femoris muscle reconstruction, as well as the percentage of these tissues with respect to the total muscle volume. Results from this study demonstrate that h-b FES induces a compliance-dependent recovery of muscle volume and size of muscle fibers, as evidenced by the

  2. 3D False Color Computed Tomography for Diagnosis and Follow-Up of Permanent Denervated Human Muscles Submitted to Home-Based Functional Electrical Stimulation.

    PubMed

    Carraro, Ugo; Edmunds, Kyle J; Gargiulo, Paolo

    2015-03-11

    This report outlines the use of a customized false-color 3D computed tomography (CT) protocol for the imaging of the rectus femoris of spinal cord injury (SCI) patients suffering from complete and permanent denervation, as characterized by complete Conus and Cauda Equina syndrome. This muscle imaging method elicits the progression of the syndrome from initial atrophy to eventual degeneration, as well as the extent to which patients' quadriceps could be recovered during four years of home-based functional electrical stimulation (h-b FES). Patients were pre-selected from several European hospitals and functionally tested by, and enrolled in the EU Commission Shared Cost Project RISE (Contract n. QLG5-CT-2001-02191) at the Department of Physical Medicine, Wilhelminenspital, Vienna, Austria. Denervated muscles were electrically stimulated using a custom-designed stimulator, large surface electrodes, and customized progressive stimulation settings. Spiral CT images and specialized computational tools were used to isolate the rectus femoris muscle and produce 3D and 2D reconstructions of the denervated muscles. The cross sections of the muscles were determined by 2D Color CT, while muscle volumes were reconstructed by 3D Color CT. Shape, volume, and density changes were measured over the entirety of each rectus femoris muscle. Changes in tissue composition within the muscle were visualized by associating different colors to specified Hounsfield unit (HU) values for fat, (yellow: [-200; -10]), loose connective tissue or atrophic muscle, (cyan: [-9; 40]), and normal muscle, fascia and tendons included, (red: [41; 200]). The results from this analysis are presented as the average HU values within the rectus femoris muscle reconstruction, as well as the percentage of these tissues with respect to the total muscle volume. Results from this study demonstrate that h-b FES induces a compliance-dependent recovery of muscle volume and size of muscle fibers, as evidenced by the

  3. Effect of exhalation exercise on trunk muscle activity and oswestry disability index of patients with chronic low back pain

    PubMed Central

    Kang, Jeong-Il; Jeong, Dae-Keun; Choi, Hyun

    2016-01-01

    [Purpose] This study investigated the effect of exhalation exercises on trunk muscle activity and Oswestry Disability Index by inducing trunk muscle activity through increasing intra-abdominal pressure and activating muscles, contributing to spinal stability. [Subjects and Methods] This intervention program included 20 male patients with chronic low back pain. A total of 10 subjects each were randomly assigned to an exhalation exercise group as the experimental group and a spinal stabilization exercise group as the control group. [Results] There were significant differences in the activities of the rectus abdominis, transverse abdominis, external oblique abdominal, and erector spinae muscles as well as in the Oswestry Disability Index within the experimental group. There were meaningful differences in the activities of the rectus abdominis, external oblique abdominal, and erector spinae muscles and in the Oswestry Disability Index within the control group. In addition, there was a meaningful intergroup difference in transverse abdominis muscle activity alone and in the Oswestry Disability Index. [Conclusion] The breathing exercise effectively increased muscle activity by training gross and fine motor muscles in the trunk. Moreover, it was verified as a very important element for strengthening body stability because it both released and prevented low back pain. PMID:27390406

  4. Muscular Activity and Fatigue in Lower-Limb and Trunk Muscles during Different Sit-To-Stand Tests.

    PubMed

    Roldán-Jiménez, Cristina; Bennett, Paul; Cuesta-Vargas, Antonio I

    2015-01-01

    Sit-to-stand (STS) tests measure the ability to get up from a chair, reproducing an important component of daily living activity. As this functional task is essential for human independence, STS performance has been studied in the past decades using several methods, including electromyography. The aim of this study was to measure muscular activity and fatigue during different repetitions and speeds of STS tasks using surface electromyography in lower-limb and trunk muscles. This cross-sectional study recruited 30 healthy young adults. Average muscle activation, percentage of maximum voluntary contraction, muscle involvement in motion and fatigue were measured using surface electrodes placed on the medial gastrocnemius (MG), biceps femoris (BF), vastus medialis of the quadriceps (QM), the abdominal rectus (AR), erector spinae (ES), rectus femoris (RF), soleus (SO) and the tibialis anterior (TA). Five-repetition STS, 10-repetition STS and 30-second STS variants were performed. MG, BF, QM, ES and RF muscles showed differences in muscle activation, while QM, AR and ES muscles showed significant differences in MVC percentage. Also, significant differences in fatigue were found in QM muscle between different STS tests. There was no statistically significant fatigue in the BF, MG and SO muscles of the leg although there appeared to be a trend of increasing fatigue. These results could be useful in describing the functional movements of the STS test used in rehabilitation programs, notwithstanding that they were measured in healthy young subjects.

  5. Effect of exhalation exercise on trunk muscle activity and oswestry disability index of patients with chronic low back pain.

    PubMed

    Kang, Jeong-Il; Jeong, Dae-Keun; Choi, Hyun

    2016-06-01

    [Purpose] This study investigated the effect of exhalation exercises on trunk muscle activity and Oswestry Disability Index by inducing trunk muscle activity through increasing intra-abdominal pressure and activating muscles, contributing to spinal stability. [Subjects and Methods] This intervention program included 20 male patients with chronic low back pain. A total of 10 subjects each were randomly assigned to an exhalation exercise group as the experimental group and a spinal stabilization exercise group as the control group. [Results] There were significant differences in the activities of the rectus abdominis, transverse abdominis, external oblique abdominal, and erector spinae muscles as well as in the Oswestry Disability Index within the experimental group. There were meaningful differences in the activities of the rectus abdominis, external oblique abdominal, and erector spinae muscles and in the Oswestry Disability Index within the control group. In addition, there was a meaningful intergroup difference in transverse abdominis muscle activity alone and in the Oswestry Disability Index. [Conclusion] The breathing exercise effectively increased muscle activity by training gross and fine motor muscles in the trunk. Moreover, it was verified as a very important element for strengthening body stability because it both released and prevented low back pain.

  6. Muscular Activity and Fatigue in Lower-Limb and Trunk Muscles during Different Sit-To-Stand Tests

    PubMed Central

    Roldán-Jiménez, Cristina; Bennett, Paul; Cuesta-Vargas, Antonio I.

    2015-01-01

    Sit-to-stand (STS) tests measure the ability to get up from a chair, reproducing an important component of daily living activity. As this functional task is essential for human independence, STS performance has been studied in the past decades using several methods, including electromyography. The aim of this study was to measure muscular activity and fatigue during different repetitions and speeds of STS tasks using surface electromyography in lower-limb and trunk muscles. This cross-sectional study recruited 30 healthy young adults. Average muscle activation, percentage of maximum voluntary contraction, muscle involvement in motion and fatigue were measured using surface electrodes placed on the medial gastrocnemius (MG), biceps femoris (BF), vastus medialis of the quadriceps (QM), the abdominal rectus (AR), erector spinae (ES), rectus femoris (RF), soleus (SO) and the tibialis anterior (TA). Five-repetition STS, 10-repetition STS and 30-second STS variants were performed. MG, BF, QM, ES and RF muscles showed differences in muscle activation, while QM, AR and ES muscles showed significant differences in MVC percentage. Also, significant differences in fatigue were found in QM muscle between different STS tests. There was no statistically significant fatigue in the BF, MG and SO muscles of the leg although there appeared to be a trend of increasing fatigue. These results could be useful in describing the functional movements of the STS test used in rehabilitation programs, notwithstanding that they were measured in healthy young subjects. PMID:26506612

  7. Effect of exhalation exercise on trunk muscle activity and oswestry disability index of patients with chronic low back pain.

    PubMed

    Kang, Jeong-Il; Jeong, Dae-Keun; Choi, Hyun

    2016-06-01

    [Purpose] This study investigated the effect of exhalation exercises on trunk muscle activity and Oswestry Disability Index by inducing trunk muscle activity through increasing intra-abdominal pressure and activating muscles, contributing to spinal stability. [Subjects and Methods] This intervention program included 20 male patients with chronic low back pain. A total of 10 subjects each were randomly assigned to an exhalation exercise group as the experimental group and a spinal stabilization exercise group as the control group. [Results] There were significant differences in the activities of the rectus abdominis, transverse abdominis, external oblique abdominal, and erector spinae muscles as well as in the Oswestry Disability Index within the experimental group. There were meaningful differences in the activities of the rectus abdominis, external oblique abdominal, and erector spinae muscles and in the Oswestry Disability Index within the control group. In addition, there was a meaningful intergroup difference in transverse abdominis muscle activity alone and in the Oswestry Disability Index. [Conclusion] The breathing exercise effectively increased muscle activity by training gross and fine motor muscles in the trunk. Moreover, it was verified as a very important element for strengthening body stability because it both released and prevented low back pain. PMID:27390406

  8. Electromyographic analysis of lower limb muscles during the golf swing performed with three different clubs.

    PubMed

    Marta, Sérgio; Silva, Luís; Vaz, João Rocha; Castro, Maria António; Reinaldo, Gustavo; Pezarat-Correia, Pedro

    2016-01-01

    The aim of this study was to describe and compare the EMG patterns of select lower limb muscles throughout the golf swing, performed with three different clubs, in non-elite middle-aged players. Fourteen golfers performed eight swings each using, in random order, a pitching wedge, 7-iron and 4-iron. Surface electromyography (EMG) was recorded bilaterally from lower limb muscles: tibialis anterior, peroneus longus, gastrocnemius medialis, gastrocnemius lateralis, biceps femoris, semitendinosus, gluteus maximus, vastus medialis, rectus femoris and vastus lateralis. Three-dimensional high-speed video analysis was used to determine the golf swing phases. Results showed that, in average handicap golfers, the highest muscle activation levels occurred during the Forward Swing Phase, with the right semitendinosus and the right biceps femoris muscles producing the highest mean activation levels relative to maximal electromyography (70-76% and 68-73% EMG(MAX), respectively). Significant differences between the pitching wedge and the 4-iron club were found in the activation level of the left semitendinosus, right tibialis anterior, right peroneus longus, right vastus medialis, right rectus femuris and right gastrocnemius muscles. The lower limb muscles showed, in most cases and phases, higher mean values of activation on electromyography when golfers performed shots with a 4-iron club.

  9. Electromyographic analysis of lower limb muscles during the golf swing performed with three different clubs.

    PubMed

    Marta, Sérgio; Silva, Luís; Vaz, João Rocha; Castro, Maria António; Reinaldo, Gustavo; Pezarat-Correia, Pedro

    2016-01-01

    The aim of this study was to describe and compare the EMG patterns of select lower limb muscles throughout the golf swing, performed with three different clubs, in non-elite middle-aged players. Fourteen golfers performed eight swings each using, in random order, a pitching wedge, 7-iron and 4-iron. Surface electromyography (EMG) was recorded bilaterally from lower limb muscles: tibialis anterior, peroneus longus, gastrocnemius medialis, gastrocnemius lateralis, biceps femoris, semitendinosus, gluteus maximus, vastus medialis, rectus femoris and vastus lateralis. Three-dimensional high-speed video analysis was used to determine the golf swing phases. Results showed that, in average handicap golfers, the highest muscle activation levels occurred during the Forward Swing Phase, with the right semitendinosus and the right biceps femoris muscles producing the highest mean activation levels relative to maximal electromyography (70-76% and 68-73% EMG(MAX), respectively). Significant differences between the pitching wedge and the 4-iron club were found in the activation level of the left semitendinosus, right tibialis anterior, right peroneus longus, right vastus medialis, right rectus femuris and right gastrocnemius muscles. The lower limb muscles showed, in most cases and phases, higher mean values of activation on electromyography when golfers performed shots with a 4-iron club. PMID:26197882

  10. After Surgery

    MedlinePlus

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  11. Turbinate surgery

    MedlinePlus

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery ... There are several types of turbinate surgery: Turbinectomy: All or part of the lower turbinate is taken out. This can be done in several different ways, but sometimes a ...

  12. Chest wall dynamics and muscle recruitment during professional flute playing.

    PubMed

    Cossette, Isabelle; Monaco, Pierpaolo; Aliverti, Andrea; Macklem, Peter T

    2008-02-01

    Respiratory parameters and sound were recorded during professional flute playing in order to assess what physiological processes were associated with the control of sound production that results in 'breath support' which in turn is associated with high quality playing. Four standing young professional flautists played flute excerpts with and without breath support. Recordings included optoelectronic plethysmographic measurements of chest wall volume (V(cw)) and its compartments, surface electromyography of the scalene, lateral abdominal, rectus abdominus, parasternal and sternocleidomastoid muscles, mouth pressure, and sound. Flow was estimated from differentiating V(cw) during playing. Results showed that flute support entails antagonistic contraction of non-diaphragmatic inspiratory muscles that tends to hold the rib cage at higher lung volume. This relieves the expiratory muscles from the task of producing the right mouth pressure, especially at the end of the phrases, so they can contribute more to the finer control of mouth pressure modulations required for high quality playing.

  13. Torque action of two-joint muscles in the swing period of stiff-legged gait: a forward dynamic model analysis.

    PubMed

    Riley, P O; Kerrigan, D C

    1998-09-01

    Stiff-legged gait, characterized by limited knee flexion during the swing period, is a common consequence of upper motor neuron injury. The purpose of this investigation was to determine whether the rectus femoris and hamstrings muscles (which act at both the hip and knee) contribute to stiff-legged gait if active during the swing period of the gait cycle. Ten subjects with unilateral stiff-legged gait due to stroke were evaluated. Swing period free gait data were obtained. A biomechanical model of the affected limb was developed for each subject. Muscle and tendon lengths were scaled to individual subjects while constant nominal values for maximum muscle forces were used for all subjects. Torque driven forward dynamic simulations were employed to determine the sensitivity of swing period maximum knee flexion angle to changes in hip and knee torques. Combined torque and muscle driven simulations were used to access the action of specific two-joint muscles. Both hip flexion torque and knee extension torque were found to influence knee angle, but knee angle was more sensitive to changes in torque at the knee joint. The actions of the rectus femoris and long hamstrings are most marked at the knee, although their action at the hip opposes their action at the knee. Rectus femoris activity during early swing acts to limit knee flexion and contributes to stiff-legged gait. Long hamstring activity in early swing contributes to knee flexion.

  14. Atrophy of the quadriceps muscle in children with a painful hip.

    PubMed

    Robben, S G; Lequin, M H; Meradji, M; Diepstraten, A F; Hop, W C

    1999-09-01

    The objective of this study was to determine the degree of muscle wasting of various components of the quadriceps muscle in children with a painful hip. Between January 1994 and September 1997, 327 consecutive children with a unilateral painful hip and/or limping were evaluated prospectively with ultrasonography. Quadriceps thickness was measured on both sides. Moreover, muscle thickness was measured in 59 control subjects. The patients were divided into eight groups; transient synovitis (n = 134), Perthes' disease (n = 35), slipped capital femoral epiphysis (n = 5), osteomyelitis (n = 4), aspecific synovitis (n = 5), rheumatoid arthritis (n = 3) and miscellaneous (n = 16). In 125 patients, no sonographic and radiological abnormalities were found and during follow-up the symptoms disappeared ('no pathology' group). Ipsilateral muscle wasting was present in all patient groups, whereas the control subjects showed no significant difference in muscle thickness between legs. The degree of muscle wasting was compared between transient synovitis, the 'no pathology' group, Perthes' disease and control subjects. For both quadriceps and vastus intermedius muscles, there was a significant difference between these groups, except between control subjects and the 'no pathology' group. For the rectus femoris muscle, there was a significant difference between these groups, except between transient synovitis and 'no pathology'. Muscle wasting showed a positive correlation with duration of symptoms and pre-existing muscle mass. In conclusion, different diseases show different degrees of muscle wasting, and there are different patterns of muscle wasting of various components of the quadriceps femoris muscle.

  15. Alteration of Surface EMG amplitude levels of five major trunk muscles by defined electrode location displacement.

    PubMed

    Huebner, Agnes; Faenger, Bernd; Schenk, Philipp; Scholle, Hans-Christoph; Anders, Christoph

    2015-04-01

    Exact electrode positioning is vital for obtaining reliable results in Surface EMG. This study aimed at systematically assessing the influence of defined electrode shifts on measured Surface EMG amplitudes of trunk muscles in a group of 15 middle aged healthy male subjects. The following leftsided muscles were investigated: rectus abdominis muscle, internal and external oblique abdominal muscles, lumbar multifidus muscle, and longissimus muscle. In addition to the recommended electrode positions, extra electrodes were placed parallel to these and along muscle fiber direction. Measurements were performed under isometric conditions in upright body position. Gradually changing, but defined loads were applied considering subject's upper body weight. For the abdominal muscles amplitude differences varied considerably depending on load level, magnitude, and direction. For both back muscles amplitudes dropped consistently but rather little for parallel electrode displacements. However, for the longissimus muscle a caudal electrode shift resulted in an amplitude increase of similar extent and independent from load level. Influence of electrode position variations can be proven for all trunk muscles but are more evident in abdominal than back muscles. Those muscle-specific effects confirm the necessity for an exact definition of electrode positioning to allow comparisons between individual subjects, groups of subjects, and studies.

  16. Abdominal Closure after TRAM Flap Breast Reconstruction with Transversus Abdominis Muscle Release and Mesh

    PubMed Central

    Avendano-Peza, Héctor; Novitsky, Yuri W.

    2016-01-01

    Summary: Breast reconstruction with a pedicled transverse rectus abdominis muscle (TRAM) flap can result in significant abdominal wall donor-site morbidity. Although the pedicled TRAM flap donor area reinforced with mesh results in decreased rates of postoperative abdominal bulging and hernias, the best technique to accomplish that is yet to be elucidated. We present our novel technique of posterior components separation with transversus abdominis muscle release and retromuscular mesh reinforcement for donor-area closure during pedicled TRAM flap breast reconstruction. PMID:27757337

  17. Sarcopenia in Orthopedic Surgery.

    PubMed

    Bokshan, Steven L; DePasse, J Mason; Daniels, Alan H

    2016-01-01

    Sarcopenia is a loss of skeletal muscle mass in the elderly that is an independent risk factor for falls, disability, postoperative complications, and mortality. Although its cause is not completely understood, sarcopenia generally results from a complex bone-muscle interaction in the setting of chronic disease and aging. Sarcopenia cannot be diagnosed by muscle mass alone. Diagnosis requires 2 of the following 3 criteria: low skeletal muscle mass, inadequate muscle strength, and inadequate physical performance. Forty-four percent of elderly patients undergoing orthopedic surgery and 24% of all patients 65 to 70 years old are sarcopenic. Although dual-energy x-ray absorptiometry and bioelectrical impedance analysis may be used to measure sarcopenia and are relatively inexpensive and accessible, they are generally considered less specific for sarcopenia compared with computed tomography and magnetic resonance imaging. Sarcopenia has been shown to predict poor outcomes within the medical and surgical populations and has been directly correlated with increases in taxpayer costs. Strengthening therapy and nutritional supplementation have become the mainstays of sarcopenia treatment. Specifically, the American Medical Directors Association has released guidelines for nutritional supplementation. Although sarcopenia frequently occurs with osteoporosis, it is an independent predictor of fragility fractures. Initiatives to diagnose, treat, and prevent sarcopenia in orthopedic patients are needed. Further investigation must also explore sarcopenia as a predictor of surgical outcomes in orthopedic patients. PMID:26913764

  18. Biochemical and transcriptomic analyses of two bovine skeletal muscles in Charolais bulls divergently selected for muscle growth.

    PubMed

    Sudre, Karine; Cassar-Malek, Isabelle; Listrat, Anne; Ueda, Yasuko; Leroux, Christine; Jurie, Catherine; Auffray, Charles; Renand, Gilles; Martin, Patrice; Hocquette, Jean-François

    2005-06-01

    This work aimed to investigate the consequences of muscle growth selection on muscle characteristics. An oxidative muscle (Rectus abdominis, RA) and a glycolytic one (Semitendinosus, ST) were studied in two groups of six extreme young Charolais bulls of high or low muscle growth. Mitochondrial activity was lower in muscles of bulls with high muscle growth. Transcriptomic studies allowed the identification of putatively differentially expressed genes. The differential expression between genetic types of two genes in RA (a heat shock protein and a thyroid receptor interacting protein) and of seven genes in ST (including LEU5, tropomyosin 2, and sarcosin) was confirmed by different statistical approaches or Northern blot analysis, as well as the differential expression of five genes (including PSMD4 and DPM synthase) between RA and ST. Both biochemical and transcriptomic results indicate that selection on muscle growth potential is associated with reduced slow-oxidative muscle characteristics. Further studies are required to understand the physiological importance of genes whose expression is changed by selection.

  19. Optimizing the Distribution of Leg Muscles for Vertical Jumping.

    PubMed

    Wong, Jeremy D; Bobbert, Maarten F; van Soest, Arthur J; Gribble, Paul L; Kistemaker, Dinant A

    2016-01-01

    A goal of biomechanics and motor control is to understand the design of the human musculoskeletal system. Here we investigated human functional morphology by making predictions about the muscle volume distribution that is optimal for a specific motor task. We examined a well-studied and relatively simple human movement, vertical jumping. We investigated how high a human could jump if muscle volume were optimized for jumping, and determined how the optimal parameters improve performance. We used a four-link inverted pendulum model of human vertical jumping actuated by Hill-type muscles, that well-approximates skilled human performance. We optimized muscle volume by allowing the cross-sectional area and muscle fiber optimum length to be changed for each muscle, while maintaining constant total muscle volume. We observed, perhaps surprisingly, that the reference model, based on human anthropometric data, is relatively good for vertical jumping; it achieves 90% of the jump height predicted by a model with muscles designed specifically for jumping. Alteration of cross-sectional areas-which determine the maximum force deliverable by the muscles-constitutes the majority of improvement to jump height. The optimal distribution results in large vastus, gastrocnemius and hamstrings muscles that deliver more work, while producing a kinematic pattern essentially identical to the reference model. Work output is increased by removing muscle from rectus femoris, which cannot do work on the skeleton given its moment arm at the hip and the joint excursions during push-off. The gluteus composes a disproportionate amount of muscle volume and jump height is improved by moving it to other muscles. This approach represents a way to test hypotheses about optimal human functional morphology. Future studies may extend this approach to address other morphological questions in ethological tasks such as locomotion, and feature other sets of parameters such as properties of the skeletal

  20. Optimizing the Distribution of Leg Muscles for Vertical Jumping.

    PubMed

    Wong, Jeremy D; Bobbert, Maarten F; van Soest, Arthur J; Gribble, Paul L; Kistemaker, Dinant A

    2016-01-01

    A goal of biomechanics and motor control is to understand the design of the human musculoskeletal system. Here we investigated human functional morphology by making predictions about the muscle volume distribution that is optimal for a specific motor task. We examined a well-studied and relatively simple human movement, vertical jumping. We investigated how high a human could jump if muscle volume were optimized for jumping, and determined how the optimal parameters improve performance. We used a four-link inverted pendulum model of human vertical jumping actuated by Hill-type muscles, that well-approximates skilled human performance. We optimized muscle volume by allowing the cross-sectional area and muscle fiber optimum length to be changed for each muscle, while maintaining constant total muscle volume. We observed, perhaps surprisingly, that the reference model, based on human anthropometric data, is relatively good for vertical jumping; it achieves 90% of the jump height predicted by a model with muscles designed specifically for jumping. Alteration of cross-sectional areas-which determine the maximum force deliverable by the muscles-constitutes the majority of improvement to jump height. The optimal distribution results in large vastus, gastrocnemius and hamstrings muscles that deliver more work, while producing a kinematic pattern essentially identical to the reference model. Work output is increased by removing muscle from rectus femoris, which cannot do work on the skeleton given its moment arm at the hip and the joint excursions during push-off. The gluteus composes a disproportionate amount of muscle volume and jump height is improved by moving it to other muscles. This approach represents a way to test hypotheses about optimal human functional morphology. Future studies may extend this approach to address other morphological questions in ethological tasks such as locomotion, and feature other sets of parameters such as properties of the skeletal

  1. Lower extremity muscle activation during baseball pitching.

    PubMed

    Campbell, Brian M; Stodden, David F; Nixon, Megan K

    2010-04-01

    The purpose of this study was to investigate muscle activation levels of select lower extremity muscles during the pitching motion. Bilateral surface electromyography data on 5 lower extremity muscles (biceps femoris, rectus femoris, gluteus maximus, vastus medialis, and gastrocnemius) were collected on 11 highly skilled baseball pitchers and compared with individual maximal voluntary isometric contraction (MVIC) data. The pitching motion was divided into 4 distinct phases: phase 1, initiation of pitching motion to maximum stride leg knee height; phase 2, maximum stride leg knee height to stride foot contact (SFC); phase 3, SFC to ball release; and phase 4, ball release to 0.5 seconds after ball release (follow-through). Results indicated that trail leg musculature elicited moderate to high activity levels during phases 2 and 3 (38-172% of MVIC). Muscle activity levels of the stride leg were moderate to high during phases 2-4 (23-170% of MVIC). These data indicate a high demand for lower extremity strength and endurance. Specifically, coaches should incorporate unilateral and bilateral lower extremity exercises for strength improvement or maintenance and to facilitate dynamic stabilization of the lower extremities during the pitching motion.

  2. Adaptation of Slow Myofibers: The Effect of Sustained BDNF Treatment of Extraocular Muscles in Infant Nonhuman Primates

    PubMed Central

    Willoughby, Christy L.; Fleuriet, Jérome; Walton, Mark M.; Mustari, Michael J.; McLoon, Linda K.

    2015-01-01

    Purpose. We evaluated promising new treatment options for strabismus. Neurotrophic factors have emerged as a potential treatment for oculomotor disorders because of diverse roles in signaling to muscles and motor neurons. Unilateral treatment with sustained release brain-derived neurotrophic factor (BDNF) to a single lateral rectus muscle in infant monkeys was performed to test the hypothesis that strabismus would develop in correlation with extraocular muscle (EOM) changes during the critical period for development of binocularity. Methods. The lateral rectus muscles of one eye in two infant macaques were treated with sustained delivery of BDNF for 3 months. Eye alignment was assessed using standard photographic methods. Muscle specimens were analyzed to examine the effects of BDNF on the density, morphology, and size of neuromuscular junctions, as well as myofiber size. Counts were compared to age-matched controls. Results. No change in eye alignment occurred with BDNF treatment. Compared to control muscle, neuromuscular junctions on myofibers expressing slow myosins had a larger area. Myofibers expressing slow myosin had larger diameters, and the percentage of myofibers expressing slow myosins increased in the proximal end of the muscle. Expression of BDNF was examined in control EOM, and observed to have strongest immunoreactivity outside the endplate zone. Conclusions. We hypothesize that the oculomotor system adapted to sustained BDNF treatment to preserve normal alignment. Our results suggest that BDNF treatment preferentially altered myofibers expressing slow myosins. This implicates BDNF signaling as influencing the slow twitch properties of EOM. PMID:26030102

  3. Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series

    PubMed Central

    Bhave, Anil; Zywiel, Michael G; Ulrich, Slif D; McGrath, Mike S; Seyler, Thorsten M; Marker, David R; Delanois, Ronald E; Mont, Michael A

    2009-01-01

    Background Development of hip adductor, tensor fascia lata, and rectus femoris muscle contractures following total hip arthroplasties are quite common, with some patients failing to improve despite treatment with a variety of non-operative modalities. The purpose of the present study was to describe the use of and patient outcomes of botulinum toxin injections as an adjunctive treatment for muscle tightness following total hip arthroplasty. Methods Ten patients (14 hips) who had hip adductor, abductor, and/or flexor muscle contractures following total arthroplasty and had been refractory to physical therapeutic efforts were treated with injection of botulinum toxin A. Eight limbs received injections into the adductor muscle, 8 limbs received injections into the tensor fascia lata muscle, and 2 limbs received injection into the rectus femoris muscle, followed by intensive physical therapy for 6 weeks. Results At a mean final follow-up of 20 months, all 14 hips had increased range in the affected arc of motion, with a mean improvement of 23 degrees (range, 10 to 45 degrees). Additionally all hips had an improvement in hip scores, with a significant increase in mean score from 74 points (range, 57 to 91 points) prior to injection to a mean of 96 points (range, 93 to 98) at final follow-up. There were no serious treatment-related adverse events. Conclusion Botulinum toxin A injections combined with intensive physical therapy may be considered as a potential treatment modality, especially in difficult cases of muscle tightness that are refractory to standard therapy. PMID:19709429

  4. Changes in Activation of Abdominal Muscles at Selected Angles During Trunk Exercise by Using Ultrasonography

    PubMed Central

    Kim, Hyun-Dong; Bae, Hyun-Woo; Kim, Jong-Gil; Han, Nami; Eom, Mi-Ja

    2015-01-01

    Objective To investigate the changes of activation of the abdominal muscles depending on exercise angles and whether the activation of rectus abdominis differs according to the location, during curl up and leg raise exercises, by measuring the thickness ratio of abdominal muscles using ultrasonography. Methods We examined 30 normal adults without musculoskeletal problems. Muscle thickness was measured in the upper rectus abdominis (URA), lower rectus abdominis (LRA), obliquus externus (EO), obliquus internus (IO), and transversus abdominis (TrA), at pre-determined angles (30°, 60°, 90°) and additionally at the resting angle (0°). Muscle thickness ratio was calculated by dividing the resting (0°) thickness for each angle, and was used as reflection of muscle activity. Results The muscle thickness ratio was significantly different depending on the angles in URA and LRA. For curl up-URA p=0 (30°<60°), p=0 (60°>90°), p=0.44 (30°<90°) and LRA p=0.01 (30°<60°), p=0 (60°>90°), p=0.44 (30°>90°), respectively, by one-way ANOVA test-and for leg raise-URA p=0 (30°<60°), p=0 (60°<90°), p=0 (30°<90°) and LRA p=0.01 (30°<60°), p=0 (60°<90°), p=0 (30°<90°), respectively, by one-way ANOVA test-exercises, but not in the lateral abdominal muscles (EO, IO, and TrA). Also, there was no significant difference in the muscle thickness ratio of URA and LRA during both exercises. In the aspect of muscle activity, there was significant difference in the activation of RA muscle by selected angles, but not according to location during both exercises. Conclusion According to this study, exercise angle is thought to be an important contributing factor for strengthening of RA muscle; however, both the exercises are thought to have no property of strengthening RA muscle selectively based on the location. PMID:26798609

  5. The hyal and ventral branchial muscles in caecilian and salamander larvae: homologies and evolution.

    PubMed

    Kleinteich, Thomas; Haas, Alexander

    2011-05-01

    Amphibians (Lissamphibia) are characterized by a bi-phasic life-cycle that comprises an aquatic larval stage and metamorphosis to the adult. The ancestral aquatic feeding behavior of amphibian larvae is suction feeding. The negative pressure that is needed for ingestion of prey is created by depression of the hyobranchial apparatus as a result of hyobranchial muscle action. Understanding the homologies of hyobranchial muscles in amphibian larvae is a crucial step in understanding the evolution of this important character complex. However, the literature mostly focuses on the adult musculature and terms used for hyal and ventral branchial muscles in different amphibians often do not reflect homologies across lissamphibian orders. Here we describe the hyal and ventral branchial musculature in larvae of caecilians (Gymnophiona) and salamanders (Caudata), including juveniles of two permanently aquatic salamander species. Based on previous alternative terminology schemes, we propose a terminology for the hyal and ventral branchial muscles that reflects the homologies of muscles and that is suited for studies on hyobranchial muscle evolution in amphibians. We present a discussion of the hyal and ventral branchial muscles in larvae of the most recent common ancestor of amphibians (i.e. the ground plan of Lissamphibia). Based on our terminology, the hyal and ventral branchial musculature of caecilians and salamanders comprises the following muscles: m. depressor mandibulae, m. depressor mandibulae posterior, m. hyomandibularis, m. branchiohyoideus externus, m. interhyoideus, m. interhyoideus posterior, m. subarcualis rectus I, m. subarcualis obliquus II, m. subarcualis obliquus III, m. subarcualis rectus II-IV, and m. transversus ventralis IV. Except for the m. branchiohyoideus externus, all muscles considered herein can be assigned to the ground plan of the Lissamphibia with certainty. The m. branchiohyoideus externus is either apomorphic for the Batrachia (frogs

  6. The Gross Morphology and Histochemistry of Respiratory Muscles in Bottlenose Dolphins, Tursiops truncatus

    PubMed Central

    Cotten, Pamela B.; Piscitelli, Marina A.; McLellan, William A.; Rommel, Sentiel A.; Dearolf, Jennifer L.; Pabst, D. Ann

    2011-01-01

    Most mammals possess stamina because their locomotor and respiratory (i.e., ventilatory) systems are mechanically coupled. These systems are decoupled, however, in bottlenose dolphins (Tursiops truncatus) as they swim on a breath-hold. Locomotion and ventilation are coupled only during their brief surfacing event, when they respire explosively (up to 90% of total lung volume in approximately 0.3s) (Ridgway et al., 1969). The predominantly slow-twitch fiber profile of their diaphragm (Dearolf, 2003) suggests that this muscle does not likely power their rapid ventilatory event. Based upon Bramble's (1989) biomechanical model of locomotor-respiratory coupling in galloping mammals, it was hypothesized that locomotor muscles function to power ventilation in bottlenose dolphins. It was further hypothesized that these muscles would be composed predominantly of fast-twitch fibers to facilitate the bottlenose dolphin's rapid ventilation. The gross morphology of cranio-cervical (scalenus, sternocephalicus, sternohyoid), thoracic (intercostals, transverse thoracis), and lumbo-pelvic (hypaxialis, rectus abdominis, abdominal obliques) muscles (n=7) and the fiber-type profiles (n=6) of selected muscles (scalenus, sternocephalicus, sternohyoid, rectus abdominis) of bottlenose dolphins were investigated. Physical manipulations of excised thoracic units were carried out to investigate potential actions of these muscles. Results suggest that the cranio-cervical muscles act to draw the sternum and associated ribs cranio-dorsally, which flares the ribs laterally, and increases the thoracic cavity volume required for inspiration. The lumbo-pelvic muscles act to draw the sternum and caudal ribs caudally, which decreases the volumes of the thoracic and abdominal cavities required for expiration. All muscles investigated were composed predominantly of fast-twitch fibers (range 61-88% by area) and appear histochemically poised for rapid contraction. These combined results suggest that

  7. Trunk Muscle Activation and Estimating Spinal Compressive Force in Rope and Harness Vertical Dance.

    PubMed

    Wilson, Margaret; Dai, Boyi; Zhu, Qin; Humphrey, Neil

    2015-12-01

    Rope and harness vertical dance takes place off the floor with the dancer suspended from his or her center of mass in a harness attached to a rope from a point overhead. Vertical dance represents a novel environment for training and performing in which expected stresses on the dancer's body are different from those that take place during dance on the floor. Two male and eleven female dancers with training in vertical dance performed six typical vertical dance movements with electromyography (EMG) electrodes placed bilaterally on rectus abdominus, external oblique, erector spinae, and latissimus dorsi. EMG data were expressed as a percentage of maximum voluntary isometric contraction (MVIC). A simplified musculoskeletal model based on muscle activation for these four muscle groups was used to estimate the compressive force on the spine. The greatest muscle activation for erector spinae and latissimus dorsi and the greatest trunk compressive forces were seen in vertical axis positions where the dancer was moving the trunk into a hyper-extended position. The greatest muscle activation for rectus abdominus and external oblique and the second highest compressive force were seen in a supine position with the arms and legs extended away from the center of mass (COM). The least muscle activation occurred in positions where the limbs were hanging below the torso. These movements also showed relatively low muscle activation compression forces. Post-test survey results revealed that dancers felt comfortable in these positions; however, observation of some positions indicated insufficient muscular control. Computing the relative contribution of muscles, expressed as muscle activation and estimated spinal compression, provided a measure of how much the muscle groups were working to support the spine and the rest of the dancer's body in the different movements tested. Additionally, identifying typical muscle recruitment patterns in each movement will help identify key exercises

  8. The hyal and ventral branchial muscles in caecilian and salamander larvae: homologies and evolution.

    PubMed

    Kleinteich, Thomas; Haas, Alexander

    2011-05-01

    Amphibians (Lissamphibia) are characterized by a bi-phasic life-cycle that comprises an aquatic larval stage and metamorphosis to the adult. The ancestral aquatic feeding behavior of amphibian larvae is suction feeding. The negative pressure that is needed for ingestion of prey is created by depression of the hyobranchial apparatus as a result of hyobranchial muscle action. Understanding the homologies of hyobranchial muscles in amphibian larvae is a crucial step in understanding the evolution of this important character complex. However, the literature mostly focuses on the adult musculature and terms used for hyal and ventral branchial muscles in different amphibians often do not reflect homologies across lissamphibian orders. Here we describe the hyal and ventral branchial musculature in larvae of caecilians (Gymnophiona) and salamanders (Caudata), including juveniles of two permanently aquatic salamander species. Based on previous alternative terminology schemes, we propose a terminology for the hyal and ventral branchial muscles that reflects the homologies of muscles and that is suited for studies on hyobranchial muscle evolution in amphibians. We present a discussion of the hyal and ventral branchial muscles in larvae of the most recent common ancestor of amphibians (i.e. the ground plan of Lissamphibia). Based on our terminology, the hyal and ventral branchial musculature of caecilians and salamanders comprises the following muscles: m. depressor mandibulae, m. depressor mandibulae posterior, m. hyomandibularis, m. branchiohyoideus externus, m. interhyoideus, m. interhyoideus posterior, m. subarcualis rectus I, m. subarcualis obliquus II, m. subarcualis obliquus III, m. subarcualis rectus II-IV, and m. transversus ventralis IV. Except for the m. branchiohyoideus externus, all muscles considered herein can be assigned to the ground plan of the Lissamphibia with certainty. The m. branchiohyoideus externus is either apomorphic for the Batrachia (frogs

  9. The effects of sling exercise using vibration on trunk muscle activities of healthy adults.

    PubMed

    Choi, Youngin; Kang, Hyungkyu

    2013-10-01

    [Purpose] This study compared the effects of sling exercises with and without vibration on the muscular activity of the internal oblique (IO), rectus abdominis (RA), multifidus (MF), and erector spinae (ES) muscles of healthy adults. [Methods] Eleven healthy university students (11 men) with a mean age of 22.8 years were enrolled in this study. Subjects performed supine and prone bridge exercises with the knees flexed using a sling suspension system with and without vibration. The amplitudes of the EMG activities of selected trunk muscles (internal oblique, rectus abdominis, erector spinae, multifidus) were recorded. Two types of exercise conditions were executed in a random sequence for 5 seconds each. The signals detected from the middle 3 seconds (after discarding the signals of the first and the last one seconds) were used in the analysis. A 3-minute break was given after each exercise to minimize muscle fatigue. [Results] During the supine bridge exercise with vibration, the activities of the IO, RA, MF, and ES muscles were significantly higher than those of the supine bridge exercise without vibration. Additionally, during the prone bridge exercise with vibration, the activities of the IO, RA, MF, and ES were significantly higher than those of the prone bridge exercise without vibration. [Conclusion] Sling exercises with vibration improved the trunk muscle activities of healthy adults compared to the sling exercises without vibration. The information presented here is important for clinicians who use lumbar stabilization exercises as an evaluation tool or a rehabilitation exercise. PMID:24259778

  10. The effects of sling exercise using vibration on trunk muscle activities of healthy adults.

    PubMed

    Choi, Youngin; Kang, Hyungkyu

    2013-10-01

    [Purpose] This study compared the effects of sling exercises with and without vibration on the muscular activity of the internal oblique (IO), rectus abdominis (RA), multifidus (MF), and erector spinae (ES) muscles of healthy adults. [Methods] Eleven healthy university students (11 men) with a mean age of 22.8 years were enrolled in this study. Subjects performed supine and prone bridge exercises with the knees flexed using a sling suspension system with and without vibration. The amplitudes of the EMG activities of selected trunk muscles (internal oblique, rectus abdominis, erector spinae, multifidus) were recorded. Two types of exercise conditions were executed in a random sequence for 5 seconds each. The signals detected from the middle 3 seconds (after discarding the signals of the first and the last one seconds) were used in the analysis. A 3-minute break was given after each exercise to minimize muscle fatigue. [Results] During the supine bridge exercise with vibration, the activities of the IO, RA, MF, and ES muscles were significantly higher than those of the supine bridge exercise without vibration. Additionally, during the prone bridge exercise with vibration, the activities of the IO, RA, MF, and ES were significantly higher than those of the prone bridge exercise without vibration. [Conclusion] Sling exercises with vibration improved the trunk muscle activities of healthy adults compared to the sling exercises without vibration. The information presented here is important for clinicians who use lumbar stabilization exercises as an evaluation tool or a rehabilitation exercise.

  11. Skeletal muscle responses to unloading in humans

    NASA Technical Reports Server (NTRS)

    Dudley, G.; Tesch, P.; Hather, B.; Adams, G.; Buchanan, P.

    1992-01-01

    This study examined the effects of unloading on skeletal muscle structure. Method: Eight subjects walked on crutches for six weeks with a 110 cm elevated sole on the right shoe. This removed weight bearing by the left lower limb. Magnetic resonance imaging of both lower limbs and biopsies of the left m. vastus laterallis (VL) were used to study muscle structure. Results: Unloading decreased (P less than 0.05) muscle cross-sectional areas (CSA) of the knee extensors 16 percent. The knee flexors showed about 1/2 of this response (-7 percent, P less than 0.05). The three vasti muscles each showed decreases (P less than 0.05) of about 15 percent. M. rectus femoris did not change. Mean fiber CSA in VL decreased (P less than 0.05) 14 percent with type 2 and type 1 fibers showing reductions of 15 and 11 percent respectively. The ankle extensors showed a 20 percent decrease (P less than 0.05) in CSA. The reduction for the 'fast' m. gastrocnemius was 27 percent compared to the 18 percent decrease for the 'slow' soleus. Summary: The results suggest that decreases in muscle CSA are determined by the relative change in impact loading history because atrophy was (1) greater in extensor than flexor muscles, (2) at least as great in fast as compared to slow muscles or fibers, and (3) not dependent on single or multi-joint function. They also suggest that the atrophic responses to unloading reported for lower mammals are quantitatively but not qualitatively similar to those of humans.

  12. Core Muscle Activation in One-Armed and Two-Armed Kettlebell Swing.

    PubMed

    Andersen, Vidar; Fimland, Marius S; Gunnarskog, Aril; Jungård, Georg-Andrè; Slåttland, Roy-Andrè; Vraalsen, Øyvind F; Saeterbakken, Atle H

    2016-05-01

    The aim of the study was to compare the electromyographic activity of rectus abdominis, oblique external, and lower and upper erector spinae at both sides of the truncus in 1-armed and 2-armed kettlebell swing. Sixteen healthy men performed 10 repetitions of both exercises using a 16-kg kettlebell in randomized order. For the upper erector spinae, the activation of the contralateral side during 1-armed swing was 24% greater than that of the ipsilateral side during 1-armed swing (p < 0.001) and 11% greater during 2-armed swing (p = 0.026). Furthermore, the activation in 2-armed swing was 12-16% greater than for the ipsilateral side in 1-armed swing (p < 0.001). For rectus abdominis, however, 42% lower activation of the contralateral side was observed during 1-armed swing compared with ipsilateral sides during 2-armed swing (p = 0.038) and 48% compared with the ipsilateral side during 1-armed swing (p = 0.044). Comparing the different phases of the swing, most differences in the upper erector spinae were found in the lower parts of the movement, whereas for the rectus abdominis, the differences were found during the hip extension. In contrast, similar muscle activity in the lower erector spinae and external oblique between the different conditions was observed (p = 0.055-0.969). In conclusion, performing the kettlebell swing with 1 arm resulted in greater neuromuscular activity for the contralateral side of the upper erector spinae and ipsilateral side of the rectus abdominis, and lower activation of the opposite side of the respective muscles.

  13. Optimizing the Distribution of Leg Muscles for Vertical Jumping

    PubMed Central

    Wong, Jeremy D.; Bobbert, Maarten F.; van Soest, Arthur J.; Gribble, Paul L.; Kistemaker, Dinant A.

    2016-01-01

    A goal of biomechanics and motor control is to understand the design of the human musculoskeletal system. Here we investigated human functional morphology by making predictions about the muscle volume distribution that is optimal for a specific motor task. We examined a well-studied and relatively simple human movement, vertical jumping. We investigated how high a human could jump if muscle volume were optimized for jumping, and determined how the optimal parameters improve performance. We used a four-link inverted pendulum model of human vertical jumping actuated by Hill-type muscles, that well-approximates skilled human performance. We optimized muscle volume by allowing the cross-sectional area and muscle fiber optimum length to be changed for each muscle, while maintaining constant total muscle volume. We observed, perhaps surprisingly, that the reference model, based on human anthropometric data, is relatively good for vertical jumping; it achieves 90% of the jump height predicted by a model with muscles designed specifically for jumping. Alteration of cross-sectional areas—which determine the maximum force deliverable by the muscles—constitutes the majority of improvement to jump height. The optimal distribution results in large vastus, gastrocnemius and hamstrings muscles that deliver more work, while producing a kinematic pattern essentially identical to the reference model. Work output is increased by removing muscle from rectus femoris, which cannot do work on the skeleton given its moment arm at the hip and the joint excursions during push-off. The gluteus composes a disproportionate amount of muscle volume and jump height is improved by moving it to other muscles. This approach represents a way to test hypotheses about optimal human functional morphology. Future studies may extend this approach to address other morphological questions in ethological tasks such as locomotion, and feature other sets of parameters such as properties of the skeletal

  14. Is muscle coordination affected by loading condition in ballistic movements?

    PubMed

    Giroux, Caroline; Guilhem, Gaël; Couturier, Antoine; Chollet, Didier; Rabita, Giuseppe

    2015-02-01

    This study aimed to investigate the effect of loading on lower limb muscle coordination involved during ballistic squat jumps. Twenty athletes performed ballistic squat jumps on a force platform. Vertical force, velocity, power and electromyographic (EMG) activity of lower limb muscles were recorded during the push-off phase and compared between seven loading conditions (0-60% of the concentric-only maximal repetition). The increase in external load increased vertical force (from 1962 N to 2559 N; P=0.0001), while movement velocity decreased (from 2.5 to 1.6 ms(-1); P=0.0001). EMG activity of tibialis anterior first peaked at 5% of the push-off phase, followed by gluteus maximus (35%), vastus lateralis and soleus (45%), rectus femoris (55%), gastrocnemius lateralis (65%) and semitendinosus (75%). This sequence of activation (P=0.67) and the amplitude of muscle activity (P=0.41) of each muscle were not affected by loading condition. However, a main effect of muscle was observed on these parameters (peak value: P<0.001; peak occurrence: P=0.02) illustrating the specific role of each muscle during the push-off phase. Our findings suggest that muscle coordination is not influenced by external load during a ballistic squat jump.

  15. Muscle Activation during Gait in Children with Duchenne Muscular Dystrophy

    PubMed Central

    Vuillerot, Carole; Tiffreau, Vincent; Peudenier, Sylviane; Cuisset, Jean-Marie; Pereon, Yann; Leboeuf, Fabien; Delporte, Ludovic; Delpierre, Yannick; Gross, Raphaël

    2016-01-01

    The aim of this prospective study was to investigate changes in muscle activity during gait in children with Duchenne muscular Dystrophy (DMD). Dynamic surface electromyography recordings (EMGs) of 16 children with DMD and pathological gait were compared with those of 15 control children. The activity of the rectus femoris (RF), vastus lateralis (VL), medial hamstrings (HS), tibialis anterior (TA) and gastrocnemius soleus (GAS) muscles was recorded and analysed quantitatively and qualitatively. The overall muscle activity in the children with DMD was significantly different from that of the control group. Percentage activation amplitudes of RF, HS and TA were greater throughout the gait cycle in the children with DMD and the timing of GAS activity differed from the control children. Significantly greater muscle coactivation was found in the children with DMD. There were no significant differences between sides. Since the motor command is normal in DMD, the hyper-activity and co-contractions likely compensate for gait instability and muscle weakness, however may have negative consequences on the muscles and may increase the energy cost of gait. Simple rehabilitative strategies such as targeted physical therapies may improve stability and thus the pattern of muscle activity. PMID:27622734

  16. Muscle Activation during Gait in Children with Duchenne Muscular Dystrophy.

    PubMed

    Ropars, Juliette; Lempereur, Mathieu; Vuillerot, Carole; Tiffreau, Vincent; Peudenier, Sylviane; Cuisset, Jean-Marie; Pereon, Yann; Leboeuf, Fabien; Delporte, Ludovic; Delpierre, Yannick; Gross, Raphaël; Brochard, Sylvain

    2016-01-01

    The aim of this prospective study was to investigate changes in muscle activity during gait in children with Duchenne muscular Dystrophy (DMD). Dynamic surface electromyography recordings (EMGs) of 16 children with DMD and pathological gait were compared with those of 15 control children. The activity of the rectus femoris (RF), vastus lateralis (VL), medial hamstrings (HS), tibialis anterior (TA) and gastrocnemius soleus (GAS) muscles was recorded and analysed quantitatively and qualitatively. The overall muscle activity in the children with DMD was significantly different from that of the control group. Percentage activation amplitudes of RF, HS and TA were greater throughout the gait cycle in the children with DMD and the timing of GAS activity differed from the control children. Significantly greater muscle coactivation was found in the children with DMD. There were no significant differences between sides. Since the motor command is normal in DMD, the hyper-activity and co-contractions likely compensate for gait instability and muscle weakness, however may have negative consequences on the muscles and may increase the energy cost of gait. Simple rehabilitative strategies such as targeted physical therapies may improve stability and thus the pattern of muscle activity. PMID:27622734

  17. Comparison of Estimated and Measured Muscle Activity During Inclined Walking.

    PubMed

    Alexander, Nathalie; Schwameder, Hermann

    2016-04-01

    While inclined walking is a frequent daily activity, muscle forces during this activity have rarely been examined. Musculoskeletal models are commonly used to estimate internal forces in healthy populations, but these require a priori validation. The aim of this study was to compare estimated muscle activity using a musculoskeletal model with measured EMG data during inclined walking. Ten healthy male participants walked at different inclinations of 0°, ± 6°, ± 12°, and ± 18° on a ramp equipped with 2 force plates. Kinematics, kinetics, and muscle activity of the musculus (m.) biceps femoris, m. rectus femoris, m. vastus lateralis, m. tibialis anterior, and m. gastrocnemius lateralis were recorded. Agreement between estimated and measured muscle activity was determined via correlation coefficients, mean absolute errors, and trend analysis. Correlation coefficients between estimated and measured muscle activity for approximately 69% of the conditions were above 0.7. Mean absolute errors were rather high with only approximately 38% being ≤ 30%. Trend analysis revealed similar estimated and measured muscle activities for all muscles and tasks (uphill and downhill walking), except m. tibialis anterior during uphill walking. This model can be used for further analysis in similar groups of participants.

  18. Strabismus Surgery

    MedlinePlus

    ... used. Some surgeons prescribe an antibiotic or combination antibiotic/steroid drop or ointment after surgery. More technical ... Screening Recommendations Loading... Most Common Searches Adult ...

  19. Breakpoints in ventilation, cerebral and muscle oxygenation, and muscle activity during an incremental cycling exercise

    PubMed Central

    Racinais, Sebastien; Buchheit, Martin; Girard, Olivier

    2014-01-01

    The aim of this study was to locate the breakpoints of cerebral and muscle oxygenation and muscle electrical activity during a ramp exercise in reference to the first and second ventilatory thresholds. Twenty-five cyclists completed a maximal ramp test on an electromagnetically braked cycle-ergometer with a rate of increment of 25 W/min. Expired gazes (breath-by-breath), prefrontal cortex and vastus lateralis (VL) oxygenation [Near-infrared spectroscopy (NIRS)] together with electromyographic (EMG) Root Mean Square (RMS) activity for the VL, rectus femoris (RF), and biceps femoris (BF) muscles were continuously assessed. There was a non-linear increase in both cerebral deoxyhemoglobin (at 56 ± 13% of the exercise) and oxyhemoglobin (56 ± 8% of exercise) concomitantly to the first ventilatory threshold (57 ± 6% of exercise, p > 0.86, Cohen's d < 0.1). Cerebral deoxyhemoglobin further increased (87 ± 10% of exercise) while oxyhemoglobin reached a plateau/decreased (86 ± 8% of exercise) after the second ventilatory threshold (81 ± 6% of exercise, p < 0.05, d > 0.8). We identified one threshold only for muscle parameters with a non-linear decrease in muscle oxyhemoglobin (78 ± 9% of exercise), attenuation in muscle deoxyhemoglobin (80 ± 8% of exercise), and increase in EMG activity of VL (89 ± 5% of exercise), RF (82 ± 14% of exercise), and BF (85 ± 9% of exercise). The thresholds in BF and VL EMG activity occurred after the second ventilatory threshold (p < 0.05, d > 0.6). Our results suggest that the metabolic and ventilatory events characterizing this latter cardiopulmonary threshold may affect both cerebral and muscle oxygenation levels, and in turn, muscle recruitment responses. PMID:24782786

  20. [Cosmetic eyelid surgery].

    PubMed

    Ruban, J-M; Barbier, J; Malet, T; Baggio, E

    2014-01-01

    Cosmetic eyelid surgery is becoming increasingly popular. It can rejuvenate the patient's appearance with relatively minor side effects. Its risk/benefit ratio is one of the best in facial cosmetic surgery. However, the patient does not always accurately assess the aesthetic appearance of his or her eyelids. This underscores the importance of clinical examination in order to determine the patient's wishes, and then make an accurate diagnosis and potential surgical plan. We currently oppose, in general, surgical techniques involving tissue removal (skin-muscle and/or fat) in favor of those involving tissue repositioning and grafting (autologous fat pearl transposition, obtained by liposuction, and lipostructure). Furthermore, the place of adjuvant therapies to blepharoplasty is steadily increasing. They mainly include surface treatments (peels and lasers), dermal fillers and anti-wrinkle botulinum toxin injections. They are also increasingly used in isolation in novel ways. In all cases, a perfect knowledge of anatomy and relevant skills and experience remain necessary.

  1. The origin of the temporalis muscle flap.

    PubMed

    Speculand, B

    1992-12-01

    This paper explores the origin of the temporalis muscle flap which has been attributed to Golovine, a Moscow ophthalmic surgeon, who described a forehead skin transposition flap. Small temporalis muscle transpositions were used in surgery for TMJ ankylosis, but the use of the majority of the muscle for reconstruction of facial defects was first described by Sir Harold Gillies during the 1914-18 war.

  2. Chiton myogenesis: perspectives for the development and evolution of larval and adult muscle systems in molluscs.

    PubMed

    Wanninger, Andreas; Haszprunar, Gerhard

    2002-02-01

    We investigated muscle development in two chiton species, Mopalia muscosa and Chiton olivaceus, from embryo hatching until 10 days after metamorphosis. The anlagen of the dorsal longitudinal rectus muscle and a larval prototroch muscle ring are the first detectable muscle structures in the early trochophore-like larva. Slightly later, a ventrolaterally situated pair of longitudinal muscles appears, which persists through metamorphosis. In addition, the anlagen of the putative dorsoventral shell musculature and the first fibers of a muscular grid, which is restricted to the pretrochal region and consists of outer ring and inner diagonal muscle fibers, are generated. Subsequently, transversal muscle fibers form underneath each future shell plate and the ventrolateral enrolling muscle is established. At metamorphic competence, the dorsoventral shell musculature consists of numerous serially repeated, intercrossing muscle fibers. Their concentration into seven (and later eight) functional shell plate muscle bundles starts after the completion of metamorphosis. The larval prototroch ring and the pretrochal muscle grid are lost at metamorphosis. The structure of the apical grid and its atrophy during metamorphosis suggests ontogenetic repetition of (parts of) the original body-wall musculature of a proposed worm-shaped molluscan ancestor. Moreover, our data show that the "segmented" character of the polyplacophoran shell musculature is a secondary condition, thus contradicting earlier theories that regarded the Polyplacophora (and thus the entire phylum Mollusca) as primarily eumetameric (annelid-like). Instead, we propose an unsegmented trochozoan ancestor at the base of molluscan evolution.

  3. Rhabdomyosarcoma: Surgery

    MedlinePlus

    ... is and what type of operation is done. Physical changes after surgery can range from little more than a scar to changes in appearance or in how some parts of the body function, which may require physical rehabilitation. For more on surgery as a treatment ...

  4. Modeling Muscles

    ERIC Educational Resources Information Center

    Goodwyn, Lauren; Salm, Sarah

    2007-01-01

    Teaching the anatomy of the muscle system to high school students can be challenging. Students often learn about muscle anatomy by memorizing information from textbooks or by observing plastic, inflexible models. Although these mediums help students learn about muscle placement, the mediums do not facilitate understanding regarding integration of…

  5. Unnecessary surgery.

    PubMed Central

    Leape, L L

    1989-01-01

    The extent of unnecessary surgery has been the object of considerable speculation and occasional wild accusation in recent years. Most evidence of the existence of unnecessary surgery, such as information from studies of geographic variations and the results of second surgical opinion programs, is circumstantial. However, results from the few studies that have measured unnecessary surgery directly indicate that for some highly controversial operations the fraction that are unwarranted could be as high as 30 percent. Most unnecessary surgery results from physician uncertainty about the effectiveness of an operation. Elimination of this uncertainty requires more efficient production and dissemination of scientific information about clinical effectiveness. In the absence of adequate data from scientific studies, the use of a consensus of expert opinion, disseminated by means of comprehensive practice guidelines, offers the best opportunity to identify and eliminate unnecessary surgery. PMID:2668237

  6. Piriformis muscle syndrome: a recurrent case after surgical release

    PubMed Central

    Haghnegahdar, Ali; Sedighi, Mahsa; Motalebi, Hassan

    2015-01-01

    We report a recurrent Piriformisc muscle syndrome after surgical release. After the primary neurolysis, a second operation was performed to release adhesions. This case shows a different type of sciatic nerve entrapment by an abnormal thin muscle slip. Results of the revision surgery guide us to the point that revision surgery for Piriformis muscle syndrome should be meticulously selected, and after considering medical and interventional therapies. PMID:26286539

  7. Piriformis muscle syndrome: a recurrent case after surgical release.

    PubMed

    Haghnegahdar, Ali; Sedighi, Mahsa; Motalebi, Hassan

    2015-08-18

    We report a recurrent Piriformisc muscle syndrome after surgical release. After the primary neurolysis, a second operation was performed to release adhesions. This case shows a different type of sciatic nerve entrapment by an abnormal thin muscle slip. Results of the revision surgery guide us to the point that revision surgery for Piriformis muscle syndrome should be meticulously selected, and after considering medical and interventional therapies.

  8. Myofascial force transmission between transferred rat flexor carpi ulnaris muscle and former synergistic palmaris longus muscle

    PubMed Central

    Maas, Huub; Huijing, Peter A.

    2011-01-01

    Summary We investigated the extent of mechanical interaction between rat flexor carpi ulnaris (FCU) and palmaris longus (PL) muscles following transfer of FCU to the distal tendons of extensor carpi radialis brevis and longus (ECRB/L) muscles. Five weeks after recovery from surgery, isometric forces exerted at the distal tendons of FCU and PL were quantified at various FCU lengths. PL was kept at a constant length. Changing the muscle-tendon complex length of transferred FCU (by maximally 3.5 mm) decreased PL force significantly (by 7%). A linear relationship was found between changes in FCU muscle belly length, being a measure of muscle relative positions, and PL force. These results indicate that despite transfer of FCU muscle to the extensor side of the forearm, changing FCU length still affects force transmission of its, now, antagonistic PL muscle. We conclude that a transferred muscle may still be mechanically linked to its former synergistic muscles. PMID:23738260

  9. Superior oblique surgery: when and how?

    PubMed Central

    Şekeroğlu, Hande Taylan; Sanac, Ali Sefik; Arslan, Umut; Sener, Emin Cumhur

    2013-01-01

    Background The purpose of this paper is to review different types of superior oblique muscle surgeries, to describe the main areas in clinical practice where superior oblique surgery is required or preferred, and to discuss the preferred types of superior oblique surgery with respect to their clinical outcomes. Methods A consecutive nonrandomized retrospective series of patients who had undergone superior oblique muscle surgery as a single procedure were enrolled in the study. The diagnosis, clinical features, preoperative and postoperative vertical deviations in primary position, type of surgery, complications, and clinical outcomes were reviewed. The primary outcome measures were the type of strabismus and the type of superior oblique muscle surgery. The secondary outcome measure was the results of the surgeries. Results The review identified 40 (20 male, 20 female) patients with a median age of 6 (2–45) years. Nineteen patients (47.5%) had Brown syndrome, eleven (27.5%) had fourth nerve palsy, and ten (25.0%) had horizontal deviations with A pattern. The most commonly performed surgery was superior oblique tenotomy in 29 (72.5%) patients followed by superior oblique tuck in eleven (27.5%) patients. The amount of vertical deviation in the fourth nerve palsy and Brown syndrome groups (P = 0.01 for both) and the amount of A pattern in the A pattern group were significantly reduced postoperatively (P = 0.02). Conclusion Surgery for the superior oblique muscle requires experience and appropriate preoperative evaluation in view of its challenging nature. The main indications are Brown syndrome, fourth nerve palsy, and A pattern deviations. Superior oblique surgery may be effective in terms of pattern collapse and correction of vertical deviations in primary position. PMID:23946644

  10. Pelvic floor muscle training in males: practical applications.

    PubMed

    Siegel, Andrew L

    2014-07-01

    The pelvic floor muscles are vital to male genitourinary health. Pelvic floor muscle training may prove helpful in a variety of clinical circumstances: stress urinary incontinence that follows prostate surgery, overactive bladder, postvoid dribbling, erectile dysfunction, ejaculation issues including premature ejaculation, and pelvic pain due to levator muscle spasm.

  11. [Microsurgery in reanimation, lymphoedema and hand surgery].

    PubMed

    Bonde, Christian T; Jensen, Lisa Toft; Tos, Tina; Kiil, Birgitte Jul; Toft, Gete Ester; Larsen, Søren Erik; Birkeland, Peter; Sørensen, Jens Ahm

    2016-06-01

    Microsurgery is defined as surgery performed with the aid of ocular magnification. In Denmark, this is undertaken by four units. This review describes the history of microsurgery which evolved during the 1960s. Microsurgery in hand surgery is primarily replantation and revascularisation but also peripheral nerve surgery as well as brachial plexus surgery. Lymphoedema is being treated with super microsurgery on an experimental basis. Dynamic reconstruction of facial palsy is performed in a two-stage operation with cross-over nerve graft and a free microvascular muscle flap, typically gracilis. PMID:27292577

  12. Muscle activation during lower body resistance training.

    PubMed

    Ebben, W P; Feldmann, C R; Dayne, A; Mitsche, D; Alexander, P; Knetzger, K J

    2009-01-01

    This study evaluated the biceps femoris (BF), rectus femoris (RF), and vastus lateralis (VL) activation and activation ratios of a variety of resistance training exercises characterized by knee extension, and determined if subject strength or gender affects these variables. The exercises evaluated included the leg extension, squat, deadlift, lunge, and step up. Subjects included 20 athletes and recreationally active college students. Electromyography (EMG) of the muscles expressed as a percentage of maximum voluntary isometric contraction (MVIC), as well as the BF to RF and BF to VL EMG ratio, were determined for each exercise. There was no significant interaction between gender and exercise type for the RMS EMG of the BF (p = 0.67), RF (p = 0.53), or VL (p = 0.06). Main effects were found for the RMS EMG of the BF (p = 0.00), RF (p = 0.00), and VL (p = 0.00), as well as the RMS EMG of the BF to RF activation ratio (p = 0.00) and BF to VL activation ratios (p = 0.003), between exercises. Peak RMS EMG was also assessed. Post hoc analysis identified specific differences in muscle activation and ratios between exercises. Clinicians should consider the magnitude of muscle activation and activation ratios when prescribing hamstring and quadriceps exercises. PMID:18975260

  13. Increasing Exercise Intensity Reduces Heterogeneity of Glucose Uptake in Human Skeletal Muscles

    PubMed Central

    Kemppainen, Jukka; Fujimoto, Toshihiko; Knuuti, Juhani; Kalliokoski, Kari K.

    2012-01-01

    Proper muscle activation is a key feature of survival in different tasks in daily life as well as sports performance, but can be impaired in elderly and in diseases. Therefore it is also clinically important to better understand the phenomenon that can be elucidated in humans non-invasively by positron emission tomography (PET) with measurements of spatial heterogeneity of glucose uptake within and among muscles during exercise. We studied six healthy young men during 35 minutes of cycling at relative intensities of 30% (low), 55% (moderate), and 75% (high) of maximal oxygen consumption on three separate days. Glucose uptake in the quadriceps femoris muscle group (QF), the main force producing muscle group in recreational cycling, and its four individual muscles, was directly measured using PET and 18F-fluoro-deoxy-glucose. Within-muscle heterogeneity was determined by calculating the coefficient of variance (CV) of glucose uptake in PET image voxels within the muscle of interest, and among-muscles heterogeneity of glucose uptake in QF was expressed as CV of the mean glucose uptake values of its separate muscles. With increasing intensity, within-muscle heterogeneity decreased in the entire QF as well as within its all four individual parts. Among-muscles glucose uptake heterogeneity also decreased with increasing intensity. However, mean glucose uptake was consistently lower and heterogeneity higher in rectus femoris muscle that is known to consist of the highest percentage of fast twitch type II fibers, compared to the other three QF muscles. In conclusion, these results show that in addition to increased contribution of distinct muscle parts, with increases in exercise intensity there is also an enhanced recruitment of muscle fibers within all of the four heads of QF, despite established differences in muscle-part specific fiber type distributions. Glucose uptake heterogeneity may serve as a useful non-invasive tool to elucidate muscle activation in aging and

  14. Elastic modulus of muscle and tendon with shear wave ultrasound elastography: variations with different technical settings.

    PubMed

    Kot, Brian Chin Wing; Zhang, Zhi Jie; Lee, Arthur Wai Chun; Leung, Vivian Yee Fong; Fu, Siu Ngor

    2012-01-01

    Standardization on Shear wave ultrasound elastography (SWUE) technical settings will not only ensure that the results are accurate, but also detect any differences over time that may be attributed to true physiological changes. The present study evaluated the variations of elastic modulus of muscle and tendon using SWUE when different technical aspects were altered. The results of this study indicated that variations of elastic modulus of muscle and tendon were found when different transducer's pressure and region of interest (ROI)'s size were applied. No significant differences in elastic modulus of the rectus femoris muscle and patellar tendon were found with different acquisition times of the SWUE sonogram. The SWUE on the muscle and tendon should be performed with the lightest transducer's pressure, a shorter acquisition time for the SWUE sonogram, while measuring the mean elastic modulus regardless the ROI's size.

  15. Lower muscle co-contraction in flutter kicking for competitive swimmers.

    PubMed

    Matsuda, Yuji; Hirano, Masami; Yamada, Yosuke; Ikuta, Yasushi; Nomura, Teruo; Tanaka, Hiroaki; Oda, Shingo

    2016-02-01

    The purpose of this study was to examine the difference in muscle activation pattern and co-contraction of the rectus and biceps femoris in flutter-kick swimming between competitive and recreational swimmers, to better understand the mechanism of repetitive kicking movements during swimming. Ten competitive and 10 recreational swimmers swam using flutter kicks at three different velocities (100%, 90%, and 80% of their maximal velocity) in a swimming flume. Surface electromyographic signals (EMG) were obtained from the rectus (RF) and biceps femoris (BF), and lower limb kinematic data were obtained at the same time. The beginning and ending of one kick cycle was defined as when the right lateral malleolus reached its highest position in the vertical axis. The offset timing of muscle activation of RF in the recreational swimmers was significantly later at all velocities than in the competitive swimmers (47-48% and 26-33% of kick time of one cycle for recreational and competitive swimmers, respectively), although the kinematic data and other activation timing of RF and BF did not differ between groups. A higher integrated EMG of RF during hip extension and knee extension induced a higher level of muscle co-contraction between RF and BF in the recreational swimmers. These results suggest that long-term competitive swimming training can induce an effective muscle activation pattern in the upper legs.

  16. Muscle activation patterns when passively stretching spastic lower limb muscles of children with cerebral palsy.

    PubMed

    Bar-On, Lynn; Aertbeliën, Erwin; Molenaers, Guy; Desloovere, Kaat

    2014-01-01

    The definition of spasticity as a velocity-dependent activation of the tonic stretch reflex during a stretch to a passive muscle is the most widely accepted. However, other mechanisms are also thought to contribute to pathological muscle activity and, in patients post-stroke and spinal cord injury can result in different activation patterns. In the lower-limbs of children with spastic cerebral palsy (CP) these distinct activation patterns have not yet been thoroughly explored. The aim of the study was to apply an instrumented assessment to quantify different muscle activation patterns in four lower-limb muscles of children with CP. Fifty-four children with CP were included (males/females n = 35/19; 10.8 ± 3.8 yrs; bilateral/unilateral involvement n =  32/22; Gross Motor Functional Classification Score I-IV) of whom ten were retested to evaluate intra-rater reliability. With the subject relaxed, single-joint, sagittal-plane movements of the hip, knee, and ankle were performed to stretch the lower-limb muscles at three increasing velocities. Muscle activity and joint motion were synchronously recorded using inertial sensors and electromyography (EMG) from the adductors, medial hamstrings, rectus femoris, and gastrocnemius. Muscles were visually categorised into activation patterns using average, normalized root mean square EMG (RMS-EMG) compared across increasing position zones and velocities. Based on the visual categorisation, quantitative parameters were defined using stretch-reflex thresholds and normalized RMS-EMG. These parameters were compared between muscles with different activation patterns. All patterns were dominated by high velocity-dependent muscle activation, but in more than half, low velocity-dependent activation was also observed. Muscle activation patterns were found to be both muscle- and subject-specific (p<0.01). The intra-rater reliability of all quantitative parameters was moderate to good. Comparing RMS-EMG between incremental position

  17. Signal intensity of MR-images of thigh muscles following acute open- and closed chain kinetic knee extensor exercise - index of muscle use.

    PubMed

    Enocson, A G; Berg, H E; Vargas, R; Jenner, G; Tesch, P A

    2005-07-01

    Exercise-induced shifts in signal intensity (SI) of magnetic resonance (MR) images were examined to assess indirectly muscle use in closed- and open-chain knee extensor exercises. Eight men performed five sets of 8-12 repetitions in the leg press (LP) and the seated knee extension (KE) exercises at 50, 75 and 100%, respectively of the 5 x 10 repetition maximum (RM) load. Prior to exercise and after each load setting, images of the thigh were obtained. The increase in SI (Delta SI) of the quadriceps at 100% load was greater (P < 0.05) after KE (32.1 +/- 9.0%) than after LP (21.9 +/- 9.2%). Regardless of load, the four individual muscles of the quadriceps showed similar changes in SI after LP. The three vastii muscles showed comparable increases in SI after KE. M. rectus femoris showed greater (P < 0.05) Delta SI than the vastii muscles at 100%. Neither exercise produced increase in SI of mm. semimembranosus, semitendinosus, gracilis or biceps femoris. Mm. adductor magnus and longus showed increased (13.3 +/- 6.5%; P < 0.05) SI after LP, but not after KE, at 100% load. The present data also infer greater involvement of the quadriceps muscle in the open-chain knee extension than in the closed-chain leg press exercise. The results of the current investigation also indicate similar over-all use among the three vastii muscles in LP and KE, but differential m. rectus femoris use between the two exercises. This report extends the merits of the MR imaging technique as an aid to study individual muscle involvement in a particular exercise task. PMID:15918061

  18. A comparative study of the electromyographic activities of lower extremity muscles during level walking and Pedalo riding

    PubMed Central

    Lee, DongGeon; Kim, YouJeong; Yun, JiHyeon; Jung, MiHye; Lee, GyuChang

    2016-01-01

    [Purpose] To analyze the electromyographic (EMG) activities of several lower extremity muscles during ground walking and pedaling using the Pedalo Reha-Bar device. [Subjects and Methods] Fifteen healthy adults aged 20–29 year participated in this study. The subjects’ surface EMG signals while walking and Pedalo Reha-Bar riding were recorded. The subjects performed 20 steps on flat ground and 20 cycles on the Pedalo Reha-Bar. During the tasks, EMG signals of the rectus femoris, biceps femoris, tibialis anterior, soleus, and gastrocnemius within a 20-second period were recorded. The mean EMG signals within the 10 seconds from 6 to 15 seconds were used for the data analysis. [Results] There was a significant increase in the bilateral use of the rectus femoris and a significant decrease in the use of the left tibialis anterior and left soleus in pedaling using the Pedalo Reha-Bar device compared to ground walking. [Conclusion] Level walking and the Pedalo Reha-Bar riding utilize different types of muscles activities. These results suggest that Pedalo Reha-Bar riding may be used for neuromuscular activation, especially of the rectus femoris. PMID:27313354

  19. Effects of walking speed and age on the muscle forces of unimpaired gait subjects

    NASA Astrophysics Data System (ADS)

    Fliger, Carlos G.; Crespo, Marcos J.; Braidot, Ariel A.; Ravera, Emiliano P.

    2016-04-01

    Clinical gait analysis provides great contributions to the understanding of gait disorders and also provides a mean for a more comprehensive treatment plan. However, direct measures of muscle forces are difficult to obtain in clinical settings because it generally requires invasive techniques. Techniques of musculoskeletal modeling have been used for several decades to improve the benefits of clinical gait analysis, but many of the previous studies were focused on analyzing separately the muscle forces distribution of children or adult subjects with only one condition of walking speed. For these reason, the present study aims to enhance the current literature by describing the age and speed gait effects on muscle forces during walking. We used a musculoskeletal model with 23 degrees of freedom and 92 musculotendon actuators to represent 76 muscles in the lower extremities and torso. The computed muscle control algorithm was used to estimate the muscle forces from the kinematics and to adjust the model obtained in the residual reduction algorithm. We find that hamstrings has an important peak in the mid-stance phase in the adult group but this peak disappears in the children group with the same walking speed condition. Furthermore, the rectus femoris presents an increase in the muscle force during the pre- and mid-swing in concordance with the increment in the walking speed of subjects. This behavior could be associated with the role that the rectus femoris has in the acceleration of the knee joint. Finally, we show that the soleus is the muscle that perform the major force throughout the gait cycle regardless of age and walking speed.

  20. Isolation and characterization of muscle fatigue substance with anti-tumor activities.

    PubMed

    Munoz, Ruben M; Han, Haiyong; Tegeler, Tony; Petritis, Konstantinos; Von Hoff, Daniel D; Hoffman, Stanley A

    2013-01-01

    Research during the 1950's indicated that exercise played a role in the reduction of tumor growth. In the 1960's our studies confirmed that tumor-bearing rats, exercised to fatigue, demonstrated tumor inhibition. Our further studies isolated an extract (Fatigue Substance, or F-Substance) from rectus femoris muscles of rats which had been electrically stimulated to fatigue. This extract significantly inhibited growth of transplanted rat tumors. Research continued until 1978 when it became apparent the methodology at that time was not able to further identify the substance's active components. Using current technology, we now report on the further isolation and characterization of F-Substance. In cell proliferation assays, extracts from electrically stimulated rat rectus femoris muscles had more significant inhibitory effect on the breast cancer cell line MCF-7 than those isolated from unstimulated muscles. To identify the molecule(s) responsible for the antitumor activity, a rat cytokine antibody array was used to profile the cytokines in the substances. Among the 29 different cytokines contained on the array, 3 showed greater than 3-fold difference between the substances isolated from the stimulated and unstimulated muscles. LIX (also known as CXCL5) is 6-fold higher in the substances isolated from stimulated muscles than those from the unstimulated muscles. TIMP-1 is 4.6 fold higher and sICAM is 3.6 fold higher in the substances from the stimulated muscles. Our results indicated that cytokines released from contracting muscles might be responsible for the antitumor effect of F-Substance.

  1. Bone remodelling in the natural acetabulum is influenced by muscle force-induced bone stress.

    PubMed

    Fernandez, Justin; Sartori, Massimo; Lloyd, David; Munro, Jacob; Shim, Vickie

    2014-01-01

    A modelling framework using the international Physiome Project is presented for evaluating the role of muscles on acetabular stress patterns in the natural hip. The novel developments include the following: (i) an efficient method for model generation with validation; (ii) the inclusion of electromyography-estimated muscle forces from gait; and (iii) the role that muscles play in the hip stress pattern. The 3D finite element hip model includes anatomically based muscle area attachments, material properties derived from Hounsfield units and validation against an Instron compression test. The primary outcome from this study is that hip loading applied as anatomically accurate muscle forces redistributes the stress pattern and reduces peak stress throughout the pelvis and within the acetabulum compared with applying the same net hip force without muscles through the femur. Muscle forces also increased stress where large muscles have small insertion sites. This has implications for the hip where bone stress and strain are key excitation variables used to initiate bone remodelling based on the strain-based bone remodelling theory. Inclusion of muscle forces reduces the predicted sites and degree of remodelling. The secondary outcome is that the key muscles that influenced remodelling in the acetabulum were the rectus femoris, adductor magnus and iliacus.

  2. Effectiveness of the Wavelet Transform on the Surface EMG to Understand the Muscle Fatigue During Walk

    NASA Astrophysics Data System (ADS)

    Hussain, M. S.; Mamun, Md.

    2012-01-01

    Muscle fatigue is the decline in ability of a muscle to create force. Electromyography (EMG) is a medical technique for measuring muscle response to nervous stimulation. During a sustained muscle contraction, the power spectrum of the EMG shifts towards lower frequencies. These effects are due to muscle fatigue. Muscle fatigue is often a result of unhealthy work practice. In this research, the effectiveness of the wavelet transform applied to the surface EMG (SEMG) signal as a means of understanding muscle fatigue during walk is presented. Power spectrum and bispectrum analysis on the EMG signal getting from right rectus femoris muscle is executed utilizing various wavelet functions (WFs). It is possible to recognize muscle fatigue appreciably with the proper choice of the WF. The outcome proves that the most momentous changes in the EMG power spectrum are symbolized by WF Daubechies45. Moreover, this research has compared bispectrum properties to the other WFs. To determine muscle fatigue during gait, Daubechies45 is used in this research to analyze the SEMG signal.

  3. Chronic Paraspinal Muscle Injury Model in Rat

    PubMed Central

    Cho, Tack Geun; Kim, Young Baeg

    2016-01-01

    Objective The objective of this study is to establish an animal model of chronic paraspinal muscle injury in rat. Methods Fifty four Sprague-Dawley male rats were divided into experimental group (n=30), sham (n=15), and normal group (n=9). Incision was done from T7 to L2 and paraspinal muscles were detached from spine and tied at each level. The paraspinal muscles were exposed and untied at 2 weeks after surgery. Sham operation was done by paraspinal muscles dissection at the same levels and wound closure was done without tying. Kyphotic index and thoracolumbar Cobb's angle were measured at preoperative, 2, 4, 8, and 12 weeks after the first surgery for all groups. The rats were sacrificed at 4, 8, and 12 weeks after the first surgery, and performed histological examinations. Results At 4 weeks after surgery, the kyphotic index decreased, but, Cobb's angle increased significantly in the experimental group (p<0.05), and then that were maintained until the end of the experiment. However, there were no significant differences of the kyphotic index and Cobb's angle between sham and normal groups. In histological examinations, necrosis and fibrosis were observed definitely and persisted until 12 weeks after surgery. There were also presences of regenerated muscle cells which nucleus is at the center of cytoplasm, centronucleated myofibers. Conclusion Our chronic injury model of paraspinal muscles in rats shows necrosis and fibrosis in the muscles for 12 weeks after surgery, which might be useful to study the pathophysiology of the degenerative thoracolumbar kyphosis or degeneration of paraspinal muscles.

  4. Chronic Paraspinal Muscle Injury Model in Rat

    PubMed Central

    Cho, Tack Geun; Kim, Young Baeg

    2016-01-01

    Objective The objective of this study is to establish an animal model of chronic paraspinal muscle injury in rat. Methods Fifty four Sprague-Dawley male rats were divided into experimental group (n=30), sham (n=15), and normal group (n=9). Incision was done from T7 to L2 and paraspinal muscles were detached from spine and tied at each level. The paraspinal muscles were exposed and untied at 2 weeks after surgery. Sham operation was done by paraspinal muscles dissection at the same levels and wound closure was done without tying. Kyphotic index and thoracolumbar Cobb's angle were measured at preoperative, 2, 4, 8, and 12 weeks after the first surgery for all groups. The rats were sacrificed at 4, 8, and 12 weeks after the first surgery, and performed histological examinations. Results At 4 weeks after surgery, the kyphotic index decreased, but, Cobb's angle increased significantly in the experimental group (p<0.05), and then that were maintained until the end of the experiment. However, there were no significant differences of the kyphotic index and Cobb's angle between sham and normal groups. In histological examinations, necrosis and fibrosis were observed definitely and persisted until 12 weeks after surgery. There were also presences of regenerated muscle cells which nucleus is at the center of cytoplasm, centronucleated myofibers. Conclusion Our chronic injury model of paraspinal muscles in rats shows necrosis and fibrosis in the muscles for 12 weeks after surgery, which might be useful to study the pathophysiology of the degenerative thoracolumbar kyphosis or degeneration of paraspinal muscles. PMID:27651859

  5. Brain surgery

    MedlinePlus

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  6. Thyroid Surgery

    MedlinePlus

    ... thyroid surgery, requiring treatment with thyroid hormone (see Hypothyroidism brochure ). This is especially true if you had ... Nodules Goiter Graves’ Disease Hashimoto’s Thyroiditis Hyperthyroidism (Overactive) Hypothyroidism (Underactive) Iodine Deficiency Low Iodine Diet Radioactive Iodine ...

  7. Cosmetic Surgery

    MedlinePlus

    ... defect or cosmetic flaw that has diminished their self-esteem over time. It's important to remember that cosmetic ... can create both physical changes and changes in self-esteem. But if you are seeking surgery with the ...

  8. Rodding Surgery

    MedlinePlus

    ... Rods can be made of stainless steel or titanium. Regular rods do not expand. They have many ... v regular), the rod materials (stainless steel v titanium) and the age for a first rodding surgery. ...

  9. [Robotic surgery].

    PubMed

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era.

  10. [Robotic surgery].

    PubMed

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era. PMID:25643879

  11. Behavior of the Linea Alba During a Curl-up Task in Diastasis Rectus Abdominis: An Observational Study.

    PubMed

    Lee, Diane; Hodges, Paul W

    2016-07-01

    Study Design Cross-sectional repeated measures. Background Rehabilitation of diastasis rectus abdominis (DRA) generally aims to reduce the inter-rectus distance (IRD). We tested the hypothesis that activation of the transversus abdominis (TrA) before a curl-up would reduce IRD narrowing, with less linea alba (LA) distortion/deformation, which may allow better force transfer between sides of the abdominal wall. Objectives This study investigated behavior of the LA and IRD during curl-ups performed naturally and with preactivation of the TrA. Methods Curl-ups were performed by 26 women with DRA and 17 healthy control participants using a natural strategy (automatic curl-up) and with TrA preactivation (TrA curl-up). Ultrasound images were recorded at 2 points above the umbilicus (U point and UX point). Ultrasound measures of IRD and a novel measure of LA distortion (distortion index: average deviation of the LA from the shortest path between the recti) were compared between 3 tasks (rest, automatic curl-up, TrA curl-up), between groups, and between measurement points (analysis of variance). Results Automatic curl-up by women with DRA narrowed the IRD from resting values (mean U-point between-task difference, -1.19 cm; 95% confidence interval [CI]: -1.45, -0.93; P<.001 and mean UX-point between-task difference, -0.51 cm; 95% CI: -0.69, -0.34; P<.001), but LA distortion increased (mean U-point between-task difference, 0.018; 95% CI: 0.0003, 0.041; P = .046 and mean UX-point between-task difference, 0.025; 95% CI: 0.004, 0.045; P = .02). Although TrA curl-up induced no narrowing or less IRD narrowing than automatic curl-up (mean U-point difference between TrA curl-up versus rest, -0.56 cm; 95% CI: -0.82, -0.31; P<.001 and mean UX-point between-task difference, 0.02 cm; 95% CI: -0.22, 0.19; P = .86), LA distortion was less (mean U-point between-task difference, -0.025; 95% CI: -0.037, -0.012; P<.001 and mean UX-point between-task difference, -0.021; 95% CI: -0.038, -0

  12. Behavior of the Linea Alba During a Curl-up Task in Diastasis Rectus Abdominis: An Observational Study.

    PubMed

    Lee, Diane; Hodges, Paul W

    2016-07-01

    Study Design Cross-sectional repeated measures. Background Rehabilitation of diastasis rectus abdominis (DRA) generally aims to reduce the inter-rectus distance (IRD). We tested the hypothesis that activation of the transversus abdominis (TrA) before a curl-up would reduce IRD narrowing, with less linea alba (LA) distortion/deformation, which may allow better force transfer between sides of the abdominal wall. Objectives This study investigated behavior of the LA and IRD during curl-ups performed naturally and with preactivation of the TrA. Methods Curl-ups were performed by 26 women with DRA and 17 healthy control participants using a natural strategy (automatic curl-up) and with TrA preactivation (TrA curl-up). Ultrasound images were recorded at 2 points above the umbilicus (U point and UX point). Ultrasound measures of IRD and a novel measure of LA distortion (distortion index: average deviation of the LA from the shortest path between the recti) were compared between 3 tasks (rest, automatic curl-up, TrA curl-up), between groups, and between measurement points (analysis of variance). Results Automatic curl-up by women with DRA narrowed the IRD from resting values (mean U-point between-task difference, -1.19 cm; 95% confidence interval [CI]: -1.45, -0.93; P<.001 and mean UX-point between-task difference, -0.51 cm; 95% CI: -0.69, -0.34; P<.001), but LA distortion increased (mean U-point between-task difference, 0.018; 95% CI: 0.0003, 0.041; P = .046 and mean UX-point between-task difference, 0.025; 95% CI: 0.004, 0.045; P = .02). Although TrA curl-up induced no narrowing or less IRD narrowing than automatic curl-up (mean U-point difference between TrA curl-up versus rest, -0.56 cm; 95% CI: -0.82, -0.31; P<.001 and mean UX-point between-task difference, 0.02 cm; 95% CI: -0.22, 0.19; P = .86), LA distortion was less (mean U-point between-task difference, -0.025; 95% CI: -0.037, -0.012; P<.001 and mean UX-point between-task difference, -0.021; 95% CI: -0.038, -0

  13. Stimulation of glucose uptake by insulin-like growth factor II in human muscle is not mediated by the insulin-like growth factor II/mannose 6-phosphate receptor.

    PubMed Central

    Burguera, B; Elton, C W; Caro, J F; Tapscott, E B; Pories, W J; Dimarchi, R; Sakano, K; Dohm, G L

    1994-01-01

    Although the growth-promoting effects of insulin-like growth factor II (IGF-II) have been intensively studied, the acute actions of this hormone on glucose metabolism have been less well evaluated, especially in skeletal muscle of humans. We and other groups have shown that IGFs reduce glycaemic levels in humans and stimulate glucose uptake in rat muscle. The purpose of the present study was to evaluate the effect of IGF-II on glucose transport in muscle of normal and obese patients with and without non-insulin-dependent diabetes mellitus (NIDDM), as well as to identify the receptor responsible for this action. 2-Deoxyglucose transport was determined in vitro using a muscle-fibre strip preparation. IGF-II were investigated in biopsy material of rectus abdominus muscle taken from lean and obese patients and obese patients with NIDDM at the time of surgery. In the lean group, IGF-II (100 nM) stimulated glucose transport 2.1-fold, which was slightly less than stimulation by insulin (2.8-fold) at the same concentration. Binding of IGF-II was approx. 25% of that of insulin at 1 nM concentrations of both hormones. Obesity with or without NIDDM significantly reduced IGF-II-stimulated glucose uptake compared with the lean group. In order to explore which receptor mediated the IGF-II effect, we compared glucose uptake induced by IGF-II and two IGF-II analogues: [Leu27]IGF-II, with high affinity for the IGF-II/Man 6-P receptor but markedly reduced affinity for the IGF-I and insulin receptors, and [Arg54,Arg55]IGF-II was similar to that of IGF-II, whereas [Leu27]IGF-II had a very diminished effect. Results show that IGF-II is capable of stimulating muscle glucose uptake in lean but not in obese subjects and this effect seems not to be mediated via an IGF-II/Man 6-P receptor. Images Figure 2 PMID:8010960

  14. Corrective Jaw Surgery

    MedlinePlus

    ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  15. Relationship between magnetic resonance imaging signal intensity and volume of extraocular muscles in thyroid-associated ophthalmopathy with methylprednisolone pulse therapy

    PubMed Central

    Higashiyama, Tomoaki; Nishida, Yasuhiro; Ohji, Masahito

    2016-01-01

    Purpose To characterize the relationship between inflammation and swelling of extraocular muscles in thyroid-associated ophthalmopathy before and after methylprednisolone pulse therapy. Methods The signal intensities and volumes of the superior rectus (SR), inferior rectus (IR), lateral rectus (LR), medial rectus (MR), and superior oblique (SO) muscles were measured with magnetic resonance imaging in 25 eyes of 25 patients with thyroid-associated ophthalmopathy in the acute inflammatory phase before and after methylprednisolone pulse therapy. The signal intensity ratios (SIRs) of muscles and brain white matter were calculated. Result The mean SIRs before treatment were 2.28±0.74 in SR, 2.66±0.57 in IR, 2.03±0.42 in LR, 2.45±0.49 in MR, and 1.98±0.48 in SO muscles. The mean SIRs after treatment were 1.82±0.62, 1.84±0.52, 1.70±0.35, 1.95±0.46, and 1.60±0.36, respectively. The mean volumes (cm3) before treatment were 1.35±0.67 in SR, 1.21±0.39 in IR, 0.66±0.13 in LR, 0.94±0.31 in MR, and 0.58±0.14 in SO muscles. Those after treatment were 1.12±0.45, 0.91±0.31, 0.61±0.12, 0.85±0.28, and 0.49±0.11, respectively. The SIRs showed significantly positive correlations with volumes both before and after treatment in SR muscles (before, r=0.77; after, r=0.69), IR muscles (before, r=0.65; after, r=0.60), MR muscles (before, r=0.69; after, r=0.73), and SO muscles (before, r=0.52; after, r=0.50) (P<0.01 for all correlations). Conclusion Swelling reflected the inflammation in extraocular muscles of thyroid-associated ophthalmopathy both before and after treatment. PMID:27143850

  16. Dynamic Frequency Analyses of Lower Extremity Muscles during Sit-To-Stand Motion for the Patients with Knee Osteoarthritis

    PubMed Central

    Suzuki, Kentaro; Yagi, Masahide

    2016-01-01

    Objective Muscle activities during the sit-to-stand motion (STS) are characterized by coordinated movements between hip extensors and knee extensors. However, previous reports regarding the STS and lower extremity muscle activities have focused on some quantitative assessment, but little qualitative research. This study aimed to examine the muscle activities of the lower extremity both quantitatively and qualitatively. Methods Study participants included 13 patients with knee osteoarthritis (knee OA) and 11 age-matched asymptomatic controls. The task was STS from a chair with a height-adjustable seat. EMG activities were acquired using surface electromyogram. The root mean square signals normalized as a percentage of maximum voluntary isometric contraction values (RMS%MVC) and the mean power frequency (MPF) were calculated. Results During STS, knee OA patients had increased RMS%MVC of the vastus medialis and raised MPF of the rectus femoris before buttocks-off. Conclusion These findings suggest that STS of knee OA patients not only increased relative muscle activity of the vastus medialis, but also enlisted the rectus femoris in knee extension to improve muscle contraction force by activating more type II fibers to accomplish buttocks-off. PMID:26807578

  17. The Effect of Backpack Load on Muscle Activities of the Trunk and Lower Extremities and Plantar Foot Pressure in Flatfoot

    PubMed Central

    Son, Hohee

    2013-01-01

    [Purpose] The purpose of this study was to investigate the changes in muscle activation of the trunk and lower extremities and plantar foot pressure due to backpack loads of 0, 10, 15, and 20% of body weight during level walking in individuals with flatfoot. [Methods] Fourteen young flatfoot subjects and 12 normal foot subjects participated in this study. In each session, the subjects were assigned to carry a backpack load, and there were four level walking modes: (1) unloaded walking (0%), (2) 10% body weight (BW) load, (3) 15% BW load, and (4) 20% BW load. Trunk and lower extremity muscle activities were recorded by surface EMG, and contact area and plantar foot pressure were determined using a RS scan system. [Results] The erector spinae, vastus medialis, tibialis anterior and gastrocnemius muscle activities, but not the rectus femoris and rectus abdominis muscle activities of flatfoot subjects significantly and progressively increased as load increased in flatfoot subjects. Contact area and pressure of the lateral and medial heel zones were significantly increased too. [Conclusion] Based on this data, the weight of a backpack could influence muscle activation and plantar foot pressure in flatfoot. PMID:24396193

  18. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test.

    PubMed

    Vigotsky, Andrew D; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson's r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = -1.39° (-5.53, +2.75); t(22) = -0.70; p = 0.4933; Cohen's d = - 0.15 (-0.58, 0.29)) or rectus femoris length (change = -0.005 (-0.013, +0.003); t(22) = -1.30; p = 0.2070; Cohen's d = - 0.27 (-0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol.

  19. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test.

    PubMed

    Vigotsky, Andrew D; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson's r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = -1.39° (-5.53, +2.75); t(22) = -0.70; p = 0.4933; Cohen's d = - 0.15 (-0.58, 0.29)) or rectus femoris length (change = -0.005 (-0.013, +0.003); t(22) = -1.30; p = 0.2070; Cohen's d = - 0.27 (-0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol. PMID:26421244

  20. Evaluation of three-dimensional printing for internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach: a preliminary report

    PubMed Central

    Zeng, Canjun; Xiao, Jidong; Wu, Zhanglin; Huang, Wenhua

    2015-01-01

    Objective: The aim of this study is to evaluate the efficacy and feasibility of three-dimensional printing (3D printing) assisted internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach. Methods: A total of 38 patients with unstable pelvic fractures were analyzed retrospectively from August 2012 to February 2014. All cases were treated operatively with internal fixation assisted by three-dimensional printing from minimal invasive para-rectus abdominis approach. Both preoperative CT and three-dimensional reconstruction were performed. Pelvic model was created by 3D printing. Data including the best entry points, plate position and direction and length of screw were obtained from simulated operation based on 3D printing pelvic model. The diaplasis and internal fixation were performed by minimal invasive para-rectus abdominis approach according to the optimized dada in real surgical procedure. Matta and Majeed score were used to evaluate currative effects after operation. Results: According to the Matta standard, the outcome of the diaplasis achieved 97.37% with excellent and good. Majeed assessment showed 94.4% with excellent and good. The imageological examination showed consistency of internal fixation and simulated operation. The mean operation time was 110 minutes, mean intraoperative blood loss 320 ml, and mean incision length 6.5 cm. All patients have achieved clinical healing, with mean healing time of 8 weeks. Conclusion: Three-dimensional printing assisted internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach is feasible and effective. This method has the advantages of trauma minimally, bleeding less, healing rapidly and satisfactory reduction, and worthwhile for spreading in clinical practice. PMID:26550226

  1. Weaning marginally affects glucose transporter (GLUT4) expression in calf muscles and adipose tissues.

    PubMed

    Hocquette, J F; Castiglia-Delavaud, C; Graulet, B; Ferré, P; Picard, B; Vermorel, M

    1997-08-01

    The nutritional regulation of glucose transporter GLUT4 was studied in eight muscles and four adipose tissues from two groups of preruminant (PR) or ruminant (R) calves of similar age (170 d), empty body weight (194 kg) at slaughter, and level of net energy intake from birth onwards. Isocitrate dehydrogenase (EC 1.1.1.41) activity in muscles was not different between PR and R except in masseter muscle from the cheek (+71% in R; P < 0.003), which becomes almost constantly active at weaning for food chewing. Basal and maximally-insulin-stimulated glucose transport rate (GTR) per g tissue wet weight in rectus abdominis muscle were significantly higher in R calves (+31 and 41% respectively; P < 0.05). GLUT4 protein contents did not differ in muscles from PR and R except in masseter (+74% in R; P < 0.05) indicating that the increased GTR in rectus abdominis cannot be accounted for by an enhanced GLUT4 expression. GLUT4 mRNA levels did not differ between the two groups of animals in all muscles suggesting a regulation of GLUT4 at the protein level in masseter. GLUT4 number expressed on a per cell basis was lower in adipose tissue from R calves (-39%; P < 0.05) and higher in internal than in peripheral adipose tissues. In summary, the regulation of GLUT4 in calves at weaning differs markedly from that previously described in rodents (for review, see Girard et al. 1992). Furthermore, significant inter-individual variations were shown for metabolic activities in muscle and for biochemical variables in adipose tissue.

  2. Relationships between thyroid status, tissue oxidative metabolism, and muscle differentiation in bovine fetuses.

    PubMed

    Cassar-Malek, I; Picard, B; Kahl, S; Hocquette, J F

    2007-07-01

    The temporal relationships between thyroid status and differentiation of liver, heart and different skeletal muscles were examined in 42 bovine fetuses from day 110 to day 260 of development using principal component analysis of the data. Plasma concentrations of reverse-triiodothyronine (rT(3)) and thyroxine (T(4)) increased during development from day 110 to day 210 or 260, respectively, whereas concentration of triiodothyronine (T(3)) and hepatic type-1 5'-deiodinase activity (5'D1) increased from day 180 onwards. On day 260, high T(4) and rT(3) and low T(3) concentrations were observed together with a mature 5'D1 activity. Cytochrome-c oxidase (COX) activity expressed per mg protein increased at day 180 in masseter and near birth in masseter, rectus abdominis and cutaneus trunci muscles (P<0.05). Significant changes in citrate synthase (CS) activity per mg protein were observed between day 110 and day 180 in the liver and between day 210 and day 260 in the liver, the heart and the longissimus thoracis muscle (P<0.05). Muscle contractile differentiation was shown by the disappearance of the fetal myosin heavy chain from day 180 onwards. A positive correlation (r>0.47, P<0.01) was shown between thyroid status parameters (5'D1, concentrations of T(4) and T(3)) and COX activity in muscles known to be oxidative after birth (masseter, rectus abdominis) but not in liver and heart, nor in muscles known to be glycolytic after birth (cutaneus trunci, longissimus thoracis). A similar correlation was found between thyroid parameters and CS activity in liver and masseter. Results indicate that elevation of plasma T(3) concentrations in the last gestational trimester could be involved in the differentiation of oxidative skeletal muscles.

  3. Determination of muscle activity during running at reduced body weight.

    PubMed

    Liebenberg, Jaco; Scharf, Jennifer; Forrest, Dana; Dufek, Janet S; Masumoto, K; Mercer, J A

    2011-01-01

    The aim of this study was to investigate how lower extremity muscles are influenced by body weight support during running at different speeds. Nine participants (age 24 ± 2 years, height 1.75 ± 0.12 m, mass 73.5 ± 15.7 kg) ran at 100%, 115%, and 125% of preferred speed at 100%, 90%, 80%, 70%, and 60% of body weight on a treadmill that provided body weight support. Preferred speed was self-selected by each participant and represented a speed that he or she could sustain if going for a 30 min run. Electromyography (EMG) data were recorded (1000 Hz, 1 min) from the bicep femoris, rectus femoris, tibialis anterior, and gastrocnemius for each condition together with knee angle (electrogoniometer). Average and root mean square EMG were calculated across 30 s. Muscle patterns were determined by smoothing (low-pass filter, 4 Hz) and extracting patterns for 49 cycles defined by consecutive maximum knee flexion angles. Repeated-measures analyses of variance were used to compare average and root mean square across body weight and speeds. Correlations were computed between the 100% speed/100% body weight condition and all other conditions per muscle. There was no interaction between body weight and speed (P > 0.05). Average and root mean square decreased as body weight decreased for all muscles (P < 0.05) and increased across speeds for all muscles (P < 0.05). Correlations for all muscles between conditions were high (range: 0.921-0.999). Although a percent reduction in body weight did not lead to the same reduction in muscle activity, it was clear that reducing body weight leads to a reduction in muscle activity with no changes in muscle activity patterns. PMID:21170806

  4. Articular geometry of the medial tarsometatarsal joint in the foot: comparison of metatarsus primus adductus and metatarsus primus rectus.

    PubMed

    Dykyj, D; Ateshian, G A; Trepal, M J; MacDonald, L R

    2001-01-01

    The three-dimensional surface geometry of the medial tarsometatarsal joint ("first metatarsocuneiform") of the first ray was analyzed to determine if the shape of the joint is distinct in the medially deviated first metatarsal with metatarsus primus adductus (MPA). Clinical evaluation of 29 cadaver feet identified 13 feet with MPA and 16 with metatarsus primus rectus (MPR). Three-dimensional (3D) coordinates x, y, z of the first metatarsal and medial cuneiform joint facets of the feet were digitized on a Coordinate Measuring Machine (accuracy = 0.01 mm) and the data fitted with B-spline surfaces from which 3D curvature maps were generated. Comparison of means of surface-averaged maximum and minimum principal curvatures and root-mean-square curvatures showed significant (p < .0005) differences between the MPA and MPR subsets, male and female subsets, and metatarsal and cuneiform subsets. These results show that the articular shape of the medial tarsometatarsal joint in feet with MPA is significantly less contoured, or is flatter, than the same joint in normal or MPR feet. Results also showed that the female joints are more curved than male joints, and that metatarsal and cuneiform facets closely conform in shape to each other. These preliminary results may be related to questions concerning the anatomical and functional basis for the first metatarsal deviation, for radiographic presentation of the joint and surgical options in correcting related forefoot deformities. PMID:11777231

  5. Advances in quantitative muscle ultrasonography using texture analysis of ultrasound images.

    PubMed

    Molinari, Filippo; Caresio, Cristina; Acharya, U Rajendra; Mookiah, Muthu Rama Krishnan; Minetto, Marco Alessandro

    2015-09-01

    Musculoskeletal ultrasound imaging can be used to investigate the skeletal muscle structure in terms of architecture (thickness, cross-sectional area, fascicle length and fascicle pennation angle) and texture. Gray-scale analysis is commonly used to characterize transverse scans of the muscle. Gray mean value is used to distinguish between normal and pathologic muscles, but it depends on the image acquisition system and its settings. In this study, quantitative ultrasonography was performed on five muscles (biceps brachii, vastus lateralis, rectus femoris, medial gastrocnemius and tibialis anterior) of 20 healthy patients (10 women, 10 men) to assess the characterization performance of higher-order texture descriptors to differentiate genders and muscle types. A total of 53 features (7 first-order descriptors, 24 Haralick features, 20 Galloway features and 2 local binary pattern features) were extracted from each muscle region of interest (ROI) and were used to perform the multivariate linear regression analysis (MANOVA). Our results show that first-order descriptors, Haralick features (energy, entropy and correlation measured along different angles) and local binary pattern (LBP) energy and entropy were highly linked to the gender, whereas Haralick entropy and symmetry, Galloway texture descriptors and LBP entropy helped to distinguish muscle types. Hence, the combination of first-order and higher-order texture descriptors (Haralick, Galloway and LBP) can be used to discriminate gender and muscle types. Therefore, multi-texture analysis may be useful to investigate muscle damage and myopathic disorders.

  6. Fatty degeneration of gluteus minimus muscle as a predictor of falls.

    PubMed

    Kiyoshige, Yoshiro; Watanabe, Emi

    2015-01-01

    The cause of falls is multifactorial, however, hip fractures in elderly would be prevented if accidental falls are predictable. We assessed magnetic resonance images of 38 patients with groin pain after taking a fall whose fracture could not be detected by plain X-rays, and 45 patients with no episode of falls. Their ages were over 65 years. Fatty degeneration of muscles, gluteus maximus, gluteus medius, gluteus minimus, obturator externus, adductor longus, rectus femoris and iliopsoas muscles, were evaluated by Goutallier's staging. Odds ratio was calculated by a logistic regression analysis allocating dependent variable for falls and independent variables for Goutallier's stage, age and gender. The fatty degeneration of gluteus maximus muscle was generalized, while that of gluteus minimus muscle was unevenly distributed, especially in anterior area. Gluteus minimus muscle initiated its fatty degeneration earlier than gluteus medius muscle. Odds ratio of falling was 3.2 (95% confidence intervals: 1, 14, 8.94) for Goutallier' stage of the gluteus medius muscle. Fatty degeneration of gluteus medius muscle has a crucial role in providing stability of the pelvis including hip joint. Evaluating fatty streaks in the gluteus minimus muscle could help give early indication to those who have a higher risk of falling. PMID:25440137

  7. Advances in quantitative muscle ultrasonography using texture analysis of ultrasound images.

    PubMed

    Molinari, Filippo; Caresio, Cristina; Acharya, U Rajendra; Mookiah, Muthu Rama Krishnan; Minetto, Marco Alessandro

    2015-09-01

    Musculoskeletal ultrasound imaging can be used to investigate the skeletal muscle structure in terms of architecture (thickness, cross-sectional area, fascicle length and fascicle pennation angle) and texture. Gray-scale analysis is commonly used to characterize transverse scans of the muscle. Gray mean value is used to distinguish between normal and pathologic muscles, but it depends on the image acquisition system and its settings. In this study, quantitative ultrasonography was performed on five muscles (biceps brachii, vastus lateralis, rectus femoris, medial gastrocnemius and tibialis anterior) of 20 healthy patients (10 women, 10 men) to assess the characterization performance of higher-order texture descriptors to differentiate genders and muscle types. A total of 53 features (7 first-order descriptors, 24 Haralick features, 20 Galloway features and 2 local binary pattern features) were extracted from each muscle region of interest (ROI) and were used to perform the multivariate linear regression analysis (MANOVA). Our results show that first-order descriptors, Haralick features (energy, entropy and correlation measured along different angles) and local binary pattern (LBP) energy and entropy were highly linked to the gender, whereas Haralick entropy and symmetry, Galloway texture descriptors and LBP entropy helped to distinguish muscle types. Hence, the combination of first-order and higher-order texture descriptors (Haralick, Galloway and LBP) can be used to discriminate gender and muscle types. Therefore, multi-texture analysis may be useful to investigate muscle damage and myopathic disorders. PMID:26026375

  8. Effects of postmortem aging and USDA quality grade on Warner-Bratzler shear force values of seventeen individual beef muscles.

    PubMed

    Gruber, S L; Tatum, J D; Scanga, J A; Chapman, P L; Smith, G C; Belk, K E

    2006-12-01

    Forty USDA Select and 40 upper two-thirds USDA Choice beef carcasses were used to determine the effects of postmortem aging on tenderness of 17 individual beef muscles. Biceps femoris-long head, complexus, gluteus medius, infraspinatus, longissimus dorsi, psoas major, rectus femoris, semimembranosus, semitendinosus, serratus ventralis, spinalis dorsi, supraspinatus, tensor fasciae latae, teres major, triceps brachii-long head, vastus lateralis, and vastus medialis muscles were removed from each carcass. Seven steaks (2.54-cm thick) were cut from every muscle, and each steak was assigned to one of the following postmortem aging periods: 2, 4, 6, 10, 14, 21, or 28 d postmortem. After completion of the designated aging period, steaks were removed from storage (2 degrees C, never frozen), cooked to a peak internal temperature of 71 degrees C, and evaluated using Warner-Bratzler shear force (WBSF). Analysis of WBSF revealed a 3-way interaction (P = 0.004) among individual muscle, USDA quality grade, and postmortem aging period. With the exception of the Select teres major, WBSF of all muscles (both quality grades) decreased with increasing time of postmortem storage. Nonlinear regression was used to characterize the extent (aging response) and rate of decrease in WBSF from 2 through 28 d postmortem for each muscle within each quality grade. In general, WBSF of upper two-thirds Choice muscles decreased more rapidly from 2 to 10 d postmortem than did corresponding Select muscles. Muscles that had greater aging responses generally had greater 2-d WBSF values. The upper two-thirds Choice psoas major, serratus ventralis, and vastus lateralis muscles required similar aging times to complete a majority of the aging response (< or =0.1 kg of aging response remaining) compared with analogous Select muscles. The upper two-thirds Choice complexus, gluteus medius, semitendinosus, triceps brachii-long head, and vastus medialis muscles required 4 to 6 d less time to complete a

  9. Kinesiology Taping does not Modify Electromyographic Activity or Muscle Flexibility of Quadriceps Femoris Muscle: A Randomized, Placebo-Controlled Pilot Study in Healthy Volleyball Players

    PubMed Central

    Halski, Tomasz; Dymarek, Robert; Ptaszkowski, Kuba; Słupska, Lucyna; Rajfur, Katarzyna; Rajfur, Joanna; Pasternok, Małgorzata; Smykla, Agnieszka; Taradaj, Jakub

    2015-01-01

    Background Kinesiology taping (KT) is a popular method of supporting professional athletes during sports activities, traumatic injury prevention, and physiotherapeutic procedures after a wide range of musculoskeletal injuries. The effectiveness of KT in muscle strength and motor units recruitment is still uncertain. The objective of this study was to assess the effect of KT on surface electromyographic (sEMG) activity and muscle flexibility of the rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM) muscles in healthy volleyball players. Material/Methods Twenty-two healthy volleyball players (8 men and 14 women) were included in the study and randomly assigned to 2 comparative groups: “kinesiology taping” (KT; n=12; age: 22.30±1.88 years; BMI: 22.19±4.00 kg/m2) in which KT application over the RF muscle was used, and “placebo taping” (PT; n=10; age: 21.50±2.07 years; BMI: 22.74±2.67 kg/m2) in which adhesive nonelastic tape over the same muscle was used. All subjects were analyzed for resting sEMG activity of the VL and VM muscles, resting and functional sEMG activity of RF muscle, and muscle flexibility of RF muscle. Results No significant differences in muscle flexibility of the RF muscle and sEMG activity of the RF, VL, and VM muscles were registered before and after interventions in both groups, and between the KT and PT groups (p>0.05). Conclusions The results show that application of the KT to the RF muscle is not useful to improve sEMG activity. PMID:26232122

  10. Muscle Activation Differs between Three Different Knee Joint-Angle Positions during a Maximal Isometric Back Squat Exercise

    PubMed Central

    Jarbas da Silva, Josinaldo; Jon Schoenfeld, Brad; Nardi, Priscyla Silva Monteiro; Pecoraro, Silvio Luis; D'Andréa Greve, Julia Maria; Hartigan, Erin

    2016-01-01

    The purpose of this study was to compare muscle activation of the lower limb muscles when performing a maximal isometric back squat exercise over three different positions. Fifteen young, healthy, resistance-trained men performed an isometric back squat at three knee joint angles (20°, 90°, and 140°) in a randomized, counterbalanced fashion. Surface electromyography was used to measure muscle activation of the vastus lateralis (VL), vastus medialis (VM), rectus femoris (RF), biceps femoris (BF), semitendinosus (ST), and gluteus maximus (GM). In general, muscle activity was the highest at 90° for the three quadriceps muscles, yet differences in muscle activation between knee angles were muscle specific. Activity of the GM was significantly greater at 20° and 90° compared to 140°. The BF and ST displayed similar activation at all joint angles. In conclusion, knee position alters muscles activation of the quadriceps and gluteus maximus muscles. An isometric back squat at 90° generates the highest overall muscle activation, yet an isometric back squat at 140° generates the lowest overall muscle activation of the VL and GM only. PMID:27504484

  11. Effect of the Mandibular Orthopedic Repositioning Appliance on Trunk and Upper Limb Muscle Activation during Maximum Isometric Contraction

    PubMed Central

    Lee, Sang-Yeol; Hong, Min-Ho; Park, Min-Chull; Choi, Sung-Min

    2013-01-01

    [Purpose] The purpose of this study was to measure the muscle activities of the trunk muscles and upper limb muscles during maximum isometric contraction when temporomandibular joint alignment was achieved with a mandibular orthopedic repositioning appliance in order provide basic data on the effects of mandibular orthopedic repositioning appliance on the entire body. [Subjects] The present study was conducted with healthy Korean adults in their 20s (males=10, females=10). [Methods] An 8 channel surface electromyography system was used to measure the muscle activities of the upper limb muscles and neck muscles of the subjects during maximum isometric contraction with and without use of a mandibular orthopedic repositioning appliance. [Results] The maximum isometric contractions of the trunk and upper limb muscles when mandibular orthopedic repositioning appliance were used were compared with those when no mandibular orthopedic repositioning appliance was used. The results showed that the sternocleidomastoid muscle, cervical and lumbar erector spinae, upper trapezius, biceps, triceps, rectus abdominis and internal oblique and external oblique muscles all showed significant increases in maximum isometric contractions with a mandibular orthopedic repositioning appliance. [Conclusion] The use of a mandibular orthopedic repositioning appliance is considered to be a method for normal adults to improve the stability of the entire body with the improvement of the stability of the TMJ. The proximal improvement in stability improves of the proximal thereby improving not only muscle strength with increased muscle activation but also stability during exercises. PMID:24396194

  12. Carotid artery surgery

    MedlinePlus

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  13. Muscle-specific glucose and free fatty acid uptake after sprint interval and moderate-intensity training in healthy middle-aged men.

    PubMed

    Eskelinen, Jari-Joonas; Heinonen, Ilkka; Löyttyniemi, Eliisa; Saunavaara, Virva; Kirjavainen, Anna; Virtanen, Kirsi A; Hannukainen, Jarna C; Kalliokoski, Kari K

    2015-05-01

    We tested the hypothesis that sprint interval training (SIT) causes larger improvements in glucose and free fatty acid uptake (FFAU) in lower and upper body muscles than moderate-intensity training (MIT). Twenty-eight healthy, untrained, middle-aged men were randomized into SIT (n = 14, 4-6 × 30 s of all-out cycling/4 min recovery) and MIT groups [n = 14, 40-60 min cycling at 60% of peak O2 uptake (V̇o2 peak)] and completed six training sessions within 2 wk. Pre- and postmeasurements included V̇o2 peak, whole body (M-value), muscle-specific insulin-stimulated glucose uptake (GU), and fasting FFAU measured with positron emission tomography in thigh [quadriceps femoris (QF) and hamstrings] and upper body (deltoids, biceps, and triceps brachii) muscles. V̇o2 peak and M-value improved significantly by 6 and 12% in SIT, and 3 and 8% in MIT, respectively,. GU increased significantly only in the QF, and there was no statistically significant difference between the training modes. GU increased in all four heads of QF in response to SIT, but only in the vasti muscles in response to MIT, whereas in rectus femoris the response was completely lacking. Training response in FFAU in QF was smaller and nonsignificant, but it also differed between the training modes in the rectus femoris. In conclusion, SIT and MIT increased insulin-stimulated GU only in the main working muscle QF and not in the upper body muscles. In addition, the biarticular rectus femoris did not respond to moderate-intensity training, reflecting most probably poor activation of it during moderate-intensity cycling. PMID:25767035

  14. Evaluation of surgeon’s muscle fatigue during thoracoscopic pulmonary lobectomy using interoperative surface electromyography

    PubMed Central

    Yoon, Seung-Hyun; Jung, Myung-Chul

    2016-01-01

    Background The aim of this study was to document the physical stress experienced by a surgeon during thoracoscopic pulmonary lobectomy and mediastinal lymph node dissection for lung cancer by measuring the intraoperative electromyography (EMG). Methods Surface EMG was recorded during 12 cases of thoracoscopic lobectomy. During the operation, 16 channels of a wireless EMG were used to measure muscle activity and fatigue from the bilateral muscles of the splenius capitis (SC), upper trapezius (UT), middle deltoid (MD), flexor carpi radialis (FCR), extensor carpi radialis (ECR), lumbar erector spinae (LES), rectus femoralis (RF), and tibialis anterior (TA). The EMG signals were processed to collect the values of the root mean square for muscle activity and median frequency (MF) for muscle fatigue. Results All operations were completed without adverse events. The mean operating time was 99.16±35.15 minutes. During the operation, the mean muscle activity of all muscles was 21.91±12.85 mV. High muscle activity was observed in the bilateral FCR and ECR, whereas low muscle activity was observed in the bilateral SC and LES. The final MFs in the bilateral SC and LES were found to be decreased from the initial status, which implied increased muscle fatigue. The muscles of the right and left LES were significantly fatigued by up to 29% and 37% compared to their initial status (P=0.021 and P=0.007, respectively). The MFs of the bilateral LES decreased with time (an average decreases of 0.008/5 minutes, P=0.002 in right LES and 0.004/5 minutes, P=0.018 in left LES). Conclusions During thoracoscopic lobectomy, muscle fatigue was observed in muscles related to a static posture, such as the bilateral SC, UT, and ES. Further studies are required to investigate the ergonomic adjustments needed to reduce muscle fatigue in these static muscles. PMID:27293833

  15. Cosmetic surgery.

    PubMed Central

    Harris, D. L.

    1989-01-01

    The psychotherapeutic nature of cosmetic surgery is emphasised by outlining the range of symptoms from which patients suffer and by explaining the sequence of psychological reactions which cause them. The principles which govern the selection of patients are defined. A brief account of each of the main cosmetic operations is given together with notes on their limitations and risks. PMID:2589786

  16. Fetal Surgery

    PubMed Central

    Laberge, Jean-Martin

    1986-01-01

    Fetal surgery has come of age. For decades experimental fetal surgery proved essential in studying normal fetal physiology and development, and pathophysiology of congenital defects. Clinical fetal surgery started in the 1960s with intrauterine transfusions. In the 1970s, the advent of ultrasonography revolutionized fetal diagnosis and created a therapeutic vacuum. Fetal treatment, medical and surgical, is slowly trying to fill the gap. Most defects detected are best treated after birth, some requiring a modification in the time, mode and place of delivery for optimal obstetrical and neonatal care. Surgical intervention in utero should be considered for malformations that cause progressive damage to the fetus, leading to death or severe morbidity; that can be corrected or palliated in utero with a reasonable expectation of normal postnatal development; that cannot wait to be corrected after birth, even considering pre-term delivery; that are not accompanied by chromosomal or other major anomalies. At present, congenital hydronephrosis is the most common indication for fetal surgery, followed by obstructive hydrocephalus. Congenital diaphragmatic hernia also fulfills the criteria, but its correction poses more problems, and no clinical attempts have been reported so far. In the future many other malformations or diseases may become best treated in utero. The ethical and moral issues are complex and need to be discussed as clinical and experimental progress is made. PMID:21267309

  17. Robotic surgery.

    PubMed

    Oleynikov, Dmitry

    2008-10-01

    This article discusses the developments that led up to robotic surgical systems as well as what is on the horizon for new robotic technology. Topics include how robotics is enabling new types of procedures, including natural orifice endoscopic translumenal surgery in which one cannot reach by hand under any circumstances, and how these developments will drive the next generation of robots. PMID:18790158

  18. Cardiac Surgery

    PubMed Central

    Weisse, Allen B.

    2011-01-01

    Well into the first decades of the 20th century, medical opinion held that any surgical attempts to treat heart disease were not only misguided, but unethical. Despite such reservations, innovative surgeons showed that heart wounds could be successfully repaired. Then, extracardiac procedures were performed to correct patent ductus arteriosus, coarctation of the aorta, and tetralogy of Fallot. Direct surgery on the heart was accomplished with closed commissurotomy for mitral stenosis. The introduction of the heart-lung machine and cardiopulmonary bypass enabled the surgical treatment of other congenital and acquired heart diseases. Advances in aortic surgery paralleled these successes. The development of coronary artery bypass grafting greatly aided the treatment of coronary heart disease. Cardiac transplantation, attempts to use the total artificial heart, and the application of ventricular assist devices have brought us to the present day. Although progress in the field of cardiovascular surgery appears to have slowed when compared with the halcyon times of the past, substantial challenges still face cardiac surgeons. It can only be hoped that sufficient resources and incentive can carry the triumphs of the 20th century into the 21st. This review covers past developments and future opportunities in cardiac surgery. PMID:22163121

  19. Arthroscopic Surgery.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    Arthroscopic surgery (or microsurgery) is a significant breakthrough in treating knee injuries. Its applications range from basic diagnosis to arthroscopic menisectomy, although its use in some procedures is still highly controversial. Many surgeons perform the diagnostic procedure, but follow this with the conventional surgical approach.…

  20. Ophthalmic striated muscle neoplasms.

    PubMed

    Knowles, D M; Jakobiec, F A; Potter, G D; Jones, I S

    1976-01-01

    Rhabdomyosarcoma, the most common primary malignant childhood orbital tumor, is composed of neoplastic striated muscle cells (rhabdomyoblasts) in various stages of differentiation and in patterns suggestive of neoplastic analogs of normal muscle embryogenesis. Orbital rhabdomyosarcoma is most commonly seen in children and adolescents, the average age of onset of symptoms being 7.8 years. The tumor usually presents as a rapidly evolving exophthalmos, often associated with drooping of the upper eyelid. A mass is palapable in only 25% of cases, loss of central vision at the time of presentation is uncommon, and laboratory studies are often of little help in diagnosis. The best diagnostic aid is a high index of suspicion whenever one sees a rapidly progressive exophthalamos in a child. Orbital rhabdomyosarcoma is almost always of the embryonal type, believed to originate in the orbital soft tissues from undifferentiated pluripotential embryonic mesenchyme. In the past, orbital exenteration has been the primary therapy. Review of 162 literature cases of orbital rhabdomyosarcoma, generally treated by unassisted surgery, revealed that only 25% of the patients survived 3 or more years. Recently, it has been shown that radiation therapy, alone or combined with chemotherapy, can be successful. A multidisciplinary approach, utilizing surgery, radiation therapy and chemotherapy has also been advocated. Both approaches appear to offer greater survival than unassisted orbital exenteration. The possibility of primary radiation therapy is extremely promising; if it becomes increasingly effective, a mutilating surgical procedure may become obsolete.

  1. [Laparoscopic surgery in day surgery].

    PubMed

    Micali, S; Bitelli, M; Torelli, F; Valitutti, M; Micali, F

    1998-06-01

    Since ten years laparoscopic techniques have been employed as alternatives of many established open procedures in gynecologic, abdominal and finally urologic surgery. Laparoscopic techniques show significant advantages compared to open surgery, such as less hospitalization, reduced need of analgesic drugs, quick return to daily activities and far a better cosmetic results. Laparoscopic surgery has been advocated for urologic, uro-gynecologic and andrologic diseases. Since 1983 one-day surgery was proposed for only a few gynecologic and abdominal procedures and only recently for laparoscopic renal biopsy and abdominal testis evaluation. In these preliminary experiences the conditions for a correct management of laparoscopic one-day surgery have been clearly pointed out: 1. correct surgical indication; 2. through knowledge of surgical technique; 3. duration of the procedure less than 90 minutes; 4. correct anesthesia. Technique of anesthesia must be adapted to the surgical procedure required, its duration and the physical features of the patient. General anesthesia is usually preferred for either longer and more complex procedures or when a higher abdominal insufflation pressure is needed. Spinal or local anesthesia are preferred for simpler procedures or when only one trocar is required. At date only few urologic procedures seem to be suitable to one-day laparoscopic surgery. 1) Varicocele: although laparoscopic varicocelectomy in one-day surgery has never been reported previously, it can be performed in a short time, only 3 trocars are needed and insufflation pressure can be maintained within 15 mm Hg. 2) Renal biopsy and marsupialization of renal cysts. These are usually managed percutaneously but in some particular indications procedures under direct vision should be preferable. Both are short-lasting and only superficial general anesthesia is required; as surgical access is retroperitoneal only two trocars are sufficient; at date only renal biopsies have

  2. Between-muscle differences in the adaptation to experimental pain.

    PubMed

    Hug, François; Hodges, Paul W; van den Hoorn, Wolbert; Tucker, Kylie

    2014-11-15

    This study aimed to determine whether muscle stress (force per unit area) can be redistributed between individual heads of the quadriceps muscle when pain is induced into one of these heads. Elastography was used to measure muscle shear elastic modulus (an index of muscle stress). Electromyography (EMG) was recorded from vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF). In experiment I (n = 20), participants matched a knee extension force, and thus any reduction of stress within the painful muscle would require compensation by other muscles. In experiment II (n = 13), participants matched VL EMG amplitude and were free to vary external force such that intermuscle compensation would be unnecessary to maintain the experimental task. In experiments I and II, pain was induced by injection of hypertonic saline into VM or RF. Experiment III aimed to establish whether voluntary drive to the individual muscles could be controlled independently. Participants (n = 13) were asked to voluntarily reduce activation of VM or RF while maintaining knee extension force. During VM pain, there was no change in shear elastic modulus (experiments I and II) or EMG amplitude of VM (experiment II). In contrast, RF pain was associated with a reduction in RF elastic modulus (experiments I and II: -8 to -17%) and EMG amplitude (experiment II). Participants could voluntarily reduce EMG amplitude of RF (-26%; P = 0.003) but not VM (experiment III). These results highlight between-muscle differences in adaptation to pain that might be explained by their function (monoarticular vs. biarticular) and/or the neurophysiological constraints associated to their activation.

  3. Responsiveness of muscle tone characteristics to progressive force production.

    PubMed

    Mustalampi, Sirpa; Häkkinen, Arja; Kautiainen, Hannu; Weir, Adam; Ylinen, Jari

    2013-01-01

    It is possible to measure muscle tone reliably, quickly and objectively using tonometers although they are not yet widely used. In clinical practice, it may be helpful if clinicians could assess the degree of contraction in different parts of a muscle without having to perform time-consuming electromyography measurements. The purpose of this study was to evaluate the responsiveness of different muscle tone characteristics to progressively increased contraction force of quadriceps muscle. Twenty healthy subjects (mean age 39.9 years, 50% women) volunteered. Using 2 different tonometers various muscle viscoelastic properties were measured. The frequency (hertz), logarithmic decrement, and stiffness (newtons per meter) of damped mechanical oscillation of the muscle tissue and tissue compliance (millijoules) were registered from rectus femoris muscle at rest and 20, 40, 60, 80% of maximal voluntary contraction determined using dynamometry. All the values changed linearly with increasing force level. Compliance, oscillation stiffness, and frequency parameters showed large effect sizes (ESs ≥ 0.8). The standardized respoknse mean for compliance was 5.3 (4.8-5.7) mJ, for oscillation stiffness 1.8 (1.3-2.2) N·m(-1), frequency 1.1 (0.6-1.5) Hz, and decrement -0.6 (-1.0 to -0.2). The results indicate that the compliance and oscillation stiffness parameters showed the highest responsiveness and can thus best detect changes in muscle contraction state. The additional value of using tonometers to measure these properties in clinical practice should be investigated further.

  4. Lower Extremity Muscle Thickness During 30-Day 6 degrees Head-Down Bed Rest with Isotonic and Isokinetic Exercise Training

    NASA Technical Reports Server (NTRS)

    Ellis, S.; Kirby, L. C.; Greenleaf, J. E.

    1993-01-01

    Muscle thickness was measured in 19 Bed-Rested (BR) men (32-42 year) subjected to IsoTonic (ITE, cycle orgometer) and IsoKi- netic (IKE, torque orgometer) lower extremity exercise training, and NO Exercise (NOE) training. Thickness was measured with ultrasonography in anterior thigh-Rectus Femoris (RF) and Vastus Intermadius (VI), and combined posterior log-soleus, flexor ballucis longus, and tibialis posterior (S + FHL +TP) - muscles. Compared with ambulatory control values, thickness of the (S + FHL + TP) decreased by 90%-12% (p less than 0.05) In all three test groups. The (RF) thickness was unchanged in the two exercise groups, but decreased by 10% (p less than 0.05) in the NOE. The (VI) thickness was unchanged In the ITE group, but decreased by 12%-l6% (p less than 0.05) in the IKE and NOE groups. Thus, intensive, alternating, isotonic cycle ergometer exercise training is as effective as intensive, intermittent, isokinetic exercise training for maintaining thicknesses of rectus femoris and vastus lntermedius anterior thigh muscles, but not posterior log muscles, during prolonged BR deconditioning.

  5. Structural functional associations of the orbit in thyroid eye disease: Kalman filters to track extraocular rectal muscles

    NASA Astrophysics Data System (ADS)

    Chaganti, Shikha; Nelson, Katrina; Mundy, Kevin; Luo, Yifu; Harrigan, Robert L.; Damon, Steve; Fabbri, Daniel; Mawn, Louise; Landman, Bennett

    2016-03-01

    Pathologies of the optic nerve and orbit impact millions of Americans and quantitative assessment of the orbital structures on 3-D imaging would provide objective markers to enhance diagnostic accuracy, improve timely intervention, and eventually preserve visual function. Recent studies have shown that the multi-atlas methodology is suitable for identifying orbital structures, but challenges arise in the identification of the individual extraocular rectus muscles that control eye movement. This is increasingly problematic in diseased eyes, where these muscles often appear to fuse at the back of the orbit (at the resolution of clinical computed tomography imaging) due to inflammation or crowding. We propose the use of Kalman filters to track the muscles in three-dimensions to refine multi-atlas segmentation and resolve ambiguity due to imaging resolution, noise, and artifacts. The purpose of our study is to investigate a method of automatically generating orbital metrics from CT imaging and demonstrate the utility of the approach by correlating structural metrics of the eye orbit with clinical data and visual function measures in subjects with thyroid eye disease. The pilot study demonstrates that automatically calculated orbital metrics are strongly correlated with several clinical characteristics. Moreover, it is shown that the superior, inferior, medial and lateral rectus muscles obtained using Kalman filters are each correlated with different categories of functional deficit. These findings serve as foundation for further investigation in the use of CT imaging in the study, analysis and diagnosis of ocular diseases, specifically thyroid eye disease.

  6. Structural Functional Associations of the Orbit in Thyroid Eye Disease: Kalman Filters to Track Extraocular Rectal Muscles

    PubMed Central

    Chaganti, Shikha; Nelson, Katrina; Mundy, Kevin; Luo, Yifu; Harrigan, Robert L; Damon, Steve; Fabbri, Daniel; Mawn, Louise; Landman, Bennett

    2016-01-01

    Pathologies of the optic nerve and orbit impact millions of Americans and quantitative assessment of the orbital structures on 3-D imaging would provide objective markers to enhance diagnostic accuracy, improve timely intervention and eventually preserve visual function. Recent studies have shown that the multi-atlas methodology is suitable for identifying orbital structures, but challenges arise in the identification of the individual extraocular rectus muscles that control eye movement. This is increasingly problematic in diseased eyes, where these muscles often appear to fuse at the back of the orbit (at the resolution of clinical computed tomography imaging) due to inflammation or crowding. We propose the use of Kalman filters to track the muscles in three-dimensions to refine multi-atlas segmentation and resolve ambiguity due to imaging resolution, noise, and artifacts. The purpose of our study is to investigate a method of automatically generating orbital metrics from CT imaging and demonstrate the utility of the approach by correlating structural metrics of the eye orbit with clinical data and visual function measures in subjects with thyroid eye disease. The pilot study demonstrates that automatically calculated orbital metrics are strongly correlated with several clinical characteristics. Moreover, the superior, inferior, medial and lateral rectus muscles obtained using Kalman filters are each correlated with different categories of functional deficit. These findings serve as foundation for further investigation in the use of CT imaging in the study, analysis and diagnosis of ocular diseases, specifically thyroid eye disease. PMID:27127330

  7. Single motor unit activity in human extraocular muscles during the vestibulo-ocular reflex.

    PubMed

    Weber, Konrad P; Rosengren, Sally M; Michels, Rike; Sturm, Veit; Straumann, Dominik; Landau, Klara

    2012-07-01

    Motor unit activity in human eye muscles during the vestibulo-ocular reflex (VOR) is not well understood, since the associated head and eye movements normally preclude single unit recordings. Therefore we recorded single motor unit activity following bursts of skull vibration and sound, two vestibular otolith stimuli that elicit only small head and eye movements. Inferior oblique (IO) and inferior rectus (IR) muscle activity was measured in healthy humans with concentric needle electrodes. Vibration elicited highly synchronous, short-latency bursts of motor unit activity in the IO (latency: 10.5 ms) and IR (14.5 ms) muscles. The activation patterns of the two muscles were similar, but reciprocal, with delayed activation of the IR muscle. Sound produced short-latency excitation of the IO muscle (13.3 ms) in the eye contralateral to the stimulus. Simultaneous needle and surface recordings identified the IO as the muscle of origin of the vestibular evoked myogenic potential (oVEMP) thus validating the physiological basis of this recently developed clinical test of otolith function. Single extraocular motor unit recordings provide a window into neural activity in humans that can normally only be examined using animal models and help identify the pathways of the translational VOR from otoliths to individual eye muscles.

  8. [Tumor surgery].

    PubMed

    Hausamen, J E

    2000-05-01

    Surgery is still the primary therapeutic approach in treatment of tumors in the head and neck area, dating back to the early nineteenth century. More than 150 years ago, hemimaxillectomies and mandibular resections as well as hemiglossectomies were already performed by leading surgeons. The block principle we are now following dates back to Crile, who also established the principle of cervical lymph node dissection. Ablative oncologic surgery has always been closely linked with plastic and reconstructive surgery, rendering radical surgical interventions possible without disfiguring patients. The development of facial reconstructive surgery proceeded in stages, in the first instance as secondary reconstruction using tube pedicled flaps. The change to the concept of primary reconstruction occurred via arterialized skin flaps and myocutaneous flaps to the widely accepted and performed free tissue transfer. Free bone grafting, inaugurated earlier and still representing the majority of bone grafting, has been supplemented for certain reconstructive purposes by free vascularized bone transfer from various donor sites. Although the five-year-survival rate of carcinoma of the oral cavity has remained unchanged in the past 30 years, distinctive improvements in tumor surgery can be recorded. This is primarily based on improved diagnostics such as modern imaging techniques and the refinement of surgical techniques. The DOSAK has worked out distinctive guidelines for effective ablative oncologic surgery. Surgical approaches offering wide exposure and carrying low morbidity play a decisive role in radical resections. For this reason, midfacial degloving offers an essential improvement for the resection of midface tumors, especially from an aesthetic point of view. Tumors situated deep behind the viscerocranium at the skull base can be clearly exposed either through a lateral approach following a temporary osteotomy of the mandibular ramus or a transmandibular, transmaxillar, or

  9. Surgery for Breast Cancer

    MedlinePlus

    ... Next Topic Breast-conserving surgery (lumpectomy) Surgery for breast cancer Most women with breast cancer have some type ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  10. Heart bypass surgery

    MedlinePlus

    Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

  11. Lung Carcinoid Tumor: Surgery

    MedlinePlus

    ... for lung carcinoid tumor symptoms Surgery to treat lung carcinoid tumors Surgery is the main treatment for ... often be cured by surgery alone. Types of lung surgery Different operations can be used to treat ( ...

  12. Tennis elbow surgery - discharge

    MedlinePlus

    Lateral epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... Soon after surgery, severe pain will decrease, but you may have mild soreness for 3 to 6 months.

  13. LASIK - Laser Eye Surgery

    MedlinePlus

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ...

  14. Resistance exercise-induced fluid shifts: change in active muscle size and plasma volume

    NASA Technical Reports Server (NTRS)

    Ploutz-Snyder, L. L.; Convertino, V. A.; Dudley, G. A.

    1995-01-01

    The purpose of this study was to test the hypothesis that the reduction in plasma volume (PV) induced by resistance exercise reflects fluid loss to the extravascular space and subsequently selective increase in cross-sectional area (CSA) of active but not inactive skeletal muscle. We compared changes in active and inactive muscle CSA and PV after barbell squat exercise. Magnetic resonance imaging (MRI) was used to quantify muscle involvement in exercise and to determine CSA of muscle groups or individual muscles [vasti (VS), adductor (Add), hamstring (Ham), and rectus femoris (RF)]. Muscle involvement in exercise was determined using exercise-induced contrast shift in spin-spin relaxation time (T2)-weighted MR images immediately postexercise. Alterations in muscle size were based on the mean CSA of individual slices. Hematocrit, hemoglobin, and Evans blue dye were used to estimate changes in PV. Muscle CSA and PV data were obtained preexercise and immediately postexercise and 15 and 45 min thereafter. A hierarchy of muscle involvement in exercise was found such that VS > Add > Ham > RF, with the Ham and RF showing essentially no involvement. CSA of the VS and Add muscle groups were increased 10 and 5%, respectively, immediately after exercise in each thigh with no changes in Ham and RF CSA. PV was decreased 22% immediately following exercise. The absolute loss of PV was correlated (r2 = 0.75) with absolute increase in muscle CSA immediately postexercise, supporting the notion that increased muscle size after resistance exercise reflects primarily fluid movement from the vascular space into active but not inactive muscle.

  15. Whole-Body muscle MRI in a series of patients with congenital myopathy related to TPM2 gene mutations.

    PubMed

    Jarraya, Mohamed; Quijano-Roy, Susana; Monnier, Nicole; Béhin, Anthony; Avila-Smirnov, Daniela; Romero, Norma Beatriz; Allamand, Valérie; Richard, Pascale; Barois, Annie; May, Adrien; Estournet, Brigitte; Mercuri, Eugenio; Carlier, Pierre G; Carlier, Robert-Yves

    2012-10-01

    Beta-tropomyosin 2 (TPM2) gene mutations are a rare cause of congenital myopathy with variable clinical and histological features. We describe muscle involvement using Whole-Body muscle Magnetic Resonance Imaging (WBMRI) in 8 individuals with genetically proven TPM2 mutations and different clinical and histological features (nemaline myopathy, 'cap disease', Bethlem-like phenotype, arthrogryposis). Most patients shared a recognizable MRI pattern with the involvement of masticatory and distal lower leg muscles. The lower leg showed constant soleus muscle involvement, and often also involvement of peroneus, tibialis anterior, and toe flexor muscles. Pelvic and shoulder girdles, and upper limbs muscles were quite spared. Two adult subjects (a patient and a paucisymptomatic parent) had a more diffuse involvement with striking fat infiltration of the rectus femoris muscle. Two children showed variant findings: one presented with masseter involvement associated with severe axial fat infiltration, the second had masticatory and distal leg muscle involvement (soleus and gastrocnemius muscles). Our study suggests that, independently of the clinical and histological presentation, most patients with TPM2 mutations show a predominant involvement of masticatory and distal leg muscles with the other regions relatively spared. More spread involvement may be observed. This cephalic-distal MRI pattern is not frequent in other known myopathies. PMID:22980765

  16. Hip flexor muscle size, strength and recruitment pattern in patients with acetabular labral tears compared to healthy controls.

    PubMed

    Mendis, M Dilani; Wilson, Stephen J; Hayes, David A; Watts, Mark C; Hides, Julie A

    2014-10-01

    Acetabular labral tears are a source of hip pain and are considered to be a precursor to hip osteoarthritis. Hip flexor muscles contribute to hip joint stability and function but it is unknown if their size and function is altered in the presence of labral pathology. This study aimed to investigate hip flexor muscle size, strength and recruitment pattern in patients with hip labral pathology compared to control subjects. 12 subjects diagnosed with an unilateral acetabular labral tear were compared to 12 control subjects matched for age and gender. All subjects underwent magnetic resonance imaging (MRI) of their lumbo-pelvic region. Average muscle cross-sectional area (CSA) of the iliacus, psoas, iliopsoas, sartorius, tensor fascia latae and rectus femoris muscles were measured. Hip flexion strength was measured by an externally fixed dynamometer. Individual muscle recruitment pattern during a resisted hip flexion exercise task was measured by muscle functional MRI. Hip flexor muscle strength was found to be decreased in patients with labral pathology compared to control subjects (p < 0.01). No difference between groups or sides was found for hip flexor muscle size (all p > 0.17) and recruitment pattern (all p > 0.53). Decreased hip flexor muscle strength may affect physical function in patients with hip labral pathology by contributing to altered gait patterns and functional tasks. Clinical rehabilitation of these patients may need to include strengthening exercises for the hip flexor muscles.

  17. Variation of the Infrahyoid Muscle: Duplicated Omohyoid and Appearance of the Levator Glandulae Thyroideae Muscles

    PubMed Central

    Kim, Deog-Im; Kim, Ho-Jeong; Park, Jae-Young

    2010-01-01

    The embryologic origin of the omohyoid muscle is different from that of the other neck muscles. A number of variations such as the absence of muscle, variable sites of origin and insertion, and multiple bellies have been reported. However, variations in the inferior belly of the omohyoid muscle are rare. There have been no reports of the combined occurrence of the omohyoid muscle variation with the appearance of the levator glandulase thyroideae muscle. Routine dissection of a 51-year-old female cadaver revealed a duplicated omohyoid muscle and the appearance of the levator glandulae thyroideae muscle. In this case, the two inferior bellies of the omohyoid muscle were found to originate inferiorly from the superior border of the scapula. One of the inferior bellies generally continued to the superior belly with the tendinous intersection. The other inferior belly continued into the sternohyoid muscle without the tendinous intersection. In this case, the levator glandulae thyroideae muscle appeared on the left side, which attached from the upper border of the thyroid gland to the inferior border of the thyroid cartilage. These variations are significant for clinicians during endoscopic diagnosis and surgery because of the arterial and nervous damage due to iatrogenic injuries. The embryologic origins of the omohyoid and levator glandulae thyroideae muscles may be similar based on the descriptions in the relevant literature. PMID:20879073

  18. Changes in input-output relations in the corticospinal pathway to the lower limb muscles during robot-assisted passive stepping.

    PubMed

    Kamibayashi, Kiyotaka; Nakajima, Tsuyoshi; Takahashi, Makoto; Nakazawa, Kimitaka

    2011-01-01

    We investigated input (stimulus)-output (response) relations of the corticospinal pathway in the lower limb muscles during passive stepping using a robotic driven gait orthosis. Nine healthy adult subjects passively stepped with 40% body weight unloading (ground stepping) and 100% body weight unloading in the air (air stepping). During passive stepping, the motor evoked potentials (MEPs) of the lower limb muscles elicited by transcranial magnetic stimulation (TMS) were recorded at late-stance, early-, and late-swing phases of 2 stepping conditions. The input-output relation at each phase of the stepping conditions was obtained by increasing stimulus intensity in 5% increments from 40% to 70% of maximal stimulator output. The slopes of input-output relations were steeper at the early-swing phase in the rectus femoris muscle and at the late-stance and late-swing phases in the biceps femoris muscle in both stepping conditions. There were no significant differences in the MEP responses of the rectus femoris and biceps femoris muscles at each phase between the 2 conditions. Low muscle activity was seen at the late-stance phase of ground stepping in the soleus muscle and the MEP amplitude at this phase became larger. The slopes in the tibialis anterior muscle were steep at the early- and late-swing phases of ground stepping. There was a significant difference in the MEPs of the tibialis anterior muscle between the late-swing phases in ground and air stepping. The present study indicates that corticospinal excitability to the lower limb muscles is modulated by sensory inputs elicited by passive stepping.

  19. [Minimally invasive breast surgery].

    PubMed

    Mátrai, Zoltán; Gulyás, Gusztáv; Kunos, Csaba; Sávolt, Akos; Farkas, Emil; Szollár, András; Kásler, Miklós

    2014-02-01

    Due to the development in medical science and industrial technology, minimally invasive procedures have appeared in the surgery of benign and malignant breast diseases. In general , such interventions result in significantly reduced breast and chest wall scars, shorter hospitalization and less pain, but they require specific, expensive devices, longer surgical time compared to open surgery. Furthermore, indications or oncological safety have not been established yet. It is quite likely, that minimally invasive surgical procedures with high-tech devices - similar to other surgical subspecialties -, will gradually become popular and it may form part of routine breast surgery even. Vacuum-assisted core biopsy with a therapeutic indication is suitable for the removal of benign fibroadenomas leaving behind an almost invisible scar, while endoscopically assisted skin-sparing and nipple-sparing mastectomy, axillary staging and reconstruction with latissimus dorsi muscle flap are all feasible through the same short axillary incision. Endoscopic techniques are also suitable for the diagnostics and treatment of intracapsular complications of implant-based breast reconstructions (intracapsular fluid, implant rupture, capsular contracture) and for the biopsy of intracapsular lesions with uncertain pathology. Perception of the role of radiofrequency ablation of breast tumors requires further hands-on experience, but it is likely that it can serve as a replacement of surgical removal in a portion of primary tumors in the future due to the development in functional imaging and anticancer drugs. With the reduction of the price of ductoscopes routine examination of the ductal branch system, guided microdochectomy and targeted surgical removal of terminal ducto-lobular units or a "sick lobe" as an anatomical unit may become feasible. The paper presents the experience of the authors and provides a literature review, for the first time in Hungarian language on the subject. Orv. Hetil

  20. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    PubMed Central

    Lehman, Gregory J.; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H.

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson’s r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = −1.39° (−5.53, +2.75); t(22) = −0.70; p = 0.4933; Cohen’s d = − 0.15 (−0.58, 0.29)) or rectus femoris length (change = −0.005 (−0.013, +0.003); t(22) = −1.30; p = 0.2070; Cohen’s d = − 0.27 (−0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol. PMID:26421244

  1. [What do general, abdominal and vascular surgeons need to know on plastic surgery - aspects of plastic surgery in the field of general, abdominal and vascular surgery].

    PubMed

    Damert, H G; Altmann, S; Stübs, P; Infanger, M; Meyer, F

    2015-02-01

    There is overlap between general, abdominal and vascular surgery on one hand and plastic surgery on the other hand, e.g., in hernia surgery, in particular, recurrent hernia, reconstruction of the abdominal wall or defect closure after abdominal or vascular surgery. Bariatric operations involve both special fields too. Plastic surgeons sometimes use skin and muscle compartments of the abdominal wall for reconstruction at other regions of the body. This article aims to i) give an overview about functional, anatomic and clinical aspects as well as the potential of surgical interventions in plastic surgery. General/abdominal/vascular surgeons can benefit from this in their surgical planning and competent execution of their own surgical interventions with limited morbidity/lethality and an optimal, in particular, functional as well as aesthetic outcome, ii) support the interdisciplinary work of general/abdominal/vascular and plastic surgery, and iii) provide a better understanding of plastic surgery and its profile of surgical interventions and options.

  2. Not all instability training devices enhance muscle activation in highly resistance-trained individuals.

    PubMed

    Wahl, Michael J; Behm, David G

    2008-07-01

    The objective of this study was to measure the electromyographic (EMG) activity of the soleus, bicep femoris, rectus femoris, lower abdominal, and lumbosacral erector spinae (LSES) muscles with a variety of (a) instability devices, (b) stable and unstable (Dyna Disc) exercises, and (c) a fatiguing exercise in 16 highly conditioned individuals. The device protocol had participants assume standing and squatting postures while balancing on a variety of unstable platforms (Dyna Disc, BOSU ball, wobble board, and a Swiss ball) and a stable floor. The exercise protocol had subjects performing, static front lunges, static side lunges, 1-leg hip extensions, 1-leg reaches, and calf raises on a floor or an unstable Dyna Disc. For the fatigue experiment, a wall sit position was undertaken under stable and unstable (BOSU ball) conditions. Results for the device experiment demonstrated increased activity for all muscles when standing on a Swiss ball and all muscles other than the rectus femoris when standing on a wobble board. Only lower abdominals and soleus EMG activity increased while squatting on a Swiss ball and wobble board. Devices such as the Dyna Disc and BOSU ball did not exhibit significant differences in muscle activation under any conditions, except the LSES in the standing Dyna Disc conditions. During the exercise protocol, there were no significant changes in muscle activity between stable and unstable (Dyna Disc) conditions. With the fatigue protocol, soleus EMG activity was 51% greater with a stable base. These results indicate that the use of moderately unstable training devices (i.e., Dyna Disc, BOSU ball) did not provide sufficient challenges to the neuromuscular system in highly resistance-trained individuals. Since highly trained individuals may already possess enhanced stability from the use of dynamic free weights, a greater degree of instability may be necessary.

  3. [Robotic surgery].

    PubMed

    Sándor, József; Haidegger, Tamás; Kormos, Katalin; Ferencz, Andrea; Csukás, Domokos; Bráth, Endre; Szabó, Györgyi; Wéber, György

    2013-10-01

    Due to the fast spread of laparoscopic cholecystectomy, surgical procedures have been changed essentially. The new techniques applied for both abdominal and thoracic procedures provided the possibility for minimally invasive access with all its advantages. Robots - originally developed for industrial applications - were retrofitted for laparoscopic procedures. The currently prevailing robot-assisted surgery is ergonomically more advantageous for the surgeon, as well as for the patient through the more precise preparative activity thanks to the regained 3D vision. The gradual decrease of costs of robotic surgical systems and development of new generations of minimally invasive devices may lead to substantial changes in routine surgical procedures. PMID:24144815

  4. [Robotic surgery].

    PubMed

    Sándor, József; Haidegger, Tamás; Kormos, Katalin; Ferencz, Andrea; Csukás, Domokos; Bráth, Endre; Szabó, Györgyi; Wéber, György

    2013-10-01

    Due to the fast spread of laparoscopic cholecystectomy, surgical procedures have been changed essentially. The new techniques applied for both abdominal and thoracic procedures provided the possibility for minimally invasive access with all its advantages. Robots - originally developed for industrial applications - were retrofitted for laparoscopic procedures. The currently prevailing robot-assisted surgery is ergonomically more advantageous for the surgeon, as well as for the patient through the more precise preparative activity thanks to the regained 3D vision. The gradual decrease of costs of robotic surgical systems and development of new generations of minimally invasive devices may lead to substantial changes in routine surgical procedures.

  5. Hypertrophy of palmaris longus muscle, a rare anatomic aberration.

    PubMed

    Barkáts, N

    2015-01-01

    The palmaris longus muscle (PLM) is considered to be a phylogenetically degenerate muscle. For many authors, this may be the cause of its great variability. The loss of function in the PLM makes it an important muscle in plastic and reconstructive surgery. During a study of PLM agenesis rate in the Hungarian population, a 22-year-old female showed an unusual pattern of muscles in her left forearm, which was found to be a hypertrophied PLM. The hypertrophied muscle was causing symptoms of median and ulnar nerve compression.

  6. Active behavior of abdominal wall muscles: Experimental results and numerical model formulation.

    PubMed

    Grasa, J; Sierra, M; Lauzeral, N; Muñoz, M J; Miana-Mena, F J; Calvo, B

    2016-08-01

    In the present study a computational finite element technique is proposed to simulate the mechanical response of muscles in the abdominal wall. This technique considers the active behavior of the tissue taking into account both collagen and muscle fiber directions. In an attempt to obtain the computational response as close as possible to real muscles, the parameters needed to adjust the mathematical formulation were determined from in vitro experimental tests. Experiments were conducted on male New Zealand White rabbits (2047±34g) and the active properties of three different muscles: Rectus Abdominis, External Oblique and multi-layered samples formed by three muscles (External Oblique, Internal Oblique, and Transversus Abdominis) were characterized. The parameters obtained for each muscle were incorporated into a finite strain formulation to simulate active behavior of muscles incorporating the anisotropy of the tissue. The results show the potential of the model to predict the anisotropic behavior of the tissue associated to fibers and how this influences on the strain, stress and generated force during an isometric contraction. PMID:27111629

  7. Bilateral Limb Phase Relationship and Its Potential to Alter Muscle Activity Phasing During Locomotion

    PubMed Central

    López-Ortiz, Citlali; Walter, Charles B.; Brown, David A.

    2009-01-01

    It is well established that the sensorimotor state of one limb can influence another limb and therefore bilateral somatosensory inputs make an important contribution to interlimb coordination patterns. However, the relative contribution of interlimb pathways for modifying muscle activation patterns in terms of phasing is less clear. Here we studied adaptation of muscle activity phasing to the relative angular positions of limbs using a split-crank ergometer, where the cranks could be decoupled to allow different spatial angular position relationships. Twenty neurologically healthy individuals performed the specified pedaling tasks at different relative angular positions while surface electromyographic (EMG) signals were recorded bilaterally from eight lower extremity muscles. During each experiment, the relative angular crank positions were altered by increasing or decreasing their difference by randomly ordered increments of 30° over the complete cycle [0° (in phase pedaling); 30, 60, 90, 120, 150, and 180° (standard pedaling); and 210, 240, 270, 300, and 330° out of phase pedaling]. We found that manipulating the relative angular positions of limbs in a pedaling task caused muscle activity phasing changes that were either delayed or advanced, dependent on the relative spatial position of the two cranks and this relationship is well-explained by a sine curve. Further, we observed that the magnitude of phasing changes in biarticular muscles (like rectus femoris) was significantly greater than those of uniarticular muscles (like vastus medialis). These results are important because they provide new evidence that muscle phasing can be systematically influenced by interlimb pathways. PMID:19741107

  8. Active behavior of abdominal wall muscles: Experimental results and numerical model formulation.

    PubMed

    Grasa, J; Sierra, M; Lauzeral, N; Muñoz, M J; Miana-Mena, F J; Calvo, B

    2016-08-01

    In the present study a computational finite element technique is proposed to simulate the mechanical response of muscles in the abdominal wall. This technique considers the active behavior of the tissue taking into account both collagen and muscle fiber directions. In an attempt to obtain the computational response as close as possible to real muscles, the parameters needed to adjust the mathematical formulation were determined from in vitro experimental tests. Experiments were conducted on male New Zealand White rabbits (2047±34g) and the active properties of three different muscles: Rectus Abdominis, External Oblique and multi-layered samples formed by three muscles (External Oblique, Internal Oblique, and Transversus Abdominis) were characterized. The parameters obtained for each muscle were incorporated into a finite strain formulation to simulate active behavior of muscles incorporating the anisotropy of the tissue. The results show the potential of the model to predict the anisotropic behavior of the tissue associated to fibers and how this influences on the strain, stress and generated force during an isometric contraction.

  9. The determination of lactate dehydrogenase isoenzymes in normal human muscle and other tissues

    PubMed Central

    Emery, A. E. H.

    1967-01-01

    1. A technique has been developed, based on preferential inhibition by urea, for determining the amounts and proportions of the M and H sub-units of lactate dehydrogenase (referred to as LDH-M and LDH-H respectively) in human tissues, including muscle. 2. There was good agreement between the results obtained with urea inhibition and those obtained with starch-gel electrophoresis. 3. With increasing age there was a significant decrease in the total amount of lactate dehydrogenase and the amount of LDH-M in skeletal muscle. This could not be accounted for by the replacement of functioning muscle tissue by fibrous connective tissue. 4. The proportion of LDH-M was less in certain muscles (e.g. soleus and extra-ocular) than in other muscles (e.g. gastrocnemius and rectus abdominis). 5. The proportions of LDH-M and LDH-H did not differ significantly in different superficial limb muscles and were not significantly affected by either age or sex. 6. Specimens of muscle from 86 different individuals (all Europeans) have been subjected to electrophoresis, but no variants of lactate dehydrogenase isoenzymes have been found. PMID:5584002

  10. Reorganised motor control strategies of trunk muscles due to acute low back pain.

    PubMed

    Hirata, R P; Salomoni, S E; Christensen, S W; Graven-Nielsen, T

    2015-06-01

    This study assessed how the low back motor control strategies were affected by experimental pain. In twelve volunteers the right m. longissimus was injected by hypertonic and isotonic (control) saline. The pain intensity was assessed on a visual analog scale (VAS). Subjects were seated on a custom-designed chair including a 3-dimensional force sensor adjusted to the segmental height of T1. Electromyography (EMG) was recorded bilaterally from longissimus, multifidus, rectus abdominis, and external oblique muscles. Isometric trunk extensions were performed before, during, and after the saline injections at 5%, 10%, and 20% of maximum voluntary contraction force. Visual feedback of the extension force was provided whereas the tangential force components were recorded. Compared with isotonic saline, VAS scores were higher following hypertonic saline injections (P<.01). Experimental low back pain reduced the EMG activity bilaterally of the rectus abdominis muscles during contractions at 10% and 20% MVC (P<.01) although force accuracy and tangential force variability was not affected. Increased variability in the tangential force composition was found during pain compared with the non-painful condition (P<.05). The immediate adaptation to pain was sufficient to maintain the quality of the task performance; however the long-term consequence of such adaptation is unknown and may overload other structures.

  11. Reorganised motor control strategies of trunk muscles due to acute low back pain.

    PubMed

    Hirata, R P; Salomoni, S E; Christensen, S W; Graven-Nielsen, T

    2015-06-01

    This study assessed how the low back motor control strategies were affected by experimental pain. In twelve volunteers the right m. longissimus was injected by hypertonic and isotonic (control) saline. The pain intensity was assessed on a visual analog scale (VAS). Subjects were seated on a custom-designed chair including a 3-dimensional force sensor adjusted to the segmental height of T1. Electromyography (EMG) was recorded bilaterally from longissimus, multifidus, rectus abdominis, and external oblique muscles. Isometric trunk extensions were performed before, during, and after the saline injections at 5%, 10%, and 20% of maximum voluntary contraction force. Visual feedback of the extension force was provided whereas the tangential force components were recorded. Compared with isotonic saline, VAS scores were higher following hypertonic saline injections (P<.01). Experimental low back pain reduced the EMG activity bilaterally of the rectus abdominis muscles during contractions at 10% and 20% MVC (P<.01) although force accuracy and tangential force variability was not affected. Increased variability in the tangential force composition was found during pain compared with the non-painful condition (P<.05). The immediate adaptation to pain was sufficient to maintain the quality of the task performance; however the long-term consequence of such adaptation is unknown and may overload other structures. PMID:25879794

  12. Bariatric Surgery

    PubMed Central

    2005-01-01

    Executive Summary Objective To conduct an evidence-based analysis of the effectiveness and cost-effectiveness of bariatric surgery. Background Obesity is defined as a body mass index (BMI) of at last 30 kg/m2.1 Morbid obesity is defined as a BMI of at least 40 kg/m2 or at least 35 kg/m2 with comorbid conditions. Comorbid conditions associated with obesity include diabetes, hypertension, dyslipidemias, obstructive sleep apnea, weight-related arthropathies, and stress urinary incontinence. It is also associated with depression, and cancers of the breast, uterus, prostate, and colon, and is an independent risk factor for cardiovascular disease. Obesity is also associated with higher all-cause mortality at any age, even after adjusting for potential confounding factors like smoking. A person with a BMI of 30 kg/m2 has about a 50% higher risk of dying than does someone with a healthy BMI. The risk more than doubles at a BMI of 35 kg/m2. An expert estimated that about 160,000 people are morbidly obese in Ontario. In the United States, the prevalence of morbid obesity is 4.7% (1999–2000). In Ontario, the 2004 Chief Medical Officer of Health Report said that in 2003, almost one-half of Ontario adults were overweight (BMI 25–29.9 kg/m2) or obese (BMI ≥ 30 kg/m2). About 57% of Ontario men and 42% of Ontario women were overweight or obese. The proportion of the population that was overweight or obese increased gradually from 44% in 1990 to 49% in 2000, and it appears to have stabilized at 49% in 2003. The report also noted that the tendency to be overweight and obese increases with age up to 64 years. BMI should be used cautiously for people aged 65 years and older, because the “normal” range may begin at slightly above 18.5 kg/m2 and extend into the “overweight” range. The Chief Medical Officer of Health cautioned that these data may underestimate the true extent of the problem, because they were based on self reports, and people tend to over-report their

  13. Electromyographic responses of erector spinae and lower limb's muscles to dynamic postural perturbations in patients with adolescent idiopathic scoliosis.

    PubMed

    Farahpour, Nader; Ghasemi, Safoura; Allard, Paul; Saba, Mohammad Sadegh

    2014-10-01

    The aim of this study was to evaluate electromyographic (EMG) responses of erector spinae (ES) and lower limbs' muscles to dynamic forward postural perturbation (FPP) and backward postural perturbation (BPP) in patients with adolescent idiopathic scoliosis (AIS) and in a healthy control group. Ten right thoracic AIS patients (Cobb=21.6±4.4°) and 10 control adolescents were studied. Using bipolar surface electrodes, EMG activities of ES muscle at T10 (EST10) and L3 (ESL3) levels, biceps femoris (BF), gastrocnemius lateralis (G) and rectus femoris (RF) muscles in the right and the left sides during FPP and BPP were evaluated. Muscle responses were measured over a 1s time window after the onset of perturbation. In FPP test, the EMG responses of right EST10, ESL3 and BF muscles in the scoliosis group were respectively about 1.40 (p=0.035), 1.43 (p=0.07) and 1.45 (p=0.01) times greater than those in control group. Also, in BPP test, at right ESL3 muscle of the scoliosis group the EMG activity was 1.64 times higher than that in the control group (p=0.01). The scoliosis group during FPP displayed asymmetrical muscle responses in EST10 and BF muscles. This asymmetrical muscle activity in response to FPP is hypothesized to be a possible compensatory strategy rather than an inherent characteristic of scoliosis.

  14. Passive mechanical properties of rat abdominal wall muscles suggest an important role of the extracellular connective tissue matrix.

    PubMed

    Brown, Stephen H M; Carr, John Austin; Ward, Samuel R; Lieber, Richard L

    2012-08-01

    Abdominal wall muscles have a unique morphology suggesting a complex role in generating and transferring force to the spinal column. Studying passive mechanical properties of these muscles may provide insights into their ability to transfer force among structures. Biopsies from rectus abdominis (RA), external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) were harvested from male Sprague-Dawley rats, and single muscle fibers and fiber bundles (4-8 fibers ensheathed in their connective tissue matrix) were isolated and mechanically stretched in a passive state. Slack sarcomere lengths were measured and elastic moduli were calculated from stress-strain data. Titin molecular mass was also measured from single muscle fibers. No significant differences were found among the four abdominal wall muscles in terms of slack sarcomere length or elastic modulus. Interestingly, across all four muscles, slack sarcomere lengths were quite long in individual muscle fibers (>2.4 µm), and demonstrated a significantly longer slack length in comparison to fiber bundles (p < 0.0001). Also, the extracellular connective tissue matrix provided a stiffening effect and enhanced the resistance to lengthening at long muscle lengths. Titin molecular mass was significantly less in TrA compared to each of the other three muscles (p < 0.0009), but this difference did not correspond to hypothesized differences in stiffness.

  15. Assessment of bioelectrical activity of synergistic muscles during pelvic floor muscles activation in postmenopausal women with and without stress urinary incontinence: a preliminary observational study

    PubMed Central

    Ptaszkowski, Kuba; Paprocka-Borowicz, Małgorzata; Słupska, Lucyna; Bartnicki, Janusz; Dymarek, Robert; Rosińczuk, Joanna; Heimrath, Jerzy; Dembowski, Janusz; Zdrojowy, Romuald

    2015-01-01

    Objective Muscles such as adductor magnus (AM), gluteus maximus (GM), rectus abdominis (RA), and abdominal external and internal oblique muscles are considered to play an important role in the treatment of stress urinary incontinence (SUI), and the relationship between contraction of these muscles and pelvic floor muscles (PFM) has been established in previous studies. Synergistic muscle activation intensifies a woman’s ability to contract the PFM. In some cases, even for continent women, it is not possible to fully contract their PFM without involving the synergistic muscles. The primary aim of this study was to assess the surface electromyographic activity of synergistic muscles to PFM (SPFM) during resting and functional PFM activation in postmenopausal women with and without SUI. Materials and methods This study was a preliminary, prospective, cross-sectional observational study and included volunteers and patients who visited the Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Forty-two patients participated in the study and were screened for eligibility criteria. Thirty participants satisfied the criteria and were categorized into two groups: women with SUI (n=16) and continent women (n=14). The bioelectrical activity of PFM and SPFM (AM, RA, GM) was recorded with a surface electromyographic instrument in a standing position during resting and functional PFM activity. Results Bioelectrical activity of RA was significantly higher in the incontinent group than in the continent group. These results concern the RA activity during resting and functional PFM activity. The results for other muscles showed no significant difference in bioelectrical activity between groups. Conclusion In women with SUI, during the isolated activation of PFM, an increased synergistic activity of RA muscle was observed; however, this activity was not observed in asymptomatic women. This may indicate the important accessory contribution of these muscles in the

  16. Orbital approach for retrieval of transected extraocular muscles.

    PubMed

    Yen, Kimberly G; Yen, Michael T

    2009-01-01

    Transection of an extraocular muscle can occur from orbital and facial trauma, or as a complication of surgery. The injury can occur either near the muscle insertion or in the muscle belly. Identification of the proximal end of the muscle in the orbit may be difficult, especially if the transection occurs a farther distance from the insertion, and, in these cases, the muscle is often considered lost. We present two patients who suffered from traumatic transections of an extraocular muscle more than 10 mm from the insertion. Both patients underwent transconjunctival orbitotomy to retrieve and secure the severed extraocular muscle. Both patients achieved good primary gaze alignment postoperatively. Preoperative imaging should be considered in cases of traumatic extraocular muscle transection.

  17. Correlation between Extraocular Muscle Size Measured by Computed Tomography and the Vertical Angle of Deviation in Thyroid Eye Disease.

    PubMed

    Lee, Ju-Yeun; Bae, Kunho; Park, Kyung-Ah; Lyu, In Jeong; Oh, Sei Yeul

    2016-01-01

    The aim of this study was to investigate extraocular muscle (EOM) volume and cross-sectional area using computed tomography (CT), and to determine the relationship between EOM size and the vertical angle of deviation in thyroid eye disease (TED). Twenty-nine TED patients (58 orbits) with vertical strabismus were enrolled in the study. All patients underwent complete ophthalmic examination including prism, alternate cover, and Krimsky tests. Orbital CT scans were also performed on each patient. Digital image analysis was used to quantify superior rectus (SR) and inferior rectus (IR) muscle cross-sectional areas and volumes. Measurements were compared with those of controls. The correlation between muscle size and degree of vertical angle deviation was evaluated. The mean vertical angle of deviation was 26.2 ± 4.1 prism diopters. The TED group had a greater maximum cross-sectional area and EOM volume in the SR and IR than the control group (all p<0.001). Area and volume of the IR were correlated with the angle of deviation, but the SR alone did not show a significant correlation. The maximum cross-sectional area and volume of [Right IR + Left SR - Right SR - Left IR] was strongly correlated with the vertical angle of deviation (P<0.001). Quantitative CT of the orbit with evaluation of the area and volume of EOMs may be helpful in anticipating and monitoring vertical strabismus in TED patients.

  18. Clinical strategies for addressing muscle weakness following knee injury.

    PubMed

    Pietrosimone, Brian; Blackburn, J Troy; Harkey, Matthew S; Luc, Brittney A; Pamukoff, Derek N; Hart, Joe M

    2015-04-01

    Muscle strength is a determinate of physical function and increasing muscle strength is an important clinical goal for patients with knee injury. This article discusses the emerging evidence regarding a novel rehabilitation strategy that uses disinhibitory modalities to increase neuromuscular activation in conjunction with traditional muscle strengthening for the purpose of maximizing strength gains following acute knee injury or surgery and in patients with knee osteoarthritis. The use of disinhibitory modalities and specific types of neuromuscular training for clinically maximizing strength are discussed.

  19. Muscle strain (image)

    MedlinePlus

    A muscle strain is the stretching or tearing of muscle fibers. A muscle strain can be caused by sports, exercise, a ... something that is too heavy. Symptoms of a muscle strain include pain, tightness, swelling, tenderness, and the ...

  20. Muscle Mass Predicts Outcomes Following Liver Transplantation

    PubMed Central

    DiMartini, Andrea; Cruz, Ruy J.; Dew, Mary Amanda; Myaskovsky, Larissa; Goodpaster, Bret; Fox, Kristen; Kim, Kevin H.; Fontes, Paulo

    2015-01-01

    Background and aims For patients with end-stage liver disease commonly used indices of nutritional status (i.e. body weight and BMI) are often inflated due to fluid overload (i.e. ascites, peripheral edema) resulting in an underdiagnosis of malnutrition. As muscle is the largest protein reservoir in the body, an estimate of muscle mass may be a more reliable and valid estimate of nutritional status. Methods Therefore, we used pre-transplant computerized tomography data of 338 liver transplant (LTX) candidates to identify muscle and fat mass based on a specific abdominal transverse section commonly used in body composition analyses and investigated the contribution of this measure to specific post-LTX outcomes. Results We found the majority, 68%, of our patients could be defined as cachetic. For men muscle mass predicted many important post-transplant outcomes including intensive care unit (ICU) and total length of stay and days of intubation. Muscle mass was a significant predictor of survival and also predicted disposition to home vs another facility. For women muscle mass predicted lengths of ICU and total stay and days of intubation but the effect was modest. Muscle mass did not predict survival or disposition for women. Conclusions As pre-transplant muscle mass was associated with many important post-operative outcomes we discuss these findings in the context of possible pre-transplant interventions to either improve or sustain muscle mass before surgery. PMID:23960026

  1. Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report.

    PubMed

    Short, Steven M; Anloague, Philip A; Strack, Donald S

    2016-08-01

    Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352. PMID:27374014

  2. Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report.

    PubMed

    Short, Steven M; Anloague, Philip A; Strack, Donald S

    2016-08-01

    Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.

  3. Muscle activation patterns during walking from transtibial amputees recorded within the residual limb-prosthetic interface

    PubMed Central

    2012-01-01

    Background Powered lower limb prostheses could be more functional if they had access to feedforward control signals from the user’s nervous system. Myoelectric signals are one potential control source. The purpose of this study was to determine if muscle activation signals could be recorded from residual lower limb muscles within the prosthetic socket-limb interface during walking. Methods We recorded surface electromyography from three lower leg muscles (tibilias anterior, gastrocnemius medial head, gastrocnemius lateral head) and four upper leg muscles (vastus lateralis, rectus femoris, biceps femoris, and gluteus medius) of 12 unilateral transtibial amputee subjects and 12 non-amputee subjects during treadmill walking at 0.7, 1.0, 1.3, and 1.6 m/s. Muscle signals were recorded from the amputated leg of amputee subjects and the right leg of control subjects. For amputee subjects, lower leg muscle signals were recorded from within the limb-socket interface and from muscles above the knee. We quantified differences in the muscle activation profile between amputee and control groups during treadmill walking using cross-correlation analyses. We also assessed the step-to-step inter-subject variability of these profiles by calculating variance-to-signal ratios. Results We found that amputee subjects demonstrated reliable muscle recruitment signals from residual lower leg muscles recorded within the prosthetic socket during walking, which were locked to particular phases of the gait cycle. However, muscle activation profile variability was higher for amputee subjects than for control subjects. Conclusion Robotic lower limb prostheses could use myoelectric signals recorded from surface electrodes within the socket-limb interface to derive feedforward commands from the amputee’s nervous system. PMID:22882763

  4. Force enhancement during and following muscle stretch of maximal voluntarily activated human quadriceps femoris.

    PubMed

    Hahn, Daniel; Seiberl, Wolfgang; Schwirtz, Ansgar

    2007-08-01

    Force enhancement during and following muscle stretch has been observed for electrically and voluntarily activated human muscle. However, especially for voluntary contractions, the latter observation has only been made for adductor pollicis and the ankle joint muscles, but not for large muscles like quadriceps femoris. Therefore, the aim of this study was to investigate the effects of active muscle stretch on force production for maximal voluntary contractions of in vivo human quadriceps femoris (n = 15). Peak torques during and torques at the end of stretch, torques following stretch, and passive torques following muscle deactivation were compared to the isometric torques at corresponding muscle length. In addition, muscle activation of rectus femoris, vastus medialis and vastus lateralis was obtained using surface EMG. Stretches with different amplitudes (15, 25 and 35 degrees at a velocity of 60 degrees s(-1)) were performed on the plateau region and the descending limb of the force-length relation in a random order. Data analysis showed four main results: (1) peak torques did not occur at the end of the stretch, but torques at the end of the stretch exceeded the corresponding isometric torque; (2) there was no significant force enhancement following muscle stretch, but a small significant passive force enhancement persisted for all stretch conditions; (3) forces during and following stretch were independent of stretch amplitude; (4) muscle activation during and following muscle stretch was significantly reduced. In conclusion, although our results showed passive force enhancement, we could not provide direct evidence that there is active force enhancement in voluntarily activated human quadriceps femoris.

  5. Changing the demand on specific muscle groups affects the walk-run transition speed.

    PubMed

    Bartlett, Jamie L; Kram, Rodger

    2008-04-01

    It has been proposed that muscle-specific factors trigger the human walk-run transition. We investigated if changing the demand on trigger muscles alters the preferred walk-run transition speed. We hypothesized that (1) reducing the demand on trigger muscles would increase the transition speed and (2) increasing the demand on trigger muscles would decrease the transition speed. We first determined the normal preferred walk-run transition speed (PTS) using a step-wise protocol with a randomized speed order. We then determined PTS while subjects walked with external devices that decreased or increased the demand on specific muscle groups. We concurrently measured the electromyographic activity of five leg muscles (tibialis anterior, soleus, rectus femoris, medial and lateral gastrocnemius) at each speed and condition. For this study, we developed a dorsiflexor assist device that aids the dorsiflexor muscles. A leg swing assist device applied forward pulling forces at the feet thus aiding the hip flexors during swing. A third device applied a horizontal force near the center of mass, which impedes or aids forward progression thus overloading or unloading the plantarflexor muscles. We found that when demand was decreased in the muscles measured, the PTS significantly increased. Conversely, when muscle demand was increased in the plantar flexors, the PTS decreased. However, combining assistive devices did not produce an even faster PTS. We conclude that altering the demand on specific muscles can change the preferred walk-run transition speed. However, the lack of a summation effect with multiple external devices, suggests that another underlying factor ultimately determines the preferred walk-run transition speed.

  6. A newly discovered muscle: The tensor of the vastus intermedius.

    PubMed

    Grob, K; Ackland, T; Kuster, M S; Manestar, M; Filgueira, L

    2016-03-01

    The quadriceps femoris is traditionally described as a muscle group composed of the rectus femoris and the three vasti. However, clinical experience and investigations of anatomical specimens are not consistent with the textbook description. We have found a second tensor-like muscle between the vastus lateralis (VL) and the vastus intermedius (VI), hereafter named the tensor VI (TVI). The aim of this study was to clarify whether this intervening muscle was a variation of the VL or the VI, or a separate head of the extensor apparatus. Twenty-six cadaveric lower limbs were investigated. The architecture of the quadriceps femoris was examined with special attention to innervation and vascularization patterns. All muscle components were traced from origin to insertion and their affiliations were determined. A TVI was found in all dissections. It was supplied by independent muscular and vascular branches of the femoral nerve and lateral circumflex femoral artery. Further distally, the TVI combined with an aponeurosis merging separately into the quadriceps tendon and inserting on the medial aspect of the patella. Four morphological types of TVI were distinguished: Independent-type (11/26), VI-type (6/26), VL-type (5/26), and Common-type (4/26). This study demonstrated that the quadriceps femoris is architecturally different from previous descriptions: there is an additional muscle belly between the VI and VL, which cannot be clearly assigned to the former or the latter. Distal exposure shows that this muscle belly becomes its own aponeurosis, which continues distally as part of the quadriceps tendon.

  7. Robotic Surgery

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The Automated Endoscopic System for Optimal Positioning, or AESOP, was developed by Computer Motion, Inc. under a SBIR contract from the Jet Propulsion Lab. AESOP is a robotic endoscopic positioning system used to control the motion of a camera during endoscopic surgery. The camera, which is mounted at the end of a robotic arm, previously had to be held in place by the surgical staff. With AESOP the robotic arm can make more precise and consistent movements. AESOP is also voice controlled by the surgeon. It is hoped that this technology can be used in space repair missions which require precision beyond human dexterity. A new generation of the same technology entitled the ZEUS Robotic Surgical System can make endoscopic procedures even more successful. ZEUS allows the surgeon control various instruments in its robotic arms, allowing for the precision the procedure requires.

  8. Maternal germline mosaicism of kinesin family member 21A (KIF21A) mutation causes complex phenotypes in a Chinese family with congenital fibrosis of the extraocular muscles

    PubMed Central

    Liu, Gang; Chen, Xue; Sun, Xiantao; Liu, Hu; Zhao, Kanxing; Chang, Qinglin; Pan, Xinyuan; Wang, Xiuying; Yuan, Songtao; Liu, Qinghuai

    2014-01-01

    Purpose To identify the causative mutation with its possible origin in a Chinese family with congenital fibrosis of extraocular muscles type 1 (CFEOM1) and to characterize the ocular phenotypes and lesions in the corresponding intracranial nerves. Methods Three affected siblings and their asymptomatic parents underwent comprehensive ophthalmic examinations and neuropathologic analysis involving magnetic resonance imaging (MRI). KIF21A, PHOX2A, and TUBB3 genes were sequenced on the leukocyte-derived DNA to detect variants. The disease-linked haplotype was analyzed using four microsatellite markers across the KIF21A locus. Results All three affected individuals displayed typical CFEOM1. MRI revealed complicated but consistent neuromuscular abnormalities in the two patients examined, including hypoplastic oculomotor nerves, complete absence of bilateral superior rectus muscles, and unilateral absence of the abducens nerve with marked atrophy of the corresponding lateral rectus muscle. A heterozygous hotspot mutation KIF21A c.2860C>T was identified in all patients, but it was absent in both parents. Haplotype analysis of the disease locus showed the likely maternal inheritance of the disease-associated haplotype to all three affected offspring, strongly suggesting maternal germline mosaicism of the mutation. Conclusions Germline mosaicism of KIF21A c.2860C>T is likely to cause the high occurrence of this mutation in the population. This information may be useful for genetic counseling. KIF21A mutations can affect the abducens nerve and cause complete absence of the bilateral superior rectus muscles. MRI characterization of new CFEOM1 phenotypes would assist clinical management. PMID:24426772

  9. The influence of visual information on multi-muscle control during quiet stance: a spectral analysis approach.

    PubMed

    Danna-Dos-Santos, Alessander; Degani, Adriana M; Boonstra, Tjeerd W; Mochizuki, Luis; Harney, Allison M; Schmeckpeper, Megan M; Tabor, Lori C; Leonard, Charles T

    2015-02-01

    Standing upright requires the coordination of neural drives to a large set of muscles involved in controlling human bipedal stance (i.e., postural muscles). The coordination may deteriorate in situations where standing is performed under more challenging circumstances, such as standing on a smaller base of support or not having adequate visual information. The present study investigates the role of common neural inputs in the organization of multi-muscle synergies and the effects of visual input disruption to this mechanism of control. We analyzed the strength and distribution of correlated neural inputs (measured by intermuscular coherence) to six postural muscles previously recognized as components of synergistic groups involved in the maintenance of the body's vertical positioning. Two experimental conditions were studied: quiet bipedal stance performed with opened eyes (OEs) and closed eyes (CEs). Nine participants stood quietly for 30 s while the activity of the soleus, biceps femoris, lumbar erector spinae, tibialis anterior, rectus femoris, and rectus abdominis muscles were recorded using surface electrodes. Intermuscular (EMG-EMG) coherence was estimated for 12 muscle pairs formed by these muscles, including pairs formed solely by either posterior, anterior, or mixed (one posterior and one anterior) muscles. Intermuscular coherence was only found to be significant for muscle pairs formed solely by either posterior or anterior muscles, and no significant coherence was found for mixed muscle pairs. Significant intermuscular coherence was only found within a distinct frequency interval bounded between 1 and 10 Hz when visual input was available (OEs trials). The strength of correlated neural inputs was similar across muscle pairs located in different joints but executing a similar function (pushing body either backward or forward) suggesting that synergistic postural groups are likely formed based on their functional role instead of their anatomical location

  10. Differences in abdominal muscle activation during coughing between smokers and nonsmokers.

    PubMed

    Rhee, Min-Hyung; Lee, Dong-Rour; Kim, Laurentius Jongsoon

    2016-04-01

    [Purpose] The purpose of this study was to compare the activity of the abdominal muscles during coughing between smokers and nonsmokers. [Subjects] A total of 30 healthy adults (15 smokers, 15 nonsmokers) participated. [Methods] The percentage maximal voluntary isometric contraction values (%MVIC) of the rectus abdominis (RA), external abdominal oblique (EO), and internal abdominal oblique (IO) and transversus abdominis (TrA) were measured using surface electromyography. [Results] The %MVIC of the IO and TrA statistically significantly differed and the %MVIC of IO and TrA was found to be higher during coughing in nonsmokers compared with during coughing in smokers. [Conclusion] The activity of the deep abdominal muscles in nonsmokers was also higher than that of smokers during coughing. PMID:27190443

  11. Morphological correlates of the differential responses of muscles to vecuronium.

    PubMed

    Ibebunjo, C; Srikant, C B; Donati, F

    1999-08-01

    We have noted previously that duration of vecuronium block correlated with fibre size in six muscle groups in the goat. Electrophysiological considerations suggest that the important factor should be the number of acetylcholine receptors (AChR) relative to fibre size. However, this hypothesis could not be verified in the goat because the number of AChR was relatively constant in the different muscles despite differences in fibre size. Therefore, in this study, we have investigated the relationship between sensitivity to vecuronium, as reflected by the ED50 and duration of block, of six muscles in the cat and the number of AChR per unit fibre cross-sectional area (CSA). The ED50 and duration of action (time to 50% recovery of the first twitch after a dose of 15 micrograms kg-1) of vecuronium in the tibialis cranialis, soleus, rectus abdominis, masseter, diaphragm and thyroarytenoideus muscles were determined during train-of-four stimulation and EMG recording in seven cats anaesthetized with pentobarbital. CSA of the muscle fibres and number of junctional AChR in these muscles were measured by histological methods and 125I-alpha-bungarotoxin binding assay, respectively, and the number of AChR per unit fibre CSA calculated. The association between muscle response (ED50 and duration of block) and fibre CSA or number of AChR per unit fibre CSA was then tested by regression analyses. Duration of block varied between the six muscles (mean 8.9 (SEM 2.6) to 20.3 (3.1) min; P = 0.0001) but ED50 did not (7.5 (1.5) to 15.6 (2.5) micrograms kg-1; P = 0.185). Fibre CSA and number of AChR per unit fibre CSA also varied between these muscles (P = 0.0001). Duration to 50% TI recovery was prolonged in muscles with a low number of AChR relative to fibre CSA (r2 = 0.30; P = 0.0002) and the ED50 increased as the number of AChR per fibre CSA increased (r2 = 0.240; P = 0.0016). These results in the cat suggest that the number of junctional AChR relative to fibre CSA is a morphological

  12. Trunk muscle activation during golf swing: Baseline and threshold.

    PubMed

    Silva, Luís; Marta, Sérgio; Vaz, João; Fernandes, Orlando; Castro, Maria António; Pezarat-Correia, Pedro

    2013-10-01

    There is a lack of studies regarding EMG temporal analysis during dynamic and complex motor tasks, such as golf swing. The aim of this study is to analyze the EMG onset during the golf swing, by comparing two different threshold methods. Method A threshold was determined using the baseline activity recorded between two maximum voluntary contraction (MVC). Method B threshold was calculated using the mean EMG activity for 1000ms before the 500ms prior to the start of the Backswing. Two different clubs were also studied. Three-way repeated measures ANOVA was used to compare methods, muscles and clubs. Two-way mixed Intraclass Correlation Coefficient (ICC) with absolute agreement was used to determine the methods reliability. Club type usage showed no influence in onset detection. Rectus abdominis (RA) showed the higher agreement between methods. Erector spinae (ES), on the other hand, showed a very low agreement, that might be related to postural activity before the swing. External oblique (EO) is the first being activated, at 1295ms prior impact. There is a similar activation time between right and left muscles sides, although the right EO showed better agreement between methods than left side. Therefore, the algorithms usage is task- and muscle-dependent.

  13. Trunk muscle activation during golf swing: Baseline and threshold.

    PubMed

    Silva, Luís; Marta, Sérgio; Vaz, João; Fernandes, Orlando; Castro, Maria António; Pezarat-Correia, Pedro

    2013-10-01

    There is a lack of studies regarding EMG temporal analysis during dynamic and complex motor tasks, such as golf swing. The aim of this study is to analyze the EMG onset during the golf swing, by comparing two different threshold methods. Method A threshold was determined using the baseline activity recorded between two maximum voluntary contraction (MVC). Method B threshold was calculated using the mean EMG activity for 1000ms before the 500ms prior to the start of the Backswing. Two different clubs were also studied. Three-way repeated measures ANOVA was used to compare methods, muscles and clubs. Two-way mixed Intraclass Correlation Coefficient (ICC) with absolute agreement was used to determine the methods reliability. Club type usage showed no influence in onset detection. Rectus abdominis (RA) showed the higher agreement between methods. Erector spinae (ES), on the other hand, showed a very low agreement, that might be related to postural activity before the swing. External oblique (EO) is the first being activated, at 1295ms prior impact. There is a similar activation time between right and left muscles sides, although the right EO showed better agreement between methods than left side. Therefore, the algorithms usage is task- and muscle-dependent. PMID:23816264

  14. Lumbar spinal loads and muscle activity during a golf swing.

    PubMed

    Lim, Young-Tae; Chow, John W; Chae, Woen-Sik

    2012-06-01

    This study estimated the lumbar spinal loads at the L4-L5 level and evaluated electromyographic (EMG) activity of right and left rectus abdominis, external and internal obliques, erector spinae, and latissimus dorsi muscles during a golf swing. Four super VHS camcorders and two force plates were used to obtain three-dimensional (3D) kinematics and kinetics of golf swings performed by five male collegiate golfers. Average EMG levels for different phases of golf swing were determined. An EMG-assisted optimization model was applied to compute the contact forces acting on the L4-L5. The results revealed a mean peak compressive load of over six times the body weight (BW) during the downswing and mean peak anterior and medial shear loads approaching 1.6 and 0.6 BW during the follow-through phases. The peak compressive load estimated in this study was high, but less than the corresponding value (over 8 BW) reported by a previous study. Average EMG levels of different muscles were the highest in the acceleration and follow-through phases, suggesting a likely link between co-contractions of paraspinal muscles and lumbar spinal loads. PMID:22900401

  15. Open heart surgery

    MedlinePlus

    Heart surgery - open ... lung machine is used in most cases during open heart surgery. While the surgeon works on the ... with these procedures, the surgeon may have to open the chest to do the surgery.

  16. Pediatric heart surgery

    MedlinePlus

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... after the baby is born. For others, your child may be able to safely wait for months ...

  17. Gastric bypass surgery

    MedlinePlus

    ... Y gastric bypass; Gastric bypass - Roux-en-Y; Weight-loss surgery - gastric bypass; Obesity surgery - gastric bypass ... Weight-loss surgery may be an option if you are very obese and have not been able to ...

  18. Coronary Artery Bypass Surgery

    MedlinePlus

    ... t help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow ... more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free ...

  19. Laser surgery - skin

    MedlinePlus

    Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...

  20. Carotid artery surgery - discharge

    MedlinePlus

    ... Surgery, Society for Vascular Medicine, and Society for Vascular Surgery. J Am Coll Cardiol . 2011 Feb 22;57( ... 21288680 . Kinlay S, Bhatt DL. Treatment of noncoronary obstructive ... Textbook of Surgery . 19th ed. Elsevier Saunders; 2012:chap 63.

  1. Effects of wearing gumboots and leather lace-up boots on lower limb muscle activity when walking on simulated underground coal mine surfaces.

    PubMed

    Dobson, Jessica A; Riddiford-Harland, Diane L; Steele, Julie R

    2015-07-01

    This study aimed to investigate the effects of wearing two standard underground coal mining work boots (a gumboot and a leather lace-up boot) on lower limb muscle activity when participants walked across simulated underground coal mining surfaces. Quadriceps (rectus femoris, vastus medialis, vastus lateralis) and hamstring (biceps femoris, semitendinosus) muscle activity were recorded as twenty male participants walked at a self-selected pace around a circuit while wearing each boot type. The circuit consisted of level, inclined and declined surfaces composed of rocky gravel and hard dirt. Walking in a leather lace-up boot, compared to a gumboot, resulted in increased vastus lateralis and increased biceps femoris muscle activity when walking on sloped surfaces. Increased muscle activity appears to be acting as a slip and/or trip prevention strategy in response to challenging surfaces and changing boot features.

  2. Effects of individual strengthening exercises for the stabilization muscles on the nutation torque of the sacroiliac joint in a sedentary worker with nonspecific sacroiliac joint pain

    PubMed Central

    Yoo, Won-gyu

    2015-01-01

    [Purpose] We investigated the effects of individual strengthening exercises for the stabilization muscles on the nutation torque of the sacroiliac joint in a sedentary worker with nonspecific sacroiliac joint pain. [Subject] A 36-year-old female complained of pain in the sacroiliac joints. [Methods] The subject performed individual strengthening exercises for the stabilization muscles for nutation torque of the sacroiliac joint for 3 weeks. Pain-provocation tests and visual analog scale (VAS) scores were evaluated before and after the exercises. [Results] After performing the individual strengthening exercises for the erector spinae, rectus abdominis, and biceps femoris muscles for 3 weeks, the subject displayed no pain in the pain provocation tests, and the VAS score was 2/10. [Conclusion] The individual strengthening exercises for the stabilization muscles of the sacroiliac joint performed in the present study appear to be effective for sedentary workers with sacroiliac joint pain. PMID:25642098

  3. Assessing viability of extracorporeal preserved muscle transplants using external field stimulation: a novel tool to improve methods prolonging bridge-to-transplantation time.

    PubMed

    Taeger, Christian D; Friedrich, Oliver; Dragu, Adrian; Weigand, Annika; Hobe, Frieder; Drechsler, Caroline; Geppert, Carol I; Arkudas, Andreas; Münch, Frank; Buchholz, Rainer; Pollmann, Charlotte; Schramm, Axel; Birkholz, Torsten; Horch, Raymund E; Präbst, Konstantin

    2015-01-01

    Preventing ischemia-related cell damage is a priority when preserving tissue for transplantation. Perfusion protocols have been established for a variety of applications and proven to be superior to procedures used in clinical routine. Extracorporeal perfusion of muscle tissue though cumbersome is highly desirable since it is highly susceptible to ischemia-related damage. To show the efficacy of different perfusion protocols external field stimulation can be used to immediately visualize improvement or deterioration of the tissue during active and running perfusion protocols. This method has been used to show the superiority of extracorporeal perfusion using porcine rectus abdominis muscles perfused with heparinized saline solution. Perfused muscles showed statistically significant higher ability to exert force compared to nonperfused ones. These findings can be confirmed using Annexin V as marker for cell damage, perfusion of muscle tissue limits damage significantly compared to nonperfused tissue. The combination of extracorporeal perfusion and external field stimulation may improve organ conservation research. PMID:26145230

  4. Assessing viability of extracorporeal preserved muscle transplants using external field stimulation: a novel tool to improve methods prolonging bridge-to-transplantation time

    NASA Astrophysics Data System (ADS)

    Taeger, Christian D.; Friedrich, Oliver; Dragu, Adrian; Weigand, Annika; Hobe, Frieder; Drechsler, Caroline; Geppert, Carol I.; Arkudas, Andreas; Münch, Frank; Buchholz, Rainer; Pollmann, Charlotte; Schramm, Axel; Birkholz, Torsten; Horch, Raymund E.; Präbst, Konstantin

    2015-07-01

    Preventing ischemia-related cell damage is a priority when preserving tissue for transplantation. Perfusion protocols have been established for a variety of applications and proven to be superior to procedures used in clinical routine. Extracorporeal perfusion of muscle tissue though cumbersome is highly desirable since it is highly susceptible to ischemia-related damage. To show the efficacy of different perfusion protocols external field stimulation can be used to immediately visualize improvement or deterioration of the tissue during active and running perfusion protocols. This method has been used to show the superiority of extracorporeal perfusion using porcine rectus abdominis muscles perfused with heparinized saline solution. Perfused muscles showed statistically significant higher ability to exert force compared to nonperfused ones. These findings can be confirmed using Annexin V as marker for cell damage, perfusion of muscle tissue limits damage significantly compared to nonperfused tissue. The combination of extracorporeal perfusion and external field stimulation may improve organ conservation research.

  5. The effects of horseback riding simulator exercises on the muscle activity of the lower extremities according to changes in arm posture

    PubMed Central

    Park, Jungseo; Lee, Sangyong; Lee, Daehee

    2015-01-01

    [Purpose] This study aimed to determine the effects of horseback riding simulator exercise on the muscle activities of the lower extremities according to changes in arm posture. [Subjects] The subjects of this study were 30 normal adult males and females. [Methods] The horseback riding simulator exercise used a horseback riding simulator device; two arm postures were used, posture 1 (holding the handle of the device) and posture 2 (crossing both arms, with both hands on the shoulders). Electromyography was used to compare the muscle activities of the rectus femoris, biceps femoris, and hip adductors in the lower extremities. [Results] Posture 2 had significantly higher muscle activity than posture 1. [Conclusion] Posture 2, which entailed crossing both arms with both hands on the shoulders, was an effective intervention for improved muscle activity in the hip adductors. PMID:26504280

  6. Effects of wearing gumboots and leather lace-up boots on lower limb muscle activity when walking on simulated underground coal mine surfaces.

    PubMed

    Dobson, Jessica A; Riddiford-Harland, Diane L; Steele, Julie R

    2015-07-01

    This study aimed to investigate the effects of wearing two standard underground coal mining work boots (a gumboot and a leather lace-up boot) on lower limb muscle activity when participants walked across simulated underground coal mining surfaces. Quadriceps (rectus femoris, vastus medialis, vastus lateralis) and hamstring (biceps femoris, semitendinosus) muscle activity were recorded as twenty male participants walked at a self-selected pace around a circuit while wearing each boot type. The circuit consisted of level, inclined and declined surfaces composed of rocky gravel and hard dirt. Walking in a leather lace-up boot, compared to a gumboot, resulted in increased vastus lateralis and increased biceps femoris muscle activity when walking on sloped surfaces. Increased muscle activity appears to be acting as a slip and/or trip prevention strategy in response to challenging surfaces and changing boot features. PMID:25766420

  7. Assessing viability of extracorporeal preserved muscle transplants using external field stimulation: a novel tool to improve methods prolonging bridge-to-transplantation time

    PubMed Central

    Taeger, Christian D.; Friedrich, Oliver; Dragu, Adrian; Weigand, Annika; Hobe, Frieder; Drechsler, Caroline; Geppert, Carol I.; Arkudas, Andreas; Münch, Frank; Buchholz, Rainer; Pollmann, Charlotte; Schramm, Axel; Birkholz, Torsten; Horch, Raymund E.; Präbst, Konstantin

    2015-01-01

    Preventing ischemia-related cell damage is a priority when preserving tissue for transplantation. Perfusion protocols have been established for a variety of applications and proven to be superior to procedures used in clinical routine. Extracorporeal perfusion of muscle tissue though cumbersome is highly desirable since it is highly susceptible to ischemia-related damage. To show the efficacy of different perfusion protocols external field stimulation can be used to immediately visualize improvement or deterioration of the tissue during active and running perfusion protocols. This method has been used to show the superiority of extracorporeal perfusion using porcine rectus abdominis muscles perfused with heparinized saline solution. Perfused muscles showed statistically significant higher ability to exert force compared to nonperfused ones. These findings can be confirmed using Annexin V as marker for cell damage, perfusion of muscle tissue limits damage significantly compared to nonperfused tissue. The combination of extracorporeal perfusion and external field stimulation may improve organ conservation research. PMID:26145230

  8. Prognostic value of sarcopenia in liver surgery.

    PubMed

    Cornet, M; Lim, C; Salloum, C; Lazzati, A; Compagnon, P; Pascal, G; Azoulay, D

    2015-11-01

    Current knowledge indicates that malnutrition increases the rate of post-operative complications, particularly respiratory and infectious, after major surgery. Almost all liver surgery is performed in patients with cancer, a factor that increases the risk of malnutrition. The primary risk factors for post-operative complications are pre-operative hypo-albuminemia and a body mass index less than 20 kg/m(2). To improve the prediction of complications in these patients, some teams have suggested measurement of muscle thickness by computed tomography. Muscular mass can thus be quantified by measuring the total surface of the psoas muscle or the total surface of all muscles (i.e. external and internal oblique, transverse, psoas and paravertebral muscles) seen on an axial CT slice at L3. As well, data exist suggesting that sarcopenia is an independent predictive factor of post-operative morbidity and poor long-term survival after resection for cancer. Nonetheless, the literature on the subject is limited, there are no standardized definitions for sarcopenia, and the need of special software to calculate the surfaces limits its usefulness. Lastly, there are little if any data concerning the nutritional or pharmacologic means to treat sarcopenia. This update, based on a literature review, deals with the value and the prognostic impact of sarcopenia in surgery for liver tumors. The current definition of sarcopenia, validated internationally, the methods of measurement, and the consequences of sarcopenia on the outcome of liver resections are detailed in this review. PMID:26476674

  9. Prognostic value of sarcopenia in liver surgery.

    PubMed

    Cornet, M; Lim, C; Salloum, C; Lazzati, A; Compagnon, P; Pascal, G; Azoulay, D

    2015-11-01

    Current knowledge indicates that malnutrition increases the rate of post-operative complications, particularly respiratory and infectious, after major surgery. Almost all liver surgery is performed in patients with cancer, a factor that increases the risk of malnutrition. The primary risk factors for post-operative complications are pre-operative hypo-albuminemia and a body mass index less than 20 kg/m(2). To improve the prediction of complications in these patients, some teams have suggested measurement of muscle thickness by computed tomography. Muscular mass can thus be quantified by measuring the total surface of the psoas muscle or the total surface of all muscles (i.e. external and internal oblique, transverse, psoas and paravertebral muscles) seen on an axial CT slice at L3. As well, data exist suggesting that sarcopenia is an independent predictive factor of post-operative morbidity and poor long-term survival after resection for cancer. Nonetheless, the literature on the subject is limited, there are no standardized definitions for sarcopenia, and the need of special software to calculate the surfaces limits its usefulness. Lastly, there are little if any data concerning the nutritional or pharmacologic means to treat sarcopenia. This update, based on a literature review, deals with the value and the prognostic impact of sarcopenia in surgery for liver tumors. The current definition of sarcopenia, validated internationally, the methods of measurement, and the consequences of sarcopenia on the outcome of liver resections are detailed in this review.

  10. Capillary muscle

    PubMed Central

    Cohen, Caroline; Mouterde, Timothée; Quéré, David; Clanet, Christophe

    2015-01-01

    The contraction of a muscle generates a force that decreases when increasing the contraction velocity. This “hyperbolic” force–velocity relationship has been known since the seminal work of A. V. Hill in 1938 [Hill AV (1938) Proc R Soc Lond B Biol Sci 126(843):136–195]. Hill’s heuristic equation is still used, and the sliding-filament theory for the sarcomere [Huxley H, Hanson J (1954) Nature 173(4412):973–976; Huxley AF, Niedergerke R (1954) Nature 173(4412):971–973] suggested how its different parameters can be related to the molecular origin of the force generator [Huxley AF (1957) Prog Biophys Biophys Chem 7:255–318; Deshcherevskiĭ VI (1968) Biofizika 13(5):928–935]. Here, we develop a capillary analog of the sarcomere obeying Hill’s equation and discuss its analogy with muscles. PMID:25944938

  11. Lumbo-pelvic stability and electromyography of abdominal muscles in ballet dancers.

    PubMed

    Negrão Filho, R de Faria; Silva, L Alves; Monteiro, T Lombardi; Alves, N; de Carvalho, A Cesinando; de Azevedo, F Mícolis

    2009-01-01

    Evaluating the ability to rectify and maintain lumbar adjustment can contribute toward the understanding of the behavior of abdominal muscles and their participation in the stability of pelvic muscles in dancers during the posterior pelvic tilt and double straight leg lowering tests. Nine healthy volunteers (male and female ballet dancers; age mean: 25.9 +/- 7.37 years) underwent maximal isometric voluntary contraction (MIVC), isometric voluntary contraction at 50% of MIVC, posterior pelvic tilt (PPT) and double straight leg lowering (DSLL) tests. The tests were carried out in a single day, with 3 repetitions each. During the tests, electromygraphic signals of the rectus abdominis, obliquus internus and obliquus externus were recorded. The signal acquisition system was made up of bipolar surface electrodes, electrogoniometer and an electromechanic device (pressure sensor), which were connected to a signal conditioner module. Root mean square values of each muscle during the DSLL and PPT were converted into percentage of activation of 50% MIVC. Lower back pressure was submitted to the same process. ANOVA with repeated measures was performed, with the level of significance set at p < 0.05. The results revealed that all dancers were able to maintain posterior pelvic tilt and there was trend toward greater activation of the bilateral obliquus internus muscle. In an attempt to keep the pelvic region stabilized during DSLL, there was a greater contribution from the obliquus externus muscle in relation to other abdominal muscles.

  12. Aging affects spatial distribution of leg muscle oxygen saturation during ramp cycling exercise.

    PubMed

    Takagi, Shun; Kime, Ryotaro; Murase, Norio; Watanabe, Tsubasa; Osada, Takuya; Niwayama, Masatsugu; Katsumura, Toshihito

    2013-01-01

    We compared muscle oxygen saturation (SmO2) responses in several leg muscles and within a single muscle during ramp cycling exercise between elderly men (n = 8; age, 65 ± 3 years; ELD) and young men (n = 10; age, 23 ± 3 years; YNG). SmO2 was monitored at the distal site of the vastus lateralis (VLd), proximal site of the vastus lateralis (VLp), rectus femoris (RF), vastus medialis (VM), biceps femoris (BF), gastrocnemius lateralis (GL), gastrocnemius medialis (GM), and tibialis anterior (TA) by near-infrared spatial resolved spectroscopy. During submaximal exercise, significantly lower SmO2 at a given absolute work rate was observed in VLd, RF, BF, GL, and TA but not in VLp, VM, and GM in ELD than in YNG. In contrast, at all measurement sites, SmO2 at peak exercise was not significantly different between groups. These results indicate that the effects of aging on SmO2 responses are heterogeneous between leg muscles and also within a single muscle. The lower SmO2 in older men may have been caused by reduced muscle blood flow or altered blood flow distribution.

  13. Muscle activity during functional coordination training: implications for strength gain and rehabilitation.

    PubMed

    Jørgensen, Marie B; Andersen, Lars L; Kirk, Niels; Pedersen, Mogens T; Søgaard, Karen; Holtermann, Andreas

    2010-07-01

    The purpose of this study was to evaluate if different types, body positions, and levels of progression of functional coordination exercises can provide sufficiently high levels of muscle activity to improve strength of the neck, shoulder, and trunk muscles. Nine untrained women were familiarized with 7 functional coordination exercises 12 times during 4 weeks before testing. Surface electromyographic (EMG) activity was obtained from rectus abdominus, erector spinae, obliquus externus, and trapezius during the exercises with 2-4 levels of progression. Electromyography was normalized to the maximal EMG activity during maximal voluntary contractions, and a p value < 0.05 was considered significant. All recorded muscles reached sufficiently high levels of activity during the coordination exercises for strength gain (>60% of maximal EMG activity). Type of exercise played a significant role for the attained muscle activity. Body position during the exercises was important for the activity of the erector spinae, and level of progression was important for the activity of the trapezius. The findings indicate that depending on type, body position, and level of progression, functional coordination training can be performed with a muscle activity sufficient for strength gain. Functional coordination training may therefore be a good choice for prevention or rehabilitation of musculoskeletal pain or injury in the neck, shoulder, or trunk muscles.

  14. Cosmetic Plastic Surgery Statistics

    MedlinePlus

    2014 Cosmetic Plastic Surgery Statistics Cosmetic Procedure Trends 2014 Plastic Surgery Statistics Report Please credit the AMERICAN SOCIETY OF PLASTIC SURGEONS when citing statistical data or using ...

  15. Bariatric Surgery

    PubMed Central

    2005-01-01

    Executive Summary Objective To conduct an evidence-based analysis of the effectiveness and cost-effectiveness of bariatric surgery. Background Obesity is defined as a body mass index (BMI) of at last 30 kg/m2.1 Morbid obesity is defined as a BMI of at least 40 kg/m2 or at least 35 kg/m2 with comorbid conditions. Comorbid conditions associated with obesity include diabetes, hypertension, dyslipidemias, obstructive sleep apnea, weight-related arthropathies, and stress urinary incontinence. It is also associated with depression, and cancers of the breast, uterus, prostate, and colon, and is an independent risk factor for cardiovascular disease. Obesity is also associated with higher all-cause mortality at any age, even after adjusting for potential confounding factors like smoking. A person with a BMI of 30 kg/m2 has about a 50% higher risk of dying than does someone with a healthy BMI. The risk more than doubles at a BMI of 35 kg/m2. An expert estimated that about 160,000 people are morbidly obese in Ontario. In the United States, the prevalence of morbid obesity is 4.7% (1999–2000). In Ontario, the 2004 Chief Medical Officer of Health Report said that in 2003, almost one-half of Ontario adults were overweight (BMI 25–29.9 kg/m2) or obese (BMI ≥ 30 kg/m2). About 57% of Ontario men and 42% of Ontario women were overweight or obese. The proportion of the population that was overweight or obese increased gradually from 44% in 1990 to 49% in 2000, and it appears to have stabilized at 49% in 2003. The report also noted that the tendency to be overweight and obese increases with age up to 64 years. BMI should be used cautiously for people aged 65 years and older, because the “normal” range may begin at slightly above 18.5 kg/m2 and extend into the “overweight” range. The Chief Medical Officer of Health cautioned that these data may underestimate the true extent of the problem, because they were based on self reports, and people tend to over-report their

  16. COMPARISON OF TRUNK AND LOWER EXTREMITY MUSCLE ACTIVITY AMONG FOUR STATIONARY EQUIPMENT DEVICES: UPRIGHT BIKE, RECUMBENT BIKE, TREADMILL, AND ELLIPTIGO®

    PubMed Central

    Baker, Ryan; Gibson, Chris; Kearney, Andrew; Busemeyer, Tommy

    2016-01-01

    Background Stationary equipment devices are often used to improve fitness. The ElliptiGO® was recently developed that blends the elements of an elliptical trainer and bicycle, allowing reciprocal lower limb pedaling in an upright position. However, it is unknown whether the muscle activity used for the ElliptiGO® is similar to walking or cycling. To date, there is no information comparing muscle activity for exercise on the treadmill, stationary upright and recumbent bikes, and the ElliptiGO®. Purpose/Hypothesis The purpose of this study was to assess trunk and lower extremity muscle activity among treadmill walking, cycling (recumbent and upright) and the ElliptiGO® cycling. It was hypothesized that the ElliptiGO® and treadmill would elicit similar electromyographic muscle activity responses compared to the stationary bike and recumbent bike during an exercise session. Study Design Cohort, repeated measures Methods Twelve recreationally active volunteers participated in the study and were assigned a random order of exercise for each of the four devices (ElliptiGO®, stationary upright cycle ergometer, recumbent ergometer, and a treadmill). Two-dimensional video was used to monitor the start and stop of exercise and surface electromyography (SEMG) were used to assess muscle activity during two minutes of cycling or treadmill walking at 40-50% heart rate reserve (HRR). Eight muscles on the dominant limb were used for analysis: gluteus maximus (Gmax), gluteus medius (Gmed), biceps femoris (BF), lateral head of the gastrocnemius (LG), tibialis anterior (TA), rectus femoris (RF). Two trunk muscles were assessed on the same side; lumbar erector spinae at L3-4 level (LES) and rectus abdominus (RA). Maximal voluntary isometric contractions (MVIC) were determined for each muscle and SEMG data were expressed as %MVIC in order to normalize outputs. Results The %MVIC for RF during ElliptiGO® cycling was higher than recumbent cycling. The LG muscle activity was highest

  17. Altered lower leg muscle activation patterns in patients with cerebral palsy during cycling on an ergometer

    PubMed Central

    Alves-Pinto, Ana; Blumenstein, Tobias; Turova, Varvara; Lampe, Renée

    2016-01-01

    Objective Cycling on a recumbent ergometer constitutes one of the most popular rehabilitation exercises in cerebral palsy (CP). However, no control is performed on how muscles are being used during training. Given that patients with CP present altered muscular activity patterns during cycling or walking, it is possible that an incorrect pattern of muscle activation is being promoted during rehabilitation cycling. This study investigated patterns of muscular activation during cycling on a recumbent ergometer in patients with CP and whether those patterns are determined by the degree of spasticity and of mobility. Methods Electromyographic (EMG) recordings of lower leg muscle activation during cycling on a recumbent ergometer were performed in 14 adult patients diagnosed with CP and five adult healthy participants. EMG recordings were done with an eight-channel EMG system built in the laboratory. The activity of the following muscles was recorded: Musculus rectus femoris, Musculus biceps femoris, Musculus tibialis anterior, and Musculus gastrocnemius. The degree of muscle spasticity and mobility was assessed using the Modified Ashworth Scale and the Gross Motor Function Classification System, respectively. Muscle activation patterns were described in terms of onset and duration of activation as well as duration of cocontractions. Results Muscle activation in CP was characterized by earlier onsets, longer periods of activation, a higher occurrence of agonist–antagonist cocontractions, and a more variable cycling tempo in comparison to healthy participants. The degree of altered muscle activation pattern correlated significantly with the degree of spasticity. Conclusion This study confirmed the occurrence of altered lower leg muscle activation patterns in patients with CP during cycling on a recumbent ergometer. There is a need to develop feedback systems that can inform patients and therapists of an incorrect muscle activation during cycling and support the training

  18. The effects of surface condition on abdominal muscle activity during single-legged hold exercise.

    PubMed

    Ha, Sung-min; Oh, Jae-seop; Jeon, In-cheol; Kwon, Oh-yun

    2015-02-01

    To treat low-back pain, various spinal stability exercises are commonly used to improve trunk muscle function and strength. Because human movement for normal daily activity occurs in multi-dimensions, the importance of exercise in multi-dimensions or on unstable surfaces has been emphasized. Recently, a motorized rotating platform (MRP) for facilitating multi-dimensions dynamic movement was introduced for clinical use. However, the abdominal muscle activity with this device has not been reported. The purpose of this study was to compare the abdominal muscle activity (rectus abdominis, external and internal oblique muscles) during an active single-leg-hold (SLH) exercise on a floor (stable surface), foam roll, and motorized rotating platform (MRP). Thirteen healthy male subjects participated in this study. Using electromyography, the abdominal muscle activity was measured while the subjects performed SLH exercises on floor (stable surface), foam roll, and MRP. There were significant differences in the abdominal muscle activities among conditions (P<.05), except for left EO (P>.05) (Fig. 2). After the Bonferroni correction, however, no significant differences among conditions remained, except for differences in both side IO muscle activity between the floor and foam roll conditions (padj<0.017). The findings suggest that performing the SLH exercises on a foam roll and MRP is more effective increased activities of both side of RA and IO, and Rt. EO compared to floor condition. However, there were no significant differences in abdominal muscles activity in the multiple comparison between conditions (mean difference were smaller than the standard deviation in the abdominal muscle activities) (padj>0.017), except for differences in both side IO muscle activity between the floor (stable surface) and foam roll (padj<0.017) (effect size: 0.79/0.62 (non-supporting/supporting leg) for foam-roll versus floor).

  19. Effects of BOSU ball(s) during sit-ups with body weight and added resistance on core muscle activation.

    PubMed

    Saeterbakken, Atle H; Andersen, Vidar; Jansson, June; Kvellestad, Ann C; Fimland, Marius S

    2014-12-01

    The objective of this study was to assess the electromyographic activity of the rectus abdominis (upper and lower part) and external oblique during sit-ups performed on BOSU ball(s). Twenty-four men participated in a familiarization session, and in the next session, they performed the experimental tests in randomized order. The sit-ups were performed with 10 repetitions with body weight and with 10 repetition maximum (10RM) using elastic bands as external resistance under 4 different conditions: (a) on a stable surface, (b) with the BOSU ball under their feet (dome side down, lower-body instability), (c) BOSU ball under the low back (dome side up, upper-body instability), and (d) with BOSU balls under both feet and the low back (dual instability). The feet were not attached to the surface. We observed that with body weight, external oblique activation was decreased by upper-body instability and dual instability by 22-24% (p = 0.002-0.006), whereas the rectus abdominis was not affected by the surface. Using 10RM loads, the upper and lower rectus abdominis activities were increased by upper body and dual instability by 21-24% compared with that for a stable surface (P ≤ 0.001-0.036). Further, lower-body instability did not affect muscle activities significantly with either load for any condition. Hence, BOSU balls under the low back can increase and decrease abdominal muscle activation depending on the load, whereas placing a BOSU ball under the feet with the dome side down had little impact.

  20. The Role of Robotic Surgery for Rectal Cancer: Overcoming Technical Challenges in Laparoscopic Surgery by Advanced Techniques.

    PubMed

    Park, Seungwan; Kim, Nam Kyu

    2015-07-01

    The conventional laparoscopic approach to rectal surgery has several limitations, and therefore many colorectal surgeons have great expectations for the robotic surgical system as an alternative modality in overcoming challenges of laparoscopic surgery and thus enhancing oncologic and functional outcomes. This review explores the possibility of robotic surgery as an alternative approach in laparoscopic surgery for rectal cancer. The da Vinci® Surgical System was developed specifically to compensate for the technical limitations of laparoscopic instruments in rectal surgery. The robotic rectal surgery is associated with comparable or better oncologic and pathologic outcomes, as well as low morbidity and mortality. The robotic surgery is generally easier to learn than laparoscopic surgery, improving the probability of autonomic nerve preservation and genitourinary function recovery. Furthermore, in very complex procedures such as intersphincteric dissections and transabdominal transections of the levator muscle, the robotic approach is associated with increased performance and safety compared to laparoscopic surgery. The robotic surgery for rectal cancer is an advanced technique that may resolve the issues associated with laparoscopic surgery. However, high cost of robotic surgery must be addressed before it can become the new standard treatment.

  1. Aesthetic surgery of the orbits and eyelids.

    PubMed

    Broujerdi, Joseph A

    2012-11-01

    This article discusses the relevant anatomy, the aging process of the eyelid with periorbital structure, and how to evaluate patients for a proper surgical approach. A description is given of how to achieve an aesthetic balance between the forehead, eyelids, and midface to provide the patient with a natural youthful appearance. The paradigm in oculoplastic surgery has shifted to more conservative eyelid skin, muscle, and fat resection as well as more periorbital soft tissue lift, suspension, and volumization. Recent innovations and developments are discussed as well as the most common complications in eyelid and periorbital surgery.

  2. Lower Extremity Muscle Activity During a Women's Overhand Lacrosse Shot.

    PubMed

    Millard, Brianna M; Mercer, John A

    2014-06-28

    The purpose of this study was to describe lower extremity muscle activity during the lacrosse shot. Participants (n=5 females, age 22±2 years, body height 162.6±15.2 cm, body mass 63.7±23.6 kg) were free from injury and had at least one year of lacrosse experience. The lead leg was instrumented with electromyography (EMG) leads to measure muscle activity of the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and medial gastrocnemius (GA). Participants completed five trials of a warm-up speed shot (Slow) and a game speed shot (Fast). Video analysis was used to identify the discrete events defining specific movement phases. Full-wave rectified data were averaged per muscle per phase (Crank Back Minor, Crank Back Major, Stick Acceleration, Stick Deceleration). Average EMG per muscle was analyzed using a 4 (Phase) × 2 (Speed) ANOVA. BF was greater during Fast vs. Slow for all phases (p<0.05), while TA was not influenced by either Phase or Speed (p>0.05). RF and GA were each influenced by the interaction of Phase and Speed (p<0.05) with GA being greater during Fast vs. Slow shots during all phases and RF greater during Crank Back Minor and Major as well as Stick Deceleration (p<0.05) but only tended to be greater during Stick Acceleration (p=0.076) for Fast vs. Slow. The greater muscle activity (BF, RF, GA) during Fast vs. Slow shots may have been related to a faster approach speed and/or need to create a stiff lower extremity to allow for faster upper extremity movements. PMID:25114727

  3. Preservation of rat skeletal muscle energy metabolism by illumination.

    PubMed

    Lindgård, Ann; Lundberg, Jonas; Rakotonirainy, Olivier; Elander, Anna; Soussi, Bassam

    2003-04-25

    Skeletal muscle viability is crucially dependent on the tissue levels of its high energy phosphates. In this study we investigated the effect of the preservation medium Perfadex and illumination with Singlet Oxygen Energy (SOE). Singlet oxygen can be produced photochemically by energy transfer from an excited photosensitizer. The energy emitted from singlet oxygen upon relaxation to its triplet state is captured as photons at 634 nm and is here referred to as SOE. Rat hind limb rectus femoris muscles were preserved for five hours at 22 degrees C in Perfadex, saline, SOE illuminated Perfadex or SOE illuminated saline. Extracts of the muscles were analysed by 31P NMR. Data were analysed using two-way analysis of variance and are given as mean values micromol/g dry weight) +/- SEM. The ATP concentration was higher (p = 0.006) in saline groups (4.52) compared with Perfadex groups (2.82). There was no statistically significant difference in PCr between the saline groups (1.25) and Perfadex groups (0.82). However, there were higher (p = 0.003) ATP in the SOE illuminated groups (4.61) compared with the non-illuminated groups (2.73). The PCr was also higher (p < 0.0001) in the SOE illuminated groups (1.89) compared with the non-illuminated groups (0.18). In conclusion, Perfadex in this experimental model was incapable of preserving the high energy phosphates in skeletal muscle during 5 hours of ischemia. Illumination with SOE at 634 nm improved the preservation potential, in terms of a positive effect on the energy status of the muscle cell.

  4. Walking at the preferred stride frequency minimizes muscle activity.

    PubMed

    Russell, Daniel M; Apatoczky, Dylan T

    2016-03-01

    This study determined whether walking at the preferred stride frequency minimizes muscle activity compared with other cadences at the same speed. Anthropometric measurements were recorded from 10 subjects and used to estimate their predicted resonant stride frequency. The preferred walking speed and stride frequency were determined from freely adopted walking on a treadmill. For the experimental trials the treadmill was set at each individual's preferred walking speed. Participants walked for 6 min at eight cadences prescribed by an auditory metronome: preferred stride frequency and -35, -25, -15, 0, +15, +25, +35% of predicted resonant stride frequency. Oxygen consumption was measured via gas analysis. Muscle activity of the right leg gastrocnemius (GA), tibialis anterior (TA), biceps femoris (BF) and rectus femoris (RF) muscles was recorded via electromyography (EMG). On average, participants preferred to walk with a stride frequency .07 Hz lower than their predicted resonant stride frequency, however a strong positive correlation was observed between these variables. Stride frequency had a significant and large quadratic effect on VO2 (RLR(2)=.76), and activity of the GA (RLR(2)=.66), TA (RLR(2)=.83), BF (RLR(2)=.70) and RF (RLR(2)=.78) muscles. VO2, GA and TA activity were all minimal at the preferred stride frequency and increased for faster or slower cadences. BF and RF activity were minimal across a broad range of slow frequencies including the preferred stride frequency and increased for faster frequencies. The preferred stride frequency that humans readily adopt during walking minimizes the activation of the GA, TA, BF and RF muscles, which in turn minimizes the overall metabolic cost. PMID:26979903

  5. Compartmental Innervation of the Superior Oblique Muscle in Mammals

    PubMed Central

    Le, Alan; Poukens, Vadims; Ying, Howard; Rootman, Daniel; Goldberg, Robert A.; Demer, Joseph L.

    2015-01-01

    Purpose Intramuscular innervation of mammalian horizontal rectus extraocular muscles (EOMs) is compartmental. We sought evidence of similar compartmental innervation of the superior oblique (SO) muscle. Methods Three fresh bovine orbits and one human orbit were dissected to trace continuity of SO muscle and tendon fibers to the scleral insertions. Whole orbits were also obtained from four humans (two adults, a 17-month-old child, and a 33-week stillborn fetus), two rhesus monkeys, one rabbit, and one cow. Orbits were formalin fixed, embedded whole in paraffin, serially sectioned in the coronal plane at 10-μm thickness, and stained with Masson trichrome. Extraocular muscle fibers and branches of the trochlear nerve (CN4) were traced in serial sections and reconstructed in three dimensions. Results In the human, the lateral SO belly is in continuity with tendon fibers inserting more posteriorly on the sclera for infraducting mechanical advantage, while the medial belly is continuous with anteriorly inserting fibers having mechanical advantage for incycloduction. Fibers in the monkey superior SO insert more posteriorly on the sclera to favor infraduction, while the inferior portion inserts more anteriorly to favor incycloduction. In all species, CN4 bifurcates prior to penetrating the SO belly. Each branch innervates a nonoverlapping compartment of EOM fibers, consisting of medial and lateral compartments in humans and monkeys, and superior and inferior compartments in cows and rabbits. Conclusions The SO muscle of humans and other mammals is compartmentally innervated in a manner that could permit separate CN4 branches to selectively influence vertical versus torsional action. PMID:26426404

  6. Spontaneous Rectus Sheath Hematoma in Pregnancy Complicated by the Development of Transfusion Related Acute Lung Injury: A Case Report and Review of the Literature

    PubMed Central

    Gibbs, Jennifer; Bridges, Firas; Trivedi, Kiran; Vullo, John

    2016-01-01

    Background Rectus sheath hematoma (RSH) represents a rare, but serious cause of abdominal pain. Case Here we discuss the case of a healthy multigravida female who presented at 28 weeks gestation with spontaneous RSH. Conservative management with multiple blood transfusions led to the development of transfusion related acute lung injury (TRALI) and intensive care unit admission. She was managed with noninvasive ventilatory support, gradually improved, and was weaned of ventilation. After hospital discharge, she progressed to full term and delivered a viable male infant vaginally at 37 weeks gestation. Conclusion Review of the literature demonstrates 13 cases of RSH in pregnancy, including our own. No other cases were complicated by transfusion related morbidity. RSH and TRALI are rare, but life threatening entities that can complicate pregnancy. PMID:27651980

  7. Surgical resection of invasive adenoid cystic carcinoma of the lacrimal gland and wound closure using a vertical rectus abdominis myocutaneous free flap.

    PubMed

    Andrade, João Paulo; Figueiredo, Sergio; Matias, Julio; Almeida, Ana Catarina

    2016-01-01

    A 64-year-old man presented with a 3-month history of recurrent conjunctivitis. He was evaluated by an ophthalmologist and submitted to a CT scan that revealed an intraconic mass with invasion of the lateral orbital wall. He was operated, the mass was completely removed (with preservation of the intraorbital structures) and the lateral orbital wall rebuilt. The histopathological analysis revealed an adenoid cystic carcinoma of the lacrimal gland. 4 months later a painful recurrence of the lesion was diagnosed with invasion of the orbital roof and eyelids. After a multidisciplinary discussion and request from the patient, an exenteration of the orbit and removal of the lateral and superior orbital wall and dura mater was performed with the objective of a total resection. The wound and orbit were closed with a vertical rectus abdominis myocutaneous free flap to ensure closure. PMID:27646316

  8. Inverting bilateral figure-of-eight suture of the rectus sheath after burst abdomen with destruction of the linea alba: a new technique.

    PubMed

    Dietz, U A; Debus, E-S; Thiede, A; Kuhfuss, I

    2007-01-01

    The authors report a new technique for secondary abdominal closure after burst abdomen as illustrated by the case of a patient who developed a perforated sigmoid diverticulitis following septic polyarthritis. Sigmoid resection was followed on the sixth day postoperative by a burst abdomen. Upon abdominal revision the burst abdomen was found to be caused by necrotic destruction of the linea alba. Abdominal wall closure was achieved using the novel technique of inverting bilateral interrupted figure-of-eight suture of the anterior and posterior rectus sheaths in combination with relieving lateral incisions and mesh implantation in the sublay technique. It remains for future studies to show whether this technique can reduce the high incisional hernia rate following secondary abdominal wall closure.

  9. [Relationship between lumbosacral multifidus muscle and lumbar disc herniation].

    PubMed

    Chen, Wei-ye; Wang, Kuan; Yuan, Wei-an; Zhan, Hong-sheng

    2016-06-01

    As a common disease in clinical, the treatment of lumbar disc herniation (LDH) focused on local intervertebral disc, such as surgery and other interventional therapy treatment, but postoperative complications and recurrence rate has been a difficult problem in the field of profession. With the development of spine biomechanics and anatomy, researches on lumbar herniation also increased. Researchers discovered that the incidence and prognosis of LDH were inseparable with local muscle and soft tissue. As the deep paraspinal muscles, multifidus muscle plays an important role to make lumbar stability. Its abnormal function could reduce the stable of lumbar spine, and the chronic lumbar disease could also lead to multifidus muscle atrophy. PMID:27534095

  10. [Relationship between lumbosacral multifidus muscle and lumbar disc herniation].

    PubMed

    Chen, Wei-ye; Wang, Kuan; Yuan, Wei-an; Zhan, Hong-sheng

    2016-06-01

    As a common disease in clinical, the treatment of lumbar disc herniation (LDH) focused on local intervertebral disc, such as surgery and other interventional therapy treatment, but postoperative complications and recurrence rate has been a difficult problem in the field of profession. With the development of spine biomechanics and anatomy, researches on lumbar herniation also increased. Researchers discovered that the incidence and prognosis of LDH were inseparable with local muscle and soft tissue. As the deep paraspinal muscles, multifidus muscle plays an important role to make lumbar stability. Its abnormal function could reduce the stable of lumbar spine, and the chronic lumbar disease could also lead to multifidus muscle atrophy.

  11. Adynamic and dynamic muscle transposition techniques for anal incontinence

    PubMed Central

    Barišić, Goran; Krivokapić, Zoran

    2014-01-01

    Gracilis muscle transposition is well established in general surgery and has been the main muscle transposition technique for anal incontinence. Dynamization, through a schedule of continuous electrical stimulation, converts the fatigue-prone muscle fibres to a tonic fatigue-resistant morphology with acceptable results in those cases where there is limited sphincter muscle mass. The differences between gluteoplasty and graciloplasty, as well as the techniques and complications of both procedures, are outlined in this review. Overall, these techniques are rarely carried out in specialized units with experience, as there is a high revision and explantation rate. PMID:24759348

  12. A novel method for teaching key steps of strabismus surgery in the wet lab.

    PubMed

    White, Cassandra A; Wrzosek, James A; Chesnutt, David A; Enyedi, Laura B; Cabrera, Michelle T

    2015-10-01

    The surgical laboratory environment plays an important role in modern surgical education. Learning how to complete the key steps of strabismus surgery prior to actual surgery may enhance efficiency and sensitize the surgeon to potential complications. Cadaveric extraocular muscle is difficult to manipulate and specimens are not readily available; therefore, an alternative is needed to teach strabismus surgery techniques. We developed a wet lab to practice the key steps of strabismus surgery using commercially available bacon as an extraocular muscle substitute and cadaveric pig eyes for conjunctival and scleral tissue in a framework of peer teaching, expert supervision, and validated written feedback.

  13. Potentiation of acetylcholine action by huperzine-A and physostigmine on some vertebrate effectors, including human iris sphincter muscle.

    PubMed

    Patil, Kaustubha D; Buerki, Robin A; Patil, Popat N

    2003-04-01

    The main objective of this investigation was to compare the acetylcholine potentiating action of huperzine-A with acetylcholinesterase inhibitor physostigmine on the frog rectus abdominus muscle, rat phrenic nerve diaphragm preparation, guinea pig ileum and human iris sphincter muscle. In vitro on the frog rectus abdominus muscle, microM of each alkaloid, incubated for 10 min, shifted the acetylcholine concentration response curve to the left. At EC(50) level, physostigmine potentiated acetylcholine response by 4-fold. The potentiation by huperzine-A was 40-fold. The acetylcholine maximum effect, relative to the control, increased to approximately 130% by each alkaloid. Neurally mediated twitch contraction of the rat diaphragm, a skeletal muscle at 1 microM was also potentiated more by huperzine-A than that by physostigmine. Neuromuscular block by (+)-tubocurarine was reversed more easily by huperzine-A than that by physostigmine. On guinea pig ileum, a 30 nM concentration of each alkaloid incubated for 5 min potentiated acetylcholine (10 nM) by 42%, and 33% for huperzine-A and physostigmine respectively. The difference in potentiation between the alkaloids was not significant. At 300 nM of each alkaloid, intrinsic indirect contractions were observed on the ileum, where the rate of contraction by huperzine-A was faster than that by physostigmine. On the iris sphincter, huperzine-A and physostigmine produced a concentration-dependent effect. Maximum effect after each alkaloid was achieved at 30 microM. Potentiation of acetylcholine response by 0.3 microM huperzine-A after a 10-min incubation was greater than that achieved by physostigmine at an equivalent concentration on the contralateral iris sphincter. In summary, huperzine-A exhibits greater acetylcholine potentiating activity on vertebrate muscles than that produced by physostigmine. The results are discussed in relation to the potential therapeutic value of huperzine-A.

  14. The Effects of Knee Joint and Hip Abduction Angles on the Activation of Cervical and Abdominal Muscles during Bridging Exercises.

    PubMed

    Lee, Su-Kyoung; Park, Du-Jin

    2013-07-01

    [Purpose] The purpose of this study was to examine the effects of the flexion angle of the knee joint and the abduction angle of the hip joint on the activation of the cervical region and abdominal muscles. [Subjects] A total of 42 subjects were enrolled 9 males and 33 females. [Methods] The bridging exercise in this study was one form of exercise with a knee joint flexion angle of 90°. Based on this, a bridging exercise was conducted at the postures of abduction of the lower extremities at 0, 5, 10, and 15°. [Result] The changes in the knee joint angle and the hip abduction angle exhibited statistically significant effects on the cervical erector spinae, adductor magnus, and gluteus medius muscles. The abduction angles did not result in statistically significant effects on the upper trapezium, erector spinae, external oblique, and rectus abdominis muscles. However, in relation to the knee joint angles, during the bridging exercise, statistically significant results were exhibited. [Conclusion] When patients with both cervical and back pain do a bridging exercise, widening the knee joint angle would reduce cervical and shoulder muscle activity through minimal levels of abduction, permitting trunk muscle strengthening with reduced cervical muscle activity. This method would be helpful for strengthening trunk muscles in a selective manner. PMID:24259870

  15. Abundance of some skeletal muscle mitochondrial proteins is associated with increased blood serum insulin in bovine fetuses.

    PubMed

    Pajak, Beata; Pawlikowska, Patrycja; Cassar-Malek, Isabelle; Picard, Brigitte; Hocquette, Jean-François; Orzechowski, Arkadiusz

    2010-12-01

    The aim of this study was to investigate the evolution of the abundance of cytochrome oxidase c subunit IV (NCOIV) and beta subunit of ATP synthase (β-ATP) during the last third of gestation in bovine skeletal muscles. Semitendinosus, longissimus thoracis and rectus abdominis muscles were chosen for the immunoblotting of the respective protein levels. Muscle and blood samples from bovine fetuses of randomly selected breeds were collected at 180, 210, and 260 days post-conception (dpc). The muscle tissue expressions of NCOIV, β-ATP were compared to blood glucose and insulin. At 260 dpc, protein levels of NCOIV raised in skeletal muscles. Additionally, β-ATP in semitendinosus and longissimus thoracis were elevated and paralleled by higher concentrations of blood serum insulin. It corroborates our previous observations indicating that accelerated metabolic differentiation of bovine skeletal muscles is associated with elevated blood insulin and occurs during the last trimester of gestation. Our observations point to the connection between insulin-sensitivity and the molecular mechanisms of mitochondrial contribution to ontogenesis of skeletal muscles.

  16. Comparison of Two Different Modes of Active Recovery on Muscles Performance after Fatiguing Exercise in Mountain Canoeist and Football Players

    PubMed Central

    Mika, Anna; Oleksy, Łukasz; Kielnar, Renata; Wodka-Natkaniec, Ewa; Twardowska, Magdalena; Kamiński, Kamil; Małek, Zbigniew

    2016-01-01

    Background The aim of this study is to assess if the application of different methods of active recovery (working the same or different muscle groups from those which were active during fatiguing exercise) results in significant differences in muscle performance and if the efficiency of the active recovery method is dependent upon the specific sport activity (training loads). Design A parallel group non-blinded trial with repeated measurements. Methods Thirteen mountain canoeists and twelve football players participated in this study. Measurements of the bioelectrical activity, torque, work and power of the vastus lateralis oblique, vastus medialis oblique, and rectus femoris muscles were performed during isokinetic tests at a velocity of 90°/s. Results Active legs recovery in both groups was effective in reducing fatigue from evaluated muscles, where a significant decrease in fatigue index was observed. The muscles peak torque, work and power parameters did not change significantly after both modes of active recovery, but in both groups significant decrease was seen after passive recovery. Conclusions We suggest that 20 minutes of post-exercise active recovery involving the same muscles that were active during the fatiguing exercise is more effective in fatigue recovery than active exercise using the muscles that were not involved in the exercise. Active arm exercises were less effective in both groups which indicates a lack of a relationship between the different training regimens and the part of the body which is principally used during training. PMID:27706260

  17. The effects of aquatic trunk exercise on gait and muscle activity in stroke patients: a randomized controlled pilot study.

    PubMed

    Park, Byoung-Sun; Noh, Ji-Woong; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Park, Jaehong; Kim, Junghwan

    2015-11-01

    [Purpose] The purpose of this study was to investigate the relationship between muscle activity and gait function following aquatic trunk exercise in hemiplegic stroke patients. [Subjects and Methods] This study's participants included thirteen hemiplegic patients (ten males and three females). The aquatic therapy consisted of administering concentrative aquatic therapy for four weeks in a therapeutic pool. Gait parameters were measured using a gait analysis system adjusted to each subject's comfortable walking speed. Electromyographic signals were measured for the rectus abdominis, external abdominal oblique, transversus abdominis/internal-abdominal oblique, and erector spine of each patients. [Results] The pre- and post-training performances of the transversus abdominis/internal-abdominal oblique were compared statistically. There was no statistical difference between the patients' pre- and post-training values of maximal voluntary isometric contraction of the rectus abdominis, but the external abdominal oblique values tended to improve. Furthermore, gait factors improved significantly in terms of walking speeds, walking cycles, affected-side stance phases, affected-stride lengths, and stance-phase symmetry indices, respectively. [Conclusion] These results suggest that the trunk exercise during aquatic therapy may in part contribute to clinically relevant improvements in muscle activities and gait parameters. PMID:26696736

  18. The effects of aquatic trunk exercise on gait and muscle activity in stroke patients: a randomized controlled pilot study

    PubMed Central

    Park, Byoung-Sun; Noh, Ji-Woong; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Park, Jaehong; Kim, Junghwan

    2015-01-01

    [Purpose] The purpose of this study was to investigate the relationship between muscle activity and gait function following aquatic trunk exercise in hemiplegic stroke patients. [Subjects and Methods] This study’s participants included thirteen hemiplegic patients (ten males and three females). The aquatic therapy consisted of administering concentrative aquatic therapy for four weeks in a therapeutic pool. Gait parameters were measured using a gait analysis system adjusted to each subject’s comfortable walking speed. Electromyographic signals were measured for the rectus abdominis, external abdominal oblique, transversus abdominis/internal-abdominal oblique, and erector spine of each patients. [Results] The pre- and post-training performances of the transversus abdominis/internal-abdominal oblique were compared statistically. There was no statistical difference between the patients’ pre- and post-training values of maximal voluntary isometric contraction of the rectus abdominis, but the external abdominal oblique values tended to improve. Furthermore, gait factors improved significantly in terms of walking speeds, walking cycles, affected-side stance phases, affected-stride lengths, and stance-phase symmetry indices, respectively. [Conclusion] These results suggest that the trunk exercise during aquatic therapy may in part contribute to clinically relevant improvements in muscle activities and gait parameters. PMID:26696736

  19. Muscle coordination during breaststroke swimming: Comparison between elite swimmers and beginners.

    PubMed

    Vaz, João R; Olstad, Bjørn Harald; Cabri, Jan; Kjendlie, Per-Ludvik; Pezarat-Correia, Pedro; Hug, François

    2016-10-01

    The present study aimed to compare muscle coordination strategies of the upper and lower limb muscles between beginners and elite breaststroke swimmers. Surface electromyography (EMG) of eight muscles was recorded in 16 swimmers (8 elite, 8 beginners) during a 25 m swimming breaststroke at 100% of maximal effort. A decomposition algorithm was used to identify the muscle synergies that represent the temporal and spatial organisation of muscle coordination. Between-groups indices of similarity and lag times were calculated. Individual muscle patterns were moderately to highly similar between groups (between-group indices range: 0.61 to 0.84). Significant differences were found in terms of lag time for pectoralis major (P < 0.05), biceps brachii, rectus femoris and tibialis anterior (P < 0.01), indicating an earlier activation for these muscles in beginners compared to elites (range: -13.2 to -3.8% of the swimming cycle). Three muscle synergies were identified for both beginners and elites. Although their composition was similar between populations, the third synergy exhibited a high within-group variability. Moderate to high indices of similarity were found for the shape of synergy activation coefficients (range: 0.63 to 0.88) but there was a significant backward shift (-8.4% of the swimming cycle) in synergy #2 for beginners compared to elites. This time shift suggested differences in the global arm-to-leg coordination. These results indicate that the synergistic organisation of muscle coordination during breaststroke swimming is not profoundly affected by expertise. However, specific timing adjustments were observed between lower and upper limbs. PMID:26878097

  20. Muscle coordination during breaststroke swimming: Comparison between elite swimmers and beginners.

    PubMed

    Vaz, João R; Olstad, Bjørn Harald; Cabri, Jan; Kjendlie, Per-Ludvik; Pezarat-Correia, Pedro; Hug, François

    2016-10-01

    The present study aimed to compare muscle coordination strategies of the upper and lower limb muscles between beginners and elite breaststroke swimmers. Surface electromyography (EMG) of eight muscles was recorded in 16 swimmers (8 elite, 8 beginners) during a 25 m swimming breaststroke at 100% of maximal effort. A decomposition algorithm was used to identify the muscle synergies that represent the temporal and spatial organisation of muscle coordination. Between-groups indices of similarity and lag times were calculated. Individual muscle patterns were moderately to highly similar between groups (between-group indices range: 0.61 to 0.84). Significant differences were found in terms of lag time for pectoralis major (P < 0.05), biceps brachii, rectus femoris and tibialis anterior (P < 0.01), indicating an earlier activation for these muscles in beginners compared to elites (range: -13.2 to -3.8% of the swimming cycle). Three muscle synergies were identified for both beginners and elites. Although their composition was similar between populations, the third synergy exhibited a high within-group variability. Moderate to high indices of similarity were found for the shape of synergy activation coefficients (range: 0.63 to 0.88) but there was a significant backward shift (-8.4% of the swimming cycle) in synergy #2 for beginners compared to elites. This time shift suggested differences in the global arm-to-leg coordination. These results indicate that the synergistic organisation of muscle coordination during breaststroke swimming is not profoundly affected by expertise. However, specific timing adjustments were observed between lower and upper limbs.

  1. Electromyographic activity of selected trunk muscles during stabilization exercises using a gym ball.

    PubMed

    Mori, A

    2004-01-01

    Trunk stabilization is very important for the injured lower back. The use of a gym ball, the surface of which is labile, is becoming more popular for strengthening the trunk muscles and challenging the motor control system in trunk stabilization exercises. However, little is known about the activity of the trunk muscles during such exercises. The purpose of this study was to compare the electromyographic (EMG) activity of the trunk muscles during seven stabilization exercises using a gym ball. Eleven healthy men (19.9 +/- 1.8 years old) without low back pain volunteered to participate in the study. Bipolar surface electrodes were attached to the right side of the upper and lower rectus abdominis, the obliquus externus abdominis and the upper and lower back extensor muscles. EMG signals were recorded during seven types of stabilization exercises using a gym ball and normalized to maximal voluntary contraction (% MVC). A two-way analysis of variance (ANOVA) was performed on % MVC from each task for each of the five trunk muscle sites (p < 0.05). Push-up exercise, supporting with both hands on the gym ball and toes on the floor in prone position, resulted in the highest activity of all abdominal muscles, and an exercise of the lifting the gym ball up, holding it actively between both legs with both knees flexed in supine position resulted in the lowest. Lifting up of the pelvis in a bridged position exercise, supporting the head with the gym ball and with the feet on the floor in supine position, resulted in higher muscle activity of the back extensor muscles than another exercise. It is very important for physical therapists to make clear the purpose of the trunk stabilization exercises, because different kinds of exercises with the gym ball demand various levels of muscular activity and use of various parts of the trunk muscles.

  2. Chemical properties of cow and beef muscles: benchmarking the differences and similarities.

    PubMed

    Patten, L E; Hodgen, J M; Stelzleni, A M; Calkins, C R; Johnson, D D; Gwartney, B L

    2008-08-01

    The objective of this study was to identify muscles from cow populations that are equivalent or may possibly be made equivalent to muscles from A-maturity, Select-grade cattle in terms of chemical, compositional, and color characteristics. Objective color, expressible moisture, proximate composition, pH, heme iron concentration, and total collagen content were determined for 9 muscles (M. gluteus medius, M. infraspinatus, M. longissimus dorsi, M. psoas major, M. rectus femoris, M. tensor fascia latae, M. teres major, M. triceps brachii lateral-head, and M. triceps brachii long-head) from 15 cattle from each of 5 commercially identified populations [fed beef cows (B-F), non-fed beef cows (B-NF), fed dairy cows (D-F), non-fed dairy cows (D-NF), and A-maturity, Select-grade cattle (SEL)]. Muscles from B-F and B-NF populations were more similar to the SEL than were the D-F and D-NF. There were 2 muscles, the M. infraspinatus and M. teres major, from the population of B-F that were similar, physically and chemically, to SEL in most traits. The majority of the 9 muscles from the cows did not differ (P < 0.05) from SEL for percentage expressible moisture, proximate composition, and total collagen content. However, notable differences in pH, objective color L*, total pigment content, and heme iron content existed between cow populations and SEL. The muscles from SEL had significantly (P < 0.05) lower total pigment and heme iron concentrations. These differences likely relate to the visual appearance of muscles from the different populations of cattle. Two of the 9 muscles studied were similar among cow populations and A-maturity, Select-grade beef. PMID:18375663

  3. Local architecture of the vastus intermedius is a better predictor of knee extension force than that of the other quadriceps femoris muscle heads.

    PubMed

    Ando, Ryosuke; Saito, Akira; Umemura, Yoshihisa; Akima, Hiroshi

    2015-09-01

    The purpose of this study was to determine whether the muscle architecture of each head of the quadriceps femoris (QF) at multiple regions can be used to predict knee extension force. Muscle thickness and pennation angle were measured using sonographic images from multiple regions on each muscle of the QF with the knee flexed to 90°. The fascicle lengths of the rectus femoris (RF), vastus lateralis (VL) and vastus intermedius (VI) muscles were estimated based on sonographic images taken along the length of the thigh. The muscle architecture of the vastus intermedius was determined in two separate locations using sonographic images of the anterior (ant-VI) and lateral portions (lat-VI). The maximal voluntary contraction (MVC) was measured during isometric knee extension at a knee joint angle of 90°. The relationship between MVC force and muscle architecture was examined using a stepwise linear regression analysis with MVC force as the dependent variable. The muscle thickness of the ant-VI was selected as an independent variable in the first step of the linear regression analysis (R(2) = 0.66, P<0.01). In the second step, pennation angle of the lat-VI was added to the model (R(2) = 0.91, P<0.01). These results suggest that among the four muscles that make up the QF, the muscle architecture of the VI is the best predictor of knee extension force.

  4. Maintenance of skeletal muscle energy homeostasis during prolonged wintertime fasting in the raccoon dog (Nyctereutes procyonoides).

    PubMed

    Kinnunen, Sanni; Mänttäri, Satu; Herzig, Karl-Heinz; Nieminen, Petteri; Mustonen, Anne-Mari; Saarela, Seppo

    2015-05-01

    The raccoon dog (Nyctereutes procyonoides) is a canid species with autumnal fattening and prolonged wintertime fasting. Nonpathological body weight cycling and the ability to tolerate food deficiency make this species a unique subject for studying physiological mechanisms in energy metabolism. AMP-activated protein kinase (AMPK) is a cellular energy sensor regulating energy homeostasis. During acute fasting, AMPK promotes fatty acid oxidation and enhances glucose uptake. We evaluated the effects of prolonged fasting on muscle energy metabolism in farm-bred raccoon dogs. Total and phosphorylated AMPK and acetyl-CoA carboxylase (ACC), glucose transporter 4 (GLUT 4), insulin receptor and protein kinase B (Akt) protein expressions of hind limb muscles were determined by Western blot after 10 weeks of fasting. Plasma insulin, leptin, ghrelin, glucose and free fatty acid levels were measured, and muscle myosin heavy chain (MHC) isoform composition analyzed. Fasting had no effects on AMPK phosphorylation, but total AMPK expression decreased in m. rectus femoris, m. tibialis anterior and m. extensor digitorum longus resulting in a higher phosphorylation ratio. Decreased total expression was also observed for ACC. Fasting did not influence GLUT 4, insulin receptor or Akt expression, but Akt phosphorylation was lower in m. flexor digitorum superficialis and m. extensor digitorum longus. Three MHC isoforms (I, IIa and IIx) were detected without differences in composition between the fasted and control animals. The studied muscles were resistant to prolonged fasting indicating that raccoon dogs have an effective molecular regulatory system for preserving skeletal muscle function during wintertime immobility and fasting.

  5. Calorie restriction limits the generation but not the progression of mitochondrial abnormalities in aging skeletal muscle.

    PubMed

    Bua, Entela; McKiernan, Susan H; Aiken, Judd M

    2004-03-01

    The effect of early-onset calorie restriction and aging on the accumulation of electron transport system (ETS) abnormalities was studied in rat skeletal muscle. Rectus femoris and vastus lateralis muscle fibers were analyzed for cytochrome c oxidase (COX) and succinate dehydrogenase (SDH) enzyme activities. Fibers displaying COX negative and SDH hyper reactive (COX-/SDH++) phenotype were followed through 1000-2000 micrometers to determine the frequency and length of these abnormalities as well as the physiological impact on fiber structure. Calorie restricted rats had fewer ETS abnormal muscle fibers. The mean length of ETS abnormal regions in ad libitum rat muscle fibers was similar to calorie restricted rat muscles. ETS abnormal fibers from both diet groups exhibited intra-fiber atrophy. A negative correlation between ETS abnormality length and fiber cross-sectional area (CSA) ratio was observed in both ad libitum and calorie- restricted rats. Although calorie restriction reduced the number of ETS abnormalities, it did not affect the length or associated fiber atrophy of ETS abnormal regions once the abnormality was established. Thus, calorie restriction affects the onset but not the progression of electron transport system abnormalities, thereby, limiting a process that ultimately results in fiber breakage and fiber loss.

  6. Abdominal muscle activity during breathing with and without inspiratory and expiratory loads in healthy subjects.

    PubMed

    Mesquita Montes, António; Baptista, João; Crasto, Carlos; de Melo, Cristina Argel; Santos, Rita; Vilas-Boas, João Paulo

    2016-10-01

    Central Nervous System modulates the motor activities of all trunk muscles to concurrently regulate the intra-abdominal and intra-thoracic pressures. The study aims to evaluate the effect of inspiratory and expiratory loads on abdominal muscle activity during breathing in healthy subjects. Twenty-three higher education students (21.09±1.56years; 8males) breathed at a same rhythm (inspiration: two seconds; expiration: four seconds) without load and with 10% of the maximal inspiratory or expiratory pressures, in standing. Surface electromyography was performed to assess the activation intensity of rectus abdominis, external oblique and transversus abdominis/internal oblique muscles, during inspiration and expiration. During inspiration, transversus abdominis/internal oblique activation intensity was significantly lower with inspiratory load when compared to without load (p=0.009) and expiratory load (p=0.002). During expiration, the activation intensity of all abdominal muscles was significantly higher with expiratory load when compared to without load (p<0.05). The activation intensity of external oblique (p=0.036) and transversus abdominis/internal oblique (p=0.022) was significantly higher with inspiratory load when compared to without load. Transversus abdominis/internal oblique activation intensity was significantly higher with expiratory load when compared to inspiratory load (p<0.001). Transversus abdominis/internal oblique seems to be the most relevant muscle to modulate the intra-abdominal pressure for the breathing mechanics. PMID:27434376

  7. Effect of gait retraining for reducing ambulatory knee load on trunk biomechanics and trunk muscle activity.

    PubMed

    Nüesch, Corina; Laffer, Dominik; Netzer, Cordula; Pagenstert, Geert; Mündermann, Annegret

    2016-06-01

    The purpose of this study was to test the hypothesis that walking with increased medio-lateral trunk sway is associated with lower external knee adduction moment and lower extremity muscle activation, and higher external ipsilateral trunk moment and trunk muscle activity than walking with normal trunk sway in healthy participants. Fifteen participants performed walking trials with normal and increased medio-lateral trunk sway. Maximum trunk sway, first maximum knee adduction moment, lateral trunk bending moment, and bilateral vastus medialis, vastus lateralis, gluteus medius, rectus abdominis, external oblique and erector spinae muscle activity were computed. Walking with increased trunk sway was associated with lower maximum knee adduction moment (95% confidence interval (CI): 0.50-0.62Nm/kg vs. 0.62-0.76Nm/kg; P<.001) and ipsilateral gluteus medius (-17%; P=.014) and erector spinae muscle activity (-24%; P=.004) and greater maximum lateral trunk bending moment (+34%; P<.001) and contralateral external oblique muscle activity (+60%; P=.009). In all participants, maximum knee adduction moment was negatively correlated and maximum trunk moment was positively correlated with maximum trunk sway. The results of this study suggest that walking with increased trunk sway not only reduces the external knee adduction moment but also alters and possibly increases the load on the trunk. Hence, load-altering biomechanical interventions should always be evaluated not only regarding their effects on the index joint but on other load-bearing joints such as the spine. PMID:27264398

  8. Mechanism of quadriceps femoris muscle weakness in patients with anterior cruciate ligament reconstruction.

    PubMed

    Konishi, Y; Fukubayashi, T; Takeshita, D

    2002-12-01

    The purpose of this study was to investigate gamma loop function in the quadriceps femoris muscle in patients who with less than 6 month-history of anterior cruciate ligament (ACL) reconstruction. For this purpose, we compared the response to vibration stimulation in 10 patients with ACL repair and 12 normal healthy subjects, by measuring the maximal voluntary isometric contraction (MVC) and integrated electromyograms (I-EMG) of the quadriceps muscles. Pre-vibration data were obtained from each subject by measuring the MVC of the knee extension and the I-EMG from the vastus medialis, vastus lateralis, and rectus femoris muscles. Vibration stimulation was applied to the infrapatellar tendons, followed immediately by repeating the MVC and I-EMG recording. Prolonged vibration resulted in a significant decrease of both MVC and I-EMG in the control group. In contrast, the same stimulus failed to elicit changes in ACL-repair group. Our results suggest the presence of abnormal gamma loop function in the quadriceps femoris muscle of patients with ACL repair, which may explain the muscle weakness often described in such patients.

  9. Sequential muscle activity and its functional role in the upper extremity and trunk during overarm throwing.

    PubMed

    Hirashima, Masaya; Kadota, Hiroshi; Sakurai, Shizuka; Kudo, Katzutoshi; Ohtsuki, Tatsuyuki

    2002-04-01

    The proximal-to-distal segmental sequence has been identified in many sports activities, including baseball pitching and ball kicking. However, proximal-to-distal sequential muscle activity has not been identified. The aims of this study were to establish whether sequential muscle activity does occur and, if it does, to determine its functional role. We recorded surface electromyograms (EMGs) for 17 muscles from the upper extremity and abdomen during overarm throwing and detected the onset and peak times as indices of muscle activity. The following electromyographic properties were commonly identified in the participants. First, sequential muscle activity was observed from the scapular protractors to the shoulder horizontal flexors and from the shoulder horizontal flexors to the elbow extensor, but not from the elbow extensor to the wrist flexor or forearm pronator. Secondly, the external oblique contralateral to the throwing arm became activated before the ipsilateral external oblique. This sequence is considered to be very effective for the generation of high force and energy in the trunk. Thirdly, the ipsilateral external oblique began its activity almost at foot strike. Finally, the main activity of the rectus abdominis appeared just before the point of release.

  10. Changes in muscle strength, endurance, and reaction of the lower extremities with Tai Chi intervention.

    PubMed

    Li, Jing Xian; Xu, Dong Qing; Hong, Youlian

    2009-05-29

    This study examines the effects of a 16-week Tai Chi (TC) training program on the muscle strength, endurance, and reaction time of the lower extremities of elderly people. A total of 40 elderly individuals (aged 60 years) completed the study. They were divided into two groups: the TC group (11 men and 11 women) underwent a supervised TC exercise program for 16 weeks, while the control group (9 men and 9 women) received general education for a comparable time period. Pre- and post-intervention measurements were conducted. An isokinetic dynamometer was used to measure the maximum concentric strength and dynamic endurance of the knee flexors and the extensors, and the maximum concentric strength of the ankle plantarflexors and dorsiflexors. The neuromuscular response of the rectus femoris, semitendinosus, gastrocnemius, and anterior tibialis muscles was measured by the onset latency to sudden perturbations using an electromyography system. After 16 weeks, the TC group showed a 19.9% increase in muscle strength of the knee flexors (p<.000) that was significantly greater than that in the control group (p=.046). There was also a significant decrease in semitendinosus muscle latency (6.6%, p=.014) that was significantly shorter than that in the control group (p=.042). No significant training effects were found in other measures. These results suggest that improving biomechanical characteristics of lower extremity muscles may need longer TC intervention for elderly people.

  11. Muscle strain treatment

    MedlinePlus

    Treatment - muscle strain ... Question: How do you treat a muscle strain ? Answer: Rest the strained muscle and apply ice for the first few days after the injury. Anti-inflammatory medicines or acetaminophen ( ...

  12. Abdominal muscle activation changes if the purpose is to control pelvis motion or thorax motion.

    PubMed

    Vera-Garcia, Francisco J; Moreside, Janice M; McGill, Stuart M

    2011-12-01

    The aim of this study was to compare trunk muscular recruitment and lumbar spine kinematics when motion was constrained to either the thorax or the pelvis. Nine healthy women performed four upright standing planar movements (rotations, anterior-posterior translations, medial-lateral translations, and horizontal circles) while constraining pelvis motion and moving the thorax or moving the pelvis while minimizing thorax motion, and four isometric trunk exercises (conventional curl-up, reverse curl-up, cross curl-up, and reverse cross curl-up). Surface EMG (upper and lower rectus abdominis, lateral and medial aspects of external oblique, internal oblique, and latissimus dorsi) and 3D lumbar displacements were recorded. Pelvis movements produced higher EMG amplitudes of the oblique abdominals than thorax motions in most trials, and larger lumbar displacements in the medial-lateral translations and horizontal circles. Conversely, thorax movements produced larger rotational lumbar displacement than pelvis motions during rotations and higher EMG amplitudes for latissimus dorsi during rotations and anterior-posterior translations and for lower rectus abdominis during the crossed curl-ups. Thus, different neuromuscular compartments appear when the objective changes from pelvis to thorax motion. This would suggest that both movement patterns should be considered when planning spine stabilization programs, to optimize exercises for the movement and muscle activations desired.

  13. Glutamine attenuates post-traumatic glutathione depletion in human muscle.

    PubMed

    Fläring, U B; Rooyackers, O E; Wernerman, J; Hammarqvist, F

    2003-03-01

    Glutathione is quantitatively the most important endogenous scavenger system. Glutathione depletion in skeletal muscle is pronounced following major trauma and sepsis in intensive care unit patients. Also, following elective surgery, glutathione depletion occurs in parallel with a progressive decline in muscle glutamine concentration. The present study was designed to test the hypothesis that glutamine supplementation may counteract glutathione depletion in a human trauma model. A homogeneous group of patients (n = 17) undergoing a standardized surgical procedure were prospectively randomly allocated to receive glutamine (0.56 g x day(-1) x kg(-1)) or placebo as part of isonitrogenous and isocaloric nutrition. Percutaneous muscle biopsies and blood samples were taken pre-operatively and at 24 and 72 h after surgery. The concentrations of muscle glutathione and related amino acids were determined in muscle tissue and plasma. In the control (unsupplemented) subjects, total muscle glutathione had decreased by 47+/-8% and 37+/-11% and reduced glutathione had decreased by 53+/-10% and 45+/-16% respectively at 24 and 72 h after surgery (P < 0.05). In contrast, in the glutamine-supplemented group, no significant post-operative decreases in total or reduced glutathione were seen following surgery. Muscle free glutamine had decreased at 72 h after surgery in both groups, by 41.4+/-14.8% (P < 0.05) in the glutamine-supplemented group and by 46.0+/-14.3% (P < 0.05) in the control group. In conclusion, the present study demonstrates that intravenous glutamine supplementation attenuates glutathione depletion in skeletal muscle in humans following standardized surgical trauma.

  14. Effects of replacing free weights with elastic band resistance in squats on trunk muscle activation.

    PubMed

    Saeterbakken, Atle H; Andersen, Vidar; Kolnes, Maria K; Fimland, Marius S

    2014-11-01

    The purpose of this study was to assess the effects of adding elastic bands to free-weight squats on the neuromuscular activation of core muscles. Twenty-five resistance trained women with 4.6 ± 2.1 years of resistance training experience participated in the study. In randomized order, the participants performed 6 repetition maximum in free-weight squats, with and without elastic bands (i.e., matched relative intensity between exercises). During free-weight squats with elastic bands, some of the free weights were replaced with 2 elastic bands attached to the lowest part of the squat rack. Surface electromyography (EMG) activity was measured from the erector spinae, external oblique, and rectus abdominis, whereas a linear encoder measured the vertical displacement. The EMG activities were compared between the 2 lifting modalities for the whole repetition and separately for the eccentric, concentric, and upper and lower eccentric and concentric phases. In the upper (greatest stretch of the elastic band), middle, and lower positions in squats with elastic bands, the resistance values were approximately 117, 105, and 93% of the free weight-only trial. Similar EMG activities were observed for the 2 lifting modalities for the erector spinae (p = 0.112-0.782), external oblique (p = 0.225-0.977), and rectus abdominis (p = 0.315-0.729) in all analyzed phases. In conclusion, there were no effects on the muscle activity of trunk muscles of substituting some resistance from free weights with elastic bands in the free-weight squat.

  15. EMG activation of trunk and upper limb muscles following experimentally-induced overpronation and oversupination of the feet in quiet standing.

    PubMed

    Ntousis, Theodoros; Mandalidis, Dimitris; Chronopoulos, Efstathios; Athanasopoulos, Spyros

    2013-02-01

    Kinematic studies have shown that experimentally-induced overpronation or oversupination of the subtalar joint may alter the position of the legs, hips and pelvis and consequently the trunk and upper limb. The purpose of the present study was to examine whether such foot deformity affects the activity of muscles that act on the trunk and upper limb. Twenty-eight healthy individuals (11 males and 17 females) 21.4±1.9 years of age without skeletal deformity, leg length discrepancy (LLD), overpronated or oversupinated feet or excessive lateral pelvic inclination volunteered for the study. Bilateral EMG recordings of the latissimus dorsi, pectoralis major and rectus abdominis were undertaken for 30-s with each subject in the relaxed standing position and at 5° and 10° bilateral or unilateral overpronation or oversupination of the foot on the dominant side using wooden wedge-shape blocks. The recorded EMG activity was normalised based on the EMG activity produced by the muscles under investigation during maximum isometric voluntary contraction. The findings of the present study revealed that neither bilateral nor unilateral overpronation/oversupination of the feet induced a significant alteration of the EMG activity of the latissimus dorsi, pectoralis major and rectus abdominis on either the dominant or non-dominant side. These findings suggest that in the absence of other major structural deformity bilateral or unilateral foot overpronation or oversupination does not affect the EMG activity of muscles that act on the trunk and upper limb in quiet standing. PMID:22940541

  16. Muscle activation and blood flow do not explain the muscle length-dependent variation in quadriceps isometric endurance.

    PubMed

    Kooistra, R D; de Ruiter, C J; de Haan, A

    2005-03-01

    We investigated the role of central activation in muscle length-dependent endurance. Central activation ratio (CAR) and rectified surface electromyogram (EMG) were studied during fatigue of isometric contractions of the knee extensors at 30 and 90 degrees knee angles (full extension = 0 degree). Subjects (n = 8) were tested on a custom-built ergometer. Maximal voluntary isometric knee extension with supramaximal superimposed burst stimulation (three 100-mus pulses; 300 Hz) was performed to assess CAR and maximal torque capacity (MTC). Surface EMG signals were obtained from vastus lateralis and rectus femoris muscles. At each angle, intermittent (15 s on 6 s off) isometric exercise at 50% MTC with superimposed stimulation was performed to exhaustion. During the fatigue task, a sphygmomanometer cuff around the upper thigh ensured full occlusion (400 mmHg) of the blood supply to the knee extensors. At least 2 days separated fatigue tests. MTC was not different between knee angles (30 degrees : 229.6 +/- 39.3 N.m vs. 90 degrees: 215.7 +/- 13.2 N.m). Endurance times, however, were significantly longer (P < 0.05) at 30 vs. 90 degrees (87.8 +/- 18.7 vs. 54.9 +/- 12.1 s, respectively) despite the CAR not differing between angles at torque failure (30 degrees: 0.95 +/- 0.05 vs. 90 degrees: 0.96 +/- 0.03) and full occlusion of blood supply to the knee extensors. Furthermore, rectified surface EMG values of the vastus lateralis (normalized to prefatigue maximum) were also similar at torque failure (30 degrees : 56.5 +/- 12.5% vs. 90 degrees : 58.3 +/- 15.2%), whereas rectus femoris EMG activity was lower at 30 degrees (44.3 +/- 12.4%) vs. 90 degrees (69.5 +/- 25.3%). We conclude that differences in endurance at different knee angles do not find their origin in differences in central activation and blood flow but may be a consequence of muscle length-related differences in metabolic cost.

  17. Patterns of muscle coordination during stepping responses post-stroke.

    PubMed

    Gray, V L; Pollock, C L; Wakeling, J M; Ivanova, T D; Garland, S J

    2015-12-01

    This study compared self-induced stepping reactions of seventeen participants after stroke and seventeen controls. Surface electromyographic (EMG) signals were recorded bilaterally from the soleus (SOL), tibialis anterior (TA), biceps femoris (BF) and rectus femoris (RF) muscles. Principal component analysis (PCA) was used to reduce the data into muscle activation patterns and examine group differences (paretic, non-paretic, control leg). The first principal component (PC1) explained 46.7% of the EMG signal of the stepping leg. Two PCs revealed distinct activation features for the stepping paretic leg: earlier TA onset at step initiation and earlier BF and SOL onset at mid-step. For the stance leg, PC1 explained 44.4% of the EMG signal and significant differences were found in the non-paretic leg compared to paretic (p < 0.001) and control (p < 0.001). In PC1, at step onset the BF and SOL EMG and the RF and TA EMG were increased over the latter half of the step. No PC loadings were distinct for the paretic leg during stance, however differences were found in the non-paretic leg: earlier TA burst and increased BF and SOL EMG at step initiation. The results suggest impairments in the paretic leg when stepping and compensatory strategies in the non-paretic stance leg. PMID:26475243

  18. Physically-based modeling and simulation of extraocular muscles.

    PubMed

    Wei, Qi; Sueda, Shinjiro; Pai, Dinesh K

    2010-12-01

    Dynamic simulation of human eye movements, with realistic physical models of extraocular muscles (EOMs), may greatly advance our understanding of the complexities of the oculomotor system and aid in treatment of visuomotor disorders. In this paper we describe the first three dimensional (3D) biomechanical model which can simulate the dynamics of ocular motility at interactive rates. We represent EOMs using "strands", which are physical primitives that can model an EOM's complex nonlinear anatomical and physiological properties. Contact between the EOMs, the globe, and orbital structures can be explicitly modeled. Several studies were performed to assess the validity and utility of the model. EOM deformation during smooth pursuit was simulated and compared with published experimental data; the model reproduces qualitative features of the observed nonuniformity. The model is able to reproduce realistic saccadic trajectories when the lateral rectus muscle was driven by published measurements of abducens neuron discharge. Finally, acute superior oblique palsy, a pathological condition, was simulated to further evaluate the system behavior; the predicted deviation patterns agree qualitatively with experimental observations. This example also demonstrates potential clinical applications of such a model. PMID:20868704

  19. Electromyographic activity of trunk and hip muscles during stabilization exercises in four-point kneeling in healthy volunteers

    PubMed Central

    Vleeming, Andry; Bouche, Katie G.; Mahieu, Nele N.; Vanderstraeten, Guy G.; Danneels, Lieven A.

    2006-01-01

    Stabilization exercises are intended to optimize function of the muscles that are believed to govern trunk stability. Debate exists whether certain muscles are more important than others in optimally performing these exercises. Thirty healthy volunteers were asked to perform three frequently prescribed stabilization exercises in four-point kneeling. The electromyographic activity of different trunk and hip muscles was evaluated. Average amplitudes obtained during the exercises were normalized to the amplitude in maximal voluntary contraction (% MVIC). During all three exercises, the highest relative muscle activity levels (> 20% MVIC) were consistently found in the ipsilateral lumbar multifidus and gluteus maximus. During both the single leg extension (exercise 1) and the leg and arm extension exercise (exercise 2) the contralateral internal oblique and ipsilateral external oblique reached high levels (> 20%MVIC). During exercise 2 there were also high relative activity levels of the ipsilateral lumbar part and the contralateral thoracic part of the iliocostalis lumborum and the contralateral lumbar multifidus. During the leg and arm extension exercise with contralateral hip flexion (exercise 3) there were high relative muscle activity levels of all back muscles, except for the latissimus dorsi muscle. The lowest relative muscle activity levels (< 10% MVIC) were found in the rectus abdominis and the ipsilateral internal oblique during all exercises, and in the contralateral gluteus maximus during exercises 1 and 2. The results of this study show that in exercises in four-point kneeling performed by healthy subjects, hip and trunk muscles seem to work together in a harmonious way. This shows that when relative activity of muscles is measured, both “global and local” muscles function together in order to stabilize the spine. PMID:16896840

  20. A comparison of optimisation methods and knee joint degrees of freedom on muscle force predictions during single-leg hop landings.

    PubMed

    Mokhtarzadeh, Hossein; Perraton, Luke; Fok, Laurence; Muñoz, Mario A; Clark, Ross; Pivonka, Peter; Bryant, Adam L

    2014-09-22

    The aim of this paper was to compare the effect of different optimisation methods and different knee joint degrees of freedom (DOF) on muscle force predictions during a single legged hop. Nineteen subjects performed single-legged hopping manoeuvres and subject-specific musculoskeletal models were developed to predict muscle forces during the movement. Muscle forces were predicted using static optimisation (SO) and computed muscle control (CMC) methods using either 1 or 3 DOF knee joint models. All sagittal and transverse plane joint angles calculated using inverse kinematics or CMC in a 1 DOF or 3 DOF knee were well-matched (RMS error<3°). Biarticular muscles (hamstrings, rectus femoris and gastrocnemius) showed more differences in muscle force profiles when comparing between the different muscle prediction approaches where these muscles showed larger time delays for many of the comparisons. The muscle force magnitudes of vasti, gluteus maximus and gluteus medius were not greatly influenced by the choice of muscle force prediction method with low normalised root mean squared errors (<48%) observed in most comparisons. We conclude that SO and CMC can be used to predict lower-limb muscle co-contraction during hopping movements. However, care must be taken in interpreting the magnitude of force predicted in the biarticular muscles and the soleus, especially when using a 1 DOF knee. Despite this limitation, given that SO is a more robust and computationally efficient method for predicting muscle forces than CMC, we suggest that SO can be used in conjunction with musculoskeletal models that have a 1 or 3 DOF knee joint to study the relative differences and the role of muscles during hopping activities in future studies. PMID:25129166

  1. A comparison of optimisation methods and knee joint degrees of freedom on muscle force predictions during single-leg hop landings.

    PubMed

    Mokhtarzadeh, Hossein; Perraton, Luke; Fok, Laurence; Muñoz, Mario A; Clark, Ross; Pivonka, Peter; Bryant, Adam L

    2014-09-22

    The aim of this paper was to compare the effect of different optimisation methods and different knee joint degrees of freedom (DOF) on muscle force predictions during a single legged hop. Nineteen subjects performed single-legged hopping manoeuvres and subject-specific musculoskeletal models were developed to predict muscle forces during the movement. Muscle forces were predicted using static optimisation (SO) and computed muscle control (CMC) methods using either 1 or 3 DOF knee joint models. All sagittal and transverse plane joint angles calculated using inverse kinematics or CMC in a 1 DOF or 3 DOF knee were well-matched (RMS error<3°). Biarticular muscles (hamstrings, rectus femoris and gastrocnemius) showed more differences in muscle force profiles when comparing between the different muscle prediction approaches where these muscles showed larger time delays for many of the comparisons. The muscle force magnitudes of vasti, gluteus maximus and gluteus medius were not greatly influenced by the choice of muscle force prediction method with low normalised root mean squared errors (<48%) observed in most comparisons. We conclude that SO and CMC can be used to predict lower-limb muscle co-contraction during hopping movements. However, care must be taken in interpreting the magnitude of force predicted in the biarticular muscles and the soleus, especially when using a 1 DOF knee. Despite this limitation, given that SO is a more robust and computationally efficient method for predicting muscle forces than CMC, we suggest that SO can be used in conjunction with musculoskeletal models that have a 1 or 3 DOF knee joint to study the relative differences and the role of muscles during hopping activities in future studies.

  2. Muscle shape consistency and muscle volume prediction of thigh muscles.

    PubMed

    Mersmann, F; Bohm, S; Schroll, A; Boeth, H; Duda, G; Arampatzis, A

    2015-04-01

    The present study investigated the applicability of a muscle volume prediction method using only the muscle length (L(M)), the maximum anatomical cross-sectional area (ACSA(max)), and a muscle-specific shape factor (p) on the quadriceps vastii. L(M), ACSA(max), muscle volume, and p were obtained from magnetic resonance images of the vastus intermedius (VI), lateralis (VL), and medialis (VM) of female (n = 20) and male (n = 17) volleyball athletes. The average p was used to predict muscle volumes (V(p)) using the equation V(p)  = p × ACSA(max)  × L(M). Although there were significant differences in the muscle dimensions between male and female athletes, p was similar and on average 0.582, 0.658, 0.543 for the VI, VL, and VM, respectively. The position of ACSA(max) showed low variability and was at 57%, 60%, and 81% of the thigh length for VI, VL, and VM. Further, there were no significant differences between measured and predicted muscle volumes with root mean square differences of 5-8%. These results suggest that the muscle shape of the quadriceps vastii is independent of muscle dimensions or sex and that the prediction method could be sensitive enough to detect changes in muscle volume related to degeneration, atrophy, or hypertrophy.

  3. Infected Median Sternotomy Wound: Successful Treatment by Muscle Flaps

    PubMed Central

    Jurkiewicz, M. J.; Bostwick, John; Hester, T. Roderick; Bishop, J. Barry; Craver, Joseph

    1980-01-01

    The purpose of this paper is to present the experience at Emory University Hospital with the infected median sternotomy wound and to offer a treatment plan for those patients recalcitrant to the usual therapy of debridement and closed catheter irrigation with antimicrobial agents. When standard treatment fails, we proceed not only with the necessary thorough debridement to convert the wound to a relatively clean one but also concomitant closure by pectoralis major muscle flaps to completely obliterate dead space. Transposition flaps of rectus abdominus muscle or omentum are used when necessary to complete the closure. In the initial phase of this study, there were 3,239 patients who underwent open heart procedures through a median sternotomy approach in the years 1975 through 1978. In the 50 patients who had wound infections (1.54%), there were nine deaths. Three were thought to be unrelated to the sternal wound infection, four patients ruptured the ventricle or aorta, two patients died of generalized sepsis. Of these 50 patients, 22 responded to simple drainage; 28 had involvement of the mediastinum (0.86%). Of the 28 patients, 25 had debridement and closed mediastinal irrigation by catheter. Fourteen of these 25 did not respond. In these failing patients, 12 were treated by further debridement and closure by muscle flaps. Nine of these 12 were rescued. In the past nine months, an additional 1,052 patients had an open heart procedure. Of these, 11 had a median sternotomy infection. There have been no deaths in this latter group of patients, most of whom were treated by the muscle flap procedure. In addition to the improvement in mortality, morbidity has been reduced substantially. This procedure provides for a rational approach that we have found to permit salvage of a high percentage of patients who failed conventional closed irrigation techniques. ImagesFig. 1.Figs. 2a and b.Fig. 3(a).Fig. 4.Fig. 5. PMID:7387236

  4. Angle- and gender-specific quadriceps femoris muscle recruitment and knee extensor torque.

    PubMed

    Pincivero, Danny M; Salfetnikov, Yuliya; Campy, Robert M; Coelho, Alan J

    2004-11-01

    The objectives were to examine knee angle-, and gender-specific knee extensor torque output and quadriceps femoris (QF) muscle recruitment during maximal effort, voluntary contractions. Fourteen young adult men and 15 young adult women performed three isometric maximal voluntary contractions (MVC), in a random order, with the knee at 0 degrees (terminal extension), 10 degrees, 30 degrees, 50 degrees, 70 degrees, and 90 degrees flexion. Knee extensor peak torque (PT), and average torque (AT) were expressed in absolute (N m), relative (N m kg(-1)) and allometric-modeled (N m kg(-n)) units. Vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF) muscle EMG signals were full-wave rectified and integrated over the middle 3 s of each contraction, averaged over the three trials at each knee angle, and normalized to the activity recorded at 0 degrees. Muscle recruitment efficiency was calculated as the ratio of the normalized EMG of each muscle to the allometric-modeled average torque (normalized to the values at 0 degrees flexion), and expressed as a percent. Men generated significantly greater knee extensor PT and AT than women in absolute, relative and allometric-modeled units. Absolute and relative PT and AT were significantly highest at 70 degrees, while allometric-modeled values were observed to increase significantly across knee joint angles 10-90 degrees. VM EMG was significantly greater than the VL and RF muscles across all angles, and followed a similar pattern to absolute knee extensor torque. Recruitment efficiency improved across knee joint angles 10-90 degrees and was highest for the VL muscle. VM recruitment efficiency improved more than the VL and RF muscles across 70-90 degrees flexion. The findings demonstrate angle-, and gender-specific responses of knee extensor torque to maximal-effort contractions, while superficial QF muscle recruitment was most efficient at 90 degrees, and less dependent on gender.

  5. Pasture-feeding of Charolais steers influences skeletal muscle metabolism and gene expression.

    PubMed

    Cassar-Malek, I; Jurie, C; Bernard, C; Barnola, I; Micol, D; Hocquette, J-F

    2009-10-01

    Extensive beef production systems on pasture are promoted to improve animal welfare and beef quality. This study aimed to compare the influence on muscle characteristics of two management approaches representative of intensive and extensive production systems. One group of 6 Charolais steers was fed maize-silage indoors and another group of 6 Charolais steers grazed on pasture. Activities of enzymes representative of glycolytic and oxidative (Isocitrate dehydrogenase [ICDH], citrate synthase [CS], hydroxyacyl-CoA dehydrogenase [HAD]) muscle metabolism were assessed in Rectus abdominis (RA) and Semitendinosus (ST) muscles. Activities of oxidative enzymes ICDH, CS and HAD were higher in muscles from grazing animals demonstrating a plasticity of muscle metabolism according to the production and feeding system. Gene expression profiling in RA and ST muscles was performed on both production groups using a multi-tissue bovine cDNA repertoire. Variance analysis showed an effect of the muscle type and of the production system on gene expression (P<0.001). A list of the 212 most variable genes according to the production system was established, of which 149 genes corresponded to identified genes. They were classified according to their gene function annotation mainly in the "protein metabolism and modification", "signal transduction", "cell cycle", "developmental processes" and "muscle contraction" biological processes. Selenoprotein W was found to be underexpressed in pasture-fed animals and could be proposed as a putative gene marker of the grass-based system. In conclusion, enzyme-specific adaptations and gene expression modifications were observed in response to the production system and some of them could be candidates for grazing or grass-feeding traceability. PMID:19996487

  6. Muscle and prosthesis contributions to amputee walking mechanics: a modeling study.

    PubMed

    Silverman, Anne K; Neptune, Richard R

    2012-08-31

    Unilateral, below-knee amputees have altered gait mechanics, which can significantly affect their mobility. Below-knee amputees lose the functional use of the ankle muscles, which are critical during walking to provide body support, forward propulsion, leg-swing initiation and mediolateral balance. Thus, either muscles must compensate or the prosthesis must provide the functional tasks normally provided by the ankle muscles. Three-dimensional (3D) forward dynamics simulations of amputee and non-amputee walking were generated to identify muscle and prosthesis contributions to amputee walking mechanics, including the subtasks of body support, forward propulsion, leg-swing initiation and mediolateral balance. Results showed that the prosthesis provided body support in the absence of the ankle muscles. The prosthesis contributed to braking from early to mid-stance and propulsion in late stance. The prosthesis also functioned like the uniarticular soleus muscle by transferring energy from the residual leg to the trunk to provide trunk propulsion. The residual-leg vasti and rectus femoris reduced their contributions to braking in early stance, which mitigated braking from the prosthesis during this period. The prosthesis did not replace the function of the gastrocnemius, which normally generates energy to the leg to initiate swing. As a result, lower overall energy was delivered to the residual leg. The prosthesis also acted to accelerate the body laterally in the absence of the ankle muscles. These results provide further insight into muscle and prosthesis function in below-knee amputee walking and can help guide rehabilitation methods and device designs to improve amputee mobility.

  7. Pasture-feeding of Charolais steers influences skeletal muscle metabolism and gene expression.

    PubMed

    Cassar-Malek, I; Jurie, C; Bernard, C; Barnola, I; Micol, D; Hocquette, J-F

    2009-10-01

    Extensive beef production systems on pasture are promoted to improve animal welfare and beef quality. This study aimed to compare the influence on muscle characteristics of two management approaches representative of intensive and extensive production systems. One group of 6 Charolais steers was fed maize-silage indoors and another group of 6 Charolais steers grazed on pasture. Activities of enzymes representative of glycolytic and oxidative (Isocitrate dehydrogenase [ICDH], citrate synthase [CS], hydroxyacyl-CoA dehydrogenase [HAD]) muscle metabolism were assessed in Rectus abdominis (RA) and Semitendinosus (ST) muscles. Activities of oxidative enzymes ICDH, CS and HAD were higher in muscles from grazing animals demonstrating a plasticity of muscle metabolism according to the production and feeding system. Gene expression profiling in RA and ST muscles was performed on both production groups using a multi-tissue bovine cDNA repertoire. Variance analysis showed an effect of the muscle type and of the production system on gene expression (P<0.001). A list of the 212 most variable genes according to the production system was established, of which 149 genes corresponded to identified genes. They were classified according to their gene function annotation mainly in the "protein metabolism and modification", "signal transduction", "cell cycle", "developmental processes" and "muscle contraction" biological processes. Selenoprotein W was found to be underexpressed in pasture-fed animals and could be proposed as a putative gene marker of the grass-based system. In conclusion, enzyme-specific adaptations and gene expression modifications were observed in response to the production system and some of them could be candidates for grazing or grass-feeding traceability.

  8. Abdominal wall surgery

    MedlinePlus

    ... skin. Abdominoplasty can be helpful when: Diet and exercise have not helped improve muscle tone, such as in women who have had more than one pregnancy. Skin and muscle cannot regain its normal tone. ...

  9. Periodontal Plastic Surgery

    MedlinePlus

    ... Dental Implants Dentures Direct Bonding Implants versus Bridges Orthodontics and Aligners Periodontal Plastic Surgery Porcelain Crowns Porcelain ... Dental Implants Dentures Direct Bonding Implants versus Bridges Orthodontics and Aligners Periodontal Plastic Surgery Porcelain Crowns Porcelain ...

  10. Plastic Surgery for Teenagers

    MedlinePlus

    ... or severe acne and scarring. Teens frequently gain self-esteem and confidence when their physical problems are corrected. ... art as a helpful index of anxiety and self-esteem with plastic surgery. Plastic and Reconstructive Surgery 2002. ...

  11. Cosmetic ear surgery

    MedlinePlus

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  12. Weight Loss Surgery

    MedlinePlus

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you cannot lose weight ... obesity. There are different types of weight loss surgery. They often limit the amount of food you ...

  13. Ear Plastic Surgery

    MedlinePlus

    ... Meeting Calendar Find an ENT Doctor Near You Ear Plastic Surgery Ear Plastic Surgery Patient Health Information ... they may improve appearance and self-confidence. Can Ear Deformities Be Corrected? Formation of the ear during ...

  14. Refractive corneal surgery - discharge

    MedlinePlus

    ... after surgery, it should be okay to use artificial tears. Check with your doctor. Do NOT wear contact lenses on the eye that had surgery, even if you have blurry vision. Do NOT use any makeup, creams, or lotions ...

  15. Complications of Sinus Surgery

    MedlinePlus

    ... further intracranial surgeries. Impaired sense of taste or smell : The sense of smell usually improves after the procedure because airflow is ... in their voice after sinus surgery. Impairment of smell or taste: (see above) Infection: The most common ...

  16. The Correlation between the Muscle Activity and Joint Angle of the Lower Extremity According to the Changes in Stance Width during a Lifting Task

    PubMed Central

    Yoon, Jung-Gyu

    2013-01-01

    [Purpose] This study examined the correlation between the muscle activities and joint angle of the hip and knee according to the changes in stance width during a lifting task. [Subjects and Methods] The subjects of this study were 15 healthy students. A three-dimensional motion analyzer (SMART-E, BTS, Italy) was used to measure the joint angles of hip and knee during lifting. An 8-channel electromyograph (8-EMG) (Pocket EMG, BTS, Italy) was used to measure muscle activities of the erector spinae, gluteus maximus, rectus femoris, and tibialis anterior during lifting. The collected data were analyzed using the Pearson-test and SPSS 18.0. [Result] The muscle activity of the tibialis anterior was significantly decreased by increasing the stance width (r= −0.285). Muscle activity of the erector spinae was significantly decreased by increasing the knee angle (r= −0.444). The muscle activity of the gluteus maximus was significantly increased by increasing the muscle activity of the tibialis anterior (r= 0.295). [Conclusion] Efficient lifting is possible when stance width and knee flexion are increased, which results in reduced muscle activity of the tibialis anterior and the erector spinae. Lifting is facilitated when the muscle activities of the gluteus maximus and tibialis anterior are correlated. PMID:24259908

  17. Comparison of toe grip strength and muscle activities during maximal toe grip strength exertion according to the presence/absence of an ankle immobilization belt.

    PubMed

    Soma, Masayuki; Murata, Shin; Kai, Yoshihiro; Nakae, Hideyuki; Satou, Yousuke; Murata, Jun; Miyazaki, Junya

    2015-10-01

    [Purpose] The aim of this study was to compare toe grip strength and muscle activity during toe grip strength exertion according to the presence/absence of an ankle immobilization belt and to examine the relationship between the differences in muscle activity and toe grip strength. [Subjects] The Subjects were 13 healthy young women. [Methods] We measured toe grip strength and muscle activity during toe grip strength exertion in the presence and absence of an ankle immobilization belt using electromyography. Activity in the following leg muscles was recorded: rectus femoris, biceps femoris, medial head of the gastrocnemius, and tibialis anterior. We then calculated the percent integrated electromyography during toe gripping. [Results] Toe grip strength and percent integrated electromyography of the medial head of the gastrocnemius muscle were significantly higher with ankle belt immobilization compared with without ankle belt immobilization. In addition, in the presence of ankle belt immobilization, the percent integrated electromyography of the tibialis anterior muscle and medial head of the gastrocnemius muscle demonstrated a positive correlation with toe grip strength (r = 0.75 and r = 0.65, respectively). [Conclusion] These findings suggest that greater toe grip strength could be exerted in the presence of ankle belt immobilization. The measured values reflect the percent integrated electromyography of the crural muscles. Therefore, it was shown that toe grip strength should be measured in the presence of an immobilization belt.

  18. Effects of Abdominal Hollowing During Stair Climbing on the Activations of Local Trunk Stabilizing Muscles: A Cross-Sectional Study

    PubMed Central

    Lee, Ah Young; Kim, Eun Hyuk; Cho, Yun Woo; Kwon, Sun Oh; Son, Su Min

    2013-01-01

    Objective To examine using surface electromyography whether stair climbing with abdominal hollowing (AH) is better at facilitating local trunk muscle activity than stair climbing without AH. Methods Twenty healthy men with no history of low back pain participated in the study. Surface electrodes were attached to the multifidus (MF), lumbar erector spinae, thoracic erector spinae, transverse abdominus - internal oblique abdominals (TrA-IO), external oblique abdominals (EO), and the rectus abdominis. Amplitudes of electromyographic signals were measured during stair climbing. Study participants performed maximal voluntary contractions (MVC) for each muscle in various positions to normalize the surface electromyography data. Results AH during stair climbing resulted in significant increases in normalized MVCs in both MFs and TrA-IOs (p<0.05). Local trunk muscle/global trunk muscle ratios were higher during stair climbing with AH as compared with stair climbing without AH. Especially, right TrA-IO/EO and left TrA-IO/EO were significantly increased (p<0.05). Conclusion Stair climbing with AH activates local trunk stabilizing muscles better than stair climbing without AH. The findings suggest that AH during stair climbing contributes to trunk muscle activation and trunk stabilization. PMID:24466515

  19. The effects of isometric exercise types on pain and muscle activity in patients with low back pain.

    PubMed

    Rhyu, Hyun-Seung; Park, Hun-Kyung; Park, Jung-Sub; Park, Hye-Sang

    2015-08-01

    The purpose of the present study is to evaluate the effects of isometric exercise types on low back pain (LBP) patients. Isometric exercise types were mat exercise and I-Zer exercise. Subjects were divided into 3 groups: LBP control group, LBP mat exercise group, and LBP I-Zer exercise group in 23-25 aged men. Visual analogue scale (VAS) and electromyography (EMG) were used to evaluate the degree of pain and the muscle activity in LBP patients. Root mean square (RMS), median frequency (MDF), and mean frequency (MNF) were checked by EMG power spectrum analysis on longissimus thoracic (LT), iliocostalis lumborum (IL), mulitifidus (M), and rectus abdominis (RA). LBP mat exercise program and LBP I-Zer exercise program were conducted 5 sets once time, 3 times per week during 6 weeks. The two-way ANOVA with repeated measure was used to check the pain degree and muscle activity. The present results showed that muscle activity in the LBP I-Zer exercise group was increased compared to the LBP mat exercise group and LBP control group (P<0.05). LBP I-Zer exercise group and LBP mat exercise group showed increased mean frequency in LT, IL, M, and RA muscles than the LBP control group. Therefore, LBP patients performed isometric exercise may have positive effect to reduce pain degree and to increase muscle activity. Especially, LBP I-Zer exercise type showed more effectiveness in reducing pain degree and enhancing muscle activity.

  20. Effect of exercise intervention on thigh muscle volume and anatomical cross-sectional areas--quantitative assessment using MRI.

    PubMed

    Hudelmaier, Martin; Wirth, Wolfgang; Himmer, Maria; Ring-Dimitriou, Susanne; Sänger, Alexandra; Eckstein, Felix

    2010-12-01

    The objective of this study was to evaluate the location-specific magnitudes of an exercise intervention on thigh muscle volume and anatomical cross-sectional area, using MRI. Forty one untrained women participated in strength, endurance, or autogenic training for 12 weeks. Axial MR images of the thigh were acquired before and after the intervention, using a T1-weighted turbo-spin-echo sequence (10 mm sections, 0.78 mm in-plane resolution). The extensor, flexor, adductor, and sartorius muscles were segmented between the femoral neck and the rectus femoris tendon. Muscle volumes were determined, and anatomical cross-sectional areas were derived from 3D reconstructions at 10% (proximal-to-distal) intervals. With strength training, the volume of the extensors (+3.1%), flexors (+3.5%), and adductors (+3.9%) increased significantly (P < 0.05) between baseline and follow-up, and with endurance training, the volume of the extensor (+3.7%) and sartorius (+5.1%) increased significantly (P < 0.05). No relevant or statistically significant change was observed with autogenic training. The greatest standardized response means were observed for the anatomical cross-sectional area in the proximal aspect (10-30%) of the thigh and generally exceeded those for muscle volumes. The study shows that MRI can be used to monitor location-specific effects of exercise intervention on muscle cross-sectional areas, with the proximal aspect of the thigh muscles being most responsive. PMID:20665894

  1. Altering prosthetic foot stiffness influences foot and muscle function during below-knee amputee walking: a modeling and simulation analysis.

    PubMed

    Fey, Nicholas P; Klute, Glenn K; Neptune, Richard R

    2013-02-22

    Most prosthetic feet are designed to improve amputee gait by storing and releasing elastic energy during stance. However, how prosthetic foot stiffness influences muscle and foot function is unclear. Identifying these relationships would provide quantitative rationale for prosthetic foot prescription that may lead to improved amputee gait. The purpose of this study was to identify the influence of altered prosthetic foot stiffness on muscle and foot function using forward dynamics simulations of amputee walking. Three 2D muscle-actuated forward dynamics simulations of unilateral below-knee amputee walking with a range of foot stiffness levels were generated, and muscle and prosthetic foot contributions to body support and propulsion and residual leg swing were quantified. As stiffness decreased, the prosthetic keel provided increased support and braking (negative propulsion) during the first half of stance while the heel contribution to support decreased. During the second half of stance, the keel provided decreased propulsion and increased support. In addition, the keel absorbed less power from the leg, contributing more to swing initiation. Thus, several muscle compensations were necessary. During the first half of stance, the residual leg hamstrings provided decreased support and increased propulsion. During the second half of stance, the intact leg vasti provided increased support and the residual leg rectus femoris transferred increased energy from the leg to the trunk for propulsion. These results highlight the influence prosthetic foot stiffness has on muscle and foot function throughout the gait cycle and may aid in prescribing feet of appropriate stiffness.

  2. Muscle Activation and Performance During Trunk Strength Testing in High-Level Female and Male Football Players.

    PubMed

    Roth, Ralf; Donath, Lars; Zahner, Lukas; Faude, Oliver

    2016-06-01

    For performance and injury prevention in sport, core strength and endurance are focused prerequisites. Therefore we evaluated characteristics of trunk muscle activation and performance during strength-endurance related trunk field tests. Strength-endurance ability, as total time to failure, and activation of trunk muscles was measured in 39 football players of the highest German female football league (Bundesliga) (N = 18, age: 20.7 y [SD 4.4]) and the highest national male under-19 league (N = 21, age: 17.9 y [0.7]) in prone plank, side plank, and dorsal position. Maximal isometric force was assessed during trunk extension and flexion, rotation, and lateral flexion to normalize EMG and to compare with the results of strength-endurance tests. For all positions of endurance strength tests, a continuous increase in normalized EMG activation was observed (P < .001). Muscle activation of the rectus abdominis and external oblique in prone plank position exceeded the maximal voluntary isometric contraction activation, with a significantly higher activation in females (P = .02). We conclude, that in the applied strength-endurance testing, the activation of trunk muscles was high, especially in females. As high trunk muscle activation can infer fatigue, limb strength can limit performance in prone and side plank position, particularly during high trunk muscle activation.

  3. Alternating stimulation of synergistic muscles during functional electrical stimulation cycling improves endurance in persons with spinal cord injury.

    PubMed

    Decker, M J; Griffin, L; Abraham, L D; Brandt, L

    2010-12-01

    Therapeutic effects of functional electrical stimulation (FES) cycling for persons with spinal cord injury (SCI) are limited by high rates of muscular fatigue. FES-cycling performance limits and surface mechanomyography (MMG) of 12 persons with SCI were compared under two different stimulation protocols of the quadriceps muscles. One strategy used the standard "co-activation" protocol from the manufacturer of the FES cycle which involved intermittent simultaneous activation of the entire quadriceps muscle group for 400 ms. The other strategy was an "alternation" stimulation protocol which involved alternately stimulating the rectus femoris (RF) muscle for 100 ms and the vastus medialis (VM) and vastus lateralis (VL) muscles for 100 ms, with two sets with a 400 ms burst. Thus, during the alternation protocol, each of the muscle groups rested for two 100 ms "off" periods in each 400 ms burst. There was no difference in average cycling cadence (28 RPM) between the two protocols. The alternation stimulation protocol produced longer ride times and longer virtual distances traveled and used lower stimulation intensity levels with no differences in average MMG amplitudes compared to the co-activation protocol. These results demonstrate that FES-cycling performance can be enhanced by a synergistic muscle alternation stimulation strategy. PMID:20708950

  4. Muscle Activation and Performance During Trunk Strength Testing in High-Level Female and Male Football Players.

    PubMed

    Roth, Ralf; Donath, Lars; Zahner, Lukas; Faude, Oliver

    2016-06-01

    For performance and injury prevention in sport, core strength and endurance are focused prerequisites. Therefore we evaluated characteristics of trunk muscle activation and performance during strength-endurance related trunk field tests. Strength-endurance ability, as total time to failure, and activation of trunk muscles was measured in 39 football players of the highest German female football league (Bundesliga) (N = 18, age: 20.7 y [SD 4.4]) and the highest national male under-19 league (N = 21, age: 17.9 y [0.7]) in prone plank, side plank, and dorsal position. Maximal isometric force was assessed during trunk extension and flexion, rotation, and lateral flexion to normalize EMG and